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Kreatures Of Habit Podcast
Dr. Russell Surasky on Addiction, Recovery & the Science Behind Sobriety
01:13:42
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- [00:00]
Dr. Russell Ciraski
Just intuitively, if you put your biases aside, you have to be a doctor. Look at people who are living in the street just to use the drug one more time. Girls prostituting themselves for one more dose of that drug. You know, a lot of these people that you see have families that love them. They have homes, warm homes, and families that care for them. But their brain is completely hijacked by this drug. And if you don't see that and look at people in those situations and say, my God, they're living in the street just to use drug one more time, that doesn't look like their brain is hijacked to you. I don't know what evidence you're looking for.
- [00:39]
Michael Chernow
I'm Michael Chernow, and this is the Creatures of Habit podcast. Our habits will make us or break us. It's just that simple. I've lived on both sides of the tracks and have learned that the decisions we make on a consistent basis truly define who we are as human beings. On this show, I will be interviewing some of the most inspiring, motivating and high performing humans I've encountered to share their daily habits, routines and rituals that help them stay on top of their game and ultimately happy. So sit back, relax, and pay attention because what you hear over the next 30 to 45 minutes could potentially change your life.
- [01:21]
Let's go, creatures that have a podcast community. Today is a very, very, very important day. A very special guest I have on the show, Dr. Russell Ciraski, is a double board certified neurologist and addiction specialist. Now, you guys have been listening to this podcast for a long time, I assume, and if you haven't been listening to a long time to the podcast, a long time, potentially, you've been following me for a long time and you know how out front I am about my recovery and my story from addiction to a life way beyond anything I thought was possible. Russell has spent a long time working in this field of addiction. And some of the things that he says really kind of like brought a sense of ease to. To me, when listening to some podcasts and reading some of the things that I've read in my diligence, he actually says you have addiction, as in you have cancer or you have a mental health illness diagnosed. He says you have addiction. You know, coming up in the 12 step world, we were told from the day we walked through the doors that addiction is a disease. Actually, it's a disease in the brain. And some of us, if not all of us, were potentially born with a predisposition to it. And I struggled with that for a long time. I didn't really, like, believe that addiction was an actual disease because I was one of the lucky ones that's been able to, a day at a time, reverse it. And it was from sheer willpower and community and connecting with the right people. However, I know I still have it. It's just in remission. I really can't wait to dive in with the doc to my left and ask questions and hear some of the newer modalities and treatments that have come to the surface over the last decade to help with this unbelievable, savage, ferocious epidemic we have in our country, specifically around opioids. Doctor, welcome to the show.
- [03:54]
Dr. Russell Ciraski
Thrilled to be here, Mike.
- [03:55]
Michael Chernow
I actually just listened on my drive down to your episode with Dr. Gabrielle Lyon, who's a good friend of mine.
- [04:03]
Dr. Russell Ciraski
Remarkable person. She's remarkable.
- [04:05]
Michael Chernow
Awesome. This podcast really is designed to talk about habits, rituals and routines. Right? And what, what my. One of my missions is to sort of, when people talk about habits or when people hear the word habit, most people draw a negative connotation to that. Very rare that people like, you've got to hear about this great habit I've got. Most people like, I, I've got to kick this terrible habit, right? And drugs and alcohol are considered specifically for people that have addiction. And I'm going to start saying that because that was when you said that. I'd never heard anybody say that before, honestly, in my 20 years of recovery.
- [04:47]
Dr. Russell Ciraski
Yeah, that's very upsetting. I hear that all the time. But we know, we know. We know so much more about addiction than we ever did in just the last few years. And I think the opiate epidemic, particularly with fentanyl, has driven the medicine to essentially really look at, into addiction and see how can we really help people that are suffering. They're suffering, their families are suffering, you know, to untold degree. And, and medicine has really sort of left that field behind for so long. But why? I think there's multiple reasons. You know, for one, the only doctors that seem to be tracked into it by training were psychiatrists. And a lot of times it was sort of looked at as it's, oh, addiction's a psychological problem or it's a moral problem or a discipline issue. I mean, we know now, like you said, that addiction is a chronic disease of the brain.
- [05:45]
Michael Chernow
Can I just stop you there and just ask, because I want to unpack that. Is that actually scientifically defined now?
- [05:52]
Dr. Russell Ciraski
Yes. There's overwhelming evidence that addiction is a. Is a brain disease. And I'll tell you how we know that and also why. Why I think there's still a lot of hesitation and pushback with that word. So addiction. We know first of all, if we look at brain scans of people that are in recovery, say from opiate addiction, but also we see it with alcohol addiction and other substances and comparative to people who don't have it, there's very big differences specifically with what's, what's called PET scans. So we can have somebody look at triggering photographs or videos of drugs, say, or someone using drugs and look what happens to their brain versus someone who does not have addiction or isn't in recovery. And very different things happen in the brain. You know, the brain stem, the more what's called the limbic system, the area that causes compulsive unrelenting cravings. That area lights up very powerfully in someone in recovery versus someone who doesn't have it, where the rational cortex of the brain is more lighting up, looking at it sort of like in a curious way. So.
- [07:03]
Michael Chernow
But everybody has a limbic system.
- [07:05]
Dr. Russell Ciraski
Absolutely. We all do.
- [07:06]
Michael Chernow
And would you say that people that are prone or more susceptible to having addiction have a genetic connection to a more sensitive limbic system?
- [07:18]
Dr. Russell Ciraski
100%. Like everything else in medicine, most every other condition there's a combination of genetic vulnerability and exposure. So it's not one gene, it's a confluence of genes that give you a degree of susceptibility towards addiction. So for example, you know, you, you might be somewhat susceptible and therefore it might take a lot more of drinking or doing that drug for that switch in the limbic system to go off and set addiction, that neurological cascade, that devastating neurological cascade in limbic system to start and the switch of addiction on. Whereas someone else would only have to have that drug once or twice and then that switch would go off. So that's where the vulnerability comes in.
- [08:04]
Michael Chernow
What do you think? So I want to bring, I want to try to draw a comparison to this sort of more scientific outlook on addiction being a. Where there's overwhelming well being evidence that it is an actual chronic disease of the brain to environmental circumstance. Is someone susceptible of having addiction if their limbic system is not as sensitive as mine, but their environmental circumstance potentially as a child with trauma is deeply impacted.
