Author:Yeshaia Blakeney

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Developmental Splits & Boundaries

What to expect in this episode:

  1. A major developmental split we see is the split between self and other.
  2. Really Good Boundaries equate to really good mental health. Psychosis is an extreme example of this imbalance
  3. If you ever stumble upon a person on the street of LA experiencing psychosis, you notice they might cuss

 

Developmental Splits in the Psyche

 

One of the things that we work with in recovery are called splits, and splits are part of the psyche, part of the self that split off from each other and are not communicating well with each other. A common example would be my cognitive capacity, my ability to think and reason, and my emotional capacity. Those two capacities should grow together relatively close.

 

A split is where one area of the self or structure of the mind continues to grow, and the other one gets stuck. So let’s say I continue to grow cognitively; I go to college, I am able to reason and think well. But for some reason, usually some kind of trauma or traumatic dynamic or drug use, I don’t grow in the area of emotion regulation. There you have somebody who is very reasonable and under stress is 7 years old. Throws tantrums, we all know people like that who we can say the tail wags the dog. They are very reasonable, they’re smart, sophisticated, and mature when it comes to their thoughts, but emotionally they’re tyrants. That is a split, between emotion regulation and cognitive capacity.

 

One of the major splits we deal with is the split between self and other. I have to negotiate and navigate the interpersonal sphere and I have to constantly understand where I stop and start, both in my field of existence and in my boundaries. In fact, you can equate mental health directly to how good my boundaries are. Really good boundaries basically equal really good mental health.

 

An example of bad mental health, meaning mental health that has really gone chaotic or awry is psychosis, someone who is clinically detached from reality, someone who is psychotic. If you have ever walked the streets of San Francisco or downtown LA and you see a psychotic person, one of the things you’ll see is they have terrible boundaries. They will cuss you out right in your face and you’re like wait a minute here.

 

Mental health and boundaries are pretty much equated and one of the areas where people need a lot of work when they come into recovery is figuring out how to navigate and negotiate Self and Other. It’s easy to pull back into myself, it’s easy to accommodate into the other, figuring out how to navigate that in the complexity of our lives. For some people that’s really easy with friends and family, well I don’t think for anyone it’s easy, but they’ve adapted to it and know how to do it, but they don’t know how to do it in multiple roles. It’s a certain level of development. How can I be a husband, a father, a worker, an employer, an employee, a friend?

 

These are different roles with different boundaries and different demands and different competing claims.  Part of mental health and maturity, and part of recovery is becoming attuned to those fields and figuring out my general boundaries and my specific boundaries in each moment and each role. It’s a tremendous amount of work, and it’s why recovery is so hard. You’re not just treating your drug addiction, you’re also figuring out how to live well. Living well means figuring out how to navigate what it means to be a self, and what it means to care about the other.

 

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We can help you begin to heal the splits in the psyche

 

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The Relationship Between Development and Addiction

What to expect in this episode:

  1. The relationship between development and addiction
  2. The Unbroken Brain Looks at addiction as a developmental disorder
  3. You’d be shocked if you actually sat with someone who was in some sort of distress and said, “what do you feel right now”? And they could not answer.

 

The Relationship Between Development & Addiction

 

One of the ways to understand addiction, that recently became popular, that I’ve been engaged in, in this blog or this conversation for 8-10 years, is the relationship between development and addiction.

 

There was actually a popular book called “The Unbroken Brain” which was looking at addiction as a kind of learning disorder. That’s complicated and there are parts of it that I like, parts of it that I don’t. Putting that aside, I think to look at addiction as a part of the developmental process and when addiction becomes full-blown addiction as somebody being stuck in their development is a really insightful way to understand what’s happening with people in their addiction.

 

I have never met somebody who is coming into recovery from addiction that is not stunted in some particular areas of the self. That is not stuck or split in a particular area of growth in a statistically identifiable way.

 

So the most common example, that makes a lot of sense to people, is when people stop growing in the realm of emotional awareness and emotional regulation but grow in other areas. That makes sense, right?

 

Addiction could be categorized as an impulse disorder, in some ways. I can’t stop myself from impulsively engaging in this behavior over and over again.

 

What is an impulse disorder? It is the inability to regulate my cravings and emotions. On top of that, there is another area, which is around emotional awareness; actually not being aware of what’s happening inside of me.

 

You’d be shocked if you actually sat with someone who was in some sort of distress and said, “what do you feel right now”?

