The Rich Roll Podcast - A Masterclass on Addiction & Recovery

Episode Date: November 25, 2021

Across the world, untold millions fall prey to some form of addiction. If you or someone you know suffers in silence, there is hope. Today’s episode casts a light on this epidemic of darkness and paves a solution-based path towards hope. A recovering alcoholic myself, I’ve danced with that darkness. Tasted the desperation. And felt the loneliness. Time and again I failed at arresting a disease hell-bent on killing me. Until that is, I let go of everything I thought I knew about how to live, think and be—and let others help me. The solution required an education. Given the ubiquity of addiction, it’s an education I feel a responsibility to share. Towards that end, today’s episode—the third installment in our burgeoning, deep-dive Masterclass series—explores the nature of addiction, the misconceptions that perpetuate it, and the many solutions available for confronting and ultimately overcoming it. For those unaware of this new semi-regular format, today’s episode is a compilation of 10 incredible and unique perspectives on addiction and recovery taken from previous conversations. My hope is that these stories bring you greater understanding, empathy, and perhaps a modicum of peace—and for those currently suffering, tools and encouragement to finally arrest the beast and embrace help. The visually inclined can watch it all unfold on YouTube. And as always, the podcast streams wild and free on Apple Podcasts and Spotify. Big thanks to Dan Drake for his instrumental help crafting this very special episode. Masterclass Series: Click here to listen to our first deep dive on the microbiome, and here for our second on mental health. The full episodes for all guests featured in this episode can be found in the show notes below. Final Note: This conversation traverses difficult emotional terrain. If you are struggling, please raise your hand and reach out for help. You can call SAMHSA’s National Helpline at 1-800-662-HELP and if you are experiencing suicidal ideation, know you’re not alone. I encourage you to call the Suicide Prevention Hotline at 1(800) 273-TALK. I sincerely hope you find this experiment helpful and instructive—and/or that you share the episode with those who could benefit from it. Peace + Plants, Rich

The Rich Roll Podcast. Addiction doesn't discriminate. It doesn't care how rich, how successful, how fit or good looking you are. It doesn't care if you deny having it. But if you are truly indeed a drug addict or an alcoholic, it will take you down every time. 20 years ago, I was that guy. I was broken, lost, utterly alone.

My mornings typically began with a vodka tonic in the shower. It generally ended up in a blackout, coming to an all manner of strange compromising situations with no idea what I'd done or where I'd been, other than this vague but very real feeling of just incomprehensible demoralization. There was nothing sexy, romantic, or rock and roll about it. It was really just sad and pathetic. And of course, I knew I was an alcoholic. I'd known it forever. But no matter how many times I tried to stop,

I just couldn't. Because there's a huge difference between self-knowledge and actual change. I was unable to change until I was willing to let go of everything, everything I thought I knew about how to live, how to think, how to be, and simply raise my hand and let other people help me. Amazingly, I did find a way out. And today, my life is just a miracle, a miracle I could have not possibly imagined when I came to in that treatment center 23 years ago.

So if you're one of the many millions out there that suffer in the darkness, unable to grasp the light, here's the truth. The truth is you never have to use or drink again. There is a solution. It's a solution that's available to all, no matter how dire your circumstances. And that solution begins with a decision, a decision to

set aside that fear of the unknown, raise your hand, and ask for help. It saved my life, and it can save yours too. To reiterate, if you are one of those people suffering in silence, please don't wait to ask for help. Pause the podcast now and call one of the phone numbers in the show notes on the episode page at richroll.com. My story is just one out of the entirety of addicts throughout history and out of the 45 million Americans dealing with addiction in some form living today.

So given this ubiquity, I felt compelled to dedicate the third installment of our Deep Dive Masterclass series to share stories and wisdom on the subject of addiction with some of the best guests I've ever had on the show. And to also shedding a light on a topic that has in so many countless ways, truly shaped the trajectory of my life.

For those unaware of this new semi-regular format, what follows is a compilation of 10 incredible and unique perspectives on addiction, on recovery taken from previous episodes. And it's my hope that these stories can bring you greater understanding, empathy, and perhaps a modicum of peace. And for those currently suffering, even motivation to stop using and finally get help. These are truly inspiring conversations and you can find the full episodes for each guest and the previous deep dives

in the show notes on the episode page at richroll.com. We'll dive deep in a moment, but first. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place

and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. A problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen,

or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And

it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because, unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers to cover the full spectrum of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus,

you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful. And recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one,

again, go to recovery.com. Okay, so addiction. In many ways, our world has evolved from one of scarcity to overabundance. And we find ourselves ever increasingly orienting our lives around the pursuit of pleasure and the avoidance of pain. And in so doing, we set ourselves up to experience the very pain we so desperately seek to avoid.

So in light of this plight, our recent episode with Anna Lembke seems like the best way to begin. Anna is a professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She is widely published, has testified before Congress,

and has authored two important books, Drug Dealer MD and her newest, Dopamine Nation, which is a powerful primer on how to moderate compulsive overconsumption in a world where unfortunately feeling good has become confused with the highest good. Our original conversation was important, it was impactful and truly an addiction primer within itself worth adding to your queue for later.

But for now, please enjoy this powerful clip from my interview with Dr. Anna Lemke. So why don't we define our terms here a little bit? Okay, yeah. Like how do you define addiction? I define addiction as the continued compulsive use of a drug or behavior despite harm to self and or others. How do you define it?

I mean, that's the standard definition. Yeah. Right. And how does that, like, as I mentioned at the opening, there's alcoholism, there's drug addiction. There are some qualitative differences between substance addiction and behavioral addictions. And now that we're in this world where everything has an addictive allure to it,

do you qualify our relationship with our devices and online shopping and gambling in the same way? Like with this idea of addiction being a spectrum, how does it differ in terms of like our relationship to Twitter versus our relationship to heroin? I don't really see all that much difference between those things. I think it's just a matter of degree.

I mean, I've had, for example, journalists writing for esteemed publications, call me to interview me about sex addiction and say to me, well, that's, it's not really an addiction, is it? I mean, it's really just about cultural mores around, you know, what's acceptable sexual behavior and what isn't. And I've had to correct that person and say, no, you're wrong. This is really an addiction. It can devastate lives. People can lose their lives over these problems. I mean, this is what I really wanna drive home to people.

Like, yeah, there are many risk factors for addiction, but you can have none of those risk factors in today's world and get really addicted. Well, let's talk about the neurochemistry of addiction. Walk me through what's happening in our brains and the role that dopamine plays in all of this. Yeah, so dopamine is a neurotransmitter, which means that it is the molecule

that allows the electrical signal from the presynaptic neuron to be communicated to the postsynaptic neuron, because there's a little gap called the synapse between those two neurons. So neurotransmitters allow fine tuning of those electrical signals. And dopamine is the most important neurotransmitter

involved in motivation and reward. And the fundamental difference between things that are addictive and those that aren't is that things that are addictive release a lot more dopamine. So we have dopamine firing in our brain that occurs at a tonic baseline. And when we do something that's rewarding or pleasurable, we get a little rise in dopamine

levels or a spike. So for example, chocolate increases dopamine levels about 50% above baseline. Sex is about 100%. Nicotine is about 150%. And things like methamphetamines are 1,000%. Really, you have to imagine that in your brain, there's a balance like a teeter-totter in a playground. When we experience pleasure, the balance tips one way. When we experience pain, it tips the other. But one of the fundamental rules governing that balance is that it wants to remain level.

So with any deviation from neutrality, the brain will work very hard to restore a level balance or what's called homeostasis. So for example, if I do something pleasurable, like eat a piece of chocolate, I get a little tip to the side of pleasure, a little release of dopamine, but no sooner has that happened than my brain adapts to that phenomenon by down-regulating my own dopamine receptors, down-regulating my own dopamine transmission. And I imagine that as these little gremlins hopping on the pain side of the balance

to bring it level again. But the thing about the gremlins is they like it on the balance. So they stay on until the balance is tipped an equal and opposite amount to the side of pain. And that's called the opponent process reaction, the hangover, the come down, the after effect. And in my case, that's that moment of wanting another piece of chocolate.

If I wait long enough, the gremlin hops off and balance is restored. But if I continue to consume chocolate in ever larger amounts to overcome the tolerance or the number of gremlins on the pain side, then I end up with enough gremlins on the pain side, then I end up with enough gremlins on the pain side of my balance to fill this whole room. And I'm essentially in a dopamine deficit state

with a balance tilted to the side of pain. Now I have to keep using not to feel good, but just to feel normal. And when I stop using, my balance tips hard to the side of pain. I'm irritable, I'm depressed, I'm anxious, I can't sleep. Those are the universal symptoms of withdrawal from any addictive substance.

And that can last a long time. We live in a world in which we are saturated with dopamine and we live in a culture which encourages us to pursue it. But the ultimate end result of pursuing dopamine is to feel worse than when you started. And this is really the central message. People are more depressed, more anxious, more suicidal and more addicted than they were 30 years ago.