- [08:39]
Dr. Russell Ciraski
So there's a lot to unpack there. There's a lot of variables, right? So if you have an underlying mental health condition, say you have, for example, a big one, is adhd, very prevalent. And it does certainly make you more susceptible and we can talk more about that. But there are Other conditions you could have severe anxiety or what's called borderline personality disorder, bipolar disorder. These are conditions, many of them definitely make you more susceptible towards developing addiction. And so, you know, when you look at the genetics of your parents and your siblings, sometimes you find that these chaotic homes are the way they are because they are dealing with mental health issues. And that may be part of your makeup as well. I know in your story you talk about your father, and so I don't know exactly what he was dealing with. I think you had mentioned bipolarism for sure. Okay.
- [09:29]
Michael Chernow
100% potential borderline personality. I mean, I'm not a doctor, so I can't actually diagnose. But he refused to go to the, to to get looked at in the mental health arena. So. But his symptoms of what would, which was potentially a mental health issue were very, very flagrant.
- [09:48]
Dr. Russell Ciraski
Sure. So there's the genetic component of sometimes when we talk about these sort of chaotic home environments, maybe there's some genetic issues going on mental health wise, that are somewhat passed down. The other thing is that being exposed to a lot of trauma can be a part of developing conditions like borderline personality disorder, which then can set you up to be more vulnerable because it's sort of like what it probably is more. We don't know this for 100% certainty, but if your impulsivity to take drugs is much more prevalent than especially at that age. So what we know is when you introduce a drug in, you know, between 12 years old and 16 years old, you're much more likely to develop the switch of addiction to go off versus if you introduce it at 20 or 21 years old. Because the limbic system, the gas, the impulsive part of your brain, that area of the brain is developed by puberty. It's the rational cortical area of the brain, which is sort of the break that doesn't develop till you're 21 or 22 years old. So when you introduce drugs of addiction that can hijack that limbic area during those years, 13, 14, 15, 16 years old, they can hijack the system much more easily.
- [11:03]
Michael Chernow
Why was I able to get sober and stay sober for the last 20 years, and many of my peers are either dead or have not been able to sustain sobriety?
- [11:18]
Dr. Russell Ciraski
That's a great question. You know, certainly I don't know all of the factors and variables that came into your world. I believe you were influenced by people who were living the right way at a pivotal time in your life. I believe I heard you speak about that with teaching about Discipline and. And time and patience. And I think that if you can meet the right people and have the right motivation and you're driven towards something you're passionate about, that could save your life, because it pulls you out of that and it may be enough to keep you away. You know, not everyone is fortunate enough to have that.
- [11:54]
Michael Chernow
And I haven't said this really out loud ever, aside from too few people that I've talked about potentially having, you know, work on this project with me. But I believe personally, from my experience, and I can only speak to my experience right, as like a finite sort of answer to a potential question like that. But I will say that movement, physical exertion and stacking little wins via healthy nutrition, potentially better sleep, these little wins that you kick your day off with. Because when I was active, I was severe. There was nothing that I was unwilling to do to get what I needed, and there was nothing I was unwilling to try many, many times to get me out of my own skin, right? So I was a severe addict who had overdosed on heroin, and four hours later left that situation saying, oh, my gosh, I just died and made it through. This is never going to happen again. And by the way, and I want to talk about this, too, because something just happened very, very close to home for me. And I know that your story is also very powerful, and the reason why you got into this field is because you lost your brother to an opioid addiction. And. And I'm. And I'm so sorry about that, because I would imagine now, knowing what you know, you know, you're going to be able to save lives in his legacy.
- [13:27]
Dr. Russell Ciraski
Well, I really appreciate you saying that, but I just. If you don't mind, I just want to backtrack for a second about this being a disease. I think the pushback that people have is sort of this idea that, well, if I put a gun to someone's head and said, don't use the drug, they wouldn't use the drug, and therefore it's not a disease. The. The problem with that analogy is that we don't use that idea to define what a disease is or isn't in any other field of medicine. So most chronic diseases, whether it be high blood pressure or diabetes, there is always this area of voluntary control. And yet in those conditions, look at how difficult it is for people to actually stick to what they're supposed to do. And, you know, people don't have any problem calling diabetes or blood pressure a disease. And yet, you know, when you look at people try to relate, right? But they can't possibly relate to what, what a craving is for someone who's in active use with drugs, right? So people think it's like, oh, I have a craving for chocolate. You know, as you know, it's not like that. You know, I listen to people talk about this all day, every day. And, and it's essentially like you're in the desert for days with no water and you'll do anything to find that, that, that water. Also, just intuitively, if you put your biases aside, you have to be a doctor, look at people who are living in the street just to use the drug one more time. Girls prostituting themselves for one more dose of that drug. You know, a lot of these people that you see have families that love them, they have homes, warm homes and families that care for them, but their brain is completely hijacked by this drug. And if you don't see that and look at people in those situations and say, my God, they're living in the street just to use drug one more time. That doesn't look like their brain is hijacked to you. I don't know what evidence you're looking for.
- [15:18]
Michael Chernow
Well, I think it also, like, you can correlate. I mean, it's a mental illness, right? I mean, that's basically what it is. It's a mental, it's a mental illness similar to a lot of other sort of potentially high functioning or functioning mental, you know, mental illness patients, right, that, you know, there's, there are people walking around all day long that have severe depression, that have, that are bipolar, that you could look at them and not potentially think that they, you know, you wouldn't walk up to them and say, oh my gosh, you're not lying in a gurney. You know, you don't have anything wrong with you.
- [15:51]
Dr. Russell Ciraski
Your story is not you, by the way, the overdosing and going back and overdosing, that is unfortunately not unique. And this goes back to that hijacking of that limbic area of the brain that will do anything to find the drug. And basically, you know, the limbic system tricks your, your thinking brain into saying, we'll just use the drug one more day, one more time and then we'll, we'll quit. And, and the brain does that every day until usually someone overdoses and dies, especially now with fentanyl. But I see countless people overdose, get naloxone or Narcan, save their life, get to the er, leave against medical advice, they don't want to stay, right? And then overdose three hours later, again, because they, again, it's that part of their brain that just says, I need it, I need it. And I, you know, damn be the consequences. And it just goes back to that, that what happens with the enslavement. I mean people, people need to understand that, you know, we're at a place now where everyone is just one degree of separation from this illness. Either you have it or someone close to you does.