 

To have them label their feeling, and for huge parts of the population both in the recovery population and otherwise actually aren’t very good at identifying and being aware of their feelings. Being aware of your feelings is somewhat of a prerequisite to being able to work with them or regulate them.

 

If you don’t know you’re having them in any real way, cognitively, it’s hard to step back from them and do something about them. And just telling someone to relax usually isn’t helpful.

 

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We can help you find a way to bridge the gap between belonging and autonomy

 

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The Battle Between Autonomy & Belonging

What to expect in this episode:

  1. one of the most complex realms to navigate when were in recovery is the social, is the  interpersonal, is the areas that we get connected and disconnected
  2. One of the things we are working on within recovery, and it’s deeper work, is we’re working on these internal developmental splits
  3. How do you bridge these two conflicting desires? How do we stop leaning too hard into one or the other? Strength through compassion. Compassionate strength. A place where people feel the most whole. 

 

The tension between autonomy and belonging

 

There is a common meme that was floating around in recovery, I think it was in a ted talk based on this study, It said the opposite of addiction is not sobriety, the opposite of addiction is connection

 

And people love that, they love it because it holds truth. It holds a lot of truth.

 

Probably one of the most complex realms to navigate when were in recovery is the social, is the  interpersonal, is the areas that we get connected and disconnected, intrapersonally inside of ourselves, and interpersonally with each other.

 

What you see with people coming into recovery is you’ll see what I call splits. And splits are…. Dis-Integrated. They are areas of the self in the way that we interact that are not in communication with each other.

 

It’s often why when were talking about human beings we talked about our different parts. Our yin and our yang, our shadow, those kinds of things – the little devil on my shoulder, the angel on my shoulder,

 

You think about the start of these different… subpersonalities, these archetypal characters that exists inside of us often though subpersonalities are split

 

So, the person who is really mature and articulate – I can be very mature and articulate – and then one of my children spills the milk, then suddenly I’m my nine-year-old self. It kind of comes out. Or I have a trickster part of me. Different parts of myself.

 

So one of the things we are working on within recovery, and it’s deeper work, is we’re working on these internal developmental splits. These areas that are unintegrated because we’re shooting for some kind of Integrity.

 

One area were people are split, they are unintegrated that’s a really common and people struggle with it deeply, they’re in deep conflict when they come into recovery is…

 

The tension between autonomy and belonging

 

What that means is, as I’m growing and developing in my adolescence I’m trying to figure out how to become more autonomous.

 

More self-contained, more in myself. Especially as I’m moving away from my family system and then eventually I’m figuring out how to navigate the relationships in my friendship system in a way that doesn’t take too much for me.

 

So I can still have some sense of autonomy and self. So there is this tension that exists in being human between the pull of autonomy – living life as an embodied creature on my own – and belonging. We’re tribal familial creatures that crave deep connection.

 

But if I’m too much on either end I’m lost, right? If I belong too much I get swallowed up and lose my autonomy in my sense of self. We’ve seen that historically with great tragedy.

 

And if I’m too isolated, I’m disconnected from my environment, my Wi-Fi is not working – I don’t know what the hell is happening around me.

 

so what we see people coming into recovery is a split they’re usually afraid of connection because I don’t want to get swallowed up by belonging and they kind of lean heavy towards autonomy.

 

What does that look like?

 

Well, what it looks like psychologically is on the belonging end is over-accommodation. Which we commonly referred to as a people-pleasing, or co-dependence. I’m giving more and more to the people around me at a great cost to myself. I’m over accommodating.

 

It’s one of the most common traits you see addictive personalities. They over-accommodate more and more and more to their family system, to their work, socially. They’re social they’re smiley. They say,

 

“no problem, I love to do that all of this stuff, oh you want a cigarette – oh take two!”

 

They’re not connected with a part of them that gets resentful and frustrated at the cost to themselves when they choose to belong, so they get high. Getting high almost gives them the courage, so to say, to move in the other direction.

 

NO! They get drunk and say, “no – I’m not doing that! How dare you disrespect me”

 

So you see that very often, and then sometimes, I think it’s more rare honestly, maybe 10% of people, are so afraid of belonging that they’ve weighted deep on this other end of autonomy.

 

They’ve completely disconnected from everybody around them their self contained systems all on their own and you can feel that when it walks in the room.

