The Disease of Choice

Sep 20

Photo by J.L. Jenkins

Hank Holmes, an experiential counselor at the Oxford Treatment Center in Etta, Mississippi, joined co-hosts Meagen Rosenthal, Ph.D, and Alexis Lee for The Mayo Lab’s fifth episode of Season 2. Holmes shares his insights and experiences on the topic of recovery, informed by his years in the field.

In their conversation, Holmes emphasizes that recovery is an ongoing and active process, likening it to a surgical procedure. “It should be uncomfortable here. You are metaphorically doing surgery to fix your emotions, your mental state, to learn a different way of living,” he said.

Holmes shares what treatment is like for an addict, from the detoxification process to the life skills people are equipped with. The psychoeducation and experiential therapy their center provides is particularly valuable.

“We utilize experiential therapy in hopes of giving people ideas for things that they can use for coping skills,” he said. “It’s the reason that we have mediation, mindfulness; it’s the reason that we do music therapy; it’s the reason that we do yoga; it’s the reason we do art, to start getting people thinking about things that they can use as coping skills.”

“I ask the question, ‘Would anybody in this room choose to be an addict?’ And I can tell you that 0.0 times has anybody said that they would choose to be an addict. Nobody chooses to be an addict. It definitely starts with a choice. But that’s not where the disease comes in. The disease comes in on the back end … once you made that choice to pick up, you now no longer have that choice to put down.”

— Hank Holmes

They address the stigma surrounding addiction and its impact on individuals seeking recovery. “This is a disease. We have the science to back it up,” Holmes said. He later added, “It’s stigmatizing to the patients whenever their families tell them something to the effect of, ‘If you had more willpower, you could stop.’” Understanding that addiction is a complex medical condition is crucial.

Individuals in early recovery often feel as though they carry a “scarlet letter” of addiction, fearing that everyone can see and judge their past. Holmes underscored that this stigma is rooted in guilt and shame, and ultimately, it can deter people from becoming involved in the recovery community.

Dr. Rosenthal noted how many positive qualities and abilities individuals dealing with addiction possess, adding that “when we stigmatize the people who are in substance use active addiction, whatever the case may be, we're missing out on them as human beings…They are some of the kindest, most generous people I've ever met in the face of the planet.” Viewing them as unique people, each with their own potential and inherent resilience, is crucial in the journey towards promoting healing, recovery and a sense of belonging for those affected with this disease.

To hear more from Episode 5 of Season 2, scroll down to listen to the episode or read the transcript.

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Meagen Rosenthal:
I'm Meagen Rosenthal.
Alexis Lee:
And I'm Alexis Lee. And this is the Mayo Lab Podcast.
Hello, everyone, and welcome back to the Mayo Lab Podcast. My name is Alexis Lee and always joined by Meagen Rosenthal. We have a very special guest, a very special topic for you all today: recovery, being in recovery, what that is, what that looks like. It touches, I think, a lot of our listeners. It touches myself; it touches my family, and it touches a lot of people that are in this work with us. And so we're very excited. We would like to welcome Henry or Hank, we will call him Holmes, to the podcast. Welcome.
Holmes:
Thank you for having me.
Alexis Lee:
Will you tell us a little bit about yourself, your background, kind of how you've got into this work and your story a little bit, as much or little as you'd like. I know it's a loaded question.
Holmes:
All right. I'm originally from Amory, Mississippi. I graduated from Ole Miss in, I don't remember when, 2003 with a bachelor's in criminal justice and in psychology. At that point in time, I was planning on going into the FBI, but I was one of those people who were in school for criminal justice when 9/11 happened and it switched up the ballgame for everybody. I was told that I needed to go to law school if I ever planned on getting in the FBI.
Went to law school, hated it. Went one year and absolutely hated it. So I started looking for a job and saw a classified ad that said "role models wanted," and I thought that that sounded interesting. So I ended up spending the next eight years of my life working at a long-term outdoor residential treatment facility for troubled teens in Paint Rock, Alabama. Then that whole industry kind of went belly-up about 2008, 2009 when the housing market crashed. So I went and worked at an all-adolescent female lockdown facility for a couple of years.
Then I got word that the Oxford Treatment Center was looking for someone to build it and construct a ropes course to do experiential therapy. I have a background in that. So I told them, sure; I was interested in coming and building a ropes course. So for the past 10 plus years, I've been out at the Oxford Treatment Center in Etta as an experiential counselor. Built a ropes course, run the ropes course out there. I also do some lectures out there. We have a facility garden. I will admit that this past summer it's not done what... It didn't get as much attention as it needed to get. But we also used to do camping, kayaking, paddle-boarding. So for the past 10 plus years, that's where I've been working in this field.