And I contend that one of the main reasons is because of this relentless pursuit of pleasure that essentially adjusts the dopamine levels, changes the hedonic or pleasure set point to make people anhedonic, meaning without joy. Yeah. And one curious thing for me, back to the neurochemistry, is why someone becomes, if this dopamine neurotransmitter pathway that you're speaking about seems to be a general quality of all humans,

why do some people get addicted and why some people don't? And for example, like alcohol is my drug of choice, gambling, which debilitates a lot of people, carries no charge for me at all. Like I just couldn't be less interested in it. Like how does that work? Is that where genetics and nurturing and all kinds of other things come into play? I think we're all gonna get addicted to something because now that special key that works for each of our individual locks, it's out there somewhere and the worldwide web will allow us to find it. Having said that, it is true that people bring different degrees of vulnerability to the process of addiction. We do know that about 50 to

60% of the risk of becoming addicted is genetic. That's based on family studies showing that if you have a biological parent or grandparent addicted to alcohol, you are at increased risk of becoming an alcoholic yourself, even if you're raised outside of the alcoholic home in a non-using home. So that's powerful genetics. It's polygenic, it's complex, we don't fully understand it. It's thought to be related to things like impulse control, ability to delay gratification, emotional dysregulation, but we don't really know what it is. Other risk factors include co-occurring psychiatric disorders. People with psychiatric disorders are more likely to develop an addiction and also how you were raised. If you had a traumatic experience, as we've talked

about, that puts you at risk. If you have parents who have explicitly or implicitly condoned substance use, either for recreation or as a coping strategy, that puts you at risk. Things like poverty, unemployment, that puts you at risk. So there are lots and lots of risk factors, but I think that the major risk factor in the modern world, and one which is generally ignored, is simple access. If you have access to a drug, you are more likely to try it and more likely to get addicted to it. And now, as we've talked about, we live in a world of virtually infinite access. Yeah. You say there's a quote in the book, something along the lines of, there is something that will addict you and it's coming to a website near you soon. Right, right. Yeah.

What a gift that conversation was, right? So let's build on it. With that definition and with that understanding of addiction in mind, we move now to a firsthand account of what life is like as an addict. And we begin with an account of what is perhaps the most powerful neurochemical dependence, opioid addiction.

Here's what we know. There were nearly 70,000 overdose deaths in 2020 alone that involved opioids. Every hour of every day, six people in the US die from an opioid overdose. Opioid addiction is just a tragic epidemic of untold proportions and has precipitated a massive public health crisis, destroying millions of lives unnecessarily while taxing

our economy at the rate of $78.5 billion per year. This next clip chronicles one man's journey into the depths of opioid addiction, despair, and thankfully, the path to recovery. His name is Dan Perez, hardly a born media insider. Dan was a kid who grew up awkward, a kid obsessed with magic, but he also had this gift for the written word, as well as this shrewd eye for culture, talents that prematurely catapulted him to crazy heights

in the fast-paced world of glossy magazine publishing, where he landed the coveted editor gig at Details Magazine, all the while harboring a secret debilitating dependence to prescription Vicodin. But I'll let Dan tell the story. All right, well, let's get to the drugs. Yeah. It all starts with a cartwheel.

It does. Oh, man. I think men have done so many dumb fucking things over the years to impress women. I mean, countless. In my case, it was a cartwheel, which it's important to note, I had never done before. And it looked as if I had never done one before

because I came crashing down on the floor and hurt my back. And I went to see a doctor probably a day or two later and was prescribed Vicodin. And that's how the seed was planted for me. Was it that thing where the first time you took it, you just knew? When time you took it, you just knew? When I first took it, it did exactly what it was prescribed to do,

which was mellow out whatever pain I was feeling. But it was only really a day or two later that I realized, oh, wow, this is how I wanna feel. And you just saw me, like, I just took a deep breath. Answer to every question I ever had, right? This is gonna make me feel like me. This is what I need. Like, I'm home.

And it was the beginning of at least what I thought was like a really important love affair from being honest, you know? And it happened incredibly quickly. like a really important love affair from being honest, you know? And it happened incredibly quickly. And this quickly progresses, you know, you get up to like 60 pills a day and it becomes your primary occupation, trying to source and fill these scripts

and make sure that your stash never runs out. I had never worked harder at anything in my life before that point. I had never been as committed to anything in my life before that point. Maintaining a supply of these pills was really my only focus. And I had a big job at details at this point

and family and friends and trying to like manage relationships and things like that. But this was really the only thing that I paid any true, true attention to, which is fascinating in and of itself, right? Because here I was, I was running this magazine and, but this was really all I cared about.

And so when you get up to, as I did 60 Vicodin a day, I ultimately switched over to another drug that the numbers came down. It's called Roxycodone. Yeah, Roxycodone. It's like twice the dosage. It was twice the dosage, but without the Tylenol. So like with, I was taking extra strength Vicodin,

I was essentially taking, so I was taking, let's say 60 a day. I would take to just to break it down, I would take, and by the way, not immediately, I worked my way up to these numbers, right? So I didn't just dive in, you know, you know what, 60 seems like a good number. I ultimately got to 15 at a time

and I was doing it about four times a day. And so the active ingredients of an extra strength Vicodin are hydrocodone, which is the codeine-based sort of analgesic painkiller. The opiate part of it. The opiate portion of it. And acetaminophen, which is Tylenol, right? And so I was taking, in addition to all of the opiates, I was essentially taking a small bottle of

extra-stain Tylenol a day for years. But when you need that many pills, it's really hard to get them. So it does take a lot of energy. And I put a ton of energy into it and was quite artful about it, I think. Addicts are brilliant liars. And then certainly like the really close, like first cousin of that is great con artists. And so I would go into these doctor's offices and I was doctor shopping. I was seeing probably four or five different doctors at a time

and filling different prescriptions in different parts of town. And I would put on quite a performance for them on each visit. I would start my performance a block or two away from the doctor's office in the event that someone that worked in that office may have been out running out to grab a coffee or running an errand or something like that. I couldn't have them see me not in character. So it would start the second I climbed out of the subway or out of a taxi. And I would limp down the street, but I wouldn't just limp down the street. I would stop and like, and like wince. I would lean against like a fire hydrant

or whatever it was and catch my breath. Like I really committed to this performance. There were- It is funny, but it is, you know, it's sad and it's pathetic and it just speaks to the places that something like this will take you to. It does, it speaks to the depths that this will take you.

And for me, at nighttime were like my biggest highs. I would take the most pills at night because I would- The big feeding. The big feeding, exactly. I could really just kind of zonk myself out, you know? And I would take, you know, 15 pills, let's say, and then be like, you know what, I'm going to add like a couple more on top of that just to like really numb myself out. But this might kill me, but I would take them anyway. And it's not that I wanted to die because I don't think I wanted to die.

I was prepared to die though for that high. It was just something I was prepared to do. But I would wake up the next morning from these moments and I would start all over again. And this is the thing, you know, and there are probably a lot of people in recovery that will be like, you know, yeah, like you're not ready until you're ready.

Yeah. And I went down to my mom's house and got sober, spent two weeks down there and, you know. I'm home, mom. Yeah, here I am. You know, there's nothing quite like being a, you know, like a 35 year old man or person and going back to your mom's house and basically just sort of like crumbling to pieces, you know, which is precisely what happened. And I got sober.

I was down there for two weeks. I attended my first 12-step meeting. So I called the doctors, someone in my life, that in my childhood that I grew up with, who was sober said, hey, you need to tell on yourself. You need to call these doctors. And like, I was like, yes, you know, like I was in, I was like, this is the new me. And cut off the source. And I'm gonna cut it off of the source, you know?

And I called, you know, I was probably seeing three or four doctors at the time. And I called all of them except for one. And on the way back, I'm on a train. I get on that Amtrak train from Baltimore to New York, and I call, and I get a prescription, and it's waiting for me at a pharmacy. And I get off the train. I go right to the pills, and I took them for a day. Cunning, baffling, and powerful.

The most cunning, baffling, and powerful. And it isn't such a powerful disease addiction is that even while I was in Baltimore, I was in Baltimore. I made this split second decision while I was calling these doctors to eliminate, to hold back. Hold one back. To hold one back. Have that out.

That's how powerful it is. I'd gone through so much. I was out to everything. My wife had kicked me out. My pregnant wife had kicked me out. All of this stuff, it didn't matter. You know, I like made the decision in like a blink of an eye to do that.

And I went back to New York and I took pills for a day and then I stopped. And that was it. That was October 12th, 2007. Congratulations to Dan on his continued sobriety. This past October marked 14 years for him. And his story really highlights the toll addiction can take on an addict's family members.

But what if Dan was your son or your daughter? And what if he was a teenager at the time? It's truly a parent's worst fear. And teen substance abuse in general is just a huge problem. So how do we deal with it? How do we properly equip kids with the tools they need to avoid substance abuse?

How can we identify a kid who is at risk? And what can be done to prevent our young ones from developing dependency issues? To answer these questions, I did what you do when you host a podcast.