 

And so one of the splits you are trying to navigate is becoming whole in that area. Recognizing the necessity to belong and the necessity to have some sense of autonomy while belonging

 

How that manifest inside the self, often, I think in the psyche is… the sort of… the strength and compassion poles

 

and so often in a conflict and I’m not sure how to be – where something has rubbed up against my ego defenses, I’ll my immediate reaction is “I need to be strong here” if I’m not a very deferential person

 

If I push back too hard and then feeling guilty and ashamed at having like pushed back too hard so I have this other mode

 

Which is compassion and understanding.

 

Which is: people are having their feelings and emotions and I’m compassionate understanding

 

If I’m too compassionate and understanding I end up feeling weak and deferential. Like I accommodated too much of this person’s being, thoughts, ideas, whatever it was. Behaviors.

 

So what’s the solution for that internally?

 

This is high-level work, this isn’t day-one work, this is 10 year 20 year work. And this is for everybody not just addicts. But for addicts, I think it’s crucial point.

 

Strength through compassion, I call it.

 

That there’s actually a space that exists inside human beings that is incredibly compassionate and incredibly strong at the same time.

 

Meaning, I go all it in compassion but not in a differential way.

 

I fight for compassion, reasonably inside of myself inside the world.

 

It’s really high-level work but when you find that space of strength through compassion. Strength AND compassion, all in one let’s call it frequency,  that’s when humans feel the most whole.

 

Strength through compassion.

 

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We can help you find a way to bridge the gap between belonging and autonomy

 

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Therapy and the Subconscious

What to expect in this episode:

 

  1. Therapy is built on a particular premise: I don’t understand myself
  2. A lot of times, people don’t know how to do therapy, I think there are certain modalities of therapy where of instructing the client is helpful
  3. Approaching what’s happening in the background (unconsciously), a little more actively than people often do, you see much more profound effects.

 

 

Therapy can be aided by identifying unconscious thoughts

 

 

Therapy is built on a particular premise which is:

 

“I don’t understand myself

 

And there are forces and drives inside of me that manifest in my feelings, my emotions, my behaviors, the thoughts and images inside of my mind that I’m not aware of.

 

That there is a hidden realm to the consciousness and Freud and Jung and the founders of analysis came along and that was a discovery.

 

Now everybody gets that and knows that, it’s seeped into modern culture and nomenclature. I think often people don’t give, this is a tricky thing to say – it’s actually not accurate, but worth thinking about

 

A lot of times, people don’t know how to do therapy right. Now sometimes that’s good, because the therapist wants to work with whatever is in the room, they don’t want to instruct the client.

 

But I think there are certain modalities of therapy where of instructing the client on the most helpful way to approach the therapeutic process is actually helpful. But I had to discover that on my own.

 

I never had a therapist say, “Hey it might be more helpful if you do this” – ever! Which is kind of incredible considering the variety of therapeutic approaches that exist

 

I’ve found that in therapy, for me at this phase of my life, that being conscious of the things that aren’t in the front of my mind but in the back of my mind and speaking them out loud is helpful.

 

I’ll give an example.

 

I’m sitting in the room with the therapist picks up on some hesitation or some resistance that I have and then says “what’s going on” and I say “I’m feeling frustrated right now”

 

  • “okay what’s that about”

 

and I say “I’m feeling helpless in this process of therapy.”

 

And she goes “oh. Are you concerned that I can’t help you? Is that what’s coming up in the room right now?”

 

I say something but actually, in the back of my mind, I have an image of myself picking up the chair this to the right of us and breaking it in front of her and just raging 🔥

 

So instead of just saying what I say, in the midst of therapy, I’ll say – “wait a minute, I just had an image flash in my mind of me breaking a chair right in front of you and raging” – and then we work with that

 

If one of the points of certain types of therapy is to gain access to the parts of ourselves that we’re not really conscious of then I think approaching what’s happening in the background, maybe a little more actively than people often do, you see much more profound effects. In terms of your own understanding, biases, belief systems that are buried real deep in the bottom of the mind.

 

There are plenty of therapists that will disagree with that and they are 100% correct and I’m just putting that out there for the one person who goes, “oh wow you know I have those images in my mind that I don’t share that with my therapist and I’ve had them for months or years”

 

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The Traditional Social Model of Recovery

What to expect in this episode:

 

  1. The form of recovery nearest and dearest to my heart is the traditional social model of recovery
  2. It’s profound, to watch a room full of people, who were previously in active addiction, coming together to talk and help each other
  3. The future will see a mix, of the new, exciting, plnt medicine and medical techniques, with this old, traditional, beautiful social model

 

The Traditional Social Model of Recovery

I would  say the 4th and final, and probably the form of recovery that’s nearest and dearest to my heart, is the Traditional Therapeutic Social Model of Recovery

 

That is really, for me, it reaches me in a deep place. Which is not about science, it’s not all that fascinating it’s about human beings coming together in a thoughtful way to help each other figure out their lives and how to do that together

 

So that includes therapy, that includes groups, that include social support like Alcoholics Anonymous.

