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[00:00:02.140 – 00:00:02.720] Wow, we've done it. [00:00:02.720 – 00:00:03.740] Good evening, everyone. [00:00:03.740 – 00:00:06.280] My name is David, and I'm delighted to know I'm alcoholic. [00:00:06.280 – 00:00:06.860] Uh, you're… [00:00:06.860 – 00:00:10.050] I'd like to welcome you all to this open AA recovery workshop with Q&A. [00:00:10.050 – 00:00:11.900] And along with Earl S.. [00:00:11.900 – 00:00:13.340] Hello, everybody.

[00:00:13.340 – 00:00:14.500] I'm Earl S.. [00:00:14.500 – 00:00:15.660] I'm an alcoholic. [00:00:15.660 – 00:00:18.220] Um, and I'll see you later for the Q&A. [00:00:18.220 – 00:00:19.380] You're all very welcome. [00:00:19.380 – 00:00:21.820] Thank you, Stewart. [00:00:21.820 – 00:00:29.520] Uh, in keeping with AA's traditions, in particular tradition five, each AA group has but one primary purpose, to carry its message to the alcoholics who are still suffering. [00:00:29.520 – 00:00:39.870] So this is one of a series of workshops which has in- been inspired by recoveryspeakers.com and of course Mike M., I shouldn't forget Mike, and it's hosted by the Saturday night AA group here in Camberwell,

[00:00:39.870 – 00:00:41.160] London, SE5. [00:00:41.160 – 00:00:51.260] Uh, the main purpose of these workshops is to introduce and, or develop ideas and concepts, and hopefully to encourage participants to do some further investigation on their [00:00:51.260 – 00:00:51.540] own. [00:00:51.540 – 00:00:53.720] And tonight I'm sure… [00:00:53.720 – 00:01:04.500] Listen, I say this, I know I say this quite a lot, but we have an extraordinary, over my- We have a great workshop lined up for you, and it's called, titled alcoholism, Is It R. a Disease and If So, So W.? [00:01:04.500 – 00:01:05.720] And that's a presentation by Dr. [00:01:05.720 – 00:01:06.540] Lin H..

[00:01:06.540 – 00:01:09.360] And I'll just kind of give you a, a brief intro to Dr. [00:01:09.360 – 00:01:10.210] Lin H.. [00:01:10.210 – 00:01:10.690] Dr. [00:01:10.690 – 00:01:19.460] Hanks is a clinical professor emeritus at the University of Washington S. of Medicine in the Department of Psychiatry and Behavioral S.- Sciences. [00:01:19.460 – 00:01:21.780] 40 years ago, Dr. [00:01:21.780 – 00:01:31.140] Hanks was among the 100 pioneer physicians in the entire United States of America certified in alcoholism medicine. [00:01:31.140 – 00:01:41.140] Now, the common thread throughout these workshops has been a quote from step 10 in our basic text which says, it's obviously after the s- step nine, so-called step

[00:01:41.140 – 00:01:47.020] nine promises, "We have entered the world of the spirit and that our next function is to grow in understanding and effectiveness. [00:01:47.020 – 00:01:55.460] Now as we know, this is not an overnight matter." Uh, I'm gonna put up just this on- onto the screen for us now if you'd like to join in. [00:01:55.460 – 00:01:57.960] We're gonna just say a version of the… [00:01:57.960 – 00:02:00.520] I think we'll do the Even G. for us, if that's all right with people. [00:02:00.520 – 00:02:06.340] I think we've been saying it at our Thursday meeting, and it's quite a, a profound, uh, statement. [00:02:06.340 – 00:02:09.080] I'll just do this and then we'll do the set aside prayer. [00:02:09.080 – 00:02:12.609] So the Even G. said, uh, just get that.

[00:02:12.609 – 00:02:18.480] "Let me respectfully remind you, life and death are of supreme importance. [00:02:18.480 – 00:02:21.760] Time swiftly passes by and opportunity is lost. [00:02:21.760 – 00:02:26.080] Each of us should strive to awaken." Step 12, right? [00:02:26.080 – 00:02:26.940] "Awaken. [00:02:26.940 – 00:02:27.960] Take heed. [00:02:27.960 – 00:02:30.900] This night our days, your days are diminished by one. [00:02:30.900 – 00:02:36.260] Do not squander your life." And if you'd like to unmute yourselves, please do so now.

[00:02:36.260 – 00:02:41.200] And we're gonna just do this, um, just to get into the language of Alcoholics Anonymous, as I ca- we call it. [00:02:41.200 – 00:02:43.540] And we say a version of the set aside prayer. [00:02:43.540 – 00:02:46.000] So G.. [00:02:46.000 – 00:02:47.000] God. [00:02:47.000 – 00:02:56.700] Help me set aside I think, I think Open my mind for a new experience. [00:02:56.700 – 00:02:58.920] Amen. [00:02:58.920 – 00:03:07.340] And if I may just bring to your attention, I was at a meeting, a physical meeting here in London, down in a place called Mockingham and…

[00:03:07.340 – 00:03:09.940] Mottingham, Mottingham, Mottingham, beg your pardon, on Tuesday night. [00:03:09.940 – 00:03:14.880] And I came across, uh, just before the meeting started, they had this chair, as you can, hope you can see that. [00:03:14.880 – 00:03:25.160] And on this, on it, on it, it said, this was just there amongst all the other chairs, and it said, "This seat is reserved for the alcoholic who didn't make it and the alcoholic who is yet to come." [00:03:25.160 – 00:03:31.380] So if we just think of that, hopefully, and just think of those family members as well, and we'll just have a few moments to reflect on that. [00:03:31.380 – 00:03:33.240] Thank you very much. [00:03:33.240 – 00:03:41.160] Thank you, everyone. [00:03:41.160 – 00:03:42.420] I appreciate your attention.

[00:03:42.420 – 00:03:45.520] And with that, it's over to, if I may, Lin, over to you. [00:03:45.520 – 00:03:46.420] Have a good meeting. [00:03:46.420 – 00:03:53.350] Sam. [00:03:53.350 – 00:03:54.340] Uh, thank you, David. [00:03:54.340 – 00:03:59.960] Uh, it is indeed an honor, uh, to be here, uh, today. [00:03:59.960 – 00:04:02.960] I'm just gonna see if I can get this PowerPoint thing. [00:04:02.960 – 00:04:04.640] Uh, there we go.

[00:04:04.640 – 00:04:10.440] Uh, the question is, is alcoholism really a disease, and if so, so what? [00:04:10.440 – 00:04:17.979] And I want you to think about over the next, uh, hour why we're even asking this question in the first place. [00:04:17.979 – 00:04:28.140] Why, why is it important for the alcoholic to know whether or not, uh, their alcoholism is really a disease? [00:04:28.140 – 00:04:38.160] I just got a chat here from someone on the, uh, the Zoom call tonight, uh, saying that, uh, he was my patient at South M. [00:04:38.160 – 00:04:41.500] Hospital, uh, in December of 1990. [00:04:41.500 – 00:04:47.880] Well, that's quite a thrill for me, uh, to know that at least one patient did follow directions. [00:04:47.880 – 00:04:52.800] He said that's still his sobriety date, and that's, that's very gratifying to know.

[00:04:52.800 – 00:04:58.400] So, um, let's talk about alcoholism. [00:04:58.400 – 00:05:05.260] And when I talk about alcoholism I mean two things, one alcoholism and any other drug dependency. [00:05:05.260 – 00:05:09.140] And we, those two things together we call chemical dependency. [00:05:09.140 – 00:05:11.670] That's an old term, but it helps me to- [00:05:12.036 – 00:05:18.165] Uh, get this lecture across, uh, 'cause it splits the chemicals from the dependency. [00:05:18.165 – 00:05:20.226] And the key word there is other. [00:05:20.226 – 00:05:25.056] Let us not forget that ethyl alcohol is indeed a drug.

[00:05:25.056 – 00:05:32.756] Uh, now, a chemical is addictive if, number one, it alters your mind or changes your mood. [00:05:32.756 – 00:05:40.916] Number two, it's reinforcing, which means taking the drug, uh, promotes and provokes taking more drugs. [00:05:40.916 – 00:05:46.596] And the last is, uh, if it's euphoricogenic, which means it produces intense pleasure. [00:05:46.596 – 00:05:49.756] Now, these drugs are not addictive. [00:05:49.756 – 00:05:59.356] If you're depressed way down here, and I give you an antidepressant to elevate your mood, that alters your mind, changes your mood, but not depress it. [00:05:59.356 – 00:06:09.556] If you're manic, flying around nine thousand mi- uh, miles an hour, and I give you lithium to bring you back to normal speed, that alters [00:06:09.556 – 00:06:10.876] your mind and changes your mood.

[00:06:10.876 – 00:06:18.476] If you are psychotic and seeing things and hearing things that aren't really there, and I give you an antipsychotic, that also alters your mind, changes your mood. [00:06:18.476 – 00:06:20.446] But none of these is addicting. [00:06:20.446 – 00:06:30.975] And oftentimes I hear in AA, unfortunately, some members saying, "Well, you can't take antidepressants," or, "You can't take any mind-altering, mood-changing drugs." That's not true, [00:06:30.976 – 00:06:32.726] uh, because they're not all addictive. [00:06:32.726 – 00:06:36.436] So let's talk about the dependency part. [00:06:36.436 – 00:06:43.556] Uh, the way I explain it is by three, what I call the three Cs, and the first is loss of control. [00:06:43.556 – 00:06:53.716] That term should really be, uh, changed to, uh, loss of predictability, because al- alcoholics for a long time are

[00:06:53.716 – 00:06:54.976] very much in control. [00:06:54.976 – 00:07:04.656] They can titrate within milligrams percent exactly how much alcohol to drink, uh, marijuana to smoke, cocaine to snort, heroin to inject, and still function quite well. [00:07:04.656 – 00:07:15.256] Uh, most alcoholics are not underneath a bridge someplace, um, with holes in their shoes and, and, and a paper bag full of crummy rum. [00:07:15.256 – 00:07:25.276] Uh, they're out functioning, doing all kinds of things like flying airplanes, uh, doing surgery, making business decisions, driving trucks, painting houses, picking oranges, [00:07:25.276 – 00:07:27.696] because they're still very much in control. [00:07:27.696 – 00:07:31.936] It's not until they get later on in the disease that they start to lose control. [00:07:31.936 – 00:07:35.796] Loss of predictability, uh, would be a better term.

[00:07:35.796 – 00:07:40.956] The alcoholic cannot predict three things once faced with the alcohol. [00:07:40.956 – 00:07:43.456] One, whether or not he or she will use it. [00:07:43.456 – 00:07:45.936] Two, if, if they do, how much. [00:07:45.936 – 00:07:47.856] And three, what behavior will follow. [00:07:47.856 – 00:07:49.416] Let me give you an example. [00:07:49.416 – 00:07:52.376] Uh, Harry's at work. [00:07:52.376 – 00:07:53.496] It's been a bad week at work.

[00:07:53.496 – 00:07:54.756] It's Friday, just like today. [00:07:54.756 – 00:07:55.916] It's five o'clock. [00:07:55.916 – 00:07:56.616] He's getting off. [00:07:56.616 – 00:08:01.756] His buddies say to him, "Harry, let's go down to the pub, have a couple, have a couple beers and go home. [00:08:01.756 – 00:08:04.216] Happy hour." And Harry says, "No way, guys. [00:08:04.216 – 00:08:12.036] My old lady's hardly talking to me now," um, "because that's what you said last week, and that never happened." And they say, "Harry, this is this week. [00:08:12.036 – 00:08:12.716] All right?

[00:08:12.716 – 00:08:14.256] We're gonna have two beers and go home. [00:08:14.256 – 00:08:18.496] Are you coming or not?" "You guys promise?" "Yeah, I promise." So they go down to the pub. [00:08:18.496 – 00:08:19.436] They have two. [00:08:19.436 – 00:08:20.336] Harry has two. [00:08:20.336 – 00:08:21.176] Everybody goes home. [00:08:21.176 – 00:08:21.976] No problem. [00:08:21.976 – 00:08:23.896] Next F. night, same thing.

[00:08:23.896 – 00:08:26.116] Third F. night, same thing. [00:08:26.116 – 00:08:28.176] Fourth F. night, they have two. [00:08:28.176 – 00:08:29.056] Harry has two. [00:08:29.056 – 00:08:39.336] Harry looks at his watch and says, "Guys, uh, we got time for one more." And they say, "By golly, you're right." And they have one more, but Harry has twenty-one [00:08:39.336 – 00:08:39.616] more. [00:08:39.616 – 00:08:41.896] He closes the bar at two in the morning. [00:08:41.896 – 00:08:43.856] He gets a DUI on the way home.

[00:08:43.856 – 00:08:51.716] And when he gets there, his wife is not waiting for him because she is sick and tired of the unpredictability. [00:08:51.716 – 00:08:56.996] She never knows on what Friday night that's gonna happen. [00:08:56.996 – 00:08:58.576] And you know what? [00:08:58.576 – 00:09:00.776] He is just Harry. [00:09:00.776 – 00:09:03.216] That's what I mean by loss of control. [00:09:03.216 – 00:09:06.196] The second C is compulsive use. [00:09:06.196 – 00:09:12.136] Now, a compulsion is an irrational, repetitive act that's done despite your best intention not to do it.

[00:09:12.136 – 00:09:22.436] Um, it arises from a cluster of thoughts which psychologists like to think of as a single omnipotent thought, an omnipotent, [00:09:22.436 – 00:09:24.216] an all-powerful thought. [00:09:24.216 – 00:09:30.156] So powerful, it's more powerful than other powerful thoughts, which we call prepotent thoughts. [00:09:30.156 – 00:09:38.856] Most of the time, most of us are on planet Earth, we are preoccupied with acquisition of food, water, sex, clothing, and shelter. [00:09:38.856 – 00:09:48.976] Uh, you take a monkey, put a needle in his arm, uh, hook it up to some cocaine, put him in a cage, and all the monkey's got to do is press the lever to get [00:09:48.976 – 00:09:49.976] the shot of cocaine. [00:09:49.976 – 00:09:55.276] And you then deprive that monkey of food, water, and sex, okay?

[00:09:55.276 – 00:09:58.356] And you later reintroduce those into the cage. [00:09:58.356 – 00:10:06.776] The monkey will ignore all those and continue to press the lever until the supply is exhausted or the monkey is exhausted. [00:10:06.776 – 00:10:09.316] The drug becomes numero uno. [00:10:09.316 – 00:10:16.516] Everything revolves around ingestion of, a- acquisition of, ingestion of, and the consequences of drug use. [00:10:16.516 – 00:10:23.636] Now, if you hear nothing else I say this evening, I want you to please, please, please [00:10:23.900 – 00:10:24.360] Hear this. [00:10:24.360 – 00:10:34.380] What those two things say, loss of control and compulsive use, is the alcoholic does not drink or drug the way he

[00:10:34.380 – 00:10:36.640] or she does because they want to. [00:10:36.640 – 00:10:42.520] They drink or drug the way they do because they have to. [00:10:42.520 – 00:10:45.900] Whoa, that's a lot to swallow. [00:10:45.900 – 00:10:52.800] Are you trying to tell us, doc, that they no longer have the choice whether or not they drink? [00:10:52.800 – 00:10:56.300] Yes, that's exactly what I'm trying to tell you. [00:10:56.300 – 00:11:02.880] When I hear the word choice, I'm reminded of a, a trip I took several years ago. [00:11:02.880 – 00:11:09.020] I got upgraded to first class, and I'm sitting on one side of the aisle, and there's these two clergymen on the other side of the aisle.