I turn to the experts, people like my friend, Jessica Leahy. Jessica writes about education, parenting, and child welfare for The Atlantic, The Washington Post, and The New York Times. She's the author of The New York Times bestselling book, The Gift of Failure. And her second and most recent book is entitled The Addiction Inoculation, Raising Healthy Kids in a Culture of Dependence. This clip highlights drug abuse prevention, talking with your kids about drug abuse, how to spot risk factors,

and the importance of relating with your kids on their level. This is invaluable wisdom for parents, and I'm excited to share this excerpt with you. So here is Jessica Leahy. So let's talk a little bit about the difference between adult addiction and what is unique about teens and substance abuse. And maybe that's an opening to talk about the developing mind and what's particular

about a young person's experiences with drugs and alcohol. Adolescents from about puberty to the early 20s are in this period of unmatched brain plasticity. The only time where the brain is developing at this rate is from birth to two. So adolescence is so much is happening in their brains. They're not only wiring up the frontal lobe of their brain that hasn't been really online yet, which is where all that executive function, planning, schedules, all that stuff happens. Their sort of limbic system, lower brain stuff is sort of running the show right now. This is just starting to come online. Myelination is happening in the brains. Fatty sheath is going over the neurons. Synaptogenesis, synapses are just, billions of synapses are happening. And there's no retakes

on this, right? So if we get, if anything goes wrong during this period, this period of intense, of incredible plasticity, you can't go back and fix it. And that's why during adolescence, drugs and alcohol do some things to the brain that just don't happen later. Like there are risks to certain drugs and alcohol to everyone, but then there are greater risks for many of them because they mess with parts of the brain that are in the process of growing and adapting and connecting really, really quickly. So that's what makes it different. And then, you know, a lot of people call substance abuse a developmental disorder because teenagers are also uniquely wired to want to go there, right? Right.

Novelty, risk. Kids, adolescents have baseline lower levels of dopamine than little kids or adults. So when teenagers tell you they're bored, probably really are because their dopamine levels are just baseline lower, but man, drugs and alcohol really can fix that. So they're really in a place where, and also they're becoming, and that's scary. And not liking yourself is sort of a part of adolescence here and there, and drugs and alcohol can kind of fix that in the short term too.

So talk a little bit about the factors that contribute to a young person being at risk and how to identify when you see, whether it's your own child or another child, like how you can kind of intuit that that person might be walking a tightrope. The data show that if you are the kind of parent that is consistently messaging total abstinence until 21, until it is legal to drink or use pot or whatever the thing is,

then your child is less likely to have substance use disorder during their lifetime. Now, as someone who always comes at statistics and data with a question mark in my head, I say, well, except it would be the parents that have the total abstinence agenda whose kids would have less access to blah, blah, blah, blah, blah. But either way, the reason I bring that up is that the parents who are like, okay, well, I just want them to be safe so as long as they're doing it in the basement and they're not driving it's okay or if i take the keys or if they're you know as long as they're here in the home or you know i want to give them a sip so that they can

grow up to be like those europeans that have the really sort of moderate um you know they're not overusing they're drinking and just having enough and it's a part of the lifetime you know, they're not overusing, they're drinking and just having enough and it's a part of the lifetime, you know, their life and meals and stuff like that. The problem is, is that that sort of European romantic myth of raising a moderate drinker is it does. It's not true. You know, not only from the standpoint of that doesn't work for kids, a kid whose parents have a permissive attitude around drinking and doing drugs at home while drinking and doing drugs before 21.

Those kids are more likely to have a substance use disorder during their lifetime. Also, hello, Europe has the highest rates of alcoholism in the world. And not only, you know, they're even starting to have to deal with that. France has gone back and changed its guidelines around how much is healthy drinking because they realize, yeah, yeah, yeah, this has always been a part of our culture, but oh my gosh, we have a problem. I didn't realize that, wow.

And that's fine, but do you not run the risk? Hold on, like if you draw that hard line in the sand, are you not risking the behavior going underground? Like you're gonna cut off the communication. You're setting up a scenario which your kid's gonna lie to you and hide stuff from you and do what he's gonna do or she's gonna do. And then you're not privy to what's going on.

Except, so the other thing- For people that are only listening, you just have the biggest smile on your face. Go ahead. Well, no, it just have the biggest smile on your face. Well, no, it's just that this is what killed me. You know, the writing of this book was really hard for me because I do not read my children's emails. I do not read their texts. I have never gone on the high school portal and looked at my kids' grades.

I don't listen to their phone calls. I trust my children. And, you know, until I have reason not to trust my children, I don't search their rooms. I don't read their stuff. You know, that's very important to me because the research also is clear on this is that kids who are more controlled by their parents lie to their parents more. It's just the reality. So if I want my kid to be the kind of kid who can trust me and talk to me about things, I have to respect his privacy and I have to put forward the idea that I trust and respect him. Okay. So there's that.

There's also real concerted efforts to make these conversations really common and an understanding that, you know, you don't have that one sex talk. You don't have one drug and alcohol talk. And my kid's name, it just took last semester, he was in a biology class and the teacher asked the kids, how often do your parents talk to you about substance abuse? And Finn was like, oh my God, when does my parent not talk to me about substance abuse? So we're having a ton of conversations about it all the time. We're very open about those things. And in order to get to that place where I feel like they can trust me to talk to me, I have to be there to listen to all the other stuff that interests them

that isn't necessarily the stuff I want to hear. I have to respect them. And we have to have open communication. And so much of what I hear from kids is, I want to talk to my parents. I really, really do. It's just that I don't want to talk about the stuff they want to talk about all the time, which is like, I don't want to constantly be talking about school. Can't we talk about something else? And so I think, you know, the reason that one of the chapters in the book is about getting this conversation started and how hard that can be. And I talked to lots of therapists who have to try to get kids to talk about stuff when they don't want to talk. And a lot of them, you know, there's some cool stuff. Like, you know, if you're in the same room with your kid and they don't want to say words, tell them to text it to you across the room. You know, that may feel weird and horrible and fake, but it's actually can be a really authentic way of

communicating. As a parent, I can promise you that Jessica is right. Authentic communication with your kids is absolutely essential. And it was extremely instructive to hear Jessica speak about dopamine in the brain of an adolescent in light of how Anna Lemke explained the dopamine pathway just a few minutes ago. It gave me a whole new appreciation for the need teens and young adults have for novelty, which is a compulsion that practically defines my next guest, Mr. David Cho. Dave is a street artist, a fine artist, a performance artist, muralist, musician, journalist, writer, producer, fellow podcast host, creative oddity, self-proclaimed liar, thief,

altruistic narcissist and vagabond, recovering sex and gambling addict, as well as a caring, thoughtful, and wildly vulnerable host of FX's, The David Cho Show. He's one of the most captivating and charismatic people I've ever met. And his is a story of behavioral addiction, cranked up to 11 and includes quarter million dollar hands

of blackjack, so many rehabs, recovery, treatment centers, tears, and just total transformation. Dave was open, he wass, recovery, treatment centers, tears, and just total transformation. Dave was open, he was vulnerable, candid, and dropped more profundity and profanity than I would have ever expected, including his insight that in many ways, every addiction is a gambling addiction. So brace yourselves for this one.

It's one of my favorite interviews ever. So here is the incomparable David Cho. I've been to every type of 12-step meeting and one's like, because I'll be in a city where, oh shit, I can't find a gamblers, overeaters or sex and love addict or whatever the addiction, co-dependence I have. You're Helena Bonham Carter and Fight Club or Ed Norton. Exactly. gamblers, overeaters, or sex and love addict, or whatever the addiction, codependence. I have-

You're Helena Bonham Carter and Fight Club or Ed Norton. And they're like, oh, there's only an AA meeting or Narcotics Anonymous or Marijuana Anonymous. So I'll go to that meeting, even though that's not my addiction. And as I listened to thousands of people share their story, I go, oh, it's all gambling. Every addiction is gambling addiction.

Every single, when you drink and you get in a car, you're like, I kind of don't care if I make it home or not, right? That's gambling. When you're like having sex and you're like, I'm not going to wear a condom. And you're like, oh, I might have a kid. I might get AIDS.

I might, that's gambling. And so to go to my first Gamblers Anonymous meeting after going to 400 AA meetings in Los Angeles, I was shocked because AA meetings and drug NA meetings are kind of like parties in LA, right? Like it's very social. They're bright lights. Yeah, especially in LA. 300 people, you know, there's celebrities, speakers. When you go to a sex addicts meeting,

a gamblers addict meeting, the process ones, there's more shame. Yeah. So the lights are a little lower. It's really fucking dark. Yeah, it's darker. There's a lot of shares that end with suicide attempts. So I went to a GA meeting and we went in a circle and every single

share, it was a small meeting. It was like six people. Um, every single person shared about how they try to kill themselves. And I've said this before. It's the reason why they don't have balconies in Vegas, because if they did, there'd be someone jumping off every day. One out of four gambling addicts kills themselves. Um, so go, gambling, I don't understand. It's like, so I'm sitting at the meeting and everyone's like telling how much money they've stolen from their family or lied and manipulated people out of

so that they could keep gambling, getting that one lotto scratcher, horse rate, everything, right? And I'm scared to share because it's going around the circle and it gets to me and I'm like, I just won $3 million after my last, you know? last, you know? And I feel exactly the same as you. You just said you broke into a car to steal a quarter so you can get the next scratcher. I'm sitting here

telling you I have two rotting lobsters in my hotel room. I'm having sex with all these prostitutes and gambling with millions of dollars, winning, handing like $100 bills to everyone I know. And I feel exactly the same as you. So I sat there and I go, how do I feel? How did I feel when I won $3 million on my last trip? And I'm playing a quarter million dollar hands of blackjack in private, private rooms, you know? And at that point, I felt very little, you know?

