Podcast Summary: "Dr. Fong's Mind-Blowing Technique for Making Patients Feel Comfortable"

Podcast Information:

• Title: We're Out of Time
• Host: Richard Taite
• Guest: Dr. Timothy Fong, Professor of Psychiatry at UCLA
• Release Date: August 5, 2025

Introduction

In this episode of the "We're Out of Time" podcast, addiction recovery expert Richard Taite welcomes Dr. Timothy Fong, a renowned Professor of Psychiatry at UCLA. The conversation delves deep into the complexities of addiction psychiatry, co-occurring disorders, the impact of societal changes on mental health, and innovative treatment approaches.

Dr. Timothy Fong’s Background and Expertise (00:00 - 03:32)

Dr. Fong shares his journey into addiction psychiatry, inspired by his experience at the Betty Ford Center in 1995. With over 27 years in the field, he highlights his roles in research, clinical care, and community engagement:

• Research: He leads the UCLA Gambling Studies Program and the UCLA Center for Cannabis and Cannabinoids.
• Education: Dr. Fong teaches addiction and mental health to a diverse audience, including medical students and families.
• Clinical Care: He provides specialized psychiatric care focusing on the mental health aspects of addiction.
• Community Engagement: Emphasizing mutual learning and spreading messages of recovery and hope.

Notable Quote:

"We can provide some help, we can alleviate suffering, we can make their quality of life better." — Dr. Timothy Fong [02:43]

The Current Landscape of Addiction Psychiatry (03:32 - 08:08)

Dr. Fong discusses the severity of cases seen in addiction psychiatry today. Patients often present with multiple co-occurring mental health issues, medical complications, and significant life disruptions. He underscores that while the majority can improve with proper care, some cases present profound challenges:

• Severe Cases: Patients like a 33-year-old with a decade-long methamphetamine use disorder face immense physical and mental devastation.
• Prognosis: Despite the severity, Dr. Fong remains optimistic, reporting only two deaths over 27 years of practice.

Notable Quote:

"No matter how bad you think you are or how bad things are, we can make things better." — Dr. Timothy Fong [00:34]

Rise of Co-Occurring Disorders and Societal Impacts (08:08 - 16:43)

The conversation shifts to the increasing prevalence of co-occurring disorders, especially in the wake of societal changes:

• Historical Context: From the 1950s to the present, addiction and mental health have been treated separately, perpetuating stigma.
• Modern Challenges: The advent of smartphones, social isolation, and the rise of toxic substances have exacerbated mental health crises.
• Pandemic Impact: COVID-19 further intensified these issues, leading to unprecedented challenges in treatment centers.

Notable Quote:

"Isolation and loneliness taking over modern day life... drift toward loneliness and isolation." — Dr. Timothy Fong [10:00]

Successful Treatment: Integrating Biological, Psychological, Social, and Spiritual (16:43 - 25:05)

Dr. Fong emphasizes a holistic approach to treatment, incorporating multiple facets to ensure successful outcomes:

• Biological Treatments: Beyond medication, he highlights the importance of sleep, nutrition, and physical movement. Innovative methods like saunas and cold plunges are underutilized.
• Psychological Treatments: The power of genuine connection between therapist and patient is paramount. Dr. Fong is praised for his non-judgmental and empathetic approach.
• Social and Spiritual Treatments: Building purpose and community is crucial. Dr. Fong advocates for creating opportunities that foster a sense of belonging and meaning.

Notable Quotes:

"You don't judge, you don't preach, you don't criticize. You're someone we can relate to." — Dr. Timothy Fong [12:25]

"The more visits you have, the better people do." — Dr. Timothy Fong [13:18]

Developing Psychological Support Systems for Early Recovery (25:05 - 34:04)

When envisioning an ideal support system for addicts in early recovery, Dr. Fong outlines the necessity of purpose and community:

• Purpose: Providing avenues for individuals to find meaning in their lives beyond substance use.
• Community: Creating environments where individuals feel connected and supported.
• Examples: Activities like music therapy, structured programs, and community engagement initiatives.

Notable Quote:

"Any weakness can become a strength. Any strength can become a weakness." — Dr. Timothy Fong [27:59]

Handling Co-Occurring Disorders in Treatment Centers (34:04 - 37:30)

Dr. Fong critiques the current structural separation between addiction and mental health services in California, highlighting the inefficiencies it creates:

• Historical Separation: Addiction has long been treated separately from mental health, fostering stigma.
• Current State: Most treatment centers struggle to adequately address co-occurring disorders due to fragmented services and outdated training paradigms.
• Need for Integration: Emphasizing the importance of treating the whole person by integrating addiction and mental health care.

Notable Quote:

"Unfortunately, most don't do it as well as we all like to see, but others really do a tremendous job." — Dr. Timothy Fong [17:37]

Addressing Suicidal Ideation and Lethal Emotional Pain (37:30 - 34:04)

A significant portion of the discussion revolves around managing patients experiencing suicidal ideation intertwined with substance use:

• Lethal Emotional Pain: Dr. Fong introduces this term to describe acute, overwhelming emotional distress leading to suicidal thoughts.
• Emergency Action Plans: Developing personalized strategies for individuals to employ when overwhelmed, such as listening to specific music or reaching out to support networks.
• Case Example: A patient created a playlist of 80s songs as a coping mechanism during suicidal crises.

Notable Quote:

"If you have lethal emotional pain, what's your plan to deal with it?" — Dr. Timothy Fong [20:43]

Borderline Personality Disorder vs. Bipolar Disorder (34:04 - 37:30)

Dr. Fong clarifies the distinctions between Borderline Personality Disorder (BPD) and Bipolar Disorder, addressing common misconceptions:

• BPD: Rooted in personality traits that can be modified with proper diagnosis and treatment. Often misdiagnosed due to superficial similarities with other disorders.
• Bipolar Disorder: A mood disorder characterized by consistent patterns of depression and mania unrelated to personality.
• Treatment Implications: Accurate diagnosis is crucial for effective treatment strategies, emphasizing that personality disorders are not immutable.

Notable Quote:

"They're not a bad person just because you get emotional and cry when your friend doesn't text you." — Dr. Timothy Fong [28:00]

Impact of Cannabis Legalization on Mental Health (37:30 - End)

The legalization and increased availability of cannabis have had profound effects on addiction and mental health:

• Increased THC Concentration: Modern cannabis strains are far more potent, leading to higher rates of addiction and adverse mental health outcomes.
• Cannabis Withdrawal: Symptoms include sleep disturbances, nausea, and significant discomfort, challenging the perception of cannabis as harmless.
• Mental Health Implications: Cannabis exacerbates most mental health conditions rather than alleviating them, contrary to popular belief.
• Research and Resources: Dr. Fong highlights UCLA’s initiatives in studying and treating cannabis-related disorders.

Notable Quote:

"Number one, we know cannabis is addictive. Number two, we know cannabis makes the vast majority of mental health problems worse." — Dr. Timothy Fong [31:33]

Conclusion and Resources (37:30 - End)

Dr. Fong concludes by promoting UCLA’s Gambling Studies Program and the UCLA Center for Cannabis and Cannabinoids, encouraging individuals to seek help and stay informed through reliable sources. He emphasizes the importance of education and proper information in combating addiction and mental health issues.

Notable Quote:

"There’s so much noise... educate themselves through proper channels." — Dr. Timothy Fong [37:30]

Final Thoughts

This episode offers a comprehensive exploration of addiction psychiatry, highlighting the intricate interplay between mental health and substance use. Dr. Timothy Fong provides valuable insights into effective treatment modalities, the challenges posed by societal changes, and the critical need for integrated care systems. Listeners gain a deeper understanding of the multifaceted nature of addiction and the hope that comes with informed, compassionate treatment.

Additional Resources Mentioned:

• UCLA Gambling Studies Program: UCLA Gambling Program
• UCLA Center for Cannabis and Cannabinoids: Cannabis Semel UCLA
• American Academy of Addiction Psychiatry: Professional society for addiction psychiatrists.