[00:11:09.020 – 00:11:19.520] And this flight attendant comes back and says, "We're gonna be airborne in a minute, and I'm taking drink orders now." And she goes to the first clergyman and said, "Would you like an alcoholic beverage?" [00:11:19.520 – 00:11:30.260] And he says, "Oh, alcoholic beverage." He says, "Well," he said, "You know, unaccustomed as I am, uh, I'm starting on my vacation now, and I was just gonna take off my white collar. [00:11:30.260 – 00:11:31.400] You know, I'll make an exception. [00:11:31.400 – 00:11:41.640] Bring me a double martini." And she said to the clergyman sitting by the window, whose religious persuasion was such that, uh, all alcohol was mortally sinful, [00:11:41.640 – 00:11:46.800] and she said to him, "Would you like an alcoholic beverage?" He said, "Are you kidding me? [00:11:46.800 – 00:11:57.550] I would rather commit adultery." And the first clergyman grabbed her arm and says, "Just a minute, ma'am." He says, "I didn't realize we had a choice." Now, the point is [00:11:57.550 – 00:12:07.580] that alcoholics at some point do not realize that they have lost that power of, of, of choosing whether or not to take the

[00:12:07.580 – 00:12:07.900] drink. [00:12:07.900 – 00:12:10.260] So how do we know that's true? [00:12:10.260 – 00:12:12.660] How do we know that they have to use? [00:12:12.660 – 00:12:14.160] Because of the third C. [00:12:14.160 – 00:12:17.880] They will continue to use despite adverse consequences. [00:12:17.880 – 00:12:28.240] Despite the fact of social isolation, emotional turmoil, marital discord, physical damage, legal problems, financial [00:12:28.240 – 00:12:32.780] difficulty, and spiritual deterioration, they will continue to use.

[00:12:32.780 – 00:12:40.340] Now, I used to do surgery, and I used to give my patients, uh, uh, recommendations. [00:12:40.340 – 00:12:42.199] You need this operation or you don't, or whatever. [00:12:42.199 – 00:12:46.020] And most of the time, they took, followed my recommendations. [00:12:46.020 – 00:12:47.740] Sometimes they wanted a second opinion. [00:12:47.740 – 00:12:48.400] That was fine. [00:12:48.400 – 00:12:51.120] But then I get into this field, okay? [00:12:51.120 – 00:12:53.040] And I will never forget my first patient.

[00:12:53.040 – 00:12:58.940] A forty-year-old male, uh, classic mid-stage alcoholism. [00:12:58.940 – 00:13:03.260] Uh, and I s- took his hand and I took it down to his abdomen. [00:13:03.260 – 00:13:13.300] I says, "Here, you can feel this?" He says, "Yeah, what's that?" And I says, "That's your liver." He said, "Really?" I said, "Yeah, you shouldn't be able to feel it." He said, "Well, how come I can feel it, Doc?" I says, "Because it's enlarged." "Well, [00:13:13.300 – 00:13:19.840] how'd it get that way?" "It got that way from all the alcohol you're drinking." "Really?" I said, "Yeah, and if you continue to drink, it's gonna get larger. [00:13:19.840 – 00:13:25.480] Then it's gonna get inflamed, and then it's gonna scar down, uh, and, and s- that's called cirrhosis. [00:13:25.480 – 00:13:35.600] And your eye, your, your skin's gonna turn yellow, and, and your eyes are gonna turn yellow, and you're gonna die young." "Oh my God, Doc." He said, [00:13:35.600 – 00:13:45.900] "Really?" I says, "Yeah." He says, "You know, nobody ever told me that before." He says, "Now that I know that, I swear to God I will never take another drink

[00:13:45.900 – 00:13:49.960] the longest day I live." I said, "Good." I sent him on his way. [00:13:49.960 – 00:13:52.660] Three months later, he comes back. [00:13:52.660 – 00:13:58.960] His liver is now down to his knees, and his eyes are the color of this yellow print right now. [00:13:58.960 – 00:14:01.940] And I'm thinking to myself, "What's the matter with this guy? [00:14:01.940 – 00:14:09.120] He didn't follow my directions." Well, what I came to find out was that he had a learning disability. [00:14:09.120 – 00:14:18.860] I could not understand how somebody could engage in an activity, it causes problems, and still repeat the activity time after time after time. [00:14:18.860 – 00:14:21.160] It would not comprehend, comprehend.

[00:14:21.160 – 00:14:22.340] I couldn't compute. [00:14:22.340 – 00:14:23.360] It just wouldn't work. [00:14:23.360 – 00:14:26.440] Why does somebody keep going back, touch the hot burner. [00:14:26.440 – 00:14:26.700] Ouch. [00:14:26.700 – 00:14:27.240] Oh. [00:14:27.240 – 00:14:28.740] Go back another time. [00:14:28.740 – 00:14:30.220] Oh, look, now I got blisters.

[00:14:30.220 – 00:14:31.800] Oh, look, now it's bleeding. [00:14:31.800 – 00:14:33.600] No, now I got a contraction. [00:14:33.600 – 00:14:38.700] Why do they keep going back, uh, to hit the hot burner? [00:14:38.700 – 00:14:41.560] I'm gonna let you in on a little secret. [00:14:41.560 – 00:14:44.299] Doctors do not like it when we don't have the answers. [00:14:44.299 – 00:14:49.540] So I embarked on this research experiment to figure out why this occurs. [00:14:49.540 – 00:14:54.780] Why does somebody engage in an activity that's problematic, and they keep repeating time after time?

[00:14:54.780 – 00:14:58.480] Well, the first and most obvious explanation is they're ignorant. [00:14:58.480 – 00:15:04.060] They don't understand the cause-and-effect relationship between the drinking and the problems. [00:15:04.060 – 00:15:07.280] As a matter of fact, they have it ass-backwards. [00:15:07.280 – 00:15:11.020] They say, "I drink because of the problems. [00:15:11.020 – 00:15:17.620] I mean, if you had a wife or husband like I got, if you had a job like I got, if you had all the pressure, if you got kids to [00:15:36.424 – 00:15:39.624] Otherwise, nothing else I say is gonna make a lot of sense. [00:15:39.624 – 00:15:42.584] Denial is not a lie.

[00:15:42.584 – 00:15:45.404] A lie is a conscious attempt to distort the truth. [00:15:45.404 – 00:15:48.624] Denial is a subconscious, uh, mechanism. [00:15:48.624 – 00:15:52.684] It's way down deep below the level of, of consciousness. [00:15:52.684 – 00:15:56.704] And by the way, it's not confined to alcoholism. [00:15:56.704 – 00:16:06.964] Uh, I can tell you many physician friends of mine, uh, who un- understand the word denial, who have died [00:16:06.964 – 00:16:11.624] from their hemorrhoids, thinking, "Well, the, the, the blood on the tissue paper is due to hemorrhoids. [00:16:11.624 – 00:16:21.644] It couldn't be, uh, colon cancer." Or they cough up some blood and say, "Oh, well, it's a little bronchitis." You know, it's just, uh, uh, th-

[00:16:21.644 – 00:16:23.824] that's all it is, and it turns out to be lung cancer. [00:16:23.824 – 00:16:28.444] Elisabeth Kübler-Ross talks about denial, the five stages of denial. [00:16:28.444 – 00:16:32.164] Anyway, it's not confined to chemical dependency. [00:16:32.164 – 00:16:37.124] But sooner or later, the elephant gets so big in the room, okay? [00:16:37.124 – 00:16:38.444] They just can't ignore it. [00:16:38.444 – 00:16:41.024] Uh, but they still drink anyway. [00:16:41.024 – 00:16:47.804] So I had to invoke explanation number two, which is these people are unbelievably stupid.

[00:16:47.804 – 00:16:57.884] I mean, how is it at seven o'clock in the morning they're down on their knees before the porcelain altar vomiting up their guts, sometimes frank blood, [00:16:57.884 – 00:17:08.204] and they're saying their daily morning prayer, "Oh, God, I will never do this again." [00:17:08.204 – 00:17:11.044] Seven AM, okay? [00:17:11.044 – 00:17:18.224] It's now five PM, ten hours later, they're finishing up work. [00:17:18.224 – 00:17:24.004] They fully intend to go home, kiss the wife, play with the kids, have dinner, watch TV, and go to bed. [00:17:24.004 – 00:17:34.104] But on the way from the office or the job or wherever they are, on the way to the bus or the train or the car, they pass by the bar [00:17:34.104 – 00:17:44.133] and they stop for just a minute and they listen inside, and they hear the music from the jukebox, and they hear the tinkling of the ice cubes, and they hear all the chatter,

[00:17:44.133 – 00:17:47.044] and they take a little whiff and get that aroma. [00:17:47.044 – 00:17:49.584] Do they remember ten hours before? [00:17:49.584 – 00:17:50.904] No, no, no. [00:17:50.904 – 00:18:01.004] They remember twenty-four hours before when they were standing in the same place and how they went in that bar and had that first cold beer or that double martini, and how everything [00:18:01.004 – 00:18:01.944] changed for the better. [00:18:01.944 – 00:18:03.604] That's what they remember. [00:18:03.604 – 00:18:05.344] Are these people stupid?

[00:18:05.344 – 00:18:07.364] No, they're not stupid at all. [00:18:07.364 – 00:18:09.664] This has got nothing to do with stupidity. [00:18:09.664 – 00:18:13.244] In fact, the smarter you are, the harder it is to get i- into recovery. [00:18:13.244 – 00:18:23.284] Before I– after I did surgery, I ran a program for physicians, uh, and dentists, doctorate level healthcare professionals [00:18:23.284 – 00:18:24.944] with alcoholism and drug dependency. [00:18:24.944 – 00:18:26.244] You wanna know something? [00:18:26.244 – 00:18:29.084] Uh, they don't let you in medical school if you're stupid.

[00:18:29.084 – 00:18:37.044] I also, for the last thirty years, have been working with commercial airline pilots who have a similar program for pilots who are alcoholic. [00:18:37.044 – 00:18:38.244] You know what? [00:18:38.244 – 00:18:40.904] They don't let you in the cockpit if you're stupid. [00:18:40.904 – 00:18:43.304] This has got absolutely nothing to do with stupidity. [00:18:43.304 – 00:18:48.004] So I had to invoke explanation number three, which is these people are crazy. [00:18:48.004 – 00:18:52.784] And if you look at the way they act, you would think they're everything in the crazy book. [00:18:52.784 – 00:19:01.104] They're depressed, they're manic, they look cyclothymic, they look like they're obsessive compulsive, histrionic, passive aggressive, narcissistic.

[00:19:01.104 – 00:19:04.344] Uh, they even have what I call IBS. [00:19:04.344 – 00:19:05.904] They're itsy bitsy skitsy. [00:19:05.904 – 00:19:06.244] Okay? [00:19:06.244 – 00:19:16.793] If you take these people and get the alcohol out of their brain for a good six months, and then you do all the psychometric [00:19:16.793 – 00:19:27.364] testing on them, you find out somewhere between twenty-five and forty percent of the alcoholics also have a second mental illness, and [00:19:27.364 – 00:19:31.484] that's the same incidence, the same prevalence as in the general population. [00:19:31.484 – 00:19:33.024] So that's not the explanation.

[00:19:33.024 – 00:19:34.364] Well, I know what the problem is. [00:19:34.364 – 00:19:36.724] These people are immoral. [00:19:36.724 – 00:19:37.104] Okay? [00:19:37.104 – 00:19:40.864] And again, if you look at their behavior, you would come to that conclusion. [00:19:40.864 – 00:19:44.304] I was in Miami on live TV in the eighties. [00:19:44.304 – 00:19:46.764] I was standing to the right. [00:19:46.764 – 00:19:53.504] In the middle was a, a, a cocaine addict, uh, and on the other side, another, uh, uh, individual.

[00:19:53.504 – 00:20:03.984] Cocaine addict looked straight in the TV camera and he said, "I'd kill my mother for crack." And I thought to myself, "Wow, that's [00:20:03.984 – 00:20:07.324] pretty immoral." Now, here's what happens with this disease. [00:20:07.324 – 00:20:17.344] Everybody has a certain value system, and everybody has certain standards, and when your standards deviate below your value system, [00:20:17.344 – 00:20:22.084] that's called a value system conflict or spiritual deterioration. [00:20:22.084 – 00:20:32.304] And what happens with this illness is, as it progresses, your value system becomes progressively eroded down to the fact where you don't have one. [00:20:32.304 – 00:20:34.664] That condition is called amoral. [00:20:34.664 – 00:20:36.544] Very different from immoral.

[00:20:36.544 – 00:20:41.884] You when these people get into recovery, they are solid citizens. [00:20:41.884 – 00:20:47.614] In fact, they're usually better at what they do, uh, than when they were, uh, drinking, and they're better fa- [00:20:47.728 – 00:20:51.488] fathers, husbands, little league coaches, better at their job. [00:20:51.488 – 00:20:53.508] C- they contribute to the communities. [00:20:53.508 – 00:20:56.127] They're living useful lives. [00:20:56.127 – 00:20:57.848] Well, that's not the answer either. [00:20:57.848 – 00:20:59.088] Well, I know what the problem is.

[00:20:59.088 – 00:20:59.828] They're weak-willed. [00:20:59.828 – 00:21:02.308] You know, if they would just try harder. [00:21:02.308 – 00:21:05.608] If they just went the, uh, the, uh, the extra mile. [00:21:05.608 – 00:21:10.628] And it's not in their whole life, because many of these people are high producers. [00:21:10.628 – 00:21:12.168] They've accomplished lots of things. [00:21:12.168 – 00:21:18.128] It's just in the relationship between their, uh, willpower and the chemical. [00:21:18.128 – 00:21:28.148] And the chemical is a power greater than their own willpower, and that's the hard part to understand about, uh,

[00:21:28.148 – 00:21:30.008] this phenomenon called alcoholism. [00:21:30.008 – 00:21:32.188] But that's not the answer either. [00:21:32.188 – 00:21:37.108] So that leaves me with one explanation, is they are sick. [00:21:37.108 – 00:21:40.597] Now, why did I spend so much time on that? [00:21:40.597 – 00:21:50.608] Because it's important to [00:21:50.608 – 00:21:58.008] understand that you are sick as opposed to being will- weak-willed or immoral, and you'll see why in a minute. [00:21:58.008 – 00:21:59.768] So what is a disease?

[00:21:59.768 – 00:22:03.048] A disease is a dysfunctional state with characteristic form. [00:22:03.048 – 00:22:05.668] What do I mean by dysfunctional state? [00:22:05.668 – 00:22:09.958] In medicine we have, we have parameters, upper and lower limits of normal. [00:22:09.958 – 00:22:16.788] For example, your blood pressure should be something like 120 to 130 over 70 to 80. [00:22:16.788 – 00:22:21.828] Um, your potassium should be three point five to five. [00:22:21.828 – 00:22:26.028] Your sodium should be, uh, 135 to 143. [00:22:26.028 – 00:22:29.588] If you exceed those limits, that's a dysfunctional state.

[00:22:29.588 – 00:22:36.468] Uh, what, what do I mean by characteristic form? [00:22:36.468 – 00:22:44.168] Characteristic form is the set of criteria that the medical community has established in order to call something a disease. [00:22:44.168 – 00:22:45.888] It has to have a cause. [00:22:45.888 – 00:22:48.168] It has to have a specific defect. [00:22:48.168 – 00:22:58.268] Uh, if individual A, uh, is normal and individual B, uh, has this de- uh, is, [00:22:58.268 – 00:23:08.488] has the disease, a disease, that means individual B has either too much of something or not enough of something else that individual A has normal amounts [00:23:08.488 – 00:23:08.648] of.

[00:23:08.648 – 00:23:14.748] It has to have, uh, signs and symptoms and laboratory tests which confirm its presence. [00:23:14.748 – 00:23:16.948] It has to have a predictable course. [00:23:16.948 – 00:23:21.148] Um, and, and it should have uniform treatment. [00:23:21.148 – 00:23:25.188] And if you apply that treatment to all the individuals, you should get a similar result. [00:23:25.188 – 00:23:28.108] So let's compare some diseases. [00:23:28.108 – 00:23:35.648] I'm sure you all agree d- diabetes is a disease, AIDS is a disease, and maybe some of you think alcoholism is a disease. [00:23:35.648 – 00:23:37.948] What's the cause of diabetes?

[00:23:37.948 – 00:23:39.008] You know what? [00:23:39.008 – 00:23:39.868] We don't know. [00:23:39.868 – 00:23:45.288] And that, uh, diabetes was discovered in 100 BC, that's before cocaine. [00:23:45.288 – 00:23:46.588] What's the defect? [00:23:46.588 – 00:23:48.048] It's an insulin imbalance. [00:23:48.048 – 00:23:49.447] Does it have signs and symptoms? [00:23:49.447 – 00:23:51.748] Yes, these individuals are thirsty all the time.

[00:23:51.748 – 00:23:52.648] They drink a lot of water. [00:23:52.648 – 00:23:53.468] They eat too much. [00:23:53.468 – 00:23:54.488] They urinate too much. [00:23:54.488 – 00:23:56.488] They're, uh, they get infections. [00:23:56.488 – 00:23:57.688] They're fatigued. [00:23:57.688 – 00:23:59.417] Does it have a predictable course? [00:23:59.417 – 00:24:03.708] You do nothing for the diabetic, their kidneys will shut down.

[00:24:03.708 – 00:24:04.628] They will go blind. [00:24:04.628 – 00:24:06.378] They get peripheral neuropathy. [00:24:06.378 – 00:24:07.828] Happens time after time. [00:24:07.828 – 00:24:09.508] Does it have a treatment? [00:24:09.508 – 00:24:09.848] Sure. [00:24:09.848 – 00:24:11.788] Is it mild, moderate or severe? [00:24:11.788 – 00:24:13.488] Diet, pills, insulin.

[00:24:13.488 – 00:24:18.398] And if you give that treatment to they all, all of them, you get the same response. [00:24:18.398 – 00:24:25.028] Does the fact we don't know the cause of diabetes make it any less of a disease? [00:24:25.028 – 00:24:26.288] Of course not. [00:24:26.288 – 00:24:32.628] We're, uh, we didn't know the cause of a lot of diseases and still don't for some of them, uh, right now. [00:24:32.628 – 00:24:37.348] When I went to medical school, you know what they told us the cause of ulcers was? [00:24:37.348 – 00:24:38.708] Stress. [00:24:38.708 – 00:24:41.128] Stress causes ulcers.

[00:24:41.128 – 00:24:43.188] It's not what you eat, it's what's eating you. [00:24:43.188 – 00:24:48.108] You know, we, today, we know that ulcers are caused by a bacterium. [00:24:48.108 – 00:24:54.628] Very similar, a first cousin to the same bacterium that causes, uh, the tuberculosis. [00:24:54.628 – 00:24:56.668] What's the cause of AIDS? [00:24:56.668 – 00:24:57.848] The virus. [00:24:57.848 – 00:24:59.988] The human immunodeficiency virus. [00:24:59.988 – 00:25:00.828] What's the defect?

[00:25:00.828 – 00:25:04.308] There's a certain blood cell that's defective called a T four cell. [00:25:04.308 – 00:25:05.948] Does it have signs and symptoms? [00:25:05.948 – 00:25:06.508] Yep. [00:25:06.508 – 00:25:07.888] Does it have a predictable course? [00:25:07.888 – 00:25:08.227] Yep. [00:25:08.227 – 00:25:10.108] Uh, what's the treatment for it? [00:25:10.108 – 00:25:12.468] It doesn't have a curative treatment.

[00:25:12.468 – 00:25:17.288] We can put it in remission, but we can't cure it, so we can't measure the response. [00:25:17.288 – 00:25:23.068] Does the fact, uh, we don't know the, the treatment make it any less of a disease? [00:25:23.068 – 00:25:24.368] Of course not. [00:25:24.368 – 00:25:27.288] Do we have a treatment for Parkinson's disease? [00:25:27.288 – 00:25:27.848] No. [00:25:27.848 – 00:25:30.238] Do we have a treatment for Alzheimer's disease? [00:25:30.238 – 00:25:30.688] No.

[00:25:30.688 – 00:25:32.548] We're working on it, but we don't have it. [00:25:32.548 – 00:25:34.208] Now let's look at alcoholism. [00:25:34.208 – 00:25:35.108] What's the cause? [00:25:35.108 – 00:25:35.988] We don't know yet. [00:25:35.988 – 00:25:37.488] What's the defect? [00:25:37.488 – 00:25:45.808] The defect is a combination of a neurochemical imbalance and a psychological imbalance, and we'll talk more about that in a minute. [00:25:45.808 – 00:25:47.588] Does it have signs and symptoms?

[00:25:47.588 – 00:25:48.068] Oh, yeah. [00:25:48.068 – 00:25:50.048] Does it have a predictable course? [00:25:50.048 – 00:25:50.908] We'll show that. [00:25:50.908 – 00:25:53.388] Uh, do- uh, does it have a treatment? [00:25:53.388 – 00:25:55.088] Is it mild, moderate or severe? [00:25:55.088 – 00:25:57.408] AA, outpatient, inpatient. [00:25:57.408 – 00:25:59.518] If we do that, we get

[00:25:59.612 – 00:26:03.832] The similar response, X percent get better time after time after time. [00:26:03.832 – 00:26:13.492] So, "Oh, Doc, that's all s- that sounds really good, but I know you doctors, you medicalize everything. [00:26:13.492 – 00:26:15.432] Uh, I know why you call it a disease. [00:26:15.432 – 00:26:21.312] You call it a disease because being sick is less shameful than willful misconduct." You know what? [00:26:21.312 – 00:26:21.872] That's true. [00:26:21.872 – 00:26:31.932] If I can convince you you're sick rather than, uh, willful misconduct, you'll get better faster, but that's not [00:26:31.932 – 00:26:32.662] why we call it a disease.

[00:26:32.662 – 00:26:39.812] "Oh, I know why you call it a disease, because then insurance will pay for the treatment." Well, that's partially true, too, but that's not why we call it a disease. [00:26:39.812 – 00:26:48.072] "The real reason, Doc, you call it a disease is because then having an illness absolves one from social responsibility." Hold on just a minute. [00:26:48.072 – 00:26:49.732] No, no, no, no, no. [00:26:49.732 – 00:26:59.832] If you have diabetes, you don't take your insulin, uh, you're driving down the road, you lapse into a coma, you cross the midline, crash and kill somebody, that's called [00:26:59.832 – 00:27:01.112] vehicular manslaughter. [00:27:01.112 – 00:27:04.892] Having diabetes does not excuse you from that. [00:27:04.892 – 00:27:11.392] If you have a seizure disorder, don't take your Tegretol, have a seizure, and the same thing happens, uh-uh.

[00:27:11.392 – 00:27:14.692] Having epilepsy does not excuse that. [00:27:14.692 – 00:27:24.732] If you're alcoholic, you go to treatment, uh, you get dry, but you don't get sober 'cause you don't go to AA, you drink again, crash and kill somebody, having alcoholism [00:27:24.732 – 00:27:27.572] does not excuse you from that. [00:27:27.572 – 00:27:28.312] Dr. [00:27:28.312 – 00:27:36.392] Bob said, "Never, ever rob an alcoholic of his consequences," and that's not what we're trying to say here. [00:27:36.392 – 00:27:39.052] So what are the characteristics of the disease? [00:27:39.052 – 00:27:43.112] It's chronic, it's primary, it's predictable, and it's contagious.

[00:27:43.112 – 00:27:45.612] Let's take a look at these, what that means. [00:27:45.612 – 00:27:48.012] Chronic means it's permanent. [00:27:48.012 – 00:27:51.252] The name of the disease is not alcohol wasn't, it's alcoholism. [00:27:51.252 – 00:27:54.192] It also means it's prone to relapse, okay? [00:27:54.192 – 00:27:57.792] Uh, but now we have a little different attitudinal difference. [00:27:57.792 – 00:28:07.932] If you're a diabetic and you're on the cruise ship and you go past that, uh, dessert table at midnight, pick up a piece of key lime pie and your blood sugar shoots to four hundred, dang, that's called a relapse, [00:28:07.932 – 00:28:09.972] and you wind up in sickbay for two hours.

[00:28:09.972 – 00:28:12.072] Nobody gets too excited about that. [00:28:12.072 – 00:28:22.172] If you have coronary artery disease and your doc tells you, "Hey, you got to lose some weight, stay away from stressful situations, stop your smoking, uh, watch your diet," and you don't do any [00:28:22.172 – 00:28:25.952] of those things and have a second heart attack, that's called a relapse. [00:28:25.952 – 00:28:27.892] Nobody gets too excited about that. [00:28:27.892 – 00:28:37.912] But let the alcoholic on the same cruise ship walk past the bar, pick up one of those pin- pina coladas that look about ten feet tall with pineapple growing out of it in a [00:28:37.912 – 00:28:42.472] nice frosty glass, go on a two-week binge, oh, now it's different. [00:28:42.472 – 00:28:44.572] You shouldn't have done that.

[00:28:44.572 – 00:28:49.072] If you had more willpower, if you had stronger moral fiber, you wouldn't have done that, you schmuck. [00:28:49.072 – 00:28:49.352] Okay? [00:28:49.352 – 00:28:50.972] Double standard there. [00:28:50.972 – 00:28:59.752] The reality is the diabetic and the heart patient have more control whether or not they relapse than the alcoholic, and I'll show you why in a minute. [00:28:59.752 – 00:29:01.372] It's a primary disease. [00:29:01.372 – 00:29:03.492] That means it stands alone independently. [00:29:03.492 – 00:29:06.412] It's not secondary to some underlying disease.

[00:29:06.412 – 00:29:07.532] Let me give you an example. [00:29:07.532 – 00:29:17.432] Alcoholism, hepatitis, uh, lead intoxication, iron, uh, toxicity, those three things all cause cirrhosis. [00:29:17.432 – 00:29:20.772] Cirrhosis is the secondary disease. [00:29:20.772 – 00:29:25.672] These, alcoholism, hepatitis, and the others, that's the primary disease. [00:29:25.672 – 00:29:26.911] It's predictable. [00:29:26.911 – 00:29:32.652] There are four stages, early, middle, late, and too late, and we put a cross there because you're too late. [00:29:32.652 – 00:29:34.332] And it's contagious.

[00:29:34.332 – 00:29:39.032] Um, not in the sense that you get the disease, but what's contagious? [00:29:39.032 – 00:29:45.952] If you are living with an alcoholic or have a significant relationship to that alcoholic, the insanity is contagious. [00:29:45.952 – 00:29:53.692] The stress of living with an alcoholic produces dysfunctional coping behavior similar to that in post-traumatic stress syndrome. [00:29:53.692 – 00:30:01.792] You talk to the spouse of an alcoholic, he or she will tell you, "I've been through a million Vietnams." So who gets this illness? [00:30:01.792 – 00:30:02.432] Everyone. [00:30:02.432 – 00:30:03.972] I call it from Yale to jail. [00:30:03.972 – 00:30:05.872] So here's a little test for you.

[00:30:05.872 – 00:30:13.152] Question one, A, you're alcoholic because you drink too much, or B, you drink too much because you're alcoholic. [00:30:13.152 – 00:30:15.372] Look at that again. [00:30:15.372 – 00:30:21.131] You're alcoholic because you drink too much, A, or B, you drink too much because you're alcoholic. [00:30:21.131 – 00:30:25.692] The answer is B, you drink too much because you're alcoholic. [00:30:25.692 – 00:30:34.672] Well, early, I s- all the alcoholics I ever treated, I would always ask them, "Why do you drink the way you do?" And you know what? [00:30:34.672 – 00:30:38.652] I never got the re- uh, the, uh, the answer that was the real reason. [00:30:38.652 – 00:30:39.412] Never.

[00:30:39.412 – 00:30:41.672] I, I have stopped asking the question. [00:30:41.672 – 00:30:43.432] I just never got the real reason. [00:30:43.432 – 00:30:50.972] Uh, it's like, um, when you talk to guys, you say, "Why do you read Playboy?" They, they never give you the real reason. [00:30:50.972 – 00:30:53.272] "Oh, dynamic young writers in there. [00:30:53.272 – 00:30:54.692] Oh, and the photography in there. [00:30:54.692 – 00:30:58.412] And the ads are great, too." They never tell you the real reason they read Playboy. [00:30:58.412 – 00:31:01.472] Years ago, I belonged to this men's luncheon club.

[00:31:01.472 – 00:31:04.992] Uh, and over in the corner they had this little library. [00:31:04.992 – 00:31:09.692] I was the youngest guy there and they were all a bunch of old geezers, and I was about 40 at the time. [00:31:09.692 – 00:31:11.212] And one day- [00:31:12.006 – 00:31:14.056] I took, there was one guy who told me the real reason. [00:31:14.056 – 00:31:16.876] I went over, and it was a friend of my dad's. [00:31:16.876 – 00:31:27.576] And I said, "Pat, why are you reading that, that Playboy?" He said, "Doc, you really wanna know?" I said, "Yeah, I really wanna know." He, and he looked around, and he says, "I read Playboy [00:31:27.576 – 00:31:32.746] for the same reason I read National G.." And I said, "Really?