But like you win $3 million, it feels good. But not that good because I was already rich. When I lose $3 million and even better yet, when I lose $30 million, then that yet when I lose 30 million then that feels amazing right that feels amazing so I think that was the disconnect with trying to talk to people in my tribe who are addicts and people who aren't addicts right and it doesn't matter if you're an addict or you're not an addict because everyone knows an addict or at least has one in their family so that's the thing when people go,

I don't, but I don't understand. Why don't you stop drinking? Or why don't you stop? Why don't you stop the behavior? It's like, I want to fucking lose. That's why. Do you get it? Do you understand now?

I don't want to win. I'm happier when I'm losing. I want to lose everything. But that's even harder for somebody to understand because you're not operating on a rational plane. Right. You know, you're not operating on a rational plane. Right. You're trying to numb the discomfort of your internal pain while also seeking to feel something

that will make you feel alive. And if winning's not gonna do it, losing certainly is going to. To have- It doesn't matter what that feeling is, as long as it's a feeling different from however you feel. Everything was off. You know, I did, I did like these expensive brain scans to show that I had like frontal, like,

like a kind of temporary brain damage from just like complete overstimulation. Like, yeah, your dopamine must've been completely fucked up. One of my closest friends, he said to me in the car ride, he said, Hey, listen, um, like, we can't change you. We can't control you. So if you want to get out of the car right now, go ahead. Um, but you're not an idiot. You know how the story ends. You've seen enough, you've watched enough movies, you know, enough people like you will die. You will go to jail again. You like these things will happen So the only thing you got a question is do you want to do it now? or do you want to wait till you hit your bottom and I was like, I kind of want to wait till I hit that bottom and In that moment of sobriety and clarity I was like I'll get the help now

I'll get the help now. Liberation from surrender. I've experienced it and I've heard it over and over again, including from our next guest, Dr. Jud Brewer, coming right up after a few brief words from our sponsors. All right, back to the show. So what is it about the human condition that everyone seems to need a coping mechanism? Why can't we all just will our way

out of negative compulsive behaviors? Well, it turns out that my next guest, Dr. Jud Brewer, has answered those very questions. Dr. Judd Brewer, has answered those very questions. Dr. Judd is a psychiatrist, a neuroscientist, a thought leader and scientific researcher in the field of habit change and the science of self-mastery. He is the director of research

at the Center for Mindfulness and an associate professor in medicine and psychiatry at UMass Medical School. As you just heard, on some level, we're all craving animals, subject to compulsions that don't serve us, whether it's substance abuse, social media, binge eating, or other behaviors that lead us astray,

that we find ourselves repeating uncontrollably. And in this clip, Judd shares more than a few valuable insights into the nature of cravings, including the mechanisms and neurology behind them and certain keys, including mindfulness, for addressing and ultimately overcoming them. I got a ton out of this conversation

and I think you will as well. And so here we go. This is me and Dr. Judd Brewer. Yeah, I don't know if you've ever pulled up to a stoplight late at night and you look around and everybody's crotch is glowing. It's like suddenly 30 seconds at a red light is intolerable.

Right. Well, we only got there because we've let ourselves get there. And we can say, oh, I'm not going to do that. I'm going to be a good boy and willpower my way through this. Forget about it. Like you said, that doesn't work. So let's get into why it doesn't. Why is it that I can't override that impulse and through sheer force of will, like marshal my mental and emotional powers to prevent myself

from doing that thing that I am so lured to. Yeah. It sounds pretty good, doesn't it? You know, where these rational thinking beings, I think Descartes really sent us down a path that was not so good. You know, oh, I'm thinking therefore I can think my way through stuff. It's not how our brains work. Yeah. You know. There's a part of the brain, the prefrontal cortex, that's involved in willpower. It's the weakest part of the brain from an evolutionary perspective. It's the first that goes offline when we're stressed, when we're angry, when we're sad, when we're tired. That's why we wander into the kitchen late at night looking for something because we've learned that. And so we can say, don't do that. But then

we just crash harder. And in the morning, we set that resolve to like, okay, I'm really going to do it this time. But that's just not how our brains work. Our brains don't work that way. But we think, I think it's more we're rationalizing. We're like, oh, willpower, it must be something. Let's study it. And there, you know, there's been a little bit of this and that, but it turns out that willpower, you know, if you look at the people, you know, that quote, unquote, have good willpower habits, there's some really interesting pieces there. One is they actually find things that they enjoy doing. So people, you know, people do something like eat healthy or exercise.

If you ask them why they do it, the people that are really good at doing it, and you probably know this personally, it feels good as compared to, oh, I need to get in shape to get my body looking this way for the beach. Right, it's not like an intellectual exercise. Not at all.

And that part makes sense, but that's not willpower. And it makes sense because that that's not willpower. And it makes sense because that is reward-based learning. We're doing something out of the reward of doing it, not because we're doing it. So that's one of the big misconceptions around willpower is that if you look at reward-based learning, it's based on the reward. It's not based on the behavior itself. So if it were the behavior, we'd just say, stop doing this, but it's actually the reward that drives future behavior. And that's where we can start to intervene. How does it correlate with intelligence?

Because just speaking from personal experience, I've noticed over the years through my adventures and journeys in the recovery community, that people who are hyper-intelligent often struggle the most because they want to intellectualize this where truly it is an emotional thing more than anything else.

And so they struggle trying to wrap their heads around how to do this and they can't let go of the idea that that solution resides within the mind. Yeah, well, so hi, my name is Judd and I'm a thinking addict. There you go. If you look at the bookshelves in my house, they are way too numerous.

So speaking from personal experience, and I think this applies, is there's this, it's almost like the thinking part of our brain is kind of like this, it's like refined sugar or refined carbohydrates. It actually just gets us stoked. We're like, oh, that's interesting. I'm just gonna learn more and I'm gonna learn more

and I'm gonna figure out the solution to this thing. Meanwhile, day after day after day, you're perpetuating the same behaviors. Unknowingly. Yeah, while you're buying every self-help book that's available. Totally, totally. So what we really need is to land in our body

because our body is really, really wise. And so this is, you know, this intellectual thing is like, you know, it's that, it just drives more addiction where it's like, I wanna learn more as compared to really landing on our direct experience that says, dude, why would you do that? I'll give you an example.

So we did a study with people who are trying to quit smoking and we randomized people to get cognitive therapy or mindfulness training where we train them to really just pay attention to the results of their behavior. So when they come into the mindfulness group, they don't even know what they're getting, you know? And so they come in, they're like, I'm here to quit smoking. And I say, okay, next, when you go home, smoke. And they're looking at me like, is this the experiment that you're running? Is this the study? And I say, no, smoke, but pay attention as you smoke and see what

happens. So they pay attention to the smell, to the taste, to the feeling of the superheated smoke going into their lungs. And they come back and they're this Mr. Yuck look on their face. They're like, oh my God, how did I never notice that before? Because they realize that smoking tastes like shit. And they can only get that wisdom from their direct experience. I had a guy who, so we, in our first study, we, first class was on Monday, second class was on Thursday. This guy was smoking 30 cigarettes a day. He'd been smoking that for a long time. He came back on Thursday and he said, yeah, I'm down to 10 cigarettes. And I said, well, what happened? And he said, well well I noticed that I would drink coffee and

the coffee was kind of bitter so I'd smoke a cigarette to numb myself from the taste because it's amazing how smoking numbs your taste and so he realized well I don't need to smoke I could brush my teeth and he just went through this litany of 20 cigarettes where they were all he was smoking all these things out of habit where he'd you know he'd learned through this reward-based learning process that oh if I smoke I feel better you know, he'd learned through this reward based learning process that, oh, if I smoke, I feel better, you know, or whatever. And he realized, oh, this was not a good way to go. So the idea being, you talk about this in your book is diverging from what Skinner calls

the operant conditioning, right? Which is behaviorism, this traditional approach to like dealing with these kinds of problems to a more Buddhist perspective, which you call or is called dependent origination, right? And this involves being present for the experience and rather than getting into judgment, self-judgment to just be curious about what's happening.

