In part 2 of a 3-part series,the Coleman Institute's executive director, Amanda Pitts, and National Medical Director, Peter Coleman, join Cindy Stumpo on her podcast "Tough as Nails" on iHeart Radio to discuss addiction, treatment, and long-term recovery.
After hearing about a patient's detox experience at the Coleman Institute in Wellesley, MA, Stumpo and her team contacted them to hear more about his journey. Realizing that people might not be aware that an outpatient detox treatment program is available to help, the patient was on a mission to make sure people knew. This episode shares the patient's drive to ensure people can decide what treatment program if they are suffering from Alcohol Use Disorder or Substance Use Disorder. Have you missed part 1? You can catch up here.
Tough As Nails Podcast: Dealing With Addiction On The Job Part 2
Announcer:
Cindy Stumpo's a general contractor. Look. Whatever happens between the roof and the foundation. For 25 years and counting, Stumpo's been building houses and shattering stereotypes. Building a home and building a life. This is my show and this is where we're going. Cindy Stumpo is Tough as Nails.
Cindy Stumpo:
And welcome. It's Cindy Stumpo, Tough as Nails on WBZ NewsRadio 1030. And we are back, a following weekend, on a second parter of Rob Zavaruka, on dealing with addiction-
Sammie:
Parter?
Cindy Stumpo:
... on the... Did I say parter or Zavaruka?
Sammie:
Second parter.
Cindy Stumpo:
Oh, second parter. Okay, there goes that Boston accent. What is it, Cindy, Sammie.
Sammie:
What is it Cindy? I don't know. Do you know my name?
Cindy Stumpo:
Who's call... No, it's called a late Saturday night where I'm exhausted from working all week. How's that one for you?
Sammie:
Part two would probably be the correct English-
Cindy Stumpo:
Okay, Rob can you say something? Help me. Bail me out here, buddy. Hey, say good evening.
Rob Zavaruka:
Good evening. Rob Zavaruka with Cindy Stumpo.
Cindy Stumpo:
Oh, that's really great. And who else is-
Sammie:
Does everyone forget who they are [inaudible 00:01:25] today?
Cindy Stumpo:
I think me-
Rob Zavaruka:
And we're-
Sammie:
And let me remind you-
Rob Zavaruka:
No, we're-
Sammie:
... you are Cindy Stumpo, you are Rob Zavaruka. I don't know you. Who are you?
Rob Zavaruka:
We're with-
Cindy Stumpo:
Okay, can you introduce yourself, please?
Amanda Pitts:
Sure. My name is Amanda Pitts.
Cindy Stumpo:
Okay.
Amanda Pitts:
