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Is AA the best solution for addiction?

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The Urban Monk – Unbroken Brain with Guest Maia Szalavitz

Maia Szalavitz says “No” to AA as a panacea treatment for addiction. She’s been around this block and has a unique perspective on the history of treatment for addiction and where it has gone off course. According to her, addiction treatment should not be the only thing in medicine that involves indoctrination in a self-help group. She’s alluding to AA groups and the “moral narrative” that’s branded the diagnosis in an unreasonable way.

Methadone saves lives. There are chemical treatments that she argues for that are helpful. Super expensive retreats are a waste of your money…but massage is cool. Basically, Maia is arguing for a fresh look at addiction since our current “science” is clouded by 1930’s thinking that forces an antiquated system on people. What people? Our brothers and sisters who are suffering the most. Enjoy the show- this one really got me thinking.

Interview Notes From The Show:

Pedram:

Welcome back, Pedram here with Maia Szalavitz talking about addiction. She’s got a whole other way of looking at it. Let’s get into it. You’re actually coming from a different part of the world. I love the fact that you have a fresh perspective on addiction. If our view on addiction was working, if our interventions were working, it wouldn’t be sliding out of control. You’re coming at it with a different set of eyes. Let’s get into that.

The Relationship Of The Person And The Drug is the Problem - @maiasz via @PedramShojai

Maia:

Sure. A lot of times we have been looking at addiction from the wrong view. We’ve been seeing it as a problem that is simply inherent in the drug. We haven’t looked at it as a problem with the relationship between a person and the drug. That’s really what it is. People take drugs for reasons. People get addicted for reasons. Only 10 to 20% of people who use drugs like heroine or methamphetamine become addicted. What we have to be asking ourselves is what’s different about that group of people, rather than saying we will just stop the supply of these drugs because that does not work.

Pedram:

What is different about these group of people? Is it they’re all different in unique individual ways or is there a certain type of person that is going to be more susceptible to drug addiction?

Maia:

The idea of a specific addictive personality is definitely a myth. It is the case that outline temperaments, whether they are extremely fearful or extremely bold, both increase risk. Trauma certainly increases risk especially during childhood. About two thirds of people with addiction have some sort of childhood trauma experience. About 50% have a preexisting mental illness. There’s a lot of self-medication going on.

Pedram:

Did you dig this up in the literature as you were studying the subject? How did you get into this?

Maia:

I had my own personal experience of addiction when I was in my late teens and early 20s. I discovered during my experience that I’d been taught one set of myths about addiction on the street, another set of myths about addiction by the government and by the so called prevention people, and yet another set of myths about addiction when I finally went to rehab. It was only when I looked into the scientific literature going from the sociology all the way down to the neuroscience that I began to get a real understanding of what was happening.

A Specific Addictive Personality Is A Myth - @maiasz via @PedramShojai

Pedram:

One of the things that you’re saying in your popular myths about addiction and your book, very interesting, it’s called the Unbroken Brain. I’ve been around a lot of addiction in clinical settings and everyone kind of thinks they know what they know. The doctors are either it works for you or it doesn’t. If it doesn’t work for you it’s obviously your fault, right?

Maia:

Yeah.

Pedram:

It’s terrible, it’s not a healthy way to go about trying to help anybody. Your first one is once an addict always an addict. You’re saying that that’s a myth and that kind of to me flies in the face of the whole AA Narcotics Anonymous popular culture around this whole thing. It’s just that’s so crystallized that to me, that’s a revolutionary statement.

2/3 of people w/ addiction have some sort of childhood trauma - @maiasz via @PedramShojai

Maia:

Sure, if you look at the actual data from epidemiology, you will see that about half of all people with addictions with the exception of tobacco outgrow that addiction without any help largely by age 30. These people are not showing up in treatment because they don’t need help. If you look at them a couple of years earlier like these epidemiological studies do, you will find that they have the DSM diagnosable addiction or substance use disorders moderate to severe as it is now called. They have that just as badly as some of the people who require treatment in order to get better. We really have a great example here of selection bias where the sickest people show up in the legal system and in the treatment system. The other people who have the same exact condition are just not being captured in those samples. What ends up happening is that addiction looks to be way worse than it actually is.