Yeah, absolutely. And it's interesting. So one of the first aha moments for us in my research career was when I was looking, I was studying this operant conditioning or positive negative reinforcement. And I was thinking, wait a minute, this sounds way too familiar. And I started looking into this because I'd learned on a retreat or something, I'd learned this dependent origination piece. And it was kind a retreat or something, I'd learned this dependent origination piece. And it was kind of, you know, complex or these 12 steps and all this stuff about

birth. And this sounds like, whoa, what is this? But when I looked at it, and I actually worked with a Pali scholar to really explore this, it turns out that dependent origination explains operant conditioning. And so the Buddhist psychologists had figured this out 2,500 years ago before paper was even invented. And so they were describing the same process. And importantly, this process, dependent origination, was what reportedly the Buddha was contemplating on the night of his enlightenment. As in, hey, pay attention, guys, this is kind of important. So really important concept that actually is rediscovered

in modern day and drives, you know, and explains a lot of how addictive behavior is formed. Science and ancient wisdom both explain a lot about how addictive behaviors are formed. But the scary thing is the drive toward compulsion is part of what it means to be human. It's literally baked into our physiology and neurochemistry,

which means addiction can happen to anyone. And that is the message of my next guest, Amy Dresner. Amy is a former standup comic, recovering drug addict, and all-around fuck-up, her words, not mine, as well as a writer and an author who humorously chronicles her epic ups and downs for a variety of outlets from Psychology Today to Salon. I love a good addiction recovery yarn, and Amy's first book, My Fair Junkie, is just a totally wild ride that chronicles her downward spiral

from someone who pretty much had it all growing up to becoming this addiction monster, meth, Oxycontin, alcohol, and sex among her drugs of choice. It's a journey that led to felony conviction for domestic abuse. It led to psych wards, pennilessness, a community service chain gang, and more rehabs and halfway houses that you can count

until she finally got sober and had to face completely starting over in her 40s. Yes, addiction can happen to anyone, but that also means that recovery can happen for anyone. And as Amy likes to say, if she can get sober, truly anyone can get sober. Here's an excerpt from episode 428 with Amy Drezner. You know, when I have people on that are in recovery,

like I always wanna hear what they have to say to somebody who might be listening, who is struggling, whether it's with relationships, sex or substances or some other behavior that is causing them pain as somebody who's been there and found their way out. Like, how do you speak to that person? I would say, first of all, be gentle with yourself, you know, drop the shame because that will just continue the use. Like you're doing the best you

can with the tools that you have. I would say to be honest with other people and get help and go get a therapist or go to AA or go to SLA or whatever, get into a support group because it's so important. When we're in a behavior that feels pathological, we isolate and that just makes it so much worse. And for me, a huge part of the healing has been the fellowship and my friends and feeling connected and reaching out. I would say, don't give up no matter how many times you slip, like if you're alive, you've still got a chance that you can get through this, that you're not a bad person,

bad person, even if you've done bad things. I mean, I think that's amazing advice. Yeah. I think the hardest part for people is that first step. Like, well, how do I reach out? Or like, what exactly is, what is the thing that I actually need to do first? And the other thing is don't wait till you feel like you're ready. You'll wait forever. Like if I waited till I was ready to write a book or if I, like I've been waiting to feel like I'm ready

and wanna go to the gym and that's been a year and a half. I know, don't judge me. But it's like, you take action and that changes the feeling. Mood follows action. That took me forever to figure out. And there's a line in the book that my dad told me

and it took me 20 years to figure it out. He said, stability doesn't create discipline. Discipline creates stability. I was waiting to feel okay before I could do these things, but it was doing these things that made me feel okay. So I would say, you know, tell your feelings to shut the fuck up, your head to shut the fuck up, and you take the action and it will change things, you know? And it's like, you can get better. If I can get sober, anyone can get sober, sorry.

Like, come on. That's always gnarly. Yeah. And one of the things you've written a lot about is the importance of structure in your life, like having a schedule. Oh God, yeah. Well, now, I mean, I work from home. I work from home.

I have a three-day-a-week editing job. I work for the, and it's hard. It's really hard. I have to force myself to get out and do things. I guess the other thing too, it's like, you can change. You can change. I really thought forever I was broken and I was stuck with that person who I was.

And it's like, I'm not that person today. I'm a completely different person. And it's like, I never thought that I could be the person who shows up and is inspiring to people and, you know, sweeps the floor, not the streets. But you know what I mean? Like it's. Yeah. And when you're in that cycle and you're surrounded by people who are telling you you're a piece of shit and you're never going to change.

Yeah, that's. You believe that you're never going to change. Of course, yeah. Fuck what people tell you. And you can never see your way out of it. Yeah. Fuck what people tell you. You know, you can do it.

And also the other thing too is like, you know, if you have an urge to use or drink or whatever, or text that guy that's bad for you or whatever, it's like, give yourself 20 minutes. Take a bath, call someone, watch an episode of Ozark, jack off, whatever it is. Like do something and buy yourself 20 minutes. Call someone, take a drive, take a walk. Because the urge passes whether you pick up or not. That's really, it took me a long time to figure that out. And it's like, but if you don't ever

sort of wait through that feeling, you don't realize that you can get through it. It feels overwhelming. And then the urge comes to you like, I gotta do it, I gotta do it, you know? Yeah, and you feel like you're gonna die if you don't realize that you can get through it. It feels overwhelming. And then the urge comes to you like, I got to do it. I got to do it. You know? Yeah. And you feel like you're going to die if you don't indulge that impulse and you don't understand that it's so true. Right. It will pass. Yeah. And if you could just get through that and realize and go, oh, you realize that the feeling doesn't control you. It doesn't, it won't kill you. You don't have to obey it.

And that's where that freedom comes from. You know, you can, you're like, oh, I can change. And it's slow. It's a slow process, as you know. Yeah. Takes a while to reward. Slow variety. I know, right?

I hate that. All the annoying slogans. But that you can rewire your brain slowly over time, you know, through action. You really can. And you can be happy. You can have a good life and you don't have to be, you know,

a prisoner to that crap, you know? And just also don't care what people in the room think. Like if you eat it and just come back, it's not a competition. I don't like that. Everyone's got their own stuff. Everyone's got their own stuff. Everyone's got their own baggage. Some people have like really severe mental illness.

Like everyone has their own thing, you know? Yeah, I think that keeps a lot of people away. They come in and they have a weird exchange with somebody. And then they're like, I'm done with that. Yeah, of course. And then they're dead or they can't get sober. Yeah, it's like, you know, find another meeting or it's like, I mean, I just wrote a piece about this

and this Dr. Howard Wetzman said 50% of people who relapse will never go back to AA. That's heartbreaking. Yeah, because either someone said something to them or because of shame, not that they, yeah, that 50% gets hurt, but they will never even make a second try. And it was like, you know, I have such a big dose

of like, who gives a fuck about me? Like, I was never like, I gotta be queen of the drunks. Like, I was just like, I don't care. Like, this is my life and I don't care what these people think. And my social capital is not based on what people in AA think about me. And I was just like, you know, I'm on my own trajectory.

Well, that's how you get well, because you can't save your ass. If you're trying to save face and look good, then you're working at cross purposes. Exactly, exactly. Getting better. Exactly, it's like, it's not a competition. As we step into the back half of this episode,

I wanna turn our attention to another powerful story of recovery from opioid abuse. But this time I wanna zero in on that moment when an addict knows they're ready for recovery. It's a story that highlights the gift that hitting rock bottom can be, how one goes about piecing their life back together after losing everything,

and ultimately about how Alcoholics Anonymous saves lives. I'm talking about the story of Jeff Grant. Jeff is a former New York City attorney who became addicted to painkillers in the wake of a ruptured Achilles that he suffered playing basketball. It didn't take long before he started making bad decisions under the influence fueled by this dependency

that led to let's call them ethical transgressions as well as financial misdeeds, losing control of his law firm and a suicide attempt. Jeff survives all of this. He enters treatment, he gets sober. He starts putting the pieces back together. But then at about a year and a half into sobriety, he gets arrested for fraud. He pleads guilty and ends up serving 18 months in federal prison. Now Jeff is a pastor serving the imprisoned and underprivileged who is also now more than 15 years sober.

This is his story of redemption and how 12-step programs give people hope. So I said to him, all right, why don't you just resign my law license for me? And I went to my doctor friend and I got a prescription of Demerol, you know, 40 tabs and went home. And after my wife and ex-wife and kids went to sleep, I took the whole vial. It's like 40 tabs.

Yeah. Yeah. And I knew what I was doing. I mean, I was trying to kill myself. Was it a real suicide attempt or was it a desperate call for help? I mean, 40 seems like enough, but your tolerance must have been insane. My tolerance was insane, but I don't think... I thought 40 would be enough.

That was the point. I thought 40 would be enough. And I've spent a lot of years trying to figure out whether or not it was a real attempt or a cry for help. But I wanted the noise in my head to stop. A few days later, I called Silver Hill Hospital in New Canaan. And I wanted to go there. I knew to go there because clients of mine who had OD'd went there.

That's where they went. So you made a decision like I'm done and you did your own self-styled detox at home. Well, I had done it a hundred times before. So it wasn't as if I was ignorant of what a withdrawal would be like, this was just the super one. This was the biggest one I'd ever been through. And certainly the first one I overtly tried to kill myself.