[00:31:32.746 – 00:31:41.516] Why is that?" He says, " 'Cause I get to see colored pictures of places I ain't never gonna get to visit." He's the only guy that told me the real reason. [00:31:41.516 – 00:31:44.556] Why do alcoholics drink the way they do? [00:31:44.556 – 00:31:46.016] Because you're alcoholic. [00:31:46.016 – 00:31:49.716] Because you have a different response to alcohol than normal people. [00:31:49.716 – 00:31:51.696] Alcohol empowers you. [00:31:51.696 – 00:31:52.796] That's the why. [00:31:52.796 – 00:31:54.356] That's the real reason.

[00:31:54.356 – 00:31:59.956] I wanna, I want you to hear from Bill W.'s autobiography. [00:31:59.956 – 00:32:05.296] Bill's description of his first drink, it was actually his second drinking episode. [00:32:05.296 – 00:32:09.136] "Well, my self-consciousness was such that I simply had to take that drink. [00:32:09.136 – 00:32:13.196] So I took it, and another one, and then lo, the miracle. [00:32:13.196 – 00:32:19.256] The strange barrier that had existed between me and all men and women, even the closest, seemed to instantly go down. [00:32:19.256 – 00:32:22.096] I felt that I belonged where I was. [00:32:22.096 – 00:32:24.436] I belonged to life, I belonged to the universe.

[00:32:24.436 – 00:32:26.736] I was part of things at last. [00:32:26.736 – 00:32:30.736] Oh, the magic of those first three or four drinks. [00:32:30.736 – 00:32:35.266] I became the life of the party." This describes what Dr. [00:32:35.266 – 00:32:38.046] S. characterized as the allergy. [00:32:38.046 – 00:32:42.936] Normal, temperate drinkers do not experience this. [00:32:42.936 – 00:32:44.756] Do all alcoholics experience that? [00:32:44.756 – 00:32:49.356] No, but q- uh, uh, a tremendous, almost a majority of them do.

[00:32:49.356 – 00:32:56.356] So we had this old theory about heavy drinking, alcohol abuse, and alcoholism. [00:32:56.356 – 00:32:57.536] What's the difference there? [00:32:57.536 – 00:33:07.396] Alcohol abuse is inappropriate use of alcohol in excess of societal standards, sometimes self-abating and capable of cessation if sufficiently motivated. [00:33:07.396 – 00:33:09.016] Who abuses alcohol? [00:33:09.016 – 00:33:16.176] People who medicate stress, who medicate mental illness, most teenagers, most college students, and sociopaths. [00:33:16.176 – 00:33:19.896] So we have this new theory. [00:33:19.896 – 00:33:22.616] There's social drinking, that's normal in our society.

[00:33:22.616 – 00:33:28.316] Alcohol abuse, called a transient behavioral disorder, and alcoholism, which is a disease. [00:33:28.316 – 00:33:29.475] What's the difference? [00:33:29.475 – 00:33:32.216] The social drinker can stop any time he wants. [00:33:32.216 – 00:33:35.976] The abuser might stop if you give him a good enough reason. [00:33:35.976 – 00:33:44.976] You tell Sally, "Sally, you get your grades up, otherwise leave the car keys there." Or you tell Junior, "You got one more semester of college. [00:33:44.976 – 00:33:55.076] You don't get your grades up, you're going to the army." Even a sociopath, you give them a good enough reason, and you show them that the alcohol is hurting them, [00:33:55.076 – 00:33:55.956] they might stop.

[00:33:55.956 – 00:34:03.676] The alcoholic on the other hand, I don't care what reason you give them, your liver, your heart, you're gonna lose your job, you're gonna lose your wife, you're gonna… [00:34:03.676 – 00:34:05.756] They can't stop. [00:34:05.756 – 00:34:07.236] Impossible. [00:34:07.236 – 00:34:13.376] So I devot- I, I developed this double martini test, okay? [00:34:13.376 – 00:34:23.776] For the heavy social drinker, you give them a double martini and put a dead fly in it, he'll give it right back to you and say, "Doc, that's gross." You do that for an abuser, give him a double martini [00:34:23.776 – 00:34:27.216] with a dead fly in it, they'll take the fly out and drink the martini. [00:34:27.216 – 00:34:34.336] You give it to the alcoholic, he'll take the fly out and then squeeze the fly, and then drink the martini.

[00:34:34.336 – 00:34:35.556] Okay. [00:34:35.556 – 00:34:42.296] So the addicted brain is in fact different in its neurobiology from the non-addicted brain, so said Dr. [00:34:42.296 – 00:34:45.436] Lester, the former director of the National I. of Drug A.. [00:34:45.436 – 00:34:49.496] A drug hijacks one's brain, thereby one's mind, and then one's life. [00:34:49.496 – 00:34:54.736] Um, in basic brain function, all these systems are in balance. [00:34:54.736 – 00:34:57.656] We have these chemical messengers called neurotransmitters. [00:34:57.656 – 00:35:01.556] They act fast, in short duration, and in small amounts.

[00:35:01.556 – 00:35:03.476] That's what the side of the brain looks like. [00:35:03.476 – 00:35:11.376] We have a judgment center, this reward center, and then a memory center, and all, all those other places in the brain. [00:35:11.376 – 00:35:14.576] Uh, this is what the brain really looks like inside. [00:35:14.576 – 00:35:24.276] And if you see all those connections, the one right smack in the center there, you see there's, there's three, three plugs all connected, but the one plug is not connected. [00:35:24.276 – 00:35:31.816] The way this works in the brain is it's the one plug that's not connected is the way, the way t- the neur- neurons in the brain work. [00:35:31.816 – 00:35:34.656] Up on top is this, just an extension. [00:35:34.656 – 00:35:38.556] And then we have this gap, and on the bottom we have these receptor sites.

[00:35:38.556 – 00:35:44.236] And, and those little blue dots are those neurotransmitters, and those little red triangles are neurotransmitters. [00:35:44.236 – 00:35:50.096] And they go across this gap called the synapse, and they fit into these receptor sites. [00:35:50.096 – 00:35:52.736] And when that happens, the nerve impulse kicks in. [00:35:52.736 – 00:35:56.916] Uh, and this is what that receptor site looks like. [00:35:56.916 – 00:35:58.716] There's a center for barbiturates. [00:35:58.716 – 00:36:00.456] There's a center for what we call GABA. [00:36:00.456 – 00:36:02.976] There's a center for benzodiazepines.

[00:36:02.976 – 00:36:04.856] There's a center there for alcohol. [00:36:04.856 – 00:36:14.976] And keep that in mind, because this is why alcoholics can't take things like Valium and Librium and, [00:36:14.976 – 00:36:16.476] and any of the barbiturates and so forth. [00:36:16.476 – 00:36:17.976] And we'll come back to that in a minute. [00:36:17.976 – 00:36:21.676] So when you put alcohol and drugs in, what happens to the brain? [00:36:21.676 – 00:36:23.206] These messengers are slowed down and- [00:36:23.440 – 00:36:25.600] Prolonged with a decreased response.

[00:36:25.600 – 00:36:29.300] We got this new fancy X-rays now we call spec scans and PET scans. [00:36:29.300 – 00:36:39.700] They're, uh, somebody can be wide awake, and we inject this isotope in their vein close to their brain, and we can see what parts of the brain light up [00:36:39.700 – 00:36:41.960] when we ask them to do certain things. [00:36:41.960 – 00:36:52.320] And when we do that and we s- give them alcohol, uh, blood flow is increased to areas required for drug use and decreased to areas of thinking, [00:36:52.320 – 00:36:54.100] learning, and memory. [00:36:54.100 – 00:36:55.740] Ah, that's interesting. [00:36:55.740 – 00:36:57.360] Take a look at this.

[00:36:57.360 – 00:37:07.320] This is an individual, uh, who is, uh, off cocaine on the left, normal, and on the right, look at this. [00:37:07.320 – 00:37:12.120] No, all those orange spots are all gone. [00:37:12.120 – 00:37:14.220] Decreased area of blood flow. [00:37:14.220 – 00:37:20.880] Glucose, sugar, that's the inner– that's the fuel for the brain. [00:37:20.880 – 00:37:23.200] These are receptor sites. [00:37:23.200 – 00:37:25.740] In the top row, that's normal, okay? [00:37:25.740 – 00:37:31.220] And in the middle row, that's a cocaine abuser off cocaine for ten days.

[00:37:31.220 – 00:37:35.540] In the bottom row, uh, is a cocaine abuser off for one hundred days. [00:37:35.540 – 00:37:40.660] Those normal o- orange, B. areas are not even back to normal in one hundred days. [00:37:40.660 – 00:37:42.780] Isn't that interesting? [00:37:42.780 – 00:37:49.220] How did the guys back in the thirties and the forties come up with go to ninety meetings in ninety days? [00:37:49.220 – 00:37:51.620] They didn't have these scans then. [00:37:51.620 – 00:37:57.960] They, but they knew inherently that it takes at least that long for the brain to regenerate back to normal. [00:37:57.960 – 00:38:00.220] Now we know why, okay?

[00:38:00.220 – 00:38:03.300] So why the loss of control I talked about before? [00:38:03.300 – 00:38:05.740] Because in the brain, there's altered blood flow. [00:38:05.740 – 00:38:08.100] The messengers and their effects are altered. [00:38:08.100 – 00:38:10.580] The synaptic strength is, is changed. [00:38:10.580 – 00:38:15.360] There's altered circuitry, and there's even cellular change and damage in some cases. [00:38:15.360 – 00:38:16.880] This is a D2 receptor. [00:38:16.880 – 00:38:18.960] Again, normal on the top.

[00:38:18.960 – 00:38:24.060] Cocaine abuser off one month, four months later, they're not even back to normal. [00:38:24.060 – 00:38:28.100] Again, we see it takes time for the brain to heal. [00:38:28.100 – 00:38:35.640] It's why that first year in recovery, those first ninety days, the first six months, uh, the first nine months, critical. [00:38:35.640 – 00:38:36.760] Critical period of time. [00:38:36.760 – 00:38:39.099] This is the most important slide I want you to see. [00:38:39.099 – 00:38:49.280] Um, this, uh, this thing on, is called the anterior cer– c- cingulate gyrus, and there's two different views [00:38:49.280 – 00:38:49.580] of it.

[00:38:49.580 – 00:38:50.600] You see that red dot? [00:38:50.600 – 00:38:51.160] It's okay. [00:38:51.160 – 00:39:00.220] So, um, in the middle is, uh, this is a cocaine addict, not an abuser, a cocaine addict. [00:39:00.220 – 00:39:10.380] He is watching a video, a normal outdoor hunting video or something, and then they qui– and he's been off cocaine for [00:39:10.380 – 00:39:19.200] two years, verified by random urine drug screens, all negative drug screens over two years. [00:39:19.200 – 00:39:28.520] He's watching this hunting video, and all of a sudden, they switch it to a video of somebody using crack cocaine. [00:39:28.520 – 00:39:29.460] And look what lights up.

[00:39:29.460 – 00:39:32.439] Those two areas, the gyrus and, and the other. [00:39:32.439 – 00:39:42.480] This is why it's harder for the alcoholic to not relapse than it is for the diabetic and the coronary patient, [00:39:42.480 – 00:39:43.980] uh, to not relapse. [00:39:43.980 – 00:39:45.360] So it's a disease. [00:39:45.360 – 00:39:46.240] So what? [00:39:46.240 – 00:39:54.460] Well, if you go back and look at the types of disease, if it's chron– if it's permanent, okay? [00:39:54.460 – 00:39:57.340] That means there's no return to social drinking.

[00:39:57.340 – 00:39:59.260] That means there's no recreational drug use. [00:39:59.260 – 00:40:04.760] If it's prone to relapse, then you have to build a defense against the first drink, okay? [00:40:04.760 – 00:40:07.000] And that recovery requires maintenance. [00:40:07.000 – 00:40:15.800] Uh, we are unable at certain times to bring into our consciousness with sufficient force the memory of suffering and humiliation of even a week or a month ago. [00:40:15.800 – 00:40:17.780] It says that on page twenty-four of the big book. [00:40:17.780 – 00:40:20.860] Again, back to that schematic of the brain. [00:40:20.860 – 00:40:29.440] You see the memory center and the judgment center, there's a disconnect between that and the reward center in alcoholics.

[00:40:29.440 – 00:40:33.300] That's why they can't remember the pain and misery of even a couple months ago. [00:40:33.300 – 00:40:35.640] There has to be maintenance. [00:40:35.640 – 00:40:42.889] AA is evidence-based, empirically validated, and scientifically established as the best form of maintenance program to date. [00:40:42.889 – 00:40:46.200] In my judgment, it's what works best for most. [00:40:46.200 – 00:40:47.480] Is it the only way? [00:40:47.480 – 00:40:48.060] No. [00:40:48.060 – 00:40:51.500] There are, there are other, uh, groups.

[00:40:51.500 – 00:40:54.220] SOS, Secular O. for Recovery. [00:40:54.220 – 00:40:55.900] RR, Rational R.. [00:40:55.900 – 00:40:58.580] And SMART, Self-Motivation and Recovery treatment. [00:40:58.580 – 00:41:00.880] Moderation M., no. [00:41:00.880 – 00:41:03.440] The first three are abstinence-based. [00:41:03.440 – 00:41:05.800] Moderation M. is not. [00:41:05.800 – 00:41:15.890] Uh, they say, "Stop drinking for a month, and then we'll teach you how to drink." Uh, you have to offer these to people who have a First A. objection to going

[00:41:15.890 – 00:41:16.460] to AA. [00:41:16.460 – 00:41:21.400] Anyway, it's a primary disease, so there's no underlying disease to treat. [00:41:21.400 – 00:41:23.440] That's why total abstinence is necessary. [00:41:23.440 – 00:41:23.870] Dr. [00:41:23.870 – 00:41:30.880] S. said, "The action of alcohol- all these chronic alcoholics is a manifestation of an allergy," on page twenty-eight. [00:41:30.880 – 00:41:35.220] Um, that the body of the alcoholic is quite as abnormal as [00:41:35.344 – 00:41:35.904] His mind.

[00:41:35.904 – 00:41:41.224] In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete. [00:41:41.224 – 00:41:49.884] S. was ostracized from the New York Academy of Psychiatry and Neurology because he was such a radical psychiatrist. [00:41:49.884 – 00:41:56.924] For a psychiatrist to talk about a physical component, uh, a physical factor was heresy. [00:41:56.924 – 00:41:59.904] Uh, so where's the pathology? [00:41:59.904 – 00:42:01.004] Where is the… [00:42:01.004 – 00:42:02.244] Where's the problem in the body? [00:42:02.244 – 00:42:03.204] It's in the brain.

[00:42:03.204 – 00:42:07.804] The defect is a chemical imbalance, then avoid the chemical. [00:42:07.804 – 00:42:10.004] That means abstinence. [00:42:10.004 – 00:42:12.584] That means total abstinence. [00:42:12.584 – 00:42:22.224] In the big book, on page four-sixteen of the fourth edition, page four-forty-eight of the third edition, there was another doctor who didn't know this was a disease. [00:42:22.224 – 00:42:24.124] He said, this is Dr. [00:42:24.124 – 00:42:24.544] Paul. [00:42:24.544 – 00:42:25.504] This is Dr.