I'm currently in school, master's program for clinical mental health counseling in pursuit of getting an LPC so that I can eventually make the transition from being outdoors to being indoors. After working at Paint Rock Valley with those adolescents, I loved it and I came to realize that the reason that I loved it so much was I was a troubled teen and probably needed to have been at someplace like Paint Rock Valley, but resources, funding and my parents didn't know about it, so I didn't go to that type of place. But I really enjoyed helping those kids there. Then being in addiction is something that I totally grasp. I totally get it, and so I enjoy helping people that are struggling with substance use disorder.
Alexis Lee:
I love that. We're going to get into the experiential therapy because I love talking about that. But before we dig in and really get into it, can you talk about what being in recovery means? I know I'm in recovery and I know I get a questions, a lot of people, what does it mean to be sober versus in recovery, also, which I'm sure you get?
Holmes:
All right. There's, not a short answer to this.
Alexis Lee:
There's not. That's why we're here.
Meagen Rosenthal:
That's okay.
Holmes:
There's not a short answer to this. I find it easier to look at it from medical terminology. Like, if you were to go have surgery, you go have outpatient surgery, inpatient surgery, whenever you wake up from surgery, you're in a room that is called "the recovery room," and that's the immediate type of recovery, like you're waking up from surgery; they're making sure that nothing's going wrong, that everything's okay. But the actual recovery or the actual healing process actually happens once you leave the hospital, those days, those weeks after you actually leave the hospital.
I think about it in that perspective, and I look at going into treatment as being like outpatient surgery or being like some shape, form, or fashion of surgery. I've actually said this to patients before, that it should be uncomfortable here. You are metaphorically doing surgery to fix your emotions, your mental state, to learn a different way of living. And that should be as uncomfortable as, like I said, having outpatient surgery.
I think that since we are a licensed healthcare facility, I think that the initial recovery begins to happen in the treatment facility, but that actual recovery takes place outside of the treatment facility. I look at recovery as being an active process, like what you just alluded to, what's the difference in being in recovery and being sober. Well, to me, sobriety is part of the recovery process, but it's not the only part of the recovery process. I think of recovery as being an active process, which means getting involved with some shape, form, or fashion of a program. Obviously, people know about AA and NA, but those are not the only recovery programs. If AA and NA is not your jam, there's all sorts of other recovery programs, whether it be Celebrate Recovery, Refuge Recovery, Dharma Recovery, SMART Recovery. I think that you have to work some shape, form or fashion of a program to actually be in recovery.
But then it's also more than just that, the program. A lot of times people get this confused. The program is not the meetings. The meetings are the meetings. The program is actually working the steps, getting a sponsor. I think that all of that is needed for recovery as well, but then it goes deeper than that. That's where I think that advocacy comes into play, getting involved, networking socially, service work, altruism comes into play with recovery. As far as your question about the difference in just recovery and just being sober, that's what old timers would refer to as being a dry drunk or a dry addict, that if the only thing that made this person happy was the substance, they remove the substance, and so now what have they got? If they're miserable using and they're miserable because they use and you just remove the substance, well, they're still miserable.
That's where it comes in of having to change attitudes, having to change behaviors, having to change thoughts. If none of that stuff changes and all that you've really done is remove the substance, then what have you actually done? It's an actual active process, in my opinion. Recovery is an actual active process. Yeah.
Alexis Lee:
Yeah, I love that. And I think, too, there's this misconception of you have to go to treatment, too, to be in recovery. I know I never went to treatment, but I do work the program and I do do the things. So if that's not accessible to you, there's all these, well, what you're talking about: the resources, money, finance and stuff. So there is this way to do it, but there are people. It is the program; it is the community to actively do it.
Holmes:
I think that going to treatment makes it easier, would for sure make it a whole lot easier. But like you said, there are people who don't have to go to treatment. I just think that anybody who has the ability to go to treatment, if nothing else, if we're just going to spend this 30-day process of drying out and you have the resources and have the ability to go to treatment, then for sure you should go to treatment. But again, people have been doing this for years without having to go to treatment. But I just look at it as if you do have the ability to soften that blow, especially if we're talking about the whole detoxification process, that's going to be a whole lot easier if you're in a licensed medical facility.
Alexis Lee:
Can you talk about that process a little bit for those that don't know?
Holmes:
The detoxification process, depending upon what you're coming off of, it can be extremely difficult. The only two chemicals that you're going to detoxify from that you run the risk of dying off of is people that are coming off of benzos or people that are coming off of alcohol. A lot of times, people are shocked by that one. But it is. You go into what's called delirium tremens, which I've never experienced personally, but I have witnessed it, to where you're hallucinating, the shakes, blood pressure all over the place, heart rate all over the place and it's scary. What I've seen, in my experience what works, is we use an Ativan taper to slowly step this person down, but to where they are being medically monitored, to where they're not just at home, again, white-knuckling it, trying to get through all of that. The detoxification process can last anywhere from five to seven days.