Opiate withdrawal is gnarly. It was bad. It was bad. And how long did it go on for? I don't know, three or four days probably, it was bad. So you waited until you'd weathered that before you checked yourself into treatment? Oh yeah, because I was, I knew better than anybody.

And you did, so you had a sense that this, as somebody who's tried to get sober many times on your own, you know what it's like, it's like, okay, this time, I'm never gonna do it again. But kind of in the back of your head, you're like, you're not really sold on your own, you know what it's like. It's like, okay, this time I'm never gonna do it again. But kind of in the back of your head, you're like, you're not really sold on the idea, but this was qualitatively different, you knew. Well, I didn't have a life to go back to.

I knew that, I knew everything was gone. I didn't really understand at all at that point, the gift of a hard bottom. That's something I learned later, but everything was gone. That's something I learned later, but everything was gone. And so going to rehab was a blessing. So how do you begin to piece your life back together in the aftermath of all of this? Well, certainly through recovery.

I mean, seven weeks in rehab and they brought recovery meetings in and I kind of took to them. And more I think to the structure than to anything I was, I was too out of it to learn anything, I was gone. And on the first day out of rehab, I did what I was told to do.

I showed up at the meeting and I raised my hand and I said, I'm Jeff and I'm an alcoholic and a drug addict and I need a temporary sponsor. And I gave like three seconds on my drug of choice or I can't remember right now, but at the end of the meeting, the leader who had been leading the meeting, and I thought it was the boss,

I didn't know, it was my first meeting, I didn't know. And he came up to me and he said, this is for alcoholics and you've done drugs and you're in the wrong meeting. How dare that guy say that? I've never heard anybody say anything like that. Well, you're in the wrong meeting. How dare that guy say that? I've never heard anybody say anything like that. Well, you're a West Coast guy. Yeah, that's interesting, wow.

And this other guy came up to me who was standing right there and he was the spitting image of Freddie Mercury. I am telling you this guy, I thought it was Freddie Mercury in my haze. And he said to me, don't mind that guy, I'll be your temporary sponsor. And Brian T was my sponsor. And he gave me very clear instructions,

like what to do and for 30, 60 days, I went to a noon meeting every day and I fell asleep with my head against the wall because I couldn't even focus. But you showed up. I showed up. Took direction. Yep.

Made yourself known. Yep. And then. Began to take accountability. Did all that stuff that seems completely unrelated to staying sober. Like. Yeah, I was just struck.

People take numbers, make coffee. Lie a lot. Keep coming back. Yeah, exactly. But we had to get rid of the house and we had, and of course I did what every- You have no income at this point. No income at this point.

And a little, you know, some savings, but no income. And I did what every sane guy does when they lose their house and their career and their reputation. I moved to Greenwich, one of the wealthiest communities in the country. Why would you do that? Because I had started going to AA meetings there,

to recovery meetings there. And those meetings were so important to me that I had to be there. And also it was only six miles from our home. And although the state line is huge in terms of media and in terms of interconnectivity, but I figured my kids would still be able to maintain relationships with their friends.

And that was true, that happened. But there we were in Greenwich and for the next 20 months or so, I was living in an apartment in Greenwich and going to meetings and I went three times a day, four times a day sometimes. And I was a lock step, you know, in recovery. That was my life. And this saves your life.

Saved my life, absolutely. It's interesting to me. I'm always encouraged when I hear stories like yours of people whose lives have been spared as a result of the 12 steps, because in our fast-paced modern culture, it seems like every year there's some new hot take on what sobriety is or should be.

And now we know more about addiction and alcoholism than we ever have before. And all these other ideas are antiquated. And maybe there's truth in that, maybe there's not, but I know that 12 step and Alcoholics Anonymous saved my life. It's saved the lives of so many people that I know. And it works.

It works for me. I have no opinion on how people get sober. They find other ways of doing that, more power to them. I just know that this is what has worked for me and continues to work for me and remains my number one priority. Well, it's a big world and I assume there's people getting sober other ways.

But for me, it worked. And it gave me a home, a family, people who weren't judging me. And I had abandoned all my people, places and things because nobody would talk to me. I was a pariah. And so I didn't have the places, I didn't have the things and I didn't have the people.

So that hard bottom was a blessing. Yeah, and it had to, you know, forced you to right size your ego and take stock in the inventory of how you were living and figure out a new approach to how you were going to get through the day. Yeah, inch by inch. Big thoughts like that probably didn't happen for a while.

I was just trying to survive. Many of our guests so far, including Jeff, have referenced the larger emotional context within which their addiction began, psychological backstories that drove them to use and abuse substances, including the need for validation, things like bullying, physical or emotional abuse. In other words, trauma.

And there is no better person to speak on the way trauma affects addiction than my next guest, Dr. Gabor Mate. Dr. Mate is a world-renowned best-selling author, lecturer, and specialist on the cutting edge of addiction medicine research with some pretty fascinating, somewhat controversial, but I think quite revelatory ideas about the nexus

between trauma, early childhood development and addiction. With over 20 years of medical practice and family and palliative care, Dr. Maté has decades of firsthand experience working with hardcore drug addicts. I find his insights quite compelling, specifically this idea that the source of addiction is not to be found in genes,

but instead originates in the early childhood environment, that addiction is complex, that there is no quick fix, and that we should be advocating for a more compassionate, less punitive approach to addicts, addiction and treatment. I think you're gonna really enjoy this perspective. So without further ado, what's wrong with our kind of conventional wisdom around the idea of addiction

and where your kind of philosophy and ideas come from? Well, traditional wisdom around addiction is either the legalistic one that has it as a bad choice that people make from which they have to be deterred by means of severe punishment. Hence we got the so-called criminal justice system, which by the way, I think is a good title. It is a criminal system. The justice system is criminal, the way it treats people. Well, specifically addicts sort of trauma, further traumatizing the people that are most traumatized. That's the whole point.

Now, the point though, is that that's the legalistic view that addiction is a choice and people need to be punished when they engage in addiction-related behaviors, they're very addiction being illegal. Now, the other perspective that seems different is that addiction is a brain disease that you largely inherit, so it's not your fault because you can't help what genes you inherit, but it's a disease of the brain that arises in the brain, partly for genetic, partly for other reasons.

And what both of those perspectives share, though, different as they are, what they share is that in either case that we're looking at people's life histories and we're not looking at social history or the history of a country or a nation. So who are the populations that are most severely affected and what happened to them? So who are the populations that are most severely affected and what happened to them? And who are the individuals that are most severely affected

and what happened to them? My perspective is that addictions are attempts to soothe pain in every case. In fact, the drugs are specifically painkillers, cocaine, numbs and nerve endings, opiates, heroin. These are painkillers. Alcohol is a painkiller. Cannabis is a painkillers, cocaine, numbs and nerve endings, opiates, heroin, these are painkillers, alcohol is a painkiller, cannabis is a painkiller. Crystal meth diverts you from the experience of emotional suffering by making you feel more alive

and excited temporarily. So it's always not why the addiction, as you said, but why the pain. Keith Richards, when he was talking about his heroin habit in his book, Life, which is an autobiography. He said, and I'm almost quoting him verbatim. He said, the contortions we go through, just not to be ourselves for a few hours.

Now, why would people not want to be themselves? Because they're not comfortable in their own skins. Why are they not comfortable in their own skins? Because they suffered in their own skins at some point when they couldn't help it. So what I'm saying is that addiction in every case, whether it's the severe addiction of the heroin addicts that I dealt with or the respectable addictions of the workaholic or I'm probably free to mention that you talked about your own. Addiction at some point to extreme endurance sports, and these are always based in trauma.

So any attempt to escape the present moment has to do with discomfort that we incurred as children. And there are degrees of discomfort, degrees of trauma, but fundamentally addiction is always an attempt to escape suffering. So it's not the problem. The addiction is not the problem. The addiction is-

No, the addiction is the manifestation of the addiction is the solution to the problem. It's an attempt. And it works until it doesn't work anymore. It works temporary. In fact, that's my definition of addiction. You know, it's a temporary relief, pleasure, In fact, that's my definition of addiction. It's a temporary relief, pleasure,

craving that is satisfied momentarily, but creates negative consequences in the longterm and you can't give it up. That's what an addiction is. But yeah, that's what it is. It's an attempted solution. It's not the primary problem. And so to say that addiction is a primary brain disease,

which is the official medical perspective that I was trained in, misses the whole point. But then again, the medical profession notoriously does not understand trauma. The research is totally clear. Like it's not that I'm giving you personal insights. I mean, I am, but these insights are very much also supported and grounded in vast body of literature.