Pedram:

The people that actually turn the corner of their own resolve or stuff like that, what typically happens there? Or they just suddenly aren’t that person anymore?

Maia:

Yeah, it’s usually not that sudden, but it often happens along with a life transition like graduating college, getting married, having a child, getting a job that you love. All of these things replace the drugs. If you normally in the course of things, as you move through your 20s and early 30s, your life starts to advance and it gets very, very difficult to party the way you can during the college years, once you are no longer in college and you have to show up for a job, you have to show up for a spouse, you certainly have to show up for a baby.

A lot of people, the people who can overcome it without formal help, do so. When I say without formal help, I mean without even self-help groups or 12 step programs, anything like that. These people just simply realize that their drug use or drinking is out of hand and they about half of them go to abstinence, and about half of them moderate it.

Pedram:

Successfully obviously.

Maia:

Successfully, yes.

Pedram:

It stops being a problem. They make the transition. College was fun but now I’m a dad.

Maia:

Exactly and what’s really weird about this, is you cannot tell which college binge drinker is going to be a lifelong alcoholic and which one is simply going to the next year saying yep, I’m a dad, this is done.

1/2 of People With Addictions Outgrow Them By 30 - @maiasz via @PedramShojai

Pedram:

No battery of psychological tests, no saliva test for genetic profiling, nothing we’ve found today is a predictor of which one of those guys at the [Frap 00:06:16] party is actually going to stay at the party.

Maia:

Family history obviously matters and if you have a psychiatric disorder, this obviously increases your risk, as does having a severe history of trauma. Again, not all of those people will go on to have a long term problem. It’s really, really difficult to predict.

Pedram:

Yet once people are there that it’s obviously the pathology that they have and they’ve had and so it’s easier to call it after the shot’s gone in.

Maia:

Yeah, but again it’s like you never know who is going to just recover. I think that a lot of families of addicted people should know that the natural course of addiction tends towards recovery because they just hear this chronic, progressive disease stuff and that really isn’t what the data shows. Certainly, there are people for whom it takes a chronic course, but if it were progressive, you should see it getting harder and harder for people to stop using as they get older. In fact, the data shows the opposite, the older you get, the more likely you are to stop.

Pedram:

If someone hasn’t stopped, it’s because of something else and our solution is usually these kind of draconian measures of they end up in the law enforcement system. They end up often lot of times imprisoned, in trouble with the law. Then they go to these rehab centers where it’s obviously their fault for not getting better. That’s one of your kind of myths there, is that the coercion and incarceration is the best way to get this done. In your opinion that’s obviously not working?

Maia:

If you look at the way addiction is defined in psychiatry’s diagnostic and statistical manual, or by the National Institute on Drug Abuse, by basically all experts, addiction is compulsive behavior that continues despite negative consequences. Negative consequences is basically a fancy way of saying punishment. If punishment were to stop addiction, addiction actually wouldn’t exist. We have this idea that if we just punish them tough enough, that will work. If we just punish them harsh enough, a lot of people die.

Addiction Is Compulsive Behavior - @maiasz via @PedramShojai

Pedram:

Where did that even come in from? It seems like such an aggressive way of dealing with someone who is ailing. It’s not treated a diseases. Originally, it looks like it was treated as an abhorrent behavior that needed correction.

Maia:

This is the strange thing about the way view addiction in America. We say that addiction is a disease. We say that we see it as a disease, yet we lock people up for having symptoms of it. Then if they do get into rehab, the treatment tends to be confession, restitution, prayer, surrender to a higher power, which is you went to any other kind of medical care and were told, “You should just go and pray,” you would probably think you are not in western medicine anymore.

Pedram:

This is my diabetes prayer group.