 

I’m a huge fan of Alcoholics Anonymous, I think it’s one of the most miraculous things that the United States has produced that is a very American phenomenon. I find it incredible, I could talk about AA all day, I’ll  give a little example:

 

Alcoholics Anonymous

If I go to a meeting on a Saturday night at 10 p.m. maybe somebody asked me to speak or something like that maybe I stumble into a young people’s meeting and the average age there is maybe 19 years old and there are a hundred people in the room in Los Angeles and they talking about their addictions, their problems, their relationships, their recovery in an honest way and they’re talking about their hope for the future may go outside and hang out together or something like that. 37 years old now so

 

I look at these young people on a Saturday night. These are the same people that weeks months or years ago were right the streets selling dope, using dump, doing Lord knows what kind of crime, Lord knows what to themselves, to other people, that are now sitting in a little room on chairs talking deeply and honestly about life

 

with no parents around no judges no counselors no therapist on their own and it sort of epitomizes the social model of recovery – how to become together solve our common problems. There’s something beautiful about that.

 

So, in the future of addiction, I see some mix of those different kinds of camps happening and I see them mixing in ways I couldn’t possibly predict or see.  It’s exciting, it’s it’s scary.

 

What’s exciting about it for me is I think we need to find much more effective ways of dealing with the issues of addiction of the large-scale so it’s exciting as these new ways come in, and hopefully, for me, still at the core is that traditional recovery which is human beings coming together to solve their problems.

 

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Plant Medicine, Ayahuasca, & the Right Relationship Model

What to expect in this episode:

 

  1. Plant Medicine like psilocybin and ayahuasca are a burgeoning underground addiction solution
  2. Much like diet, there is a sliding scale of harm – in food and drug – but most fall into a fuzzy middle
  3. The future will see movement away from the abstinence-based model toward more individual recovery care

 

Plant Medicine, the spectrum of harm, and the Right Relationship Model

Looking at the future of recovery, another phenomenon that we’re experiencing now, it’s underground and it’s on the horizon, at least in the United States. Is using plant medicine to treat addiction.

 

So there are some great studies with nicotine and psilocybin which is the psychoactive component in magic mushrooms.

 

They’re also using psilocybin to treat depression, which of often is an underlying condition addiction, there has also been a lot of fanfare about Ayahuasca, which is a powerful psychedelic from South America that was used traditionally for either hundreds or thousands of years.

 

And the thought behind plant medicine is to invoke a spiritual experience and to disrupt the default network of the brain, meaning the patterns of our thinking and feeling, in such a way that people can get a boost in breaking free from addiction. Something gets rewired, you know, in the shorthand.

 

Plant medicine is becoming popular in the underground and so if you go online you’ll find it kind of buried there amongst different ways to deal with addiction, I’ve come across a lot of clients, both successful and unsuccessful, who have either tried or use plant medicine to treat addiction

 

it’s it’s a fascinating area, my own general philosophy on if I’m speaking to a parent or a potential client who’s looking for recovery and looking for help is I don’t have a philosophy it’s whatever works

 

The Future is a Multiplicity of Approaches

 

The way that I think the future of addiction is going to break down is there’s going to be a multiplicity of approaches and in the end, I think the best parallel when looking at the future of addiction is looking at how human beings approach diet. There have been all these diet fads that come and go – everybody is on keto now –  where I think it’s going to go as modern science is getting there, is what specific diet is right for you.

 

so I think we’ll break away a little bit of overtime from an abstinence-base model meaning you can’t use any substances, to understanding your body and your neurochemistry better and specifically what substances in foods does your body and self react well to, and what substances and foods does is it not react well to

 

So I think about it on a spectrum write pretty much everybody knows that processed sugars and saturated fats really aren’t good for anybody hardly ever. You want to stay away from that stuff.

 

On the other side broccoli, celery. all these things we really don’t like,  are pretty much healthy for everybody. So we have the stuff that’s pretty much healthy for everybody and pretty much bad for everybody then there’s a spectrum of the middle

 

That has to do with your own body. For some people red meat, the iron in red meat is good, and for some people, it’s not. Trying to figure that out, I think will happen with drugs eventually is the same kind of approach.