- [16:58]
Michael Chernow
So I've got a, probably a difficult question because I know for sure from my experience, I've never been able to make someone stop using or stay or get sober. It's just not something that I think any other human you can attempt, you can be supportive, you can show unconditional love, but you could lock somebody up to a pole for six months and keep them away from the drug and the alcohol. And if that human does not want to get sober, the second you unclip them from that pole, they will go and use. A few things that have been sort of circling my brain. I have two sons. I have a nine year old and a seven year old and my seven year old. They're wonderful children. And when I'm telling you that our home is the most calm, cool and collected, loving, warm, safe, like it is, in my opinion, and I'm obviously biased, but in my opinion it's a dream scenario for an upbringing where we live how we live our lives, how there's structure involved and the amount of love my wife and I give to these two kids. I see a very distinct difference between my older son and my younger son when it comes to potential addictive behaviors. I'm obviously hypersensitive to it because the last thing I want is to pass down this terrible, you know, gene cluster that could make one of my children susceptible. I've said to my wife a number of times, I believe that Dakota has what I have based on how he behaves with certain things. It's terrifying because over the holidays we got an email from our school. The school that our kids go to, very small, insulated, like just wonderful, just couldn't be a better situation school right in our, right down the road from us, that a 14 year old overdosed on fentanyl and died over the holidays, shocked the whole entire community, put me into immediate tears because my older son, who's 9, knows him. It's a school, maybe 200 kids in this school. I've always had the thought process as a parent to know that kids are going to experiment, kids are going to experiment, it doesn't matter if you're a great kid, if you're a bad kid. Trauma, no trauma. Chances are kids are going to experiment today. Experiment means death. It just does. The wrong pill, the wrong weed, the wrong cocaine, the wrong ecstasy, whatever, you know, the wrong psilocybin, like anything could be laced with fentanyl. What can parents do now to take precautions so that their children understand the severity of this deathly fatal situation we're in?
- [20:11]
Dr. Russell Ciraski
Well, so you touch on a number of very critical things there, and you're absolutely correct. Fentanyl has changed the landscape of drugs and addiction in this country. And like you mentioned, it's so incredibly deadly. You know, it's 100 times more powerful than morphine. A tiny granule can absolutely kill you in just a few moments. And it's being pressed and mixed into everything from, from what looks like Adderall pills to Xanax bars, to any pill, anything. And unfortunately, as a parent is a frightening time, because if you have a kid, high school age or going to college, and for example, Adderall is everywhere. You know, ADHD stimulants are everywhere. And so, you know, you think you're getting the actual pill from your buddy and you're trying to, you know, kids take them for tests and finals and. But. But meanwhile, those pills, they even have the numbers etched on them and you can never tell the. And it takes one pill and it's game over, like you said. And the difference now is most people who are dying from fentanyl don't even have addiction. They just tried something and they're dying, like you mentioned. And I think that's going to change the landscape here because I think what I see is most families, if you're not dealing with addiction directly in your family, you say, oh, okay, yeah, opiate addiction's terrible and you can certainly die from it, but that's how addiction goes. And we don't have that, thankfully. But now every family is at risk and susceptible because of how fentanyl has completely shifted everything. And I think that's ultimately going to push the society as a whole to make the changes to stop this, and we can talk more about what's going on there. China is basically poisoning our country by pouring the fentanyl in through the border. We don't have this here. We don't grow. This here comes from actually from China and through Mexico. And unless they change that, it doesn't matter how good our addiction treatments are. You know, we can't turn the tide unless they make a change there.
- [22:11]
Michael Chernow
What are we going to do.
- [22:12]
Dr. Russell Ciraski
Our government has to care enough to actually look, I'm not a politician. I know that they're going to have to do something akin to potentially getting military over there, because it actually is war. I mean, they're poisoning our country, destroying families. The amount of suffering that even one family goes through with addiction, let alone what's happening now. Fentanyl's in every town in America now. And so, you know, these stories, unfortunately, are all too common. And it can happen to anyone's family. And so, you know, I think you certainly your kids have to learn and realize that one time can absolutely kill you. And that really comes from parenting. You know, the other thing is that everyone should have Narcan or naloxone in their home, which is this, in case you're not familiar with it. It's a nasal spray that if someone overdoses from an opioid and it looks like they not breathing right, or they could be dying from an opiate overdose and you spray it in their nose, it will save their life. It kicks the opioids off of those brain receptors that's stopping their breathing. And you can absolutely save somebody's life because an ambulance could take 5, 10 minutes to get there. And if oxygen doesn't get to your brain in three, four minutes, you can be brain dead. So having it at home is critical. And I got to tell you, this is such a prevalent problem that, that when I give people prescriptions for Narcan, which by the way, you don't need a prescription anymore, you can get it over the counter. But when I give people prescriptions, half the time they come back and they used it. It wasn't for the person I gave it to. It was the neighbor or the friend or someone had an overdose near them. That's how prevalent this has become. But it is frightening.
- [23:49]
Michael Chernow
So, because it's pretty clear to me that there's nothing any one human can do to convince an addict like me at the time when I was active to want to stop. What advice can you give parents to educate at this point with this fatal, like, I mean, I've read it's a pinhead. A pencil tip of fentanyl will kill you with no tolerance to it.
- [24:21]
Dr. Russell Ciraski
Well, a couple of really, I think important examples here that help shed light on this. They did a study recently where they gave people that were using opioids in the street using heroin or fentanyl, these test strips where you can test the drugs. You get to see if there's fentanyl in there. And they took them and they used them. But guess what? Even when there was fentanyl, they used it anyway because their brain is addicted and they want that drug. I've had a number of patients in active addiction who I'll say to them, the only thing showing up is Fentanyl always. And I'll say to them, why do you keep going back to the guy that gives you fentanyl? Don't you know you can die? It's Russian roulette every single day. And they say, yeah, I purposely seek them out because I feel like the fentanyl is going to get me really high. I won't die, but it'll get me really high. And that just goes to show you how hijacked that part of the brain is when this is going on. And to your point about, you know, what kind of, if someone you love, someone close to you is dealing with an opioid addiction, there are a couple of very important things. Number one, every single day is it's a life threatening emergency. Every day that someone uses opiates right now is absolutely life and death. So you have to do everything you can to get them help. The second thing is that you do not want to enable that person. Now that's instinctively what most family members do. They don't mean to do it, but they wind up enabling them. And you know, I don't know if you've ever heard the phrase if you baby them, you'll bury them. And basically, and that's what I see that most kids, you know, young adults that die from opioid overdoses, they do it in the comfort of their parents, warm home and in their bedroom, they overdose and die. It's not like they're in the street doing this. So you know, that's because they're in able to get those drugs. So you want to help that person, but you do not want to do anything. Like for example, you know, if they're asking for money to, because they need food, go buy them the food, but don't just give them money. And you know, also you have to use your, your influential abilities as a parent to say, you know, basically like if you, if you don't, if you do xyz, if you stay away from the drugs, if you, if you go get treatment then, then, or you can, you know, you can't live here unless you get treatment. It should all be about using the, your ability to influence them to get help, to get treatment. Because on the other side of that they'll be very different. One of the Things that comes along with addiction is the sort of this emotional manipulation that people do on their friends and family to get the drugs. And it's very heartbreaking. And they say, and family members say, how can they do this? I thought they loved me, but that's part of the disease. The disease is to do everything you can to get that drug. But when that, that's not who they are. And I think that's very important for people to remember, because when they get better, that's not how they're going to be.