Now, as I said, the only two things that you're going to literally die coming off of is alcohol and benzos. But probably from what I've witnessed, in my experience, the hardest thing to come off of is probably the opiates just because there is what's known as post-acute withdrawals. What that is that once you've gone through that initial detox period of 5, 7, 10 days, that all of a sudden you start to feel better. What I've witnessed is that somewhere, I just always say somewhere between day 16 and day 23, you're going to go into post-acute withdrawals and then you're going to feel worse than you ever felt when you were initially coming off of the opiates. During that post-acute withdrawal that day 16 to 23, it best resembles a really bad flu, where nose is running, where they've got fever, where heart rate's all over the place. But coming off of that, if you can make it through that day 16 through 23, you're in the clear.
But again, that's just coming off of basic opiates, where coming off of something like methadone is going to be a lot longer of a process just because it stores differently than where the rest of the opiates store. So that post-acute withdrawal for somebody coming off methadone may not happen until month six or nine.
Meagen Rosenthal:
Fascinating. I love the analogy that you made between recovery being kind of like getting surgery and that it's meant to be uncomfortable. You've talked a little bit now about what the detoxification process looks like and you've mentioned also that recovery is an active process. So in recovery, in treatment, if you're there, you're getting detoxified, you are working through that process, but what other skills are folks leaving with? Because it's not just about getting the stuff out of you. It's also about what are the things you're going to do to fill in, like you said, the stuff that was missing that made you want to use the substances to begin with.
Holmes:
Right. We provide psychoeducation, learning about addiction, learning about the disease of addiction. But then there's also, and this is kind of where the experiential aspect of it comes into play, and in my opinion, what sets the Oxford Treatment Center apart is that we do utilize so much experiential therapy in hopes of giving people ideas for things that they can use for coping skills. If nothing else, use them for coping skills. It's the reason that we have meditation, mindfulness; it's the reason that we do music therapy; it's the reason that we do yoga; it's the reason that we do art is to start getting people thinking about things that they can use as coping skills.
As far as other skills learned or they go over, we have a group that's literally called Life Skills. I'm not sure what they do in there on a week-to-week basis, but I know that some of the stuff that's been discussed before is things that we kind of take for granted, like making a budget, learning how to cook, being able to manage your money, being able to manage your time. Then we also have case management for people who need to find a job. I think that in some of those life skills groups and maybe they talk about resume-building, maybe they talk about being able to write a resume, what it looks like to dress the part for job interviews. So I think that all of that gets discussed.
What's interesting to me about, and where my mind initially went whenever you asked that question, is drug rehab. Rehab means rehabilitation. What we found or what I've witnessed is that a lot of times, they need to be habilitated because in order to rehabilitate, it's first saying that you've been habilitated. But a lot of times what you find is that people have grown up in this culture, the drug culture, families, generational; it's been passed down and passed down. So they've never been habilitated. So then how do you go about trying to habilitate somebody and monitor their detoxification and making sure that they're... I mean, it's an ongoing, it's a big process with a lot of different moving parts.
But I think that at the baseline level, what we try to do is provide them with that psychoeducation, give them support, let them know that this is possible. This is not going to be something that you can't do. Addicts are some of the most strong-willed people on the face of this earth. Being able to wake up every morning without two pennies to rubbed together and manage to get high all day long, that requires willpower. So I think that a lot of it is that they just need to believe that it is possible to live a life in recovery and hopefully we provide them, hopefully they pick up some necessary tools while they are there.
Meagen Rosenthal:
I think that's a brilliant observation about how complicated the recovery process is for a lot of folks. Your idea that they need to be habilitated first implies and points out that these folks were struggling well before they ended up at your doorstep, right?
Holmes:
Right.
Meagen Rosenthal:
They were in a position and they had, for whatever reason, lack the skills, lack the support, lack the experience, lack the opportunity to do some of the things that maybe other folks in other circumstances take for granted: having a family where mom or dad or some combination thereof are at home; you get meals every night; you don't get exposed to the drug culture; you don't get exposed to all of those different things as a young person. I think it's really a great observation to point out that this is not what everyone's life is.
Holmes:
Right. The use and abuse of substances is just a sign and a symptom of a larger problem, whatever that larger problem is, whether that be anxiety, depression, OCD, post-traumatic stress, trauma. That has to be addressed, in my opinion, almost... We cannot do it justice trying to address it in a 30-day residential treatment, and we can start to open up that stuff, but it's not going to get delved into. I think that that goes along with part of the recovery process is finding a counselor, finding somebody that you can open up to talk about the stressors, just talk about the trauma, to talk about whatever it is that has kept you going back to the substance time and time again because there's a much larger issue at play in that all that you've been doing...