[00:42:25.504 – 00:42:35.964] Paul, the a- acceptance guy, from page four-forty-nine of the third edition or four-seventeen of the fourth edition, "It helped me a great deal to become convinced that alcoholism was a disease, [00:42:35.964 – 00:42:45.984] not a moral issue, that I had been drinking as a result of a compulsion, even though I had not been aware, uh, uh, at the time, [00:42:45.984 – 00:42:53.404] and that sobriety was not a matter of willpower." This is why it's important that we answer the question, is alcoholism really a disease? [00:42:53.404 – 00:43:03.844] Because it helps to mi- mitigate, it helps to dissipate, um, it helps to ameliorate the guilt and the shame that's inherent in this disease. [00:43:03.844 – 00:43:06.624] You have to know that you're sick, not bad. [00:43:06.624 – 00:43:16.624] So in the big book on page sixteen, it says in the, in the forward to the second edition, "From [00:43:16.624 – 00:43:26.924] this doctor, S., the broker W. learned the grave nature illness of alcoholism." S. told Bill, "You are sick."

[00:43:26.924 – 00:43:28.644] He told him he had an illness. [00:43:28.644 – 00:43:31.144] Bill did not like the term disease. [00:43:31.144 – 00:43:34.464] Uh, in fact, he didn't even like the term illness. [00:43:34.464 – 00:43:35.584] He called it a malady. [00:43:35.584 – 00:43:45.824] He didn't– He, he, he wasn't sure whether future research would show it really was a disease, and he didn't want to get in, in, in any kind of a controversy [00:43:45.824 – 00:43:48.104] with the medical community, so he called it a malady. [00:43:48.104 – 00:43:58.184] In AA Comes of Age on page sixty, uh, "In our first conversation, I, Bill W., wore down heavily on the

[00:43:58.184 – 00:43:59.724] medical illness hopelessness of Dr. [00:43:59.724 – 00:44:00.664] Bob's case. [00:44:00.664 – 00:44:02.244] Though Dr. [00:44:02.244 – 00:44:06.764] Bob was a doctor, this was news to him, bad news. [00:44:06.764 – 00:44:11.044] What really hit him hard was the medical illness business." Dr. [00:44:11.044 – 00:44:13.384] Bob did not understand it was a disease. [00:44:13.384 – 00:44:15.664] He knew the solution was spiritual.

[00:44:15.664 – 00:44:23.864] He knew the action plan was the steps, that he was practicing the six tenets of the Oxford Group in Akron at the time. [00:44:23.864 – 00:44:26.024] But he didn't know what the problem was. [00:44:26.024 – 00:44:29.704] And on page one-eighty, uh, Dr. [00:44:29.704 – 00:44:31.304] Bob says in his story of Dr. [00:44:31.304 – 00:44:40.784] Bob's nightmare, "He gave me the information about the subject of alcohol, which was undoubtedly helpful." This is why it's important to know it's a disease. [00:44:40.784 – 00:44:45.864] So total abstinence means you have to avoid all like drugs. [00:44:45.864 – 00:44:54.104] You can't take barbiturates, non-barbiturate sedatives, any of those benzodiazepines, any anxiolytics or hypnotics.

[00:44:54.104 – 00:44:56.144] There used to be a term called sedativism. [00:44:56.144 – 00:45:00.484] Not to replace alcoholism, but that's what one of the physicians described it. [00:45:00.484 – 00:45:09.184] The only difference between vo- vodka and Valium, between beer and barbiturates, between rum and Restoral, is one's liquid and the other's solid. [00:45:09.184 – 00:45:15.884] Remember that receptor site showed I, uh, slide I showed you, where there all those receptor sites are together? [00:45:15.884 – 00:45:23.484] This is why alcoholics can't imbibe any of these things. [00:45:23.484 – 00:45:27.784] Valium, it turns out, is the driest of all martinis. [00:45:27.784 – 00:45:32.384] Total absence means we have to avoid all addictive drugs.

[00:45:32.384 – 00:45:41.404] That means alcoholics can't have opioids, stimulants, perceptual disorders, cannabinoids, nor inhalants. [00:45:41.404 – 00:45:51.843] If you're an opioid addict, a heroin addict, okay, it says in their big book of narcotics anonymous, "Don't drink alcohol." [00:45:51.843 – 00:45:54.804] You pick up alcohol, you're gonna wind up with a needle in your arm. [00:45:54.804 – 00:45:58.464] Because remember that pleasure center I showed you in the brain? [00:45:58.464 – 00:46:06.604] There's no traffic cop up there that says, "Alcohol up here, drugs down here, depressants over there, stimulants here." They all work in the same place. [00:46:06.604 – 00:46:14.844] So regardless of your drug of choice, if you use any of these other drugs, you either get hooked on the new drug, or you'll go back to your drug of choice. [00:46:14.844 – 00:46:19.084] Don't let– You have to caution these other drugs.

[00:46:19.084 – 00:46:22.384] These are not addictive now, but they do alter your mind a little bit. [00:46:22.384 – 00:46:32.384] And sometimes, especially in early recovery, the mind gets confused and y- you, you, you, you become psychologically addicted to [00:46:32.384 – 00:46:34.544] th- to these m- mood-altering drugs. [00:46:34.544 – 00:46:42.084] Over-the-counter decongestants, antihistamines, steroids, muscle relaxants, non-addictive analgesics, non-addictive sedatives. [00:46:42.084 – 00:46:45.844] Every year, one comes out with a new non-addictive drug. [00:46:45.844 – 00:46:47.154] I remember when [00:46:47.260 – 00:46:48.540] Well, Darvon wasn't addictive.

[00:46:48.540 – 00:46:50.180] Talwin wasn't addictive. [00:46:50.180 – 00:46:51.700] Ambien wasn't addictive. [00:46:51.700 – 00:46:55.220] They all turn out to be addictive, uh, as time goes on. [00:46:55.220 – 00:46:57.050] Now listen to this, what Dr. [00:46:57.050 – 00:46:57.860] S. said. [00:46:57.860 – 00:46:59.080] This man was brilliant. [00:46:59.080 – 00:47:02.760] He said this all back in the late '30s.

[00:47:02.760 – 00:47:12.200] "These allergic types can never safely use alcohol in any form at all." Page 28 of the Big Book. [00:47:12.200 – 00:47:14.640] S. was unbelievable. [00:47:14.640 – 00:47:16.100] He was right all the time. [00:47:16.100 – 00:47:18.400] He was right about the fact it was a disease. [00:47:18.400 – 00:47:21.300] He was right about the fact it was a physical component. [00:47:21.300 – 00:47:26.100] He was right about the fact it was, uh, the body and the mind combination. [00:47:26.100 – 00:47:26.700] Okay?

[00:47:26.700 – 00:47:32.120] And he was also right about, uh, there had to be some kind of moral psychology. [00:47:32.120 – 00:47:34.440] He knew there was a spiritual solution. [00:47:34.440 – 00:47:39.750] Unheard of for a physician psychiatrist in those days, and even these days. [00:47:39.750 – 00:47:43.520] Uh, anyway, in any form. [00:47:43.520 – 00:47:48.120] So total abstinence means you can't use non-beverage alcohol. [00:47:48.120 – 00:47:50.340] What do you mean by that, non-beverage alcohol? [00:47:50.340 – 00:47:52.439] Mouthwash that has alcohol in it.

[00:47:52.439 – 00:48:02.100] Your brain doesn't care where the molecule of ethyl alcohol comes from, whether it comes from Cepacol mouthwash or Jack D. bourbon whiskey. [00:48:02.100 – 00:48:04.040] The brain can't differentiate that. [00:48:04.040 – 00:48:05.000] That, it doesn't care. [00:48:05.000 – 00:48:15.080] Liquid medications that have an alcohol base, sprays and mist preps like Primatene, uh, all kinds of food, rum pudding, [00:48:15.080 – 00:48:21.760] tiramisu, uh, cordi- uh, uh, certain kinds of candy cordials and so forth. [00:48:21.760 – 00:48:23.020] They all have… [00:48:23.020 – 00:48:29.780] You gotta be, "Well, um, it's okay to cook with wine." No, it's not okay to cook with wine.

[00:48:29.780 – 00:48:34.640] "Oh, but doc, it's gonna burn off." Well, I tell my patients, "Yours won't burn off. [00:48:34.640 – 00:48:42.940] Don't even, don't even try it." I wanna make a comment here about so-called non-alcoholic beverages. [00:48:42.940 – 00:48:47.820] Let me tell you, there is no such animal. [00:48:47.820 – 00:48:54.040] There is no way you can chemically extract all the alcohol from one of those substances. [00:48:54.040 – 00:48:57.599] You wind up with 0.5% or a little more. [00:48:57.599 – 00:48:59.840] So you wanna take a chance with that? [00:48:59.840 – 00:49:03.380] How many drinks is it gonna take to trigger that pleasure center?

[00:49:03.380 – 00:49:04.940] I don't think that's a good bet. [00:49:04.940 – 00:49:07.660] I wouldn't recommend it for my patients. [00:49:07.660 – 00:49:11.720] And by the way, why are we trying to simulate that drinking experience anyway? [00:49:11.720 – 00:49:13.680] "Well, I like the taste of it." Well, too bad. [00:49:13.680 – 00:49:15.280] Try diet Coke. [00:49:15.280 – 00:49:17.540] Okay, it's predictable. [00:49:17.540 – 00:49:22.360] There's only three options with this thing called, uh, uh, alcoholism.

[00:49:22.360 – 00:49:25.200] You either get locked up, covered up, or sober up. [00:49:25.200 – 00:49:29.060] Now, let's talk about the contagious part. [00:49:29.060 – 00:49:34.460] alcoholism is a family affliction, therefore the family needs treatment at all. [00:49:34.460 – 00:49:36.120] Isn't this a nice family here? [00:49:36.120 – 00:49:41.700] Junior's wondering what happened to dad and mom, who are zonked out at the table after taking some pills and some booze. [00:49:41.700 – 00:49:48.010] So spouses and significant others need codependency treatment and go to Al-Anon, the sister program of AA. [00:49:48.010 – 00:49:58.220] And by the way, I'm sure many of you know, the 12 steps of Al-Anon compared to the 12 steps of, uh, Alcoholics Anonymous, the only difference is one

[00:49:58.220 – 00:50:00.900] word in the 12 step. [00:50:00.900 – 00:50:01.840] One word. [00:50:01.840 – 00:50:04.969] Instead of carrying the message to alcoholics, they carry it to others. [00:50:04.969 – 00:50:11.200] Look at this nice happy family in the picture on the wall, but there's mom and dad waiting for the kids, and where's dad? [00:50:11.200 – 00:50:13.320] Well, he's still down at the bar drinking. [00:50:13.320 – 00:50:20.580] Mom's got his martini order, and she damn well better have it ready for him, 'cause he's had a hard week at work, and this is the thanks he gets if it's not ready. [00:50:20.580 – 00:50:25.940] So children need family therapy, or go to ACOA, Adult C. of Alcoholics.

[00:50:25.940 – 00:50:32.620] And now there's a new ACA called, uh, Adult C. of Alcoholics and Other D. Families, and Alateen. [00:50:32.620 – 00:50:35.400] Alateen is not for teenage alcoholics. [00:50:35.400 – 00:50:39.920] Alateen is for teenage children of alcoholics. [00:50:39.920 – 00:50:44.460] And there you can see we're talking about children of alcoholics now. [00:50:44.460 – 00:50:50.760] So let's go back to the original, uh, problem here, uh, the activity and the problem. [00:50:50.760 – 00:51:01.000] If it's not a matter of ignorance or stupidity or being crazy or immoral or weak-willed, [00:51:01.000 – 00:51:11.160] it's a matter of being sick, then what we should do is address this problem not morally, but medically, with some dignity,

[00:51:11.160 – 00:51:15.859] with some compassion, and with some confidentiality. [00:51:15.859 – 00:51:22.280] There's a reference for you if you'd like it, uh, that goes into this disease thing a little more. [00:51:22.280 – 00:51:27.440] And now I'd like to open it up for, uh, some questions. [00:51:27.440 – 00:51:31.060] Well, thank you ever so much for that, uh, Dr. [00:51:31.060 – 00:51:31.840] Hanks. [00:51:31.840 – 00:51:33.420] That was powerful, really powerful. [00:51:33.420 – 00:51:34.680] Please unmute yourselves.

[00:51:34.680 – 00:51:36.500] So hopefully you can unmute yourselves. [00:51:36.500 – 00:51:39.780] Um, lots of people are Thank you very much, doctor. [00:51:39.780 – 00:51:40.660] Incredible. [00:51:40.660 – 00:51:41.560] Thank you so much. [00:51:41.560 – 00:51:42.650] Thank you. [00:51:42.650 – 00:51:43.540] It was phenomenal. [00:51:43.540 – 00:51:47.180] Thank you.

[00:51:47.180 – 00:51:51.140] Wow, that was brilliant. [00:51:51.140 – 00:51:51.640] Well said. [00:51:51.640 – 00:51:52.799] Thank you so much. [00:51:52.799 – 00:51:53.920] Phenomenal. [00:51:53.920 – 00:51:54.530] Absolutely phenomenal. [00:51:54.530 – 00:51:55.500] It was brilliant, doctor. [00:51:55.500 – 00:51:56.980] Thank you.

[00:51:56.980 – 00:51:58.320] I'm gonna put- Thank you, doctor … [00:51:58.320 – 00:51:58.430] Dr. [00:51:58.430 – 00:51:58.850] Hanks- [00:51:59.184 – 00:52:04.604] His email in the chat again, if you'd like to contact him, please do. [00:52:04.604 – 00:52:11.004] Uh, just before we go to the Q&A, Stuart, I just wanna mention what's coming up, uh, quick about next week. [00:52:11.004 – 00:52:13.024] If I… [00:52:13.024 – 00:52:16.184] Do we have Jim M. back with us next week on the 8th of July.

[00:52:16.184 – 00:52:18.434] Um, Jim is gonna do a presentation for us. [00:52:18.434 – 00:52:18.964] Thank you, Jim. [00:52:18.964 – 00:52:21.464] AA in England, Scotland, Wales, and Ireland. [00:52:21.464 – 00:52:30.164] As though you know, it's 75 years in Ireland last year, and 75, uh, 75 years in the UK this week, or this year, beg your pardon. [00:52:30.164 – 00:52:39.084] And so the following week then, I just wanna say we have the Big Book in Great B., and then we have changes to the Big Book, and then we have the amazing story behind the book that started it all. [00:52:39.084 – 00:52:44.524] We're delighted to have, uh, Ken R. back with us and Mike F. on the 29th of July. [00:52:44.524 – 00:52:47.744] So that's the multi-lent, uh, edition.

[00:52:47.744 – 00:52:49.224] They're gonna be speaking about that. [00:52:49.224 – 00:52:50.244] Okay. [00:52:50.244 – 00:52:53.644] With that, if you want, uh, we're gonna be setting up a WhatsApp group, uh, soon. [00:52:53.644 – 00:52:56.303] If you wanna put your number in the chat, uh, please do. [00:52:56.303 – 00:52:58.044] Um, send it to me and I'll add it to that. [00:52:58.044 – 00:52:59.224] Stuart, it's all yours. [00:52:59.224 – 00:53:01.144] Hello, everybody.