- [27:28]
Michael Chernow
They turn into me.
- [27:30]
Dr. Russell Ciraski
Exactly.
- [27:31]
Michael Chernow
They turn into me. You know, and it's not every single person who struggles with addiction that turns into an ambitious sort of hard charging human. But I know a lot of them. I know a lot of unbelievably happy and successful people that are living lives way beyond anything that anybody could have imagined. And, you know, I kind of, you know, I kind of always use this comparison. Like, let's just say the last week of July 2004, someone put me in a room with 10 hardcore gamblers and just, just put me there, sat me in your seat and said, In 20 years, this person could be this person. Let's take bets. 10 out of 10 gamblers, no chance, no chance are they putting that money down on that, on that person. It's just not there. They would just look at what I looked like then and now, and they would just never say it's possible. And so I think what coming through addiction, still knowing that I have addictive tendencies for sure, but what it's done for me and anybody that's listening there is a really unique superpower that people that have addiction can harness when you remove the drugs and alcohol. And for me, what it is, is I have learned that I have the ability to absolutely commit. And the funny, interesting component of it is I had it when I was active. I was completely loyal and committed to this drug. And so now that part of my brain that made me completely committed and loyal to that drug and alcohol is now. It's still there. It's still the same brain, but it allows me to commit to the things probably more effectively than your normal brain. So it is this unique superpower that we can channel once we get rid of the drugs and the alcohol. And I believe that to be true. And, you know, that's my own little sort of philosophy on that. But I also question, like, what gives me the. Why have I been able to pursue the things that I've pursued in my life? You know, like, why is it easier for me to say I'm going to do something in a positive way, and then it's either do or it's, I'll do it or die.
- [30:19]
Dr. Russell Ciraski
Just to back up, I think it's very important to point out here that just because we say addiction is a disease doesn't mean that you're destined to keep relapsing and die. It means that there's inherent vulnerability, a susceptibility, where if you use that drug, it will always hijack your brain. And so. And it will go off the rails. This isn't like. In other words, your brain will always be susceptible to triggers in the environment, people, places and things where if you're not on guard and you don't take the steps necessary to. To remember the condition that you have and that you're in recovery and take the steps necessary to protect yourself from those things, then there's a high chance that you're going to relapse. Triggers are more powerful than most people realize, and we know why. Now, when you're engaging in something that spikes dopamine in that limbic area, there's another neurotransmitter called glutamate, and it gets released at the same time. And what that does is it etches deep into the hippocampus, an area of the brain where you store your memories about everything about that circumstance. The smells, the people, the place. You know, that's a survival drive. It's your brain's trying to figure out, where did I find this so I can do it again? And that, I mean, that's because dopamine is spiked for finding a mate for food. So survival drives. So now when you use a drug that mimics that only to 100x now your brain is certainly recording every little nuance about those situations. And so now you could be five, 10 years sober, but you put yourself back in those situations. It could be driving down the street where you used to buy drugs from a dealer, or seeing old friends that were using. And you may think, you may not even recognize the fact that it's triggering you, but we know that it does. You know, light starts tingling up that back area of her brain, beyond your control. And then what can happen is if you're not careful, all of a sudden, the next, you know, that day, the next day, why am I thinking about it? Why am I dreaming about it? Like, you know, you don't know what's going on. And people will lose 20 years of sobriety because they hung out with the wrong person, didn't use A drug. I'll give you a perfect example. So I see all the time in patients where they'll say, oh, you know, I could go out to the bar with my buddies. I'm not going to drink. You know, I'm just going to have a seltzer, and it's all going to be good. You'll see. You know, and they'll test it, they'll go out with their friends, they'll go to the bar and they'll come home and say, look, I had the diet soda, I had the seltzer. Everything was fine. I didn't drink. But what do we find all of a sudden, three days later, four days later? Why are they thinking about it? All of a sudden? They're dreaming about it. And then here comes the relapse a week later. I see it all the time for people who go, for example, on these cruises with all the alcohol everywhere and they're in recovery and they, no, I didn't drink, Doc. I didn't drink once on the cruise. It was fine. But, you know, the cleaning of the glasses, looking at people, getting tipsy, it starts lighting up that area of your brain. And then all of a sudden, yeah, you didn't drink on the cruise, but you drank the night you got home, you know, because those impulsive cravings start coming back. So when you have addiction, when you're in recovery, you have to always be on guard. And that's what I mean by. It's a disease. It's an inherent. It's a susceptibility that you now have, that you live with, and you have to protect yourself from it. But if you do that, you can have. You can have incredible lives, and you're a testament to that.
- [34:05]
Michael Chernow
Well, but I do want to. I do want to make it clear, though, you know, I mean, I'm. I'm sober consistently for 20. Over 20 years, right? And I am able to participate in events where there's alcohol, potentially even where there's. There's. There's drug use. And I actually got sober bartending, like, behind the bar. And so. And I've never been able to figure out. I mean, I can draw it to. I was just ready and it was. I was done. But I don't know what happened to me. That. And you very well could be right. You know, it could have been the people that came to the rescue for me. You know, there's a guy who I literally just got off the phone with, who's like a mentor, still older brother for me, who was the first Guy that really came to listen to me, this guy Marcus. And I looked up to him immediately. Immediately I met him, I thought my life was over. I saw this guy roll in with tattoos, 10 years sober or 12 years sober at the time maybe. And I was like, wait, that is possible in sobriety. And I latched onto that guy, and he really sort of winged me. So I don't know what it is necessarily, but I do think that. And I want to get into Vivitrol, too, because I know that that's something that you've been working on and something that you believe passionately in.