And whether we're talking about addiction or cancer, you can look back to negative childhood experiences. So even on a level of physiological changes in the brain, we're looking at the same changes. Just as some people use and need chemicals to achieve those changes. Other people get it through behaviors. But the gambler is still after a dopamine hit, dopamine being the incentive motivation chemical. He's not after the money, because if it was about the money, he would quit after he won,

rinsed his first jackpot. But it's about actually the dopamine hit that he gets, that temporary state of elation and excitement that he gets when he's engaged in the activity. So all addictions, whether they're behaviors or substances or whatever they are, they serve the same psychological purpose of escape from suffering and pain,

discomfort with the self, and they activate the same brain circuits with the same neurochemicals. So there's only one universal addiction process, drug addiction being a small, small manifestation of that. Right, and because it's so divorced from logic and rational thinking, I think that's what prevents a lot of people

from really truly understanding it and why the conversation around it has to do with judgment and shame and criminology. Well, I think if you wanna explore that minefield, we can. I think on individual level, the judgment and the disdain for drug addicts is actually well expressed by Jesus when he says, don't be hypocrite,

he says. That's the word he uses. He says, before you try to remove the sliver from your brother's eye, remove the pole from your own eye. And so what it is, is that when there's something we don't like about ourselves, then we'll look at that same thing in somebody else and reject it and imagine that we're different. So the workaholic businessman or the workaholic doctor, for that matter, or the shopaholic

man or woman. The guy who spends $8,000 on CDs. CDs in a week. I've heard of people like that. $10,000 on CDs. CDs in a week, I've heard of people like that. And they like to think of themselves as superior to the drug addict. And yet the dynamic is the same,

which is being in the grip of a compulsion that you can't control. And that has negative consequences. And you don't have the power, at least you perceive that you don't have the power to regulate yourself. And so we see that in somebody else. And it's so easy then to look at the externals,

which is that somebody is in the back alley in the downtown east side of Vancouver shooting up with heroin or cocaine. Oh, they're different from the rest of us. No, they're not. They're only different in their expression of their addiction. And they're not. They're only different in their expression of their addiction. And they're also different in their social economic background often. And also, of course, in the degree of trauma that they experience as children. So when we talk about addiction as a brain disease, yes, there's

truth to that. But what shapes the brain is the environment. And the necessary condition for healthy brain development is non-stressed parents who can really connect with the child. So you can see in our society why so many people are affected because how many parents are non-stressed? How many parents have the kind of support that traditional societies used to provide

to the clan, the tribe, the extended family where the child is always around adults or looking after him. Not that I want to romanticize the past nor that we can go back to it, but we've lost something. And so in this society, which is so disconnected, alienated,

parents are, even if they're together and 40% of the time they're not, but even if they are, they're both having to go to work, they're both under severe strain economically very often, relationship stresses, the spiritual emptiness in people's lives. Kids are being born into situations that no longer support healthy brain development. If on top of that, they're actually abused, which is what happens to most severe addicts.

Specific abuse in the form of physical beating, sexual exploitation, abandonment, neglect, emotional torment, that plays havoc, not only with the personality development, not only does it give you a lot of pain, but later you have to just soothe somehow, but it also distorts your brain development. And then, so now you have the template for addiction. A child under severe emotional stress

has got very limited resources to deal with that. They can't fight back, they can't escape, and they can't change the situation. So now the brain kicks in with its automatic defenses. One of them is emotional shutdown. So now you no longer feel the emotion because they're too painful. But if you don't feel emotion,

life becomes very dull and boring. Might have to do drugs to feel better. Or you might tune out as a way of not experiencing the stress. So you adapt by tuning out. But if that gets programmed into your brain, later on you've got this condition called ADD. Right.

Which is characterized by extreme tuning out. Right, right, right. So what happens is that these early defenses help kids survive the immediate stress, but become sources of dysfunction later on. Right. So as a matter of fact, I mean, as you all know from recovery,

what makes the difference ultimately is not just one's own individual willpower and determination, but also others who can listen to you compassionately and validate your experience and not judge you. It's not about one's own willpower and determination. It's much more about having others who can and will listen to you compassionately

and validate your experience and not judge you, a true community of support. And that principle is completely in line with our next guest's story. We've heard many recovery accounts so far that sound very linear. They were in the throes of addiction. They hit rock bottom and they find long-term recovery shortly thereafter.

But what about the people who try recovery many times before it actually sticks? What is it about that final attempt that makes their recovery last? And what should an addict do when they recoil against the idea of a quote unquote higher power in AA? Well, this is the focus of this next clip

featuring Charlie Engel. Charlie is a husband, father, and celebrated ultra marathoner who has run across deserts, summited ice-covered volcanoes, swam with crocodiles, and even served a stint in federal prison. But at his core, he is a sober addict. After a decade-long addiction to crack cocaine and alcohol, Charlie hit bottom with a near-fatal six six day binge that ended in a hail of bullets. As Charlie got sober, he turned to running, which became his lifeline, his pastime and his salvation.

Charlie told his whole story way back in the early days of the podcast, episode 67, definitely check that one out. It's absolutely epic. And this clip is from his second appearance, episode 248. In addition to talking about why his recovery didn't stick the first time, we discuss a common question we both get regarding if we have in fact just transferred our prior addictions

onto our current running, as well as the perfect summary of what an alcoholic is at their core. For that and more, here is Charlie Engel. The reason, I know this for certain, the reason treatment didn't work for me when I went when I was 27 was, you know, a 28-day program in Pacific Grove, California, traditional, you know, you do the group counseling,

get some one-on-one, you go to AA meetings that are right there in the building and all that. It's because I was a genius, right? So, I mean, that was my view. I didn't really think I was a genius, but I was smart. And smart people don't need spirituality. That was my-

They also don't need to do the work because they can read the book or skim it and go, I got it. I got this. Absolutely. So I said, almost like training for a marathon, I said, okay, I'm gonna do this for 90 days. So I practically learned that big bug word for word.

I could, you know, I'd say the serenity prayer. I would certainly talk about a higher power, but in my head, I'm like going, yeah, whatever. That's for other people. You know, I'll do the rest of this. And I did get a lot out of, you know, doing an inventory and sharing it with somebody and talking about this. You know, I understood very quickly that doing all of that was a way of purging and therapy and it did feel good, but I wasn't about to allow some kind of higher power to, I wasn't turning shit over to that guy. You know what I mean? Because that would require you to relinquish your self-will.

Exactly. And as somebody, you know, beyond the intelligence quotient, you're also an athlete and an athlete who excels in an individual sport. And if there's something you learn through the process of developing as an athlete in an individual sport is that your performance is directly related to the amount of work and focus and dedication that you and you alone decide to put into it. And what comes out of that is this idea

that self-will will avail you everything, right? In the context of running or any other number of sports. So to then say, well, you got to let go of that. Like, not only does that create something to disagree with, it doesn't even compute. Like, what do you mean? Right? Like the idea of surrendering that, I don't even understand what that entails. No, so 90 days into treatment, I mean, it's 28-day treatment, and then I stayed sober for 60 more days where I was going to meetings and I was active. And man, I was waiting for that 90-day tip because that was like a graduation diploma for me in my mind. And I knew that. I wasn't telling anybody else that. But if I could just get to 90 days, then things would be fine from that point forward.

And so I stopped going to meetings. I certainly didn't have a sponsor to talk to. And I did manage to stay sober another 90 days. But what I didn't get at that point was that there's only about, what? There's only like 1% of the time for a recovering addict that is actually dangerous. And the other 99% of the time is when we're supposed to be building up our power and our guards to be prepared for that 1%. That one moment when a drink appears or a drug appears or a feeling, heaven forbid, appears, an emotion that we're not prepared for that in the past, we could take care of that emotion in a second with a drug or a beer or whatever.

And so I didn't understand that all of this time was like training for a race. You're training 99% of the time and the race is only 1%. That race is that one moment where suddenly you're like, what's the big deal? I have a beer. You got this thing in the back of your head, this voice going, hey, you deserve this. You don't just need a beer, you deserve it, damn it. Look how hard you worked. So it was around nine months, right? Yeah.

Yeah, so at nine months, you take your diploma, you graduate from sobriety and celebrate this great achievement by going out on a bender. Absolutely. Right? And so when people come to me and they're like, I don't, you know, like I'm not an alcoholic. I'm not sure I really understand, you know,

what that means or what that is. Like, what is an alcoholic? What is an addict? And I just, I always say, imagine a person who works extremely hard to repair their life. They stay sober for an entire year. They put everything into it.

They make it their number one priority. And then when they get that one year chip, they celebrate it by getting drunk and they think that's a good idea. Yeah. That is the essence of what it means to be an alcoholic. The insanity of that tweak, that mental tweak, that mental, whatever it is, disrepair that would lead you to believe that that's a perfectly good idea. Well, and here's the thing, the discipline that it took to go that year and to know, and probably in the back of your head that on your, you know, I mean, that year didn't just appear and then you decide to get drunk. Like that thought of drinking started way before.

Right. And so how much discipline does it take to actually keep yourself in that space once you already know this is going to happen? I mean, so the power of an alcoholic or an addict is so strong. And if that could only be used, if our power can be used for good, then a lot can be accomplished. And that is why though, I think, you know, you and I and a lot of other people that you talk to and that are listening out there right now, they do understand that, man, this addictive power is what makes them good at stuff. And if they can just figure out

how to apply it to their life. Right. But then when you do that, they accuse you of just being addictive in that other discipline, which brings us up. And we talked about this last time, but I think it bears repeating, or maybe your definition or perception of that has evolved.