Maia:

Yeah and so like n these addiction, we have this idea that you’re oncologist is your support group and that’s not how we see breast cancer, and it’s not how we see things that we really think are diseases. It’s not how we see Parkinson’s or any of these other things. It’s really these persistence of this moral model that’s hiding in this medical model. Unfortunately, the twelve step programs which do help lots of people. They carry within within their core these moral stuff. These moral stuff cab be helpful to lots and lots of human beings. If we treat addiction as the only disease for which you have to have a moral solution, we’re not really treating it as a disease. We don’t treat depression this way. We don’t say if you’re depressed, you should take amoral inventory. It may help you to take a moral inventory if you’re depressed, but that isn’t how we treat depression medically.

Pedram:

It’s interesting because AA and all of the kind of cousins of AA traditionally have been pretty bullet proof because they’re getting results where every one else was getting shit. It’s been …

Maia:

That’s not quite true. With opioids, the only treatments that we have that know cut the death rate by at least 50% are maintenance with Methadone or [inaudible 00:10:45]. We refuse to believe that. We have data from around the world from all different types of studies from controlled trials, from just epidemiology, from longitudinal. Just like any kind of study you want to do, if you put these drugs into a situation where there’s a heroin or opioid epidemic, you get less death and less disease and more recovery. If you take them out, you get more death, more disease, more crime and you can run it any way you want to and the data comes out the same that these drugs are life savers. Yet, we have this idea that oh, you’re still addicted, you’re not really in recovery if you take a maintenance medication.

That comes from again misunderstanding what addiction is because addiction is compulsive behavior despite negative consequences. It’s not just physically needing something to function, because otherwise we’d all be food, air and water addict. Cocaine wouldn’t be addictive because it doesn’t cause physical withdrawal symptoms. It sure causes lots of psychological withdrawal symptoms but we don’t count those. We tend to think, oh you know, opioids are addictive because of the physical stuff. What actually matters is the psychology, is why the person feels like this drug is the only thing that makes life worth living.

Pedram:

When we look at resolution, is this an individual resolution per person, through some sort of therapy to kind of unravel where that addiction- Where that behavior came from and how we need to look at what is happening individually in my life in order to unlock this. Obviously, there’s pharmacological interventions that work and that’s falling in the face of say people going and singing kumbaya in Narcotics Anonymous where maybe that’s we feel better about being part of a group and all that. If you’re saying the stats are pointing to drugs work and everything else at that point isn’t showing anything significant. Where else can we find …

Maia:

This is like if you’re talking about whether being life counts. I tend to think that being alive counts and the longer you stay alive, the more chance you have of any form or recovery, medication or abstinence. Since medication shows this dramatic, we’d be dancing in the streets if we had this kind of reduction in mortality for any other serious illness. We’d be handing these stuff out. Here we restrict the treatment because we think it’s the same as the addiction and we just don’t understand it. This is not to say however that people don’t benefit from abstinence sometimes. It’s just that if you look at the data, you’re twice as likely to die if you do not do maintenance.

Pedram:

Yeah, that’s pretty significant. If that was a protocol in oncology, the doctor would be hold away for malpractice if they did anything short of prescribe that drug.

Do We Treat Addiciton As A Disease? - @maiasz via @PedramShojai

Maia:

Exactly and this is why I think we really need to see some lawsuits against some of these rehab programs that do not provide informed consent about medication assisted treatment. I think it’s scandalous and I think that it’s horrifying that so many parents think Methadone and Suboxone are evil because some people misuse them. They don’t understand that what maintenance does when it reduces recovery is replaces addiction with dependence. It also has the side effect of creating a high tolerance which reduces the risk of dying of overdose even if you continue to use other things on top. Because it has that dual nature, people think well everybody is using on top.
They don’t see the people who sneak into the clinic, go off to work, go off to their families, don’t talk to the media because it’s so stigmatized to be on these medications. We only hear from the people who say oh, it’s the orange handcuffs or oh I’m selling it on the street. This stuff is just as bad as heroin blah, blah, blah. We don’t get that actually you can do heroine maintenance and stabilize people. The data on that is really good as well. We just misunderstand the nature of the problem.