- [35:32]
Dr. Russell Ciraski
Well, it's a great point you're making. Why do we see that people just have such a horrific time getting sober with all. And they have everyone around them and all the tools in the meetings and so forth, but you were able to do it and get out of it and be sober for 20 years. You know, that story's not the typical story. The typical story in addiction is often relapse after relapse. And, you know, you hope that over time and with treatment programs and so forth, eventually, you know, you can get some good sobriety time. But why can that happen? Because there's a number of other variables, right? About someone's brain, about their personality traits, about their, you know, about their. Just their entire makeup that can make them more resilient. That can. That can. You know, there's obviously something in you that was driven by other things in life. You had found other passions, and the dopamine surged towards those things, and basically you weren't being pulled as hard, perhaps, but that's what. That's.
- [36:33]
Michael Chernow
So I was trying to allude earlier, and I kind of went off track. So what I've been thinking about as a project for my future, a future venture because of how successful it was for me, a facility where it's not just about recovery and staving away the booze and the alcohol and connecting to God and connecting to others, but you give the. The. The patients there. Another tool that they have complete control over. Because ultimately, I think for me, it was really a control thing too. I wanted to control how I felt all the time. I thought I was God making all the decisions in my life. If I wanted to feel good, I used. If I didn't feel. If I wanted to feel great, I used. Something good happened, I used. Something bad happened. I was bored, I used. I just used, right? And so I had control. And it's very, very. We can control very little in our lives, right? Like, whenever another Human being, animal, whatever walks into your periphery, you've now lost control basically of a lot. But with fitness, you have control. For me, fitness has been the key. It just has been the key. I've consistently worked out five days a week since I've gotten sober. And if, if I was asked today with a gun to my head, if you had to say what it is that's kept you sober, I could honestly, and I love the 12 steps, I, I love my relationship to God. But I would have to say it's been my commitment to fitness because it gives me an opportunity to do something that takes me out of my brain for an hour and a half that residually I feel great about for the rest of the day. The residual impact of what fitness does for my brain is remarkable.
- [38:54]
Dr. Russell Ciraski
I think you're hitting on some of the keys here. What fitness does for you is satiate some of that. You know, if you didn't have it, your brain might look for that in some other form and, and you channeled it into an incredibly healthy practice. But again, unless someone is exposed to a mentor or someone who shows them a way or introduces them to that kind of life, you know, it's, it's not going to happen.
- [39:21]
Michael Chernow
Maybe I pitched that idea to Donald Trump.
- [39:24]
Dr. Russell Ciraski
I think he's, I think he's got his ears open to this crisis. You know, he, I've heard him speak about it many times. So you should interrupting this episode to.
- [39:34]
Michael Chernow
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- [40:57]
Back to the pod, the Vivitrol. So why so Vivitrol? I mean, you'll be able to describe it better than I can, obviously, but Vivitrol is a non opioid addiction treatment medication that really keeps the cravings at bay. And it's a one shot a month medication that works. Why are treatment facilities not armed with Vivitrol everywhere?
- [41:28]
Dr. Russell Ciraski
Yeah. So just to talk a little bit more about Vivitrol, from what you said, it's pretty remarkable. It's a medicine that treats alcohol addiction and opiate addiction. A lot of people say, well, how can it do that? But the interesting thing we've learned is that actually alcohol, the addictive part of alcohol, actually hijacks the brain in the same final pathway where it kicks up the endorphins in the limbic area. And then the limbic area sees that level of spike of endorphins and says, this is what I want every day, this is what I should go after. Because it spikes the endorphin levels. Your limbic system has to understand salience. Like what's important in my life, what am I supposed to be driven towards? And so survival drives are always at the top of that list until something spikes the levels of the dopamine in that area, which is the way to understand salience, way above those normal levels. And then that limbic area of the brain, which is extraordinarily powerful over our drives, is hijacked and says, this is actually what I'm supposed to be looking for. And then it, with unrelenting strength, it goes after that drug every day. And so alcohol hijacks the brain ultimately in the same way. So when you introduce this medicine, Vivitrol, what it does is it goes into the opioid receptors. Right. Ultimately, alcohol does again addict people through those same receptors. So when youthe medicine in Vivitrol is now trexone, when it binds those opioid receptors in the brain, it basically blunts or shields off the ability for drugs, opioids, or alcohol to be able to spike those levels of dopamine. So one, the cravings go dramatically down, whether you like to drink, you have an alcohol addiction or opioid addiction. Two, if you have an opioid addiction, and let's just say, yes, the cravings went down, but you decide, I'm just gonna use anyway. You know, people, places, things. You're in the wrong place. And you just said, I'm going to do it. It blocks it from binding to those receptors for an entire month after that one shot. So you're not going to get high and you're not going to overdose. And so if you think about it like for a family that never sleeps wondering or worrying where their child is, knowing that they have that medicine in their system is certainly a comfort and can save their life. And the third thing is it's not addictive and there's no physical dependency on it. So if you want to stop it, you can just stop it. Now, most people, we have them stay on it for six months to a year because during that time there's other things that are important. It's not just about the medicine. It's about learning coping skills to deal with stress. Medicine can't do that for you. That's where these meetings come in. For example, getting a sober support network of people. Because if you are using and now you're not around those people, a lot of times you don't have friends anymore. And that's a big risk factor to go back to drugs. So you got to go to counseling or meetings to get a sober support network and learn coping skills and avoid triggers. So we want people, we put them on Vivitrol to help them get over that early, hardest area where their brain is still raging, to go find the drugs and keep them alive, keep them safe, and during that time, learn those skills of life. And once that's there, it's not the same for everyone. Six months, 10 months. Some people are a year, two years, whatever it may be.
- [45:01]
Michael Chernow
Can you be on it forever if you had to be?
- [45:03]
Dr. Russell Ciraski
So, yes, you certainly can, but you don't have to, you know, and, and you know, people, it's amazing, you know, when it comes to, again, blood pressure, diabetes, people just, okay, yeah, you gotta be on medicine forever. But when you're dealing with an addiction, especially the opioids, we can die any given day. There's a great reason why, when you look at the risk and benefit of staying on medicines that are helping someone stay sober and alive and productive in their life, when before they were essentially dying every day, losing everything in their life to keep someone on medicine is the smart choice in many cases. And it's sort of frowned upon, like, oh, you know, now you're on medication for your life. What good is that? What do you mean, what good is that? It saved this person's life and it's helping them and look at how they're living.
- [45:52]
Michael Chernow
Do you know anybody or have you come across anybody? And I'm sure you have at some capacity that. And this could be controversial. So know anybody listening to this that is in recovery. Don't take this the wrong way, but because I could tell you I haven't really come across people that have addiction and spend years in sobriety and then choose to go out and are able to do it successfully and responsibly.