No. Yeah, when people say, well, you're still, you're just a crazy alcoholic. You just channeled all that into your running and you have this unhealthy relationship with it. And it couldn't be, it literally couldn't be farther from the truth because everything about my addict and my addictive behavior when

I was drinking and doing drugs was about hiding every bit of who I was. I mean, first of all, I didn't really know who I was, but heaven forbid that starts to surface, I would drink it or drug it down back into the pit where it came from. So all I wanted to do was destroy and hide every bit of my personality. Running, on the other hand, does the exact opposite. I really do feel like I become the true essence of who I am and who I'm meant to be in the course of a run. And that doesn't mean it's all light and sunshine. Sometimes that means I'm a dick. Sometimes that means I'm whatever. But it's an emotion that I actually get to have.

So maybe my view has evolved. I think this is different than what I said, but it's more expansive. So maybe my view has evolved. I think this is different than what I said, but it's more expansive. I now understand that it's not a requirement just because I'm sober that life is going to be good or that I have to be nice all the time or that I'm not going to be hungry or cranky or snap at my wife on something when I absolutely shouldn't. The difference is now I get to apologize. I get to admit my wrong or even potentially stick by my rightness,

but without that alcoholic's conviction of based in fear that everything I do has to be justified in some way. And running has taught me that I... And it doesn't have to be running. It can be biking. I mean, if I couldn't run again tomorrow, I'd find another outlet for this. And I don't do it addictively. I do it instinctively. I don't run every day. I like to exercise every day because it makes me feel good. Why the hell wouldn't I want to do that? Running saved my life, but then it actually gave me a life. You need community.

It's absolutely essential. And as we come to the end of this deep dive, that sentiment is what I wanna leave you with. Sometimes that support is just in knowing that others are there for you, that others care. And sometimes what can work best in sobriety is in taking those friends along with you, in your head, on your shoulder, and in your ear.

Our next guest is Mishka Shubali. Mishka is a dear friend and has been on the podcast many times. He's a writer, he's a musician, who pens true stories about drink, drugs, disasters, desire, deception, and their aftermath. He is also the author of, I swear I'll make it up to you, which is a brutally honest booze-fueled, opiated account

of addiction, abandonment, artistic frustration, faith, guilt, sobriety, running, resentment, music, and ultimately salvation. But in this final clip, Mishka discusses how to handle cravings when they appear, what to do if you can't fully separate yourself from a triggering environment. In Mishka's case, he's still playing shows in bars.

And we end the clip with Mishka sharing about the power of community and specifically how our friendship helps to keep him sober. I'm honored to have this man in my life and I'm excited to share his perspective with you today. Here is Mishka Shubali. This is kind of an endemic thing with alcoholics. Like even people who have been sober for a long time,

suddenly they have an urge and they feel bad about themselves. Like, I can't believe that I have that urge or that compulsion. Like, haven't I moved past this? But you have to remember that if you're an alcoholic, like you're a true real alcoholic, that is your default state of mind and your condition.

So you should just understand that that goes with the territory and it's a little kind of like red flag, like, oh, maybe I need to take a little contrary action to get back on track. But of course you're gonna feel that way from time to time. Yeah. You know, the miracle is that you don't act on that.

It's like, you're gonna have those emotions. You're gonna feel that way periodically. It's what you do in response to that that dictates life outcomes. And the miracle is that you're not drinking every day. You forget that, right? That's your default state. And you've put together eight years without doing that. So you have a craving from time to time. Congratulations, you're an alcoholic. You shouldn't be ashamed of that. It's just a little nudge to say, hey, maybe I should take a look at whatever is going on with me physically and emotionally that led to that craving so I can, you know, maybe shift my behavior

or my environment a little bit to nip that in the bud so that doesn't come up next time. It gets even more interesting. On this last tour in England, um, I was, uh, I was traveling with this band bird cloud who are, uh, alcohol aficionados. They, they appreciate the sauce and, uh, and, and they're brilliant musicians and brilliant writers. And it was, you know, it was a privilege to tour with them. And also day after day, I was like, uh, and then, uh, you know, towards the end of the tour, we were in London and I had sort of like, you know, after you're on the road for a

while, you get used to setting things up a certain way. I put my capo here. I put my slide here. I put my, you know, my thing, water or seltzer here. And, uh, and then I got up, um, on stage and great night, like sold out room in, you know, and to be in a foreign country and have people singing your songs back to you. I mean, that, that's like such a fucking great feeling. That's the thing. Yeah. And I went up and I like did my first song, reached down, grabbed my drink, took a swig of it and it was pure vodka. And like.

It's not the first time this has happened to you. No. You wrote about that other time. And that was a mixed vodka drink. This was straight vodka, which got me. And I was like, did somebody do this to me on purpose? But I felt it in my mouth and I spit it out back into the glass. And I did the rest of the set totally cotton mouth, like not drinking anything.

And that's weird to have something like that happen in the public eye and then you have to go through the rest of the show. And the whole time I was thinking like, well, I already got a little bit, why not just, you know? Right, you also have that millisecond thing where it's in your mouth and it's almost like,

what is your knee jerk unconscious reaction? Like swallow or spit? Like it can go, that can go either way. Yeah, yeah. unconscious reaction, like swallow or spit. Like it can go, that can go either way. Yeah. Yeah. And, um, and so the whole, and every alcoholic justification was going through my head of like, oh, I already got a drop down my throat. It's already like, you know, it's already tainted or whatever. And, but I never did. I, I didn't take a drink. I, you know, as soon as I got off stage, I pounded a couple of bottles of water and that made me realize that the cravings that I've had,

where I like really want to drink, that's not what's going on. I really don't want to drink because I had, I had everything teed up for the perfect excuse where I had accidentally taken a drink and then it would have been so easy. Oh, I'm on tour, like in a foreign country. I've ever, And then it would have been so easy. Oh, I'm on tour, like in a foreign country. I had every excuse lined up to justify a good relapse. And I didn't do it. And I realized it's because I really don't want to drink. And when I get those cravings about, I really want to drink, I really, you know, it's that I miss being young.

I miss being 22. I'm having a hard time dealing with aging. Being like a 40 year old man. It's fucking, it's really bumming me out. It's a romantic, it's a romantic attachment or relationship with a bygone era in which you were carousing around Brooklyn and New York, like doing whatever. Yeah. Yeah. It's, it's, it feels like a time machine in a bottle where I can just have a drink and go back there to being a kid, to hanging out with my friends, to falling down in the river,

whatever bullshit we used to do. There's an adage in sobriety that, if you're truly sober, you can go anywhere. Like you shouldn't have to avoid this place or that place because it might trigger you in a certain way. But that there has to be kind of a purpose for wandering into a location that might imperil the solidity of your sober program.

And what always mystifies me is that you do this alone. Like I can't do it alone. I need other people. I need the secret society and everything that comes with that to stay sober. And I know what it's like to step outside that. And I've done so at my peril and it hasn't worked out. So I stay close, but like you still are holding

onto this sort of self-will, run, self-styled approach to sobriety. And I have no judgment on that. It's you're eight years sober, man. Like that's amazing. But it's curious to me how you're able to do that, especially when your lifestyle, you know, finds you in all kinds of locations

that aren't conducive to the highest vibration. Rich, know that you're with me everywhere I go. If you're not there, you're still there. You and a couple other friends are like definitely people who I carry on my shoulder, in my head, with me wherever I go, so that, cause I have moments of weakness and I have moments, I definitely have moments of, uh, nihilism, you know, where it's like my nihilism is in, uh, it's in regression, but it can easily come back,

you know? And, um, I just think that, um, you know, that's not the life that you would want for me. You would be worried. You would be concerned, um, that, you know, I mean, there's a lot of things that it would, you know, I mean, listen, I know at this point that I can't, I couldn't alienate you as a friend if I tried, but I know too, that if I started drinking, that it would be really hard for us to be friends, you know? And, um, so I, you know, and I friends. And I have other friends like that. So I don't go into these places alone. I bring you and a couple other people with me. All right, we did it.

This concludes today's deep dive into addiction and recovery. I hope you not only enjoyed it, but more importantly, found it helpful. And once again, if you or someone you care for is currently struggling, please don't wait. Please, I urge you to reach out for help. Towards this end, we have compiled a series of resources, which you can find in the show notes

on the episode page at richroll.com. And if you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify and on YouTube, and to leave a review or comments. Sharing the show or your favorite episode with friends or on social media is of course awesome

and always appreciated. And finally, for podcast updates, special offers on books, the meal planner, and other subjects, subscribe to our newsletter, which you can find on the footer of any page on richroll.com. Today's show was produced and engineered by Jason Camiolo. The video edition of the podcast was created

by Dan Drake and Blake Curtis. Graphic elements, courtesy of Daniel Solis. Copywriting, again, by Dan Drake, as well as Georgia Whaley. And of course, our theme music was created by Tyler Pyatt, Trapper Pyatt, and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace. Plants.

Namaste. Thank you.