[00:53:01.144 – 00:53:02.324] It's Stuart, alcoholic. [00:53:02.324 – 00:53:11.584] Um, if you'd like to come in and ask a question, be part of the meeting, um, then please raise your hand in the participant section and I'll call on you. [00:53:11.584 – 00:53:14.624] And I'll just repeat, this to ask a question. [00:53:14.624 – 00:53:16.784] Um, it's not a discussion meeting. [00:53:16.784 – 00:53:19.194] It's to ask, uh, the doctor a question. [00:53:19.194 – 00:53:21.834] Um, so we're gonna start off with Hugh H. [00:53:21.834 – 00:53:22.804] Good evening, Hugh.

[00:53:22.804 – 00:53:24.784] Good evening. [00:53:24.784 – 00:53:26.414] Uh, I'm an alcoholic. [00:53:26.414 – 00:53:27.264] My name's Hugh. [00:53:27.264 – 00:53:29.424] And, uh, thank you very much, Dr. [00:53:29.424 – 00:53:29.944] Lin. [00:53:29.944 – 00:53:33.783] That was strikingly informative. [00:53:33.783 – 00:53:35.824] Um, I have two questions.

[00:53:35.824 – 00:53:43.744] One is about, I've been sober 30 years almost, and three years ago, I broke my femur. [00:53:43.744 – 00:53:53.984] And I got combinations of opioids and, uh, I think it was Dilaudid, um, [00:53:53.984 – 00:53:56.664] until they had, uh, blocked the nerve. [00:53:56.664 – 00:54:07.164] So can you talk– I, I wonder if you could talk a little about, about the appropriateness of using those things for pain- Sure [00:54:07.164 – 00:54:07.174] … [00:54:07.174 – 00:54:08.164] by an alcoholic. [00:54:08.164 – 00:54:08.863] Right.

[00:54:08.863 – 00:54:19.124] Um, that's not as bad a situation, uh, to deal with as it is for an opioid addict who requires, uh, [00:54:19.124 – 00:54:21.684] uh, those, uh, opioid medications. [00:54:21.684 – 00:54:25.444] First of all, we don't want anyone to suffer and be in pain. [00:54:25.444 – 00:54:27.364] That's, that's not the idea. [00:54:27.364 – 00:54:31.204] Uh, however, uh, you have to take precautions. [00:54:31.204 – 00:54:41.584] And there, uh, we try to find every alternative we can to using opioid medication, and that includes all kinds of biofeedback and, uh, regional [00:54:41.584 – 00:54:48.924] anesthesia and local blocks and, uh, uh, meditation and yoga and everything else.

[00:54:48.924 – 00:54:52.984] But oftentimes those do not work, and you actually have to take the medication. [00:54:52.984 – 00:55:03.364] So we recommend that, uh, it be monitored very closely, uh, by a, uh, a third party, [00:55:03.364 – 00:55:13.424] and that, uh, that w- uh, that, that the alcoholic's program gets beefed up by, uh, having, uh, the sponsor involved, uh, and [00:55:13.424 – 00:55:18.144] visit- visiting in the hospital or at home, whatever, uh, increasing their meetings. [00:55:18.144 – 00:55:27.924] Uh, but to beef up their program, uh, uh, but be sure that their, their, uh, ingestion of the, of the, of the medication i- is monitored. [00:55:27.924 – 00:55:33.784] Uh, and, uh, if it starts to get out of hand, then we gotta, we gotta go to pl- plan B. [00:55:33.784 – 00:55:38.304] Uh, but, uh, sometimes you just can't avoid it, but we don't want you to suffer.

[00:55:38.304 – 00:55:39.864] But you, you should take precautions. [00:55:39.864 – 00:55:40.804] Thank you. [00:55:40.804 – 00:55:43.184] Uh, second question. [00:55:43.184 – 00:55:50.844] When I was newly sober, it was drilled into me that alcoholism is primary, progressive, chronic, and fatal. [00:55:50.844 – 00:55:54.684] And you used four slightly different words. [00:55:54.684 – 00:55:56.964] You started off with a couple of the same ones. [00:55:56.964 – 00:56:06.964] And then later, a nurse told me, an alcoholic nurse, that primary, progressive, chronic, and fatal is a dis- definition of any disease, or

[00:56:06.964 – 00:56:08.984] those are aspects of any disease. [00:56:08.984 – 00:56:10.444] Is that true? [00:56:10.444 – 00:56:11.644] No. [00:56:11.644 – 00:56:12.224] No. [00:56:12.224 – 00:56:18.444] I mean, um, some diseases go into what we call spontaneous remission, and that includes alcoholism. [00:56:18.444 – 00:56:21.824] Uh, alcoholism is not universally fatal. [00:56:21.824 – 00:56:24.344] It's almost universally fatal.

[00:56:24.344 – 00:56:26.664] There are, there– But there are exceptions. [00:56:26.664 – 00:56:36.984] Uh, we have people who have different kinds of what we call blood dyscrasias, different kinds of lymphomas and leukemias, and, uh, they, they, they won't take, [00:56:36.984 – 00:56:42.444] uh, chemotherapy for lots of reasons, and all of a sudden, a spontaneous remission. [00:56:42.444 – 00:56:45.464] Uh, there are several diseases like that. [00:56:45.464 – 00:56:46.894] No, not every, every disease. [00:56:46.894 – 00:56:48.884] That does not describe every disease. [00:56:48.884 – 00:56:50.344] Thank you.

[00:56:50.344 – 00:56:52.364] Here's the patient, honey. [00:56:52.364 – 00:56:54.084] Thank you very much. [00:56:54.084 – 00:56:56.684] Um, we're gonna go to Joel M. [00:56:56.684 – 00:56:58.044] in Miami, Florida. [00:56:58.044 – 00:57:01.304] I'm an alcoholic, and my problem is Joel. [00:57:01.304 – 00:57:09.484] I have two questions about terms you used because I still have my notes from 1990 when you, when you treated me. [00:57:09.484 – 00:57:10.914] I'm, I'm the one who sent you that, uh-

[00:57:11.108 – 00:57:16.268] That, that thing about I'm, I'm 31 years in the program thanks to you and Mary L.. [00:57:16.268 – 00:57:20.238] Uh, without Mary L.- There's Mary. [00:57:20.238 – 00:57:22.168] Oh my gosh, there you are. [00:57:22.168 – 00:57:25.968] Um, I, I'm, I'm, I was about to finish the sentence. [00:57:25.968 – 00:57:35.188] It's the combination of the two of you because Mary L. was our spiritual teacher and you were our medical teacher when you did your lectures every morning a- as long with everything else. [00:57:35.188 – 00:57:42.328] And I never forgot both of you, and I've quoted Mary L. many times, particularly about Einstein and all that kind of stuff. [00:57:42.328 – 00:57:48.668] W- when, 'cause I believed in Einstein and then, then she corrected me and said, "Ah, even he believed in God.

[00:57:48.668 – 00:57:51.088] Watch, watch, watch." And she brought me the proof. [00:57:51.088 – 00:57:54.368] So anyway, now, now let's get to the two questions. [00:57:54.368 – 00:57:54.888] Sure. [00:57:54.888 – 00:58:01.388] Uh, I learned from you, uh, first of all, the phrase used was mood altering, not to take any mood altering substance. [00:58:01.388 – 00:58:08.648] And when you started this lecture you made mention that there was some mood altering substances that were okay for an alcoholic. [00:58:08.648 – 00:58:09.178] Yes. [00:58:09.178 – 00:58:10.148] Or I thought you said that.

[00:58:10.148 – 00:58:12.548] And let me just get the second question in so you'll know. [00:58:12.548 – 00:58:22.808] The second question is, I also thought that it was okay, and I've been doing this for 31 years, after about five years I would eat foods [00:58:22.808 – 00:58:29.828] if the wine was cooked off, like in a Marsala chicken sauce where it's in there, as long as they, they totally cooked it off. [00:58:29.828 – 00:58:40.258] And I asked, I would ask, I'd get, you know, the, the restaurant each time, "Did they cook it off?" I would never take a dessert because desserts have cold, real alcohol in 'em, meaning non-cooked [00:58:40.258 – 00:58:40.568] off. [00:58:40.568 – 00:58:41.038] Right. [00:58:41.038 – 00:58:42.268] So those are my two questions.

[00:58:42.268 – 00:58:42.728] Okay. [00:58:42.728 – 00:58:52.808] In terms of anti-depressants, anti-psychotics, um, and, um, uh, lithium are all mood altering, technically [00:58:52.808 – 00:58:57.968] speaking, but they're not addictive because they're not reinforcing and they don't produce an intense pleasure. [00:58:57.968 – 00:59:00.328] Uh, so those are okay to take. [00:59:00.328 – 00:59:08.428] And in term- if, if the wine is totally cooked off, it's, i- if, if it's evaporated, you know, uh, then, you know, sure, you can do it. [00:59:08.428 – 00:59:12.608] But y- I- You just have to be very, very, very careful about that. [00:59:12.608 – 00:59:15.788] And, and Joel, thanks for, uh, your comments.

[00:59:15.788 – 00:59:24.948] Um, and, uh, I see, uh, you have experienced the same, uh, complication of aging as I have, uh, with our hairlines. [00:59:24.948 – 00:59:27.508] For sure. [00:59:27.508 – 00:59:30.508] Thank you. [00:59:30.508 – 00:59:30.658] Thank you. [00:59:30.658 – 00:59:31.428] Thank you very much. [00:59:31.428 – 00:59:33.548] We're gonna go to Nicola C. [00:59:33.548 – 00:59:34.128] now.

[00:59:34.128 – 00:59:35.168] Good evening, Nicola. [00:59:35.168 – 00:59:39.168] Hi, good evening. [00:59:39.168 – 00:59:42.837] Um, thanks so much for, um, organizing this meeting. [00:59:42.837 – 00:59:44.688] Um, phenomenal. [00:59:44.688 – 00:59:45.788] Uh, Dr. [00:59:45.788 – 00:59:46.808] Lin, wow. [00:59:46.808 – 00:59:53.228] You've literally just in that one hour completely and utterly explained alcoholism.

[00:59:53.228 – 00:59:57.128] Um, you know, I've, um, I've, I've been kind of struggling with it. [00:59:57.128 – 00:59:59.488] Um, I've been sober now solidly for two months. [00:59:59.488 – 01:00:04.248] The longest period of sobriety I've had, um, is just one, one day shy of 11 months. [01:00:04.248 – 01:00:11.068] Um, I've always struggled with the, the concept that, um, being told that alcoholism is a sober condition. [01:00:11.068 – 01:00:16.328] Um, and that, that's always, that's always, I've always struggled with that. [01:00:16.328 – 01:00:23.648] Um, and I just wondered if perhaps you could ex- um, uh, you could give me your, your, your thoughts or, or views on why th- why that's said, please. [01:00:23.648 – 01:00:26.748] It, it, it, say that again?

[01:00:26.748 – 01:00:28.728] Alcohol is always a sober condition? [01:00:28.728 – 01:00:29.978] Is that what you- Yeah. [01:00:29.978 – 01:00:32.108] I've, um, so, uh, I am in AA. [01:00:32.108 – 01:00:35.848] Um, I do go to AA meetings, uh, religiously, no pun intended. [01:00:35.848 – 01:00:36.568] Um- Yeah … [01:00:36.568 – 01:00:43.408] and, uh, uh, it's, um, uh, uh, we're always told that alcoholism is a sober condition. [01:00:43.408 – 01:00:51.628] Well, re- recovered, recovering, recovered alcoholism is a sober condition.

[01:00:51.628 – 01:00:56.247] If, if, i- if the alcoholism is active, you're not sober. [01:00:56.247 – 01:00:57.368] Right. [01:00:57.368 – 01:01:02.368] And, but if you, but if you stop drinking, uh, that's not enough. [01:01:02.368 – 01:01:12.208] You, you, you will be abstinent, and you will be what we call dry or some people refer to that term as sodriety, not sobriety. [01:01:12.208 – 01:01:22.348] Sobriety in, in, in pl- uh, uh, is implicit that you undergo [01:01:22.348 – 01:01:24.388] a different kind of behavior. [01:01:24.388 – 01:01:30.668] You're not on a dry drunk where you're not drinking and, and, and doing the old s- same similar behavior.

[01:01:30.668 – 01:01:31.728] You got new behavior. [01:01:31.728 – 01:01:34.408] Hopefully you've had an entire psychic change. [01:01:34.408 – 01:01:34.998] Yeah. [01:01:34.998 – 01:01:37.648] And what the steps allow you to do- Mm-hmm … [01:01:37.648 – 01:01:47.708] um, they are transformative in the sense that, uh, you are able to, um, have [01:01:47.708 – 01:01:49.388] a spiritual awakening. [01:01:49.388 – 01:01:50.088] Okay?

[01:01:50.088 – 01:01:57.228] And then by virtue of that detach from some of your old narcissistic and emotional responses. [01:01:57.228 – 01:02:00.788] And that's what we mean by sobriety as opposed to sodriety. [01:02:00.788 – 01:02:02.268] Sodriety. [01:02:02.268 – 01:02:04.488] And can I just ask one thing very quickly? [01:02:04.488 – 01:02:06.968] Um, uh, tr- tryptophans. [01:02:06.968 – 01:02:12.268] Um, I don't know if you've come across, um, a herbal supplement called 5-HTP. [01:02:12.268 – 01:02:13.988] It's part of the tryptophan family.

[01:02:13.988 – 01:02:15.868] It affects the serotonin levels. [01:02:15.868 – 01:02:19.728] Now, I used to take this quite regularly when I was drinking. [01:02:19.728 – 01:02:22.758] Can I still take this or, as an alcoholic, is it- [01:02:22.981 – 01:02:23.832] gonna affect things. [01:02:23.832 – 01:02:25.392] Do you know much about it? [01:02:25.392 – 01:02:26.412] I do. [01:02:26.412 – 01:02:27.852] I, and it's probably safe.

[01:02:27.852 – 01:02:35.672] I'd like to see that bottle myself and read the ingredients but, but, uh, i- if it's pl- if it's plain, uh, tryptophan, that's okay. [01:02:35.672 – 01:02:36.872] Tryptophan is in turkey. [01:02:36.872 – 01:02:37.932] Yeah. [01:02:37.932 – 01:02:38.492] Yeah. [01:02:38.492 – 01:02:38.642] Yeah. [01:02:38.642 – 01:02:38.711] Yeah. [01:02:38.711 – 01:02:40.032] Just pure tryptophan.

[01:02:40.032 – 01:02:40.372] Okay. [01:02:40.372 – 01:02:40.682] Sure. [01:02:40.682 – 01:02:41.012] Thank you. [01:02:41.012 – 01:02:41.872] Thank you again. [01:02:41.872 – 01:02:42.252] Thank you. [01:02:42.252 – 01:02:43.082] You are welcome. [01:02:43.082 – 01:02:44.112] Thank you very much.