- [46:24]
Dr. Russell Ciraski
It's impossible. It's because the brain has fundamentally changed once addiction has set in. And so the idea a lot of people with addiction have is they want to go back to the time when they used and it was fun, right? But that will never happen again. The brain has changed. The minute you could be 15 years sober and if you take that drink or you use that drug, it just goes right off the rails. You know, there is no controlling the drug anymore. And so, you know, that is why you can't. And you know, the other interesting thing is a lot of people, you know, we talk about AA meetings. There's so many misconceptions. These 12 step meetings are so phenomenal for so many people for a number of reasons. But, you know, a lot of people say, I don't like, you know, step one, I'm powerless over the drug. Right. But people get the wrong idea about that. You're not powerless when you're in sobriety, you're powerful when you're in sobriety. What they're saying in that statement is, yeah, when you use the drug, you're powerless. And that it's just an acknowledgement of the condition that I can't use that drug and I'll be in control. That's what that step means. And I think that's very important for people to understand. You are powerful in sobriety. And I think people mistake that thinking, like, I don't want to say that I'm powerless.
- [47:42]
Michael Chernow
In the 12 step communities, they highly recommend and suggest a connection to a higher power of the universe. God, call it what you want, right? For me, that is very true. And a lot of people that come into the 12 steps run for the door. As soon as that's spoken about being a really science based analyst on addiction. What is your thoughts on that?
- [48:11]
Dr. Russell Ciraski
Well, in terms of the science, if you want to talk about that. Two major studies, one from Stanford Medical School and the Cochrane Review, have shown overwhelmingly that 12 step programs are the, are the most effective form of counseling for people with addiction. First of all, they're everywhere. They're free, they're accessible. And, you know, when you do what's called the 12 steps, you know, there's a tremendous amount of self. You know, you have to do a lot of self reflection in that work stuff that most people will never do. You have a sponsor, someone who really watches over you and guides you, someone who has a much longer period of sobriety. And so there's so many positive things that can come from them. And it doesn't mean that every single person has to live in the rooms every day when they're in sobriety, but everyone's journey is different. But knowing that they're there for you and knowing how they help you is very critical. And during the pandemic, when they shut down churches and lock down, you know, houses of worship, all those meetings got shut down. And it was devastating to people who are in recovery. Many people relapsed and many people died because of that. But just to go back to the question about the religious stuff, that's another misconception. It's spiritual. It's not tied to any particular religion. And it's about believing in something bigger than you. Sometimes just believing in the group is bigger than you. It's the belief in something greater than yourself that time and time again helps humanity and helps people in recovery. And that, that's what that's about.
- [49:47]
Michael Chernow
If there's a genetic potential. Well, there is, obviously. We're saying that there's genetics. You're genetically susceptible based on your sequences. Why are some siblings more of an addict than their brother or sister?
- [50:03]
Dr. Russell Ciraski
Well, so siblings certainly, as you pointed out, don't have identical genetics. And for example, let's say you have ADHD, which, you know, approximately 5% of the population has some degree of ADHD. And that can make you more impulsive, you know, jump first, think about it later type of issue. And, you know, untreated adhd, it's different if someone's being treated, which certainly can help them, but there's stigmas about that, too. There's this cacophony of voices online and influencers who sort of try to say things like ADHD is not a make, like it's not a real condition, or that it's a discipline issue or what have you, which it certainly isn't. And it affects people greatly. And one of the things it does is it makes you more impulsive and makes you try, and makes you try drugs more and makes you more susceptible to that switch going off. So you can certainly have. Most of the time, if I diagnose a kid with adhd, one of the parents has it. And so the point being is that not every sibling's the same. And if your kid or family member is dealing with a mental health issue, you got to treat that. Because if you don't treat it, then they're going to be much more likely to run into these issues and get hooked on drugs. It's what we know. Bipolar disorder has a 40 higher risk of addiction. ADHD, borderline personality, as we talked about, they all have very high, much higher percentages than the general population of developing addiction. So you gotta be on guard about that and don't look the other way if your kid has an issue.
- [51:48]
Michael Chernow
So back to the question about Vivitrol. If Vivitrol is so effective and it's been studied to sort of block or shield these opioid receptors from the drug, why are treatment facilities not leaving their patients? Because I heard you say that one of the sort of hurdles with Vivitrol is that you have to be off of the drug, off of opioids for seven day period of time before you're actually able to administer it. So I could see that being difficult for like running around the streets with Vivitrol shots. Right. But once somebody's in treatment and they have now been weaned off of the drugs or the alcohol, why is it just not common practice right now to, to use Vivitrol as, as a step to help these people not, you know, not make their treatment facilities revolving doors? Because let's be, let's be real here. I mean, they are the revolving doors, right? Like it's a real lucrative business. Is that why?
- [52:58]
Dr. Russell Ciraski
Well, there's a couple different reasons. One of the biggest reasons is because most people coming in that are using opioids, they actually don't do what you just said. They don't wind up coming, tapering off. What happens is it pretty much the sort of protocols at most all facilities is to use buprenorphine, which is Suboxone. And listen, Suboxone can be life saving. It's just a different path than Vivitrol. Say it's a different way that these medicines work. And the Suboxone is an opioid itself. Much safer certainly than using drugs on the street. And we can talk about that more in detail. If you want, but they go on Suboxone and they sort of stay on Suboxone maintenance. And that's the vast majority. It's much easier when someone's going to, going to withdrawal in a rehab facility to just give them the Suboxone because it instantly makes them feel better and stops the withdrawal and helps them kind of go along their path and protects them to some degree from relapse. But to go on Vivitrol, which is a non opiate medicine, so your recovery is now with no opiates at all in your brain, you have to detox off of those opiates with. You have to detox off the opiates you were using on the street, whatever, whatever one it was, and the doctor has to do that with you without using Suboxone.
- [54:12]
Michael Chernow
So what is they use? So what?
- [54:14]
Dr. Russell Ciraski
So you so. Well, this is where the issue comes in. A lot of doctors in these facilities and treatments, they don't want to deal with this. Right. You also have to take time and speak to your patients and be able to tell them I can help you. You don't necessarily. There's another avenue aside from Suboxone. And this is how we do it. We give you these constellation of medicines for a few days, you'll be comfortable. And after that, if you want the option of Vivitrol, you can have it. But because that conversation never happens, they ultimately don't get a choice.
- [54:42]
Michael Chernow
But there is a way to detox off of opioids in treatment without using Suboxone, where you're still keeping patients comfortable.