The way that I've heard it explained best, is that you've got this infection that's been growing inside of you and it has progressively continued to get worse despite you thinking that it's getting better. It is progressively getting worse in that all that you've really been doing about this infection is putting a little triple antibiotic ointment on it, covering up with a bandaid, hoping, wishing, and praying that it'll get better despite the evidence that it's getting worse. But to truly get rid of this infection, you have to metaphorically do some surgery on yourself, cut yourself open, stick your hands inside the wound, grab hold of the infection, get rid of it, and then sew yourself back up so that you can heal. But until you do that, you are going to stay stuck in that insanity of doing the same thing over and over and over again, hoping and wishing and praying that the results will be different.
Meagen Rosenthal:
Right. Well, I think that leads so nicely into what the theme for this season has been, is this idea of stigma related to substance use and a lot of other topics. So I'd be curious to know what your observation is around the impact of stigmatization for folks who are using substances who end up in your treatment facility and in any of the other work that you've been involved in.
Holmes:
I wish I had some mind-blowing great answer, but I've got the same answer that most people are going to tell you, is that it's 2023 and we still don't view this as, or there's a large part of society that does not view this as a disease. This is a disease. We have the science to back it up. They knew this back in the '30s when they wrote the Big Book. They didn't have all the science back then, but bow we know the science, that this is a treatable chronic medical disease that involves complex interactions amongst brain circuits, genetics, the environment and individual's life experiences. I think for us to not look at this...
For people to think that this is a choice is absolutely mind-boggling to me. This is not a choice. I have asked over the course of time, one of my lectures that I do on the hijacked brain, I ask the question, "Would anybody in this room choose to be an addict?" And I can tell you that 0.0 times has anybody said that they would choose to be an addict. Nobody chooses to be an addict. It definitely starts with a choice. But that's not where the disease comes in. The disease comes in on the back-end of once you made that choice to pick up, you now no longer have that choice to put down. That's the one is too many, a thousand's never enough thing, is that once a person makes the decision to start using, they're going to keep using until one of a couple of things happens: until they run out, they pass out, or they die from it. They just can't pick up and put down at will.
So I think one of the biggest stigmas is that, "Oh, they're choosing to be this way." And it's like no. Nobody chooses to run their life into the ground, obliterating themselves and all the people that are closest to them, the people that love and care about them the most, nobody chooses to do that. "Let me just see how bad I can mess my life up." It's not.
I think that that stigma of we're in 2023 and we've still got people who still are walking around in denial that this is a disease is really stigmatizing. It's really stigmatizing to the patients whenever their families tell them something to the effect of, "If you had more willpower, you could stop. If you wanted to, you could just stop." The moral failings. If you just had better morals, that you would be able to stop." No. It's much more. It's so much deeper than that. It's interesting to me that we stigmatize this disease, but why do we view it any differently than we would diabetes or heart disease or celiac disease? I guess because we think that it starts with that choice, and so they're choosing to be this way.
Voiceover:
You are listening to the Mayo Lab Podcast. For more information and resources, visit themayolab.com. Now back to the episode.
Meagen Rosenthal:
Because I think you bring up something really important because you made the distinction between at first it is a choice to pick that thing up to begin with, but then there's something that goes on in their brain to make that no longer a choice. But I think it's the words there that folks get hung up on. So it is a choice, right? But it's-
Holmes:
It definitely starts with a choice.
Meagen Rosenthal:
But it's not a choice, maybe, not a choice in the way that we think about it. Like, "I choose to pick up the cupcake. I choose to do whatever." Can you talk to us a little bit about that choice in relation to, as you've already covered, the fact that for many of these people, this is a choice to treat something else that's going on, not a choice to simply get high.
Holmes:
Right. Right. I think that it could be argued that it is a disease of choice and that it takes your ability to choose away because the use and abuse of substances raises the dopamine levels so high that they choose to ignore the consequences that are blatantly staring them in their face. Despite the fact that all these consequences are there, they continue to go back to that. I know that in the spring, y'all are getting into the whole brain aspect of it. There's so much at play that's going on. But it's not just the brain, it's that whole what you're talking about, the whole environment, life experiences, all of that stuff comes into play.
Whenever someone is needing to cope, one of the easiest coping skills is, "Hey, let's go get high. Because if I go get high, if I go get drunk, then I don't have to think about all that other bullshit, all the stuff that's making me feel so bad whenever I'm high. And today, it worked that I went down this path; I got high. So I didn't think about all that. So the next time that this comes up, the next time these feelings come up, the next time these memories come up, the next time this loneliness comes up, in order to avoid that, I'm going to go walk down this path again and again and again." And what you do over time is that you reinforce that path to be there.