[01:02:44.112 – 01:02:46.132] We're gonna go to Marsha now. [01:02:46.132 – 01:02:46.832] Hello, Marsha. [01:02:46.832 – 01:02:47.412] Good evening. [01:02:47.412 – 01:02:50.412] Good evening. [01:02:50.412 – 01:02:53.892] Well, that was a very powerful presentation. [01:02:53.892 – 01:03:01.952] I truly enjoyed it, and it was a reflection of the teaching that I had as a, uh, newcomer. [01:03:01.952 – 01:03:06.892] That was the foundational teaching that I had, um, the things that you presented.

[01:03:06.892 – 01:03:16.952] Um, I've been sober, uh, continuously and with complete abstinence for 34 years now, uh, I am, and through the grace of [01:03:16.952 – 01:03:18.192] God and this program. [01:03:18.192 – 01:03:28.312] Um, I, I first had one question regarding, um, I feel that there is an increase [01:03:28.312 – 01:03:38.332] of, uh, newcomers coming into the program, particularly women, through my observation, uh, that are coming in [01:03:38.332 – 01:03:48.592] being prescribed all manner of chemical, uh, suppressants, antidepressants, um, [01:03:48.592 – 01:03:49.952] all, all manner of drugs. [01:03:49.952 – 01:03:58.792] And, um, one of the problems that presents itself is so many times these women cannot get sober.

[01:03:58.792 – 01:04:08.872] Uh, they go in and out of the program, in and out of the program, and are constantly, um, grappling with these drugs that they're on and requesting pr- [01:04:08.872 – 01:04:09.692] you know, prescriptions. [01:04:09.692 – 01:04:20.152] And, uh, one of the problems is, is, uh, as an elder, such as I am, um, [01:04:20.152 – 01:04:29.312] in the program, we are constantly admonished not to play doctor and suggest to them what they should or should not be taking. [01:04:29.312 – 01:04:30.232] Okay? [01:04:30.232 – 01:04:40.292] On the other hand, uh, so many, uh, of the symptomology of their alcoholism is going [01:04:40.292 – 01:04:47.832] to, uh, mimic these various maladies that they are supposedly being treated for.

[01:04:47.832 – 01:04:52.002] Uh, so I would just like to ask your thoughts about that. [01:04:52.002 – 01:04:54.392] That is one half of my question. [01:04:54.392 – 01:05:00.172] Another question came up just with your response to the previous question. [01:05:00.172 – 01:05:10.192] Um, I was taught unequivocally that there was no way that alcohol could be [01:05:10.192 – 01:05:20.652] cooked off of food, and that, and that it begged the question, why would people still continue [01:05:20.652 – 01:05:31.412] to want to have the, quote, "taste" or the, uh, kind of, uh, ambiance [01:05:31.412 – 01:05:36.132] in some way, the oral ambiance of alcohol to begin with?

[01:05:36.132 – 01:05:38.572] That's my questions. [01:05:38.572 – 01:05:39.492] Sure. [01:05:39.492 – 01:05:50.172] Well, with regard to your first question, uh, I, I agree with you that, uh, lots of alcoholics [01:05:50.172 – 01:05:54.712] are, are medicated, especially for depression. [01:05:54.712 – 01:05:55.612] Okay? [01:05:55.612 – 01:06:02.392] Um, and the, and a lot of those, uh, the medication is not needed. [01:06:02.392 – 01:06:07.692] That's why we recommend that, uh, for alcoholics.

[01:06:07.692 – 01:06:17.992] Uh, we gotta remember, alcohol is a depressant, so when you stop taking alcohol, let's see whether the depression that they had, uh, remits- [01:06:17.992 – 01:06:18.312] Mm-hmm … [01:06:18.312 – 01:06:21.252] and, and, and, and their mood becomes more elevated. [01:06:21.252 – 01:06:22.492] That's number one. [01:06:22.492 – 01:06:32.932] Number two, i- in general, if you can get, get the brain free from all chemicals, [01:06:32.932 – 01:06:42.972] uh, for at least six months, then you can evaluate very accurately whether or not somebody has a coexisting mental illness [01:06:42.972 – 01:06:44.672] which may need medication.

[01:06:44.672 – 01:06:45.212] Mm-hmm. [01:06:45.212 – 01:06:46.932] But you can't always do those separately. [01:06:46.932 – 01:06:57.332] Now, if you are a good physician and a good psychiatrist who understands all, and you have somebody who clearly with, because of the medical history, has a primary [01:06:57.332 – 01:07:00.372] depression, you can't wait six months to treat that. [01:07:00.372 – 01:07:00.852] Right. [01:07:00.852 – 01:07:00.972] Yeah. [01:07:00.972 – 01:07:11.392] So it's an individual thing, uh, that has to be really, uh, uh, managed by the, the, the person's, um, uh,

[01:07:11.392 – 01:07:12.672] own physician. [01:07:12.672 – 01:07:21.372] Um, i- you actually can cook the alcohol off if you get the temperature high enough, uh, and, and people just, you know… [01:07:21.372 – 01:07:31.071] I, I don't know how many of them use those foods because it tastes like alcohol, but it, it enhances the flavor of, the natural flavor of whatever's being cooking. [01:07:31.071 – 01:07:34.092] Uh, so I just don't know the answer to that. [01:07:34.092 – 01:07:34.782] But you- [01:07:35.216 – 01:07:37.036] Br- bring, bring, bring up a good point. [01:07:37.036 – 01:07:42.756] I mean, I, it's, it's clear to me, why is somebody imbibing in a non-alcoholic beer or non-alcoholic wine?

[01:07:42.756 – 01:07:44.376] Why are they going through that ritual? [01:07:44.376 – 01:07:45.716] That just seems crazy to me. [01:07:45.716 – 01:07:48.936] Thank you very much. [01:07:48.936 – 01:07:50.776] We're gonna go to Declan now. [01:07:50.776 – 01:07:51.996] Good evening, Declan. [01:07:51.996 – 01:07:54.966] Good evening. [01:07:54.966 – 01:07:56.016] Good evening, doctor.

[01:07:56.016 – 01:07:58.816] Uh, thanks for, uh, for the presentation. [01:07:58.816 – 01:08:00.536] It was, um, very informative. [01:08:00.536 – 01:08:02.656] Just got a very quick question. [01:08:02.656 – 01:08:12.765] Just want to know, um, what the medical profession and, um, thought of the, the disconnect, the abnormal disconnect, uh, [01:08:12.765 – 01:08:20.136] in the addict, um, of memory and rewards over, you know, a, a normal person. [01:08:20.136 – 01:08:26.636] Um, how much research has been done into that, or what- That's a great question. [01:08:26.636 – 01:08:37.196] Uh, we're j- it's only been in the past five years or so that there's, there is mounting evidence that, uh, alcoholism and drug alcoholism are,

[01:08:37.196 – 01:08:42.976] uh, there, uh, there is a memory deficit component to it, uh, for sure. [01:08:42.976 – 01:08:52.996] Um, w- we knew, we knew for a long time ago, for example, with, with this, the classic alcoholic blackout, where you don't have to be intoxicated, but you [01:08:52.996 – 01:08:59.156] have to have alcohol on board, and you engage in an activity which a day or two later you can't remember at all. [01:08:59.156 – 01:09:00.336] You have no memory of it. [01:09:00.336 – 01:09:07.196] Uh, we know how alcohol blocks the conversion of that sh- that short-term memory into long-term memory. [01:09:07.196 – 01:09:07.836] Okay? [01:09:07.836 – 01:09:17.976] Uh, and because, uh, when somebody has a blackout, from a clinical perspective, if I'm a physician and you tell me you've had a blackout, my diagnosis

[01:09:17.976 – 01:09:23.616] is alcoholism till proven otherwise, because there are very few other things that can cause a blackout. [01:09:23.616 – 01:09:24.256] There are some. [01:09:24.256 – 01:09:35.156] Head trauma, a rare form of temporal lobe epilepsy, uh, using benzodiazepines, uh, electroshock therapy, uh, and [01:09:35.156 – 01:09:38.776] s- uh, it's, it's very f- few other things cause a blackout. [01:09:38.776 – 01:09:48.816] So we, we knew from long time ago that there was some memory component here, but it's only in recent years where, where we're thinking in, in terms of, uh, there, [01:09:48.816 – 01:09:50.836] there is a definite disconnect. [01:09:50.836 – 01:10:01.486] Uh, and these new PET scans I was talking about, and SPECT scans, are starting to let us see where the memory centers, wh- which are down in the amygdala, uh, d-

[01:10:01.486 – 01:10:03.676] don't react the same in alcoholics. [01:10:03.676 – 01:10:06.036] And we're trying to figure out exactly why that is. [01:10:06.036 – 01:10:16.196] But again, I, the brilliance of Bill S., uh, in the '30s, to say, you know, uh, uh, and, and, and, and it, that you can't remember [01:10:16.196 – 01:10:22.816] from even, uh, a month or, or two ago, uh, the pain and misery of the past. [01:10:22.816 – 01:10:25.956] And we think we're, we're getting closer to know the reason why, but we don't know yet. [01:10:25.956 – 01:10:27.556] Good question. [01:10:27.556 – 01:10:28.436] Yes, sir.

[01:10:28.436 – 01:10:30.376] Thank you very much. [01:10:30.376 – 01:10:32.236] We have a couple more, if that's okay. [01:10:32.236 – 01:10:34.935] Um, we're gonna go to Betty now. [01:10:34.935 – 01:10:35.796] Hello, Betty. [01:10:35.796 – 01:10:36.456] Good evening. [01:10:36.456 – 01:10:37.696] Hi, good evening. [01:10:37.696 – 01:10:38.376] Thank you for calling.

[01:10:38.376 – 01:10:38.876] My name's Betty. [01:10:38.876 – 01:10:49.656] I'm a recovered alcoholic, Area 18, District 4 of the good old US of A, and I'm really super interested in what you would have to, uh, comment on about AA singleness of purpose. [01:10:49.656 – 01:10:59.756] Um, I came to this, uh, group hoping to hear an AA history, but, um, I heard a lecture on drug alcoholism and alcoholism, which, [01:10:59.756 – 01:11:00.696] you know, that's great. [01:11:00.696 – 01:11:03.756] You know, it's really, really great, and I, I totally agree with everything you said. [01:11:03.756 – 01:11:05.516] Um, I'm not a drug addict. [01:11:05.516 – 01:11:10.216] I've never, um, had difficulty with drugs, and I love drugs.

[01:11:10.216 – 01:11:13.696] I, I am so grateful to be born in 2000 and whenever I was. [01:11:13.696 – 01:11:14.476] 2000? [01:11:14.476 – 01:11:15.296] Oh G., I'm old. [01:11:15.296 – 01:11:17.176] 1962, right? [01:11:17.176 – 01:11:19.856] I, you know, have the benefit of modern chemistry. [01:11:19.856 – 01:11:26.236] But, um, the, I never had any difficulty at all in walking away from stuff that was illegal, anything like that. [01:11:26.236 – 01:11:29.376] But that damned alcohol had a completely different effect on me.

[01:11:29.376 – 01:11:31.796] I never got euphoric when I drank. [01:11:31.796 – 01:11:32.956] I got quiet. [01:11:32.956 – 01:11:34.956] I s- I sought the quietness. [01:11:34.956 – 01:11:44.996] So, uh, the question is, um, when you send people to Alcoholics Anonymous, are you cognizant of the reverence with which most of us adhere [01:11:44.996 – 01:11:54.996] to the traditions, and are you, uh, in agreement, I guess, with this idea that one alcoholic talking to another alcoholic, that the, the, the [01:11:55.056 – 01:12:05.076] underlying, um, spiritual illness might be the same, but the symptoms are completely different from, say, a person addicted to crack and [01:12:05.076 – 01:12:07.536] that lifestyle than an alcoholic.

[01:12:07.536 – 01:12:09.236] Can you help me out a little bit with that? [01:12:09.236 – 01:12:09.736] Thank you. [01:12:09.736 – 01:12:15.276] Yeah, I was exposed to that, uh, in Miami, uh, when I ran a treatment center there. [01:12:15.276 – 01:12:25.336] Uh, there was a vast difference between a classic heroin addict, okay, and a [01:12:25.336 – 01:12:27.296] w- white male, 40-year-old alcoholic. [01:12:27.296 – 01:12:30.016] Pure, so-called pure alcoholic, you know what I mean? [01:12:30.016 – 01:12:40.696] And I was aware of the, the, uh, separation between the alcoholics and the addicts and, and their view of each other,

[01:12:40.696 – 01:12:46.456] where the alcoholics would say, "Can you imagine those junkies," okay? [01:12:47.260 – 01:12:49.680] Sticking a needle in their arm. [01:12:49.680 – 01:12:51.280] The idiots, okay? [01:12:51.280 – 01:13:01.460] And then, and then over in the, uh, on their side of the street, they would be saying to me, say, "God, those lushes, why would they put rotgut in their stomach and drink [01:13:01.460 – 01:13:07.700] their, and, and fire away their liver?" So there was this controversy. [01:13:07.700 – 01:13:18.100] And when you look at AA and NA, while they have tremendous similarities and a lot in common, there are some significant [01:13:18.100 – 01:13:18.760] differences.

[01:13:18.760 – 01:13:29.040] Now, what, what happens is, where the singleness of purpose comes in, and I'm acutely aware of alcoholics know how to handle and talk to alcoholics [01:13:29.040 – 01:13:30.680] and can't help drug addicts. [01:13:30.680 – 01:13:31.480] Okay? [01:13:31.480 – 01:13:32.540] And vice versa. [01:13:32.540 – 01:13:40.370] However, as you well know, the only requirement for AA membership is a desire to not drink, period. [01:13:40.370 – 01:13:41.940] So that's the short form on the wall. [01:13:41.940 – 01:13:42.880] No, that's not period.

[01:13:42.880 – 01:13:44.030] According to AA literature- And, and- … [01:13:44.030 – 01:13:47.160] there needs to be two But not, th- this isn't a discussion meeting. [01:13:47.160 – 01:13:48.740] You were just to ask a question. [01:13:48.740 – 01:13:49.090] Thank you. [01:13:49.090 – 01:13:52.060] I don't want to get into a debate here, if that's okay. [01:13:52.060 – 01:13:52.840] Okay. [01:13:52.840 – 01:13:53.090] Yeah.

[01:13:53.090 – 01:14:01.560] All right, so anyway, I'm aware of the, I'm aware of the controversy, but you have a lot of people, uh, who are dually addicted, both alcohol and drugs. [01:14:01.560 – 01:14:01.640] Right. [01:14:01.640 – 01:14:09.080] I- i- in, in the, in the general patient population, roughly 25% are pure alcohol only. [01:14:09.080 – 01:14:11.620] Roughly 25% are pure drugs only. [01:14:11.620 – 01:14:13.940] And then the other 50% are both. [01:14:13.940 – 01:14:18.960] So they kind of mix and m- they kind, they kind of go to each other's meetings from time to time. [01:14:18.960 – 01:14:21.040] So it's a, it's a controversial area.