Pedram:

Someone who has found some sort of relief through one of these programs and is back to work and living their life and sneaking in and out of these clinics to have their harsh harsh treatment. What percentage of these people end up leading normal healthy lives and moving away from the drugs? Or do they stay on the drugs? Does is matter?

Maia:

It doesn’t matter. We don’t count diabetes success as getting off insulin. That would be great for and I guess for some people that can happen with diet and exercise. With other forms of diabetes, that just simply doesn’t work. Your pancreas isn’t doing its job. The idea that like … Look at what we do with depression. I am on Prozac and I intend to stay on Prozac so long as it continues working because I have had enough depression in my life. I don’t think that makes me an inferior person to somebody who treated their depression with therapy. It’s just what happens to work for me. I just think we have this very moral view of drugs for psychiatric conditions.
Again, if we had a drug that would eliminate all that physical rehabilitation after stroke, everybody would be truly happy. Nobody would say oh, what about the hard work of like doing all that exercise and triumphing over your … We don’t say that about physical stuff. We subject people with mental and psychological illnesses to this moral judgment. I’m trying to say that is as unfair as saying well, your wheel chair works but we really need you to walk so we’re going to take it away now.

Pedram:

Tough, tough luck.

Maia:

Yeah.

Pedram:

Yeah.

Maia:

Yeah, exactly, we just don’t do that. We get that people have physical limitation. We get that people have physical disabilities. We just don’t understand what happens when those are differences in the brain. We also don’t get that some of the disabilities that you have with things like addiction or depression or autism also come with gifts. The persistence despite negative consequences that goes right in addiction can be a really useful skill to have in the rest of your life. I couldn’t survive as a writer without being able to persist despite a lot of rejection. I think this maybe also part of why you see so many famous people with addictions because they have to persist despite consequences to get where they are. Used appropriately, that kind of skill is very useful, but when it’s misdirected, it can be extremely harmful.

Pedram:

Yeah, first of all thank you for doing this. This is a refreshing conversation and I appreciate that you’re bringing to light because I’ve seen all these. I’ve been on the ground for over- I’ve been an acupuncturist early in my career, doing all these note protocols in these clinics. I spent a lot of time on these clinic floors. Yeah, these people were treated as if they had a disease. It was stigmatized and it was … There’s this kind of like what do we need to do to convince you to get over it mentality and that doesn’t make sense.

Maia:

No, I was actually talking with a woman with Parkinson’s earlier today and she experienced compulsive shopping and compulsive Internet and phone use as a result of some of the Parkinson’s medication. What she described was exactly identical to the stuff people with addiction experience. But because when she stopped that medication all of the strange behavior stopped, people could tell this is pharmacological. This is not you. With addiction on the other hand, we just don’t see it as neurological. We see it as psychological and fixable. What’s really odd even something as neurological as Parkinson’s can respond strongly to a placebo effect. It’s this separation between mind and body that we insist on that causes a lot of the problems here.
We really don’t know how free our will is at any given time. We really need to give each other the benefit of the doubt and obviously protect people from being harmed by other people. Also realize that people are suffering and undergoing a difficult road and they’re not taking drugs generally in order to do harm. They think it’s helping and they feel like this is the only thing that gives my life meaning. This is the only that gives me comfort. If you can imagine having to give up the love of your life, this is what is the equivalent in addiction. The good thing about that is that we do survive breakups. They are horrible experiences but we manage to survive them and our brains are not broken by having been in love with the wrong person or the wrong substance.