If you were to be at an open field first thing in the morning when it's covered in dew or covered in frost and you're on this side of the field and you're feeling bad, but you know that if you go use and you walk this path through the field, you get to this other side and you feel better, and when you turn back around, what do you see? You see your footprints. And so tomorrow, the next day, you're on this side of the field feeling bad, but you can see your footprints that felt good. "Now, I do have to go use to walk down that path," but you keep walking down that path and keep walking down that path. Over the course of 5 to 7 days, that grass starts getting folded over; somewhere around 7 to 10 days that grass starts dying out; somewhere around 14, 17 days, there's not even grass there anymore. There's just a dirt path.
I know that this dirt path is going to work every single time to help me go from feeling bad to feeling good. I'm not going to try something new. I'm not going to walk a different path because there may be snakes over there' there may be bugs over there. Will go real Mississippi,. There may be stickers over there. But I know that this path works and it helps me to avoid whatever I'm trying to avoid, whatever negative feelings, whatever negative emotions, whatever it is that I'm trying to not think about, stress, trauma, whatever that is. It just kind of puts it at bay.
So what you've done over time is that you've just reinforced it to where now you cross such a threshold, you cross such a barrier, then now I'm not even having to think about it. It becomes instinctual. My natural reaction, it becomes part of my survival mechanism is that anytime that I'm feeling anything that I don't want to feel, don't want to think, all I need to do is go get high and that's going to take it away. It's a temporary solution. But it solves the problem there in the moment to where then, like I said, it just becomes instinctual, to where this is what I do, this is what I do.
Damn the consequences. Damn everything else that's going on that's being wrecked by this because the fact of the matter is the more the consequences stack up, the more I want to go get high to avoid thinking about all those consequences, to avoid the fact that I am hurting my family, my grandmother's crying. To avoid all of that stuff, I just keep going and getting high. The consequences keep piling up. And then eventually, hopefully, you get to a point to where you are able to recognize, "Hey, these consequences? These are now outweighing the benefits and so I need to do something about this."
Alexis Lee:
Right. Right. I think you've talked great about all of this and the stigma that people take in with them to treatment and to rehab, that direct correlation. They do this work. It's great. They're not leaving the center to start their recovery on this bed of flowers, sunshine. Maybe they are. But the stigma follows them. It's like they think... Not that they think. I can't personally speak to it. But they don't leave and it's like no one's ever going to judge them again. It's a different stigma, but it covers. an you continue?
Holmes:
That is definitely one of the biggest stigmas that people in early recovery have, is that I've been branded with a scarlet letter. I've got this big A that stands for addiction and now everybody can tell, everybody can see that I'm in recovery, that I used to use whatever, so that now everybody can see this. I think that a lot of times that it keeps people at bay from going out and trying to get involved in the community. If they do go get involved with anything, maybe hopefully they go get involved with AA or NA. But we think that literally everybody can tell, that it's written on our forehead, "Hey, addict! Two weeks ago he was banging heroin or doing whatever."
It's rooted in guilt; it's rooted in shame, and it's one of those that it comes with experience of recognizing that, hey, these people don't know that. They don't know this about me, that life can go on and that this is not following, that I literally don't have a scarlet letter printed on me. They're like, I can go meet people and I don't have to first identify by what my DOC, what my drug of choice is. Because I think that for so long, all of our acquaintances when we're in active addiction is, "Hey, man, you got this? Hey, man, you got that?" And so we start to associate with people that are on that same pathway. Those are the only people that we know, and so we think that that's what everything revolves around.
Whenever so much guilt and shame comes into play, one of the big things that I see people in early recovery do is that they just think that they need to sit at home and sit on their hands and say, "If I'm going to leave the house, I'm only going to a meeting." And that's not changing anything. That's not changing anything. That's where getting involved, finding something that you like to do, some outlet. If 16 hours of your day used to be spent nodding out on heroin, you got to find something else to occupy those other 16 hours because the mental obsession is going to eventually lead you back to using. Addiction is definitely a form of OCD, the obsession and then the compulsion that follows it. So it's about being able to venture out. But yeah, addicts carry around a huge stigma of shame and guilt and thinking that everybody can see that they're in recovery.
Alexis Lee:
Yeah. I know my first year I didn't talk about I. I didn't tell people. I wasn't out there. And now that I have, so many more people than you realize, and I've met some of the best friends in those rooms, they don't tell your secrets; they're not going to share your stuff. They are going to be there for you when you call at any time of the day. That community, it almost has empowered me more in all my other relationships and my job and just life, my family, to be able to be like, "Hey, no, I have these skills," like you said, determined and all these other things that maybe came with my addiction, but it makes me a heck of a good friend and a good worker.