[01:14:21.040 – 01:14:22.820] Clearly. [01:14:22.820 – 01:14:24.180] Thank you very much. [01:14:24.180 – 01:14:26.860] We have two more questions and then we're gonna shut down. [01:14:26.860 – 01:14:30.900] Um, we have, um, Camera J., here. [01:14:30.900 – 01:14:35.070] Yes, uh, thank you, uh, Stuart, and, uh, Dr. [01:14:35.070 – 01:14:35.740] Lintz. [01:14:35.740 – 01:14:36.660] Thank you so much.

[01:14:36.660 – 01:14:40.940] It was a, a phenomenal, a just phenomenal, uh, presentation. [01:14:40.940 – 01:14:41.920] Thank you so much. [01:14:41.920 – 01:14:44.460] Um, I have two questions, really. [01:14:44.460 – 01:14:47.760] One, as a result of your reply to Jacqueline about the memory. [01:14:47.760 – 01:14:57.780] Um, is there any medical, um, is there any medical, the causes of a blackout, is there any medical reasons why a blackout, [01:14:57.780 – 01:15:08.180] and I'm, I mean a blackout where an alcoholic would ostensibly be working, apper- appearing normal, having conversations like myself, and, uh, yet would be in a blackout. [01:15:08.180 – 01:15:11.860] Is there, is there any, is there any medical, uh, cause for that?

[01:15:11.860 – 01:15:16.380] And my second question was, um, I forget what my second question was. [01:15:16.380 – 01:15:17.440] It's terrible being old. [01:15:17.440 – 01:15:25.700] Oh, yes, Doc, and my second question was, um, I've been sober 45 years in AA and I love AA and I love the inclusivity of AA. [01:15:25.700 – 01:15:32.900] I'm glad what you mentioned there about the majority of, especially young women now coming in would be dual addictive, right? [01:15:32.900 – 01:15:35.600] We like being inclusive where, where I, where I come from. [01:15:35.600 – 01:15:45.640] But, uh, over the years of people I've sponsored, I have met, uh, a number, five I'd say, uh, uh, alcoholic who, who's told me they [01:15:45.640 – 01:15:46.900] only had a physical allergy.

[01:15:46.900 – 01:15:48.400] I believe three of them. [01:15:48.400 – 01:15:58.400] So is it possible that there is within that s- uh, within that, uh, uh, uh, parameter of alcoholism, um, is it possible that there are people [01:15:58.400 – 01:16:03.970] who only have a physical allergy to alcohol, and when they stop drinking they're A-okay? [01:16:03.970 – 01:16:09.620] Well, first of all, it's not really a true allergy. [01:16:09.620 – 01:16:12.000] It's not an antigen-antibody reaction. [01:16:12.000 – 01:16:13.120] What, what Dr. [01:16:13.120 – 01:16:21.360] S. was trying to illustrate is that alcoholics have a different response to alcohol than non-alcoholics, normal temperance drinkers.

[01:16:21.360 – 01:16:22.460] And he made that comment. [01:16:22.460 – 01:16:32.480] Um, so the, I th- I think there are, that's, that was, that's part of the distinction [01:16:32.480 – 01:16:35.260] I was trying to make between the abuser and the alcoholic. [01:16:35.260 – 01:16:45.240] Uh, that the abuser doesn't have the full-fledged psychological as well as the physical component. [01:16:45.240 – 01:16:47.620] And so they don't get into the full-blown disease. [01:16:47.620 – 01:16:56.080] Uh, you know, and, but, but they, because of stress and all the other stuff and they drink too much, but they can be redirected. [01:16:56.080 – 01:16:59.980] But the a- the alcoholic, uh, that, that's a different ball of wax.

[01:16:59.980 – 01:17:01.280] It's a totally different thing. [01:17:01.280 – 01:17:11.460] And, and the blackout thing, as I said, if you have, uh, head trauma, use benzodiazepines, have [01:17:11.460 – 01:17:19.720] a rare form of temporal lobe epilepsy, general anesthesia and electroshock therapy, those can all cause that same memory deficit. [01:17:19.720 – 01:17:24.440] The way the blackout works is there's a short-term memory and long-term memory. [01:17:24.440 – 01:17:28.820] And a short-term memory is what we remember from what we did last night. [01:17:28.820 – 01:17:32.040] So that's an electrical phenomenon. [01:17:32.040 – 01:17:40.260] And in order to get it converted to a long-term memory, okay, that's a chemical phenomenon.

[01:17:40.260 – 01:17:48.940] And the blackout in the alcoholic, they get the electrical part, but, but the chemical conversion does not happen. [01:17:48.940 – 01:17:51.640] Why that's so, we don't know. [01:17:51.640 – 01:17:52.880] We still do not know today. [01:17:52.880 – 01:17:55.920] But that's, that's the reason the blackout occurs. [01:17:55.920 – 01:17:57.540] Good questions. [01:17:57.540 – 01:17:58.280] Thank you. [01:17:58.280 – 01:17:58.590] Thank you.

[01:17:59.424 – 01:18:01.664] And one final question now for this evening. [01:18:01.664 – 01:18:03.124] We're gonna go to Dan T. [01:18:03.124 – 01:18:04.404] in Australia. [01:18:04.404 – 01:18:05.724] Good morning, Dan. [01:18:05.724 – 01:18:07.484] Yeah, good morning. [01:18:07.484 – 01:18:09.044] Thank you, Stuart, and thank you, doctor. [01:18:09.044 – 01:18:10.204] That was a great presentation.

[01:18:10.204 – 01:18:20.344] I was just interested there, Doctor, one, one of your screenshots you showed, uh, an image of the brain of, uh, a guy watching [01:18:20.344 – 01:18:22.664] a, a nature film. [01:18:22.664 – 01:18:22.734] Yeah. [01:18:22.734 – 01:18:32.904] And there's a little red dot where he's getting a little bit of pleasure out of it, and then there's a film on cocaine and, and the, the light, the, the, the light comes [01:18:32.904 – 01:18:33.724] on a bit brighter. [01:18:33.724 – 01:18:38.204] And I'm pretty sure you said that that guy was, uh, two years clean and sober at the time. [01:18:38.204 – 01:18:38.504] Right.

[01:18:38.504 – 01:18:38.954] Yeah. [01:18:38.954 – 01:18:40.664] Is this, uh … [01:18:40.664 – 01:18:50.964] When I, when I went through, uh, rehab, Dr., my nurse was very S. on talking about, uh, you know, taking 70-something days to, for neural pathways to change, [01:18:50.964 – 01:18:56.544] and she used to jokingly say, "In your case, Dan, you have to stick around for a lot longer than that," since some people it takes longer. [01:18:56.544 – 01:19:06.704] And does that indicate that despite that neuroplasticity, it's, the, our brain is still elastic enough [01:19:06.704 – 01:19:11.364] to recognize old programs for happiness and reward systems? [01:19:11.364 – 01:19:21.464] Well, yeah, the re- the reward system is, is the, is, is the main chairman of the board, and, uh, a- and rules with an

[01:19:21.464 – 01:19:22.104] iron thumb. [01:19:22.104 – 01:19:26.064] A- a- and usually takes precedence over most other things. [01:19:26.064 – 01:19:36.634] And so, uh, th- that's why we, that's why we re- remember, uh, very pleasurable things, and we remember, m- [01:19:36.634 – 01:19:40.144] uh, activity that's associated with, with the pleasurable things. [01:19:40.144 – 01:19:49.924] And then the next thing, at the next level, we remember, uh, uh, activity that's strongly associated with some type of emotion. [01:19:49.924 – 01:19:54.964] Uh, so it's, um, the … [01:19:54.964 – 01:20:02.884] You, you, you raise it, a, uh, a good point, which we've only come to understand recently about this neuroplasticity and neuroadaptation.

[01:20:02.884 – 01:20:06.644] For a long time we thought that damage to the brain, that was done. [01:20:06.644 – 01:20:08.344] There was no repair. [01:20:08.344 – 01:20:10.173] But now there, there's, that … [01:20:10.173 – 01:20:14.324] Remember I talked about altered circuitry and alternate pathways which evolve. [01:20:14.324 – 01:20:24.324] Uh, and they're, they're, there's, they're starting to look at what role the spiritual programs [01:20:24.324 – 01:20:34.364] have in, in, in, in implementing or st- or initiating that neuroplasticity, and that's very early stages of research, and I just [01:20:34.364 – 01:20:36.083] don't have an answer for you there yet.

[01:20:36.083 – 01:20:38.724] Thanks very much, doctor. [01:20:38.724 – 01:20:39.044] Okay. [01:20:39.044 – 01:20:40.084] Great. [01:20:40.084 – 01:20:41.084] Thank you very much. [01:20:41.084 – 01:20:43.944] Um, thank you very much for the questions this evening. [01:20:43.944 – 01:20:46.524] Um, I'm gonna back to David now. [01:20:46.524 – 01:20:47.944] Thank you, Stuart.

[01:20:47.944 – 01:20:51.964] Cathy, we will, we will stay behind a bit after this, but we have to close the meeting at this point. [01:20:51.964 – 01:20:55.104] Um, so I'm just gonna mention what's coming up, um, next week for you. [01:20:55.104 – 01:20:59.044] We have, um, Jim W. is back with us next week. [01:20:59.044 – 01:21:00.564] What, how did that happen there? [01:21:00.564 – 01:21:02.324] Jim W.'s back with us next week. [01:21:02.324 – 01:21:03.124] He's gonna be talking. [01:21:03.124 – 01:21:05.204] Um, Lynn, did you get my message there?

[01:21:05.204 – 01:21:06.204] I just sent you a message. [01:21:06.204 – 01:21:07.784] Can you, can you look f- for that, please? [01:21:07.784 – 01:21:09.884] Something about me saying a prayer? [01:21:09.884 – 01:21:10.824] Yeah. [01:21:10.824 – 01:21:13.164] Or something of your choice in a, in a few moments. [01:21:13.164 – 01:21:14.964] Yeah, is that okay? [01:21:14.964 – 01:21:16.084] That's fine.

[01:21:16.084 – 01:21:16.764] Yeah. [01:21:16.764 – 01:21:17.404] Thank you, Lynn. [01:21:17.404 – 01:21:19.173] My, my screen saver has just gone there. [01:21:19.173 – 01:21:20.604] So J. W.'s back with us next week. [01:21:20.604 – 01:21:28.744] He's gonna be doing a presentation on, um, Alcoholics Anonymous in UK, Scot- U- UK and Ireland, uh, next week, and we're delighted to have that. [01:21:28.744 – 01:21:30.404] So we go back to Lynn. [01:21:30.404 – 01:21:31.523] Lynn, thank you.

[01:21:31.523 – 01:21:32.384] Take us out. [01:21:32.384 – 01:21:38.004] Well, it was an honor to be here, and maybe we could all, uh, unmute and close with the Serenity P.. [01:21:38.004 – 01:21:41.164] God- God- God- … [01:21:41.164 – 01:21:44.664] grant me the serenity- … [01:21:44.664 – 01:21:47.584] grant me the serenity- Accept the things I cannot change- … [01:21:47.584 – 01:21:48.233] accept the things I cannot change- … [01:21:48.233 – 01:21:49.544] courage to change the things I can- …

[01:21:49.544 – 01:21:50.534] courage to change the things I can- … [01:21:50.534 – 01:21:52.824] wisdom to know the difference … [01:21:52.824 – 01:21:54.804] wisdom to know the difference. [01:21:54.804 – 01:21:55.254] Thank you, Lynn. [01:21:55.254 – 01:21:55.744] Thanks, Lynn. [01:21:55.744 – 01:21:56.364] Brilliant. [01:21:56.364 – 01:21:56.684] Thank you, Lynn.

[01:21:56.684 – 01:21:57.953] Thanks, Lynn. [01:21:57.953 – 01:21:57.954] Brilliant. [01:21:57.954 – 01:21:57.955] Thanks, Lynn. [01:21:57.955 – 01:21:58.944] Thank you. [01:21:58.944 – 01:21:59.274] Great. [01:21:59.274 – 01:22:01.114] Thank you so much. [01:22:01.114 – 01:22:01.733] Thank you, doctor.

[01:22:01.733 – 01:22:02.673] Thank you very much. [01:22:02.673 – 01:22:03.434] Yeah, really appreciate it. [01:22:03.434 – 01:22:03.884] Thank you. [01:22:03.884 – 01:22:06.084] Thank you. [01:22:06.084 – 01:22:06.914] It was great. [01:22:06.914 – 01:22:06.915] Thank you. [01:22:06.915 – 01:22:09.884] David, has Lynn got any, doctor, got any books?

[01:22:09.884 – 01:22:11.824] Oh, yeah, good question, actually. [01:22:11.824 – 01:22:14.084] John, Lynn, do you have anything you want to mention to people? [01:22:14.084 – 01:22:15.464] Say again? [01:22:15.464 – 01:22:18.804] Do you have any, uh, literature or, uh- Yes … [01:22:18.804 – 01:22:21.884] anything you want to bring people to a website or a, a book or … [01:22:21.884 – 01:22:22.644] Oh, no. [01:22:22.644 – 01:22:23.584] No, that's okay.

[01:22:23.584 – 01:22:26.944] A- anybody wants a copy of this, let me know and I'll send it to them. [01:22:26.944 – 01:22:28.084] Okay. [01:22:28.084 – 01:22:29.024] I'd love that, yeah. [01:22:29.024 – 01:22:29.444] Thank you. [01:22:29.444 – 01:22:32.184] Um, can they have the s- visual as well, then? [01:22:32.184 – 01:22:32.684] Yeah. [01:22:32.684 – 01:22:34.544] Yeah, I'll send them the PowerPoint presentation.

[01:22:34.544 – 01:22:35.664] Wow, brilliant. [01:22:35.664 – 01:22:36.644] Thank you very much. [01:22:36.644 – 01:22:36.734] Wonderful. [01:22:36.734 – 01:22:37.284] Thank you. [01:22:37.284 – 01:22:37.783] Awesome. [01:22:37.783 – 01:22:40.944] Yeah, and you have your e- If you have the- His email, yeah. [01:22:40.944 – 01:22:43.954] Send me, s- send me an email and I'll send you the PowerPoint presentation.

[01:22:43.954 – 01:22:45.624] Oh, thank you so much. [01:22:45.624 – 01:22:52.664] Brilliant, and I just wanna mention, uh, Lynn, your, your email again is, just for people who are listening might just wanna know that. [01:22:52.664 – 01:22:55.144] Um, I put it up a couple of times and I have to look for it. [01:22:55.144 – 01:23:01.584] Yeah, it's, it's Lynn H., L-Y-N-N H-A-N-K-E-S @gmail.com. [01:23:01.584 – 01:23:04.724] Thank you, Lynn, and with that we'll stop the pause, uh, recording of the meeting. [01:23:04.724 – 01:23:07.164] We don't wanna go against your sponsor. [01:23:07.164 – 01:23:09.974] It's not a substitute for going to an AA meeting.

[01:23:09.974 – 01:23:10.223] We're recording. [01:23:10.223 – 01:23:10.354] How did I-