- [54:52]
Dr. Russell Ciraski
Without going through severe 100%. And I think it was my background in neurology that actually helped me to be able to do that. So I was able to get people onto Vivitrol rates that no other place was doing it. And it was simply because they just didn't invest the time or energy in figuring out how to help people in that way. And so I was able to put together a protocol of different medicines that really, really completely shut down the withdrawal symptoms, cravings, keep people completely comfortable and then they get an option. It's not that Suboxone is bad, it's just that if I was going into recovery and the doctor said to me, you know what, I could help you be comfortable no matter what. But at the end of that few days, would you want a medicine that's not an opioid based medicine or one that is, I might say, you know what? After, if I'm going through these few days of detox, maybe I want to be in recovery without an opiate in my system, I'm coming off an opiate and I'm not. Again, it's everyone's choice getting help in either way.
- [55:53]
Michael Chernow
But I guess where I push back there is why are you giving them a choice? Because I would imagine, you know, it's like methadone, right? Like, you know, the methadone, so we used to call them. Right. And when I was using, you know, we call them methadone because, you know, when someone's on methadone because they are high, right? They are. It's not, it's not that they're not nodding out like they, they would be typically using, you know, bang and a bundle of heroin.
- [56:21]
Dr. Russell Ciraski
Sometimes they are.
- [56:22]
Michael Chernow
Yeah, but, but people abuse methadone for sure. And, and you know, just by you want to have a look, go stand outside of a methadone clinic and see what, see what's standing outside there, right? And so like, why wouldn't there be not a choice and, and there be, hey, this is the, this, you know, look for being in recovery as long as I am. There's certainly for a long time the thought for me of using a medication to treat your addiction was like you had said, right. There is a bit of a negative connotation to it, right? Like, I know you can do it without medication. I know that's to be true. It's hard as hell, and there's no doubt about that. But once you get over a certain hurdle, the cravings and the obsession does diminish significantly. Almost. Almost. So much so that, you know, and I will never say I'm cured. I'm not. I know how I am with other things that are addictive. Phone use, you know, spending money, fitness, being healthy. Like, I'm hard nose down to the ground in those things. Right. And, and I'm working on that. But I, I just don't understand why there would be an option if you could say, hey, let's remove opioids from your system entirely because there is this opportunity now.
- [57:57]
Dr. Russell Ciraski
Again. Well, a couple of things. One, people are dying at an alarming rate. And any kind of medication assisted treatment is certainly better than not helping somebody. And Suboxone can very much help people stay sober. People who have tried and are not getting sober. Like you said, yes, for some people, those cravings go down with time. And other people, it's not always the same. Some people just continually relapse no matter how bad things get for them and they're going to die. And then you introduce a medicine to their brain. That's stops their limbic area from screaming at them to keep using. And all of a sudden they're waking up and they want to do other things with their lives. And so Suboxone can do that for some people. And so Vivitrol does as well. They did a head to head study. They compared Vivitrol to Suboxone and they looked at a number of things and they even used up to 32mg of Suboxone a day, which is a high dose. And on every level, Vivitrol, you know, met or exceeded what, what Suboxone could do. But again, Vivitrol is not an opioid. I think the feeling is also doctors say, like, well, there's, it's the patient. What if he doesn't come back and get the shot every month? Or, you know, one of the other critiques is, you know, when you, one of the things that happens when you stay away from the drug for a while is also you lose your tolerance for the drug, right? And so Vivitrol does that very quickly because it helps heal your brain. Your brain gets a weight. Those opiate receptors change when Vivitrol gets in there. It's akin to like if you went away somewhere for six months and didn't use a drug and then you came out and used.
- [59:34]
Michael Chernow
But would Vivitrol work with crack?
- [59:37]
Dr. Russell Ciraski
No, it doesn't have much ability at modulating cocaine. But alcohol, it's incredibly effective. You know, they did a study where they looked at, they gave people a placebo injection or Vivitrol injection. And the average person, it was 100 people. The average person was drinking five to six drinks in a sitting per day. And they went from, the average person went from 15 heavy drinking days in a month down to like one. You know, the, the fascinating thing is, just real quick, the fascinating thing is that someone who's in recovery from, from alcohol addiction, they can never have a drink. I think we all know that they can't have one drink. And if you think that this isn't about your individual brain and not just the drug, it's about both. If you don't have addiction to alcohol, you could take a drink, drink a few sips, put it down, forget you even had the drink. Someone with alcohol addiction looks at that and says, how can they possibly do that? If they have a sip, forget it. It's off the rails. Obviously their brain is hijacked, right? But on Vivitrol, it's very fascinating. If someone drinks Nazivitrol in their system, they'll all tell you the same thing. I'm just not into it. It's like drinking seltzer. Why? Because alcohol hits their brain and it doesn't let that area take off with the dopamine in the limbic area. So they're just like, ah. Now we don't like to use it in that way because the minute Vivitrol comes away and they drink, boom, it's going to be off the rails again. So we use Vivitrol as a tool in their recovery treatment program, like going to meetings and so forth, to help them get the sobriety. But in terms of why do they give people a choice? Just because anything's better than nothing. And, you know, when you're dealing with opiate addiction is probably the most dangerous and horrific condition in medicine in terms of how fast it robs you of everything and can kill you. And so, you know, we don't have people back 20 years ago, you knew people that would maybe using heroin on the streets for years and years. You can't do that anymore. There's no way you could survive using fentanyl for years and years. It's just a matter of very short period of time. You can survive. So we're dealing with a completely different animal. And anything that can help people stay sober and not get triggered is better than nothing.
- [62:00]
Michael Chernow
This has been such an intense interview. You know, I really was looking forward to having you here. And I just got to say that I, you know, I feel so lucky. I feel so lucky because I don't think I'm rare or unique. I don't. But I know that it's not easy getting and staying sober. And so the idea now that there are alternative solutions to helping people stay on the path, because you said it yourself, it's proven in science now with these pat scans. This isn't people that are addicted to alcohol and drugs. It's not necessarily a choice for them. If they. If they want to stop, there's a very small chance that they're going to be able to. It's proven. I think the success rate in even Alcoholics Anonymous is like 7%. So it takes a very, very, very strong mind, I think, and an amazing support system, and in my opinion, another physical activity that you can obsess about to actually keep you focused on sobriety. It's so real. It's so intense. You know, I know that we. I think that there's something like 80 to 100,000 deaths a year now in The United States of America. From drug overdose.
- [63:39]
Dr. Russell Ciraski
Every 20 minutes, someone's dead. From an opiate overdose. Every 20 minutes, five people die during this podcast.