Pedram:

I’ve seen some memorized studies, I see this a lot and like medical lectures, PET scans and all these of this is a normal brain, this is a brain on drugs. You see, it’s broken. One of your tenets is that drugs cause addiction by damaging the brain. There are neurologists out there speaking otherwise and talking about how these are kind of inextricably linked. I’d love to hear your opinion on …

Maia:

Sure. One of the interesting things about the brain is everything changes the brain. If I walk down the street, it changes the brain. If I sing a song, it changes my brain. If I eat some food, it changes my brain. It’s really difficult to tell what changes are pathological and what changes are learning. Addiction is basically a problematic form of learning. Yes, if you take toxic doses of certain drugs, you can damage your brain. You can be quite seriously addicted without taking toxic doses and without showing any visible damage. Those brain scans that people show are composites. There has never been a finding that this one thing is different in the brains of people with addiction and not seen in people without addiction. The other thing is love changes your brain profoundly and it changes your behavior and it changes your priorities. When you have a kid or when you get married or when you deeply connect to someone, your stress system changes so that like if that relationship is threatened, you will feel horrible.

That’s the same thing that happens in addiction. I just see it as sort of resetting the Dopamine and opioid systems and these very deep, emotional core systems to have the wrong priorities which then changes your decision making across the brain. This is good when it’s devoted to caring for a child or elderly person or anybody needs caring for. It is not good when it’s devoted to a drug.

We Subject People With Mental Illness To Moral Judgement - @maiasz via @PedramShojai

Pedram:

I have over the years formulated my own kind of opinions on this. I’d love for you to kind of tear them apart or nod in agreement if you think I’m not totally off base. A lot of times when patients would come into our clinics and have addictions, we would go functional medicine and we’d say okay, what are nutritional deficiencies? What’s wrong with the gut? Where is inflammation? Let’s just look at this overall system and see if there’s any imbalances that can be treated with food and kind of functional medicine and all that. A lot of times you were right. There’s a lot of deep seated wounds in the kind of personality profiles that would come in. Whether it was early childhood abuse, sexual abuse and all these things.

We worked pretty actively with our therapy staff to say look, we’re in a functional medicine protocol. We’re doing everything we can but there is pain. Until there is some band aid or some resolution of this pain, right now heroin has been the best comfort for this individual and it’s unfair to criminalize this. It’s hard to have a conversation with the addiction clinics a lot of times because if you’re treating someone functionally, you’re looking for a root cause, but everyone else was quick to blame.

Maia:

Yeah and I think certainly nutrition can play a big role for some people. There’s all kinds of things we really just don’t understand about how various nutrients affects the brain. We’re trying to figure out things like Omega 3s or whatever and the studies go one way and then they go the other way. It’s obviously highly individualized and this is the other problem that makes treating addiction so difficult. There’s a zillion ways into it and a zillion ways out of it. Yet we have had this idea that every person with addiction is the same. We would never say that in the autism community there’s a saying, if you’ve met one person with autism, you’ve met one person with autism.

Every time I as a journalist interview a scientist about any psychiatric condition, the first quote I will generally get is well, it’s a very heterogeneous condition. Which means that these diagnosis are not exactly fitting what’s going on in nature and we don’t really understand a lot of it. We can certainly see that these things cluster together and we can call it depression. That may be caused by child abuse in one case and it may be caused by racism or economic dislocation in another. Trying to figure out what’s going on with a person has to come first. When people ask me oh, I’m worried about somebody who may have an addiction.

I always say the first thing that person should do is get a complete psychiatric evaluation from somebody who’s not affiliated with any addiction program. So that you get a sense of like as much as possible and obviously sometimes you cannot tell until a few months in. You can usually get a sense of what’s going on and then you can find treatment that’s going to be tailored more towards that individual’s problems. You don’t put a CEO in a job training program for his addiction. A homeless guy might benefit from that. It’s like some of these isn’t rocket science and some of it is.
Pedram: Yeah, it’s funny how most people … I think I had a friend that had a great quote for that I liked which was this isn’t rocket surgery and in medicine everything is rocket surgery in a way. We over-complicate things in order to silo them and have answers and all that. There’s also a dark side to this. I know these clinics, all opened down the coast of California cost 50, 60, $100000 a month to go to.

Maia:

Yeah.

Pedram:

People are trading in their houses and taking into … Basically, either taking out loans or losing their family fortune trying to help some kid in the family that has a problem and they go in and out of these homes all the time. Some of the results are not that stunning.