Holmes:
Yeah. It's liberating to get that out there. The oldest sayings in AA is your secrets keep you sick. But it's also one of those things that when everything's out there, then nobody can use anything against you because I've put it all out there; it's all out there. What are you going to use against me when all my secrets have come to light? Naming the monster steals some of its power. Exposing everything to light, the light actually takes some of that away. So it is. It's liberating. I like the fact that you brought in that maybe there was a bunch of negative stuff that occurred that came from my drug use, but hey, there's a lot of good things that I learned from being there as well: determination, willpower, being able to persevere, determination. There's a lot of good things that do come from it.
Alexis Lee:
Mm-hmm. I want to dig in a little bit and switch from the individual to the families. When you are working with patients, what is the biggest thing you see either from them or from their family members as far as stigma goes?
Holmes:
There's a couple. Obviously, the family feels a great amount of guilt and shame a lot of the times. A lot of times, the families feel like maybe they're the cause and maybe something that they did caused this addiction. One of the things that gets said in Al-Anon and Nar-Anon is you didn't cause the addiction and you can't cure the addiction. But I think that a lot of times that the families do want to blame themselves and play that game of what did I do wrong? Did I not show them enough love? Did I not go throw the ball with them? Did I not give them attention? And to just understand that you weren't the cause of that. You just weren't. This was a train that was derailed. It was a runaway train going down the tracks and you're not what caused it to become runaway.
I think that the other thing that happens with families is that they do want to keep it a secret and that they do want to keep it in in that "hey, we're not going to go seek help." Make no mistake, addiction is a family disease. It doesn't just affect the substance user. It affects everybody that is in their family and everybody that's around them. So that's where the families need to vent, need to get it out, need to talk about how difficult it's been to live with somebody who has been in substance use, and that's where resources such as Al-Anon and Nar-Anon come into play or finding some shape, form, or fashion of a support group for the family.
The other thing that is the opposite of that as far as families wanting to keep its secrets is what I was saying earlier, is that a lot of times this addiction gets passed down from generation to generation and this is what we do. I mean, it's Tuesday. Let's go get high. And that's what has become normal for that family. So that secret's got to get exposed as well. In the case of the individual needing to get away from the family, maybe in that instance, they do. But I think that a lot of times with the families, they're feeling so much guilt; they're feeling so much shame; they're thinking that they are the ones that have failed, and they just need to recognize, like I said, they didn't cause it and they can't cure it.
Alexis Lee:
Mm-hmm. I love Zac Clark, when we had season one, talked about when the patient goes into treatment, so should the family.
Holmes:
Family. So should the family
Alexis Lee:
It's so true because it's like that web effect of one person takes down a family, the family takes down their people around them and it can spread like wildfire.
Holmes:
One of the coolest things that I've seen is whenever I did work with troubled teens is those kids were there for an undetermined amount of time. We said that in general the program was 12 to 18 months, but the longest I ever saw a kid there was like 26 months. There, they had a family program that went right along with, and the family had a stage system that they were trying to work just like the kid had a stage system that they were trying to work. That's one of the most creative tools that I've seen.
Here, 30 days of treatment. We have a family program that's one weekend a month, come get a little bit of addiction psychoeducation. But I think that the family should definitely be, if nothing else, should be in family counseling to talk about this. But for sure, you just remove the addict from the family unit and the family unit doesn't do anything to heal and then you introduce it right back, that's again insanity. You know what's going to eventually transpire.
Alexis Lee:
Mm-hmm. So the web. You have the families that can probably pull down their people and the community at large. What's some of the stigma we see and they experience around that?
Holmes:
This gets right back into the whole not looking at it from the disease standpoint, is that as society at large does not... I mean, yes, it's 2023. Yes, stuff has been out. But I think that at large, people still view this as being a choice. The other society community aspect of it that comes into play is the simple fact that there aren't resources available to send people to treatment. Yes, you have to have some shape, form, or fashion of insurance to go to a private facility and that's just... We're doing an injustice there.
I'm not going to go off on a rant about insurance. But if somebody had cancer, is the insurance company going to deny them days for cancer treatment? No. If they have diabetes, is the insurance going to pay for them to have their insulin, pay for them to have their needles, or pay for them to have the things that... Yes. Somebody with celiac, are they going to pay for that? Yes, they are. We have to fight the insurance companies to keep people in treatment for 30 days. Again, I think that that all goes right back to the fact that wink, wink, nod, nod. Yeah, it's a disease. If you really thought that it was a disease, then we wouldn't be having a fight to get people 30 days of treatment. I just think that it goes back to that whole stigma of that this is a choice, that they are choosing to be this way.