- [63:45]
Michael Chernow
So. And that's only the deaths that we hear about, I'm sure. Right. Like I would argue to say it's probably far more than that. It's a real thing. It's killing more people than all the wars put together. And, you know. Well, I shouldn't say that. It's not killing people, you know, more people than all the wars put together, but it's certainly killing an enormous amount of people, and it is catastrophic and it is polarized here in this country. And I just can't thank you enough, man, for, you know, writing a book about it that people should definitely pick up. Where could they pick up your book?
- [64:21]
Dr. Russell Ciraski
I believe it's pretty much available anywhere books are sold. So it's called this book Will Save youe Life. And it's written so anyone can understand it, including a doctor. Picking it up will read, will learn things, and anyone picking it up will certainly will quickly understand and get the tools to be able to help themselves or a loved one. And one thing you. I've heard you speak many times, and one thing you always say, which I think is phenomenal, is, you know, it doesn't matter how far gone you think you are or how many, you know, times you've relapsed or how bad your life is and you think you can't make it, it just isn't true. And you gotta reach out for help. And that's what I see every day doing this, which is, you know, people have written people off. Oh, they've been to rehab seven times. That's it. Forget it. They're. They're a hopeless case. And then all of a sudden, things come together and they get sober and then live fantastic lives. So you never give up on yourself or a family member, and you gotta reach out for help. You know, And I love that you say that because it's so true. And that's the main message I want people to know. It doesn't matter how bad you think it is, you can get better.
- [65:36]
Michael Chernow
There is a solution 100%. If people wanted to follow along your journey or potentially get in touch with you and understand where they can get treatment similar to the treatment that you.
- [65:46]
Dr. Russell Ciraski
Work with, I want to recommend that no matter where you are, if you. If you want to get the right kind of help, you should go to SAMHSA. SAMHSA.com and they will guide you to a certified treatment center that has doctors there that can offer medicine if they need it in your area, and that that's the fastest way to get someone to a certified treatment center. We didn't get into this, but the whole world of treatment centers is, is a whole nother problem because of all the other incentives profit wise. You think people are helping you and they're just sending you to places that give them kickbacks, you know, and they're not good treatment centers. That's a whole nother conversation.
- [66:25]
Michael Chernow
Well, let's just touch on that for a sec. Is there something that people should be looking for when researching treatment centers?
- [66:31]
Dr. Russell Ciraski
Well, I would say the number one thing that tells you that when they compare treatment centers that offer medical care or have a doctor to be able to evaluate you for mental health or addiction and offer medicine if needed, the recovery rates from those centers are so astronomically higher than places that don't offer that care. That if I would look for one thing, it would be that there's medical, some kind of medical physician supervision there. But it is a very difficult world for people to navigate. If you go on Google and just type in treatment centers, you're bombarded by places that are spending lots of money to advertise to get their name at the top and build your insurance company and not offer great care, unfortunately. And so you got to be careful where you, where you're looking, but make sure they have some medical care there.
- [67:21]
Michael Chernow
Do you have any standouts that you're comfortable mentioning?
- [67:24]
Dr. Russell Ciraski
There are. There actually are so many good ones that, you know, I don't want to just sort of name names of rehab centers and exclude others. Sure. But, but really the main thing is to look for physician oversight. That seems to be the key. Okay. Yeah.
- [67:42]
Michael Chernow
And then where can people follow along your journey?
- [67:45]
Dr. Russell Ciraski
Well, the best way would be to go to DrSuroski.com Dr. S U R A S K Y.com Awesome, Doc.
- [67:55]
Michael Chernow
You know, I think we've learned a lot. I think the biggest takeaway, which I would hope the audience can walk away with, is this idea that people that have addiction are not unlike people that have other diseases. It's actually a disease and they're not useless wastes of human flesh. They are people that are literally in the depths of a disease that conducts differently and the symptoms are different than what you would typically, or what we typically sort of correlate to a quote unquote disease that we are more commonly familiar with. Appreciate you very, very much. Thank you so much for coming on the show.
- [68:51]
Dr. Russell Ciraski
Thank you so much for having me on.
- [68:53]
Michael Chernow
All right, y'all, there you have it. You guys know how open I am about my recovery and I do that sort of not in a intentional defiance to the communities of the 12 steps that really do teach us to be a little bit more reserved and anonymous about our stuff. I don't care to be anonymous about my addiction. And I am in front and outside about it because I know that the person that I called when I was ready to get sober told me and the other people that we worked with that she was sober. And had I not known that, I don't know if I'd be sitting here today. I don't know. So the message that we are here sharing today is this idea that there is an absolute solution and not only one, multiple. If you're struggling, if you are deep in the throes and you don't believe that there is a way out. I'm sitting next to a doctor, a double board certified neurologist and addiction specialist who does this all day long, and he is here telling you you go onto WebMD to look up a symptom that you might have and believe it online. Right? And maybe it's true. But I'm sitting here from a sitting across the table from somebody who has practiced this for years in science and is sharing this idea that yes, it is a disease, yes, there is treatment for it, yes, you can change your life no matter how far down the road you think you are lost in the woods. I know this was a bit of a somber one, but it's a real thing that we're dealing with in this country and abroad. But really, here we are by far and away the most active in this opioid epidemic globally. So if you know somebody that's struggling, share this podcast, please, please share the podcast. Just ask them to listen to it. And if you are a family member of someone who's struggling, I hope this has given you a little bit of reprieve. It's very, very difficult to rationalize with someone in active addiction. I know that to be true. But at least now you know that there are certain things that you can do that are not just 12 step programs or not just treatment facilities. There are medications now today that are helping people see some light at the end of the tunnel, if not lots and lots of it. I love you guys. I appreciate you guys. You know the drill. A five star rating and a review would be greatly appreciated. But really the most important piece of this for me is that you share this podcast with people you think would would appreciate it and I hope you guys are having a great new year. I love you. Until the next one y'all. Peace.
- [72:23]
And there you have it folks. I hope we delivered some valuable content for you to implement into your life on a daily basis. Please remember that our habits have the power to make us or break us. Replacing bad habits with great ones is the answer to living a life of happiness, optimism and high performance. We are capable of achieving anything. We all have what it takes to.
- [72:49]
Give it all we've got.
- [72:51]
Commit to one great habit each day and truly commit and watch how everything in your life starts evolving from good to great. If you enjoyed this podcast, please follow us wherever you listen to your podcast, give us a five star rating and a nice review that will help us grow this podcast, bring on more amazing guests and continue to deliver invaluable content on a weekly basis. Lastly, please share this podcast with any friends or family that you think might appreciate. And always remember, want plus do equals have until the next one Fam Peace.