 

The Right Relationship Model

 

I call it the “right relationship model’.

 

Which is pretty much for everybody crack cocaine, methamphetamine, heroin… is not good for your life!

 

And I think we can all pretty much agree on that. But there are a group of substance is over here, in the proper set and setting, that can be good for huge groups of people.

 

The way that I think about that is: there are certain substances that narrow our consciousness, right, when you use methamphetamine – people use it to, like Adderall,  it’s similar to methamphetamine, a stimulant, it helps you focus.

 

The problem with methamphetamine is that it narrows your consciousness! So, you’re actually not that connected to the things around you or the people around you, more important, over time.

 

Heroin narrows our consciousness in a different way, If you’ve ever seen somebody do a large dose of heroin, they just pass out, so it’s not focusing your consciousness, it’s obliterating your consciousness, and you pass out into oblivion. But they have the same general narrowing effect.

 

Alcohol is another substance that is like that, you drink alcohol and it lowers your inhibitions and your consciousness – which is what we appreciate about it – we don’t have to think so much and deal with all those feelings of anxiety.

 

So there’s a group of substance over there that narrow and dim consciousness, that’s why we like them, there’s a group of substances in the middle – people respond differently to marijuana and even wine or something at a smaller dose,

 

Although it dims your consciousness, it maybe connects you a little more, so there’s a little bit of space there in the middle. Which is why I think we have some agreement that they are kind of, KIND OF okay.

 

Plant Medicine | Expanding your Consciousness & Empathy

 

Then you actually have this group of substances, largely in the plant medicine world, but also MDMA, that have the capacity to expand your consciousness and empathy, and it’s real it is very well documented that it actually kind of lets filters down and allows you to have a wider awareness and vision

 

and anybody who’s done MDMA knows you have an incredible amount of empathy on MDMA and you rarely see people fight, you don’t get in a fistfight on the street, on MDMA. They are dancing together with glow sticks, it’s incredible.

 

So I think where it’s going, is into that kind of model were people, meaning people in society as a whole, is figuring out what kind of substances are good for us as a whole, and in what setting, and how we deal with that legally,

 

And what substances are really killing us and separating us?

 

I’m kind of optimistic about that vision, but every vision of the future is problematic. They are huge problems with that vision, just like they’re huge problems with the way we approach drugs and alcohol the abstinence-based model now,

 

It’s more just looking at what’s probable… as to what’s good, I never know what’s good in a complex phenomenon.

 

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Medical Approach to Addiction

What to expect in this episode:

 

  1. The medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.
  2. There are also non-harm-reduction, medical approaches to addiction.
  3. Predicting more and more complex pharmaceutical approaches to addiction in the future.

 

The Medical Approach to Addiction

 

The future of recovery I see it in 4 strands, 4 different areas. We’ve covered traditional recovery.

 

One that we’ve been in, but I think will become more sophisticated, is the medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.

 

A great example is Methadone, for opiate addicts, methadone is a substance that is similar to opiates, but reduces a lot of the harm that comes along with an opiate addiction.

 

So if you are using heroin, you need a drug dealer, you have to break the law. You don’t know exactly what you’re getting when you are buying a bag of black tar or powder from somebody’s probably not that trustworthy and you’re putting it in a needle and shooting it in your arm – its and incredibly harmful or dangerous habit to have, often deadly

 

The thought was, “can we come up with something  that is like heroin, but people can still function better, that we can distribute legally, to stop people from dying & falling apart?”

 

Methadone, in many ways, has been effective. There are huge downsides, whatever, it’s a medical harm reduction approach.

 

There are also non-harm-reduction, medical approaches to addiction.

 

Antabuse is an alcohol deterrent substance. If you’re taking Antabuse and you drink, you violently throw up. And it deters you from drinking – without getting you drunk.

 

Vivitrol is a blocker. Its been around a couple of decades, it’s not widely publicized enough.

 

But if you are an opiate addict and you are on Vivitrol, then even if you use opiates you can’t get high. It just blocks the effects of drug usage. It’s actually a great tool in the world of addiction.

 

I see more and more complex pharmaceutical approaches to addiction in the future.