Maia:

No, none of the results are stunning and I mean this is why again if you have somebody who’s suffering from opioid addiction, the first thing should be stabilization on a maintenance medication. There’s a lot of talk about Vivitrol which is this antagonist medication. We don’t have data showing that that saves lives, whereas with Methadone and with Suboxone, we have … With Methadone, we have at least 50 years of data and with Suboxone, it’s something like 20. It’s like we have solid evidence that these things save lives. We have this idea that oh, well, celebrities go to this clinics so they must be good or it’s expensive so it must be good.

Actually most people if the amount of money that you spend on a residential treatment, if you spend that on individualized psychiatric care with people who are way more professional than you’re going to be getting in these treatment settings. You would have a very good program for yourself. The problem is you need to find what is going on with you in order to figure out what kind of services you need. It’s also important … I think one thing that the 12 step programs really get right is that community and connection and hope and being able to hear from other people who have succeeded at this is very important. The thing is you don’t have to live with them at an expensive hospitalization. I don’t know, the way we don’t regulate or we like …

It’s just a mess on so many different levels but I think that a lot of these places really need to be sued for malpractice with regards to medication. If you look at Dr. Drew for example, something like 15% of his patients died after treatment. A lot of them were people he took off of maintenance saying that maintenance was evil. This is not good. That’s not to say that everyone could have been saved but it is to say that we have overwhelming data of a 50% reduction in death rates so, you know.

Pedram:

Yeah and your judgment of evil just actually let some person die and your oath was to protect them and to make sure that they …

Healing Addiction Is Like Having To Give Up The Love of Your Life - @maiasz via @PedramShojai

Maia:

Exactly.

Pedram:

Yeah, yeah.

Maia:

I understand, when I first got into recovery myself, I had a cocaine and heroin problem in my 20s. When I first got into recovery, I had done a very brief and ridiculous methadone detox that was completely done badly. I thought well, that’s my experience so therefore methadone must be bad and I wrote this off head saying oh, it’s like replacing vodka with gin and all these nonsense. Then I looked at the data and I found people who for whom it had saved their lives. I began to realize that generalizing from one person’s experience is a very bad idea in science. You have to take, in medicine, you have to look beyond anecdote. You have to see what happens to the larger population. I also want to stress that I’m not saying everybody should be on maintenance forever. I’m just saying that like the data shows that if you stay on for a good few years, you get your life back.

Then if you’re having side effects or you’re bothered by the stigma or if it’s just too much of a pain in the butt, then you can consider tapering. If it works, great, all is good. If it doesn’t, you just go back and it would be fine too. It’s like we just make this harder than it has to be and we make it more expensive than it has to be because we insist that sending people away is necessary. I certainly understand that if you’re living with a drug dealer in a drug den, that is not going to be a good place to start your recovery. You can just move somewhere else, you don’t have to go into somewhere that you live in the place with other people in recovery. Sometimes that may be helpful, sometimes it’s just a scam.

Pedram:

Yeah, yeah and you know listen, if you’re living in a place where there’s access to drugs and you have a hard time saying no, I get the face shift and moving off and going somewhere. But 90 grand a month with massages and cutesy stuff, that is really kind of directed at being like a customer service business, I’m not sure about that. There are some things …

Maia:

Although I have to say if you’re going to go to a place, go to the place with massages and horses and treating you nicely because one of the things we do know about all kinds of talk therapy is that if you are treated with compassion and dignity and respect, that in itself is pretty powerful medicine.

Pedram:

There’s something that’s trending in kind of the new age community is a lot of people are talking about Ibogaine, Ayahuaska, Psilocybin, what have you seen there? We’ve heard a couple of guests on the show talking about the use of these psychedelics for addiction. What you seen?