This also gets into, I don't know, one of the greatest failings that I've seen in my lifetime was the 1980s, "Just say no." All right? "Just say no" obviously did not work. But what went right along with the "just say no" was Bush Senior with the whole "we're going to incarcerate everybody, that if you get caught with dope, you get caught with drugs in any shape, form, or fashion, we're just going to throw you in jail." You're throwing them in jail, but you're not doing anything about it while they're in jail. You're not offering them treatment; you're not offering them a rehabilitation in jail. We're just going to throw them into jail. And that has obviously not worked either.
As far as the stigma that comes from the community, I think it's the way that we view them. We view substance users as being criminals, as being people who made this godawful choice, so let's just isolate and keep them over there. Keep those people over there, failing to recognize that one of the easiest things to do would be to actually help, to actually encourage treatment, to actually make treatment for everybody accessible. Pass some law with insurance to where the insurance company can't find a loophole within 30 days of why they don't have to pay to send this person to substance abuse treatment.
Meagen Rosenthal:
I think that's such a good observation. One of the things that I've been thinking about as y'all have been talking is this idea that when we stigmatize the people who are in substance use active addiction, whatever the case may be, we're missing out on them as human beings. You have both talked about they are determined; they have amazing adaptive capacities. They are some of the kindest, most generous people I've ever met in the face of the planet. And despite how we like to think about this as it relates to stigma, every one of us has at least one or two or three or a half a dozen in our circles. These are people who are friends, our neighbors, our family members. So how do we keep those two things afloat? They're them. They're the bad people that have made these awful decisions, but then they're my sister, my mom, my dad, my aunt, my cousin, my best friend, my uncle, my neighbor, whatever the case may be. That cognitive dissonance, to keep those two things alive at the same time seems really weird to me.
And what a great disservice. We're worried about finding people jobs; we're worried about advancing things; we're worried about all of these kind of social economic things that are going on and we're disregarding a significant portion of our population because we're not offering the kinds of services that you're talking about. We are making them feel shame and guilt and all of these things over something they can't control. We don't blame people because they have cancer. We fix it. We do our best to fix it. I think flipping that script upside down, what are we missing out on? What are we missing out on when we don't engage with these folks who have so much to offer the world, once they've gone through something that has been a problem. Like you said, nobody makes a choice to wake up one morning and be like, "You know what? I'm going to ruin my life today."
Holmes:
No.
Meagen Rosenthal:
"Over the course of whatever amount of time it takes, I'm going to just take the ship down." Nobody chooses that. But they've come back, and what resilience and what power is in that process to pick themselves back up, reorganize themselves, and enter the world. But that's an amazing opportunity that we're lacking, that we're looking past when we don't think about these things.
Holmes:
Yeah. Their ability to rebuild, redesign, and reclaim. But I would even go further than you said, like my mother and my sister... I'm sorry. Everybody's addicted to something.
Meagen Rosenthal:
Yeah. You're not wrong. You're not wrong.
Holmes:
Everybody's addicted to something. It may not be something that's killing you in the process, but everybody's got their routines, everybody's got their habits. Everybody wants their morning coffee or whatever it is. It just so happens that your addiction is not killing you where their addiction is. It's so much easier to see that because they have done this... It's a lot easier to view it, to see it that, hey, they've lost this amount of weight, that hey, they've been evicted from their house. They've lost custody of their kids. They've ruined these relationships. They've wrecked this many cars. It's a lot more like, I don't know, "out there." It's a lot more in your face. But everybody's got some shape, form or fashion that they have an addiction to something, whatever that is.
Meagen Rosenthal:
Well, I did think about that earlier and I didn't want to equivocate them, thinking that that might not be appropriate. But I think about this idea of when you were talking about making the choice to walk across the dewed field and then turning that into the grass bending down and then the dirt path because you walk it so... All of us have those. Every morning, if I don't do my routine, I throw my whole day off. That's human brains are driven by patterns because we're lazy creatures. We want the shortest route to whatever happiness or whatever satisfaction that we get from that. That's a human failing; that's a human being existence issue. And like you said, for some folks, it just gets put on notice in a different kind of way than mt not having my coffee in the morning or my not whatever the case may be. Right?
Holmes:
Right.
Alexis Lee:
I mean, I'm sure you can find plenty of people around this town that will not put their phone down, or when they do put their phone down, it's like they shake. Don't even get me started.
Meagen Rosenthal:
Right. No, totally true, though. Totally true.
Alexis Lee:
But yeah. I love this conversation. To wrap up and hone in on what we've talked about and leave people with actions because we've had this conversation and I could have this conversation forever about recovery, and my friends all know it. So how would you challenge people to start different conversations this week with themselves, their family, and their community?
Holmes:
I'm going to go back to the experiential thing.
Alexis Lee:
Come on.
Holmes:
Not conversations. This is the conversation. But actually do something. Actually go somewhere, actually learn something. I would challenge everybody to go to a meeting. They're real easy to find, na.org, aa.org. You can look up and find the meetings that are in your area and they will tell you if the meeting is open or closed. If it's open, that means that it's open to the public. Anybody can go. Just go in there and sit in that meeting and listen to what goes on. You don't have to share. You can just be a fly on the wall and observe. You're going to see love. You're going to see harmony. You're going to see serenity.
But just realize that they're not "those people." There's this notion that addicts are people that are off on skid row, but like you said, it's not. It's the people that we know: brothers, sisters. There's people that you probably know that you may not know that they struggle with addiction, but to just go and just humanize them. See them for who they are as people as opposed to whatever label you want to put it on.
Then my other challenge is to find out about the disease and find out about the disease as far as addiction being a disease. Learn about that because I think that that starts to change people's way, is the more that we understand that this is a disease, it's not a choice, that that starts to take that stigma away. But then it also educates to where, "Okay, maybe now I am going to view them the same way as I would view somebody with diabetes or somebody with cancer or somebody with heart disease," is to just look at them as people, and to look at them as people who have struggles. They may be different struggles than what you're having, but they're just people who have struggles and to learn about this disease of addiction.
There's several good documentaries. The Anonymous People would be one I would throw out. Then there's a really good one that teaches straight-up about the disease. It's called Pleasure Unwoven by Dr. Kevin McCauley is another, and he breaks it down and makes it kind of entertaining and fun and explains how this is a disease.
If you're looking for another resource on how to figure out that this is a disease, a little shameless plug here, I will be doing part one of my four-part hijacked brain lecture series on September 28th. I think that's the right date. On a Thursday at 6:00 PM at I think it's... Is it Bryant Hall?
Meagen Rosenthal:
Bryant Hall.
Alexis Lee:
Yes. Bryant Hall.
Holmes:
Bryant Hall, room 209. I promise it won't be boring. I can promise that. I do get animated and the more people that are there that will participate, the more animated and the more performance-oriented I get with it. But that it won't be boring; it will be entertaining, and you may actually learn something. I break it down to where it's pretty simple. I'm not a scientist. I'm not a doctor. And I'm not trying to talk over anybody's head. I break it down and make it, yes. It's extremely complicated, no. It's extremely complex, but it doesn't have to be complicated. So if nothing else, please come to that shameless plug.
But that's my challenge, is to learn more about it. Become involved. I know they have tents set up in the Grove that are sober tailgates. See that those people are having just as much fun as the people two tents down that are absolutely wasted. Get involved. Learn something. Figure out about this disease. My challenge is to start to view these people as people who just suffer from a disease because that's who they are. Yeah. That's no question. Mine's more experiential: let's go do something.
Meagen Rosenthal:
I like it. I like it. No. and that's exactly what we're aiming for this season. Thank you so much for making the time to be here today. Just in relation to your talk, it's open to the public. So anybody who's not an Ole Miss student, find a place to park. You can come to Bryant Hall and hear your first part of your talk. I will say I witnessed or was at one of your talks last year. It's a great time. You learn a lot, and you have an amazing, you all had heard witness to this today, amazing way of explaining all of this at a terribly complex subject, but in a way that's understandable and approachable and really works towards humanizing the folks who are suffering with this disease. So thank you so much for making the time to be here today. It was a pleasure chatting with you.
Holmes:
Thank y'all for having me.
Meagen Rosenthal:
Thank you.
Voiceover:
Thank you for joining us on this episode of the Mayo Lab Podcast. The Mayo Lab Podcast is produced by Dr. Natasha Dieter, Dr. Meagen Rosenthal, Alexis Lee, Slade Lewis, and Hannah Finch. This podcast was recorded at Broadcast Studio in Oxford, Mississippi. The show was mixed and mastered by Clay Jones, and our original music was composed by Slade Lewis. The Mayo Lab Podcast is brought to you by the William McGee Institute for Student Wellbeing. For more information on the Mayo Lab Podcast, head over to themayolab.com and follow us on social media @TheMayoLab.
If you enjoyed listening to the Mayo Lab Podcast, we'd love for you to subscribe, rate and give a review on iTunes, Spotify, or wherever you are listening to this podcast.
This podcast represents the opinions of Dr. Meagen Rosenthal, Alexis Lee, and their guests on the show. This podcast is not intended to be a substitute for the medical advice of a licensed counselor or a physician. The listener should consult with their mental health professional in any matters relating to his or her health or the health of a child.