 

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Traditional 12-Step Treatment

What to expect in this episode:

 

  1. Understanding the evolution of addiction rehab & recovery is important to understand where we are heading
  2. The 12-Step program is a spiritual program that evolved after psychotherapy failed to help
  3. This has become the foundation for most North American Treatment Programs, but the success rate could improve…

 

Traditional Addiction Rehab | The 12-Step Program

 

In terms of the future of recovery, I think we’re already in the midst of a rapid change in; let’s call it the recovery underground. To understand, first I think we need to understand traditional recovery and where that even comes from.

 

Traditional recovery is pretty much 12-step based in North America. Alcoholics Anonymous, Narcotics Anonymous everyone is familiar with that. The reason why traditional recovery developed in the first place is because the mental health and physical health systems that we’ve had historically weren’t helpful when it came to treating addiction.

 

So we knew very early on in 20s 30s 40s even before that, that Psychotherapy did not work with helping people to recover from addictions it’s a well-known historical fact. We’ve kind of forgotten that over time but it’s a well-known historical fact.  Alcoholics Anonymous came along as an interesting spiritual program with elements of therapy and morality and eventually community and literature that people started to get sober and people start to recover. That worked and works!

 

So traditional recovery in North America is 12-step and it was it was the dominant form of recovery for the… last eighty years let’s call it. The success rates that we see now, I think they’re controversial, to be honest with you, I think it’s a difficult question to ask, to talk about that, but let’s say the success rates are 15%. That might be generous that might be stingy,

 

it just isn’t good enough.

 

What are the Alternatives that are on the horizon for people in recovery?

 

 

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Marijuana Decriminalization | The Future of Addiction

What to expect in this episode:

  1. Exploring how marijuana fits in society
  2. Being Pro-decriminalization doesn’t mean there is no harm or side effects
  3. We’re in an interesting experiment to see what happens when we decriminalize a substance, the stigma goes away, & how that affects our society in general over time.

 

Marijuana Decriminalization | The Future of Addiction

 

I don’t think we really know over the long-term what it’s like to regulate self-medicating marijuana over 5 years 10 years 15 years 20 years and the impact that has on individuals and the impact that has on groups or productivity or our society as a whole.

 

So we’re in the midst of an interesting experiment to see what happens when we decriminalize a substance and the stigma goes away, which I think is a good thing, how does that affect our society in general over time.

 

So part of what will be understanding is what does society look like in relationship to mass consumption of marijuana over a long period of time.

 

Probably chill.

 

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Suboxone Treatment | The Future of Addiction

What to expect in this episode:

  1. The immediate future of addiction is going to be dealing with the fallout of our current harm-reduction approach to the opiate crisis
  2. Suboxone or Subutex is currently subscribed widely to save lives but we don’t know what years of use will do
  3. It is widely known that suboxone is much harder to detox from than heroin, so what happens when all these people need or want to stop taking it?

The Immediate Future of Addiction | Suboxone and the Opiate Crisis

 

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we’re doing now with addiction.

 

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we're doing now with addiction. Click To Tweet

 

So, we have a gigantic opiate crisis in the United States, unprecedented really. One of the things that we’ve done to save people’s lives, understandably, is we’ve approached it from a governmental level and an Institutional level, and our approach has been harm reduction. Which means finding medications that reduce the amount of harm caused by heroin and oxy and these drugs and so the consequence of that is we are going to have a generation of young people or some percentage of this next generation that is on some sort of opiate blocker or opiate substitute the most common is called Suboxone most common is called a Suboxone or Subutex and the first crisis we’re going to deal with in terms of the future of addiction as we’re going to have hundreds of thousands or even millions of people who have been on Suboxone or Subutex for 3, 4, 5,10 years and we don’t really understand on that scale the effects of those drugs long-term on the individual.

 

We don’t know how that affects people’s development over the long-term you know, what happens when you put it on 18-year-old on Suboxone how does it affect the development when they are 24. Maybe it’s hardly at all, maybe it’s a really big deal, we don’t really know. But my guess is it’s something we’re going to have to deal with. As people start to have mental health problems years out of their development may be in relation to the Suboxone the questions going to be how do we get these people off of this drug? And, what I found in my own experience in treatment, is it’s actually harder to come off of suboxone than it is to come off of heroin – it’s actually well known. If you’ve been on Suboxone for a long time, you know, two, three, four, five years the detox is horrendous and often the depression is really heavy and lasts months if not years and so…

 

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn't die but they didn't completely heal Click To Tweet

 

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn’t die but they didn’t completely heal and they’re on this medication, maybe for life or maybe they want to get off and what do we do so that’s a new media crisis that we will be in the headlines in a couple of years.

 

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