Maia:

I think that there’s good data to suggest that they may be useful in some cases. But by no means are they a cure. I actually interviewed the guy who discovered Ibogaine as useful for addiction a long time ago through a very early version of this book. He told me a story that always stuck with me and that always made sense to me. He tried it. He wasn’t expecting to wake up and not have any heroin withdrawal. When he did, he was like, “Wow, I’m free of this. This is great. I’m going to make this my life’s purpose to like go and help people with this.” He gave it to a couple of his friends and a few of them were like, “Yep, I have no withdrawal, I’m going to go to score now,” because that was their light. That was what they liked doing, that was their identity.
Simply taking away the withdrawal doesn’t solve that. It is certainly nice to have withdrawal relieved and it is also the case that psychedelic insights can often be helpful. There usually isn’t a one shot cure for addictions. It’s just sometimes an insight will change everything and sometimes it won’t. We sort of have to keep re-learning this lesson over and over. Are these potentially useful tools that we should be studying and we should be expanding access to? Absolutely, but we have to be careful because Ibogaine may potentially have some cardiac toxicity. We need to study this. I’m sure as with everything else, it will work for about 20 to 30% of people and won’t work for the rest of them. But hey, that’s another 20% that we can help and that’s all good. I’m just very nervous of people over-selling psychedelic cures basically.

Pedram:

Yeah. Well, people are over-selling everything, right? Everyone is looking for a panacea for everything and that’s a challenge in medicine, it’s a challenge in everything. It’s like wave your wand, make it go away, absolve me off my sins, I’m done. It’s a bit more layered than that. Listen, I love your approach. There’s so much in the book that we weren’t able to talk about. There’s just a lot there but it’s thorough and it’s intelligent and it’s a really good look at the entire industry in the topic of addiction. The book is called The Unbroken Brain. Maia, how do you pronounce your last name?

Should Self-Help Groups Be For All Illnesses? - @maiasz via @PedramShojai

Maia:

Sure, it’s Szalavitz, you just ignore the first z.

Pedram:

Got it, Szalavitz. Maia Szalavitz’s The Unbroken Brain, wonderful. I love this conversation. It’s something that we all need to be talking about more. You really got me thinking about just kind of the moral agenda and the fabric of the narrative that’s kind of worked its way into a model that’s very scientific that just this thing kind of Trojan horsed its way in. It’s really unfair to people who have this diagnosis and so let’s just help people.

Maia:

Yeah, I think that when the 12 step stuff was introduced into treatment, nothing else was working for people. This was before this medications were developed for opioids. This was when medicine had sort of thrown up its hands. That’s understandable in the 30s. At this point, it should be a self-help group and there should not be- Addiction treatment should not be the only thing in medicine that involved indoctrination into a self-help group. It should be suggested and recommended for people who may benefit along with other things that people may benefit from, because this system right now is not working. It also violates AA’s own traditions to have people getting paid for doing 12 step work. It’s bad for 12 step programs, it’s bad for the treatment system, it’s bad for the people for whom it doesn’t work which is unfortunately a majority of people. We need to create more options and get more stuff to people that you can’t get for free at a church basement.

Pedram:

Yeah, amen to that. Thank you for doing the work that you’re doing. If you anyone is listening has trouble with addiction, know people that have trouble with addiction, it’s a great read and I highly recommend it. Maia, thank you so much. It’s been great.

Maia:

Yes, thank you so much for having me.

Pedram:

There we heard it, addiction is complicated and we’ve also been looking at it in a kind of a different way. It’s not right the way we treat it and if it was in pathology, we would look at it very differently in a medical model. I love what Maia’s talking about. I hope you enjoyed it. Let me know in the comments wherever you’re consuming this. Next week, Larry Atkins talking about media and how its skewed. Fascinating subject. He basically graced us with a little bit of time. He was really busy and got in and he’s been around this block and I think you’re going to enjoy it.

Couple of episodes from last week if you missed or last few weeks if you missed them, over here if you’re watching the video. Subscribe here if you’re not a member of the Urban Monk Academy. Go to the urbanmonk.com, check out what I have over there. Free videos, free meditations, also it’s good stuff for you. See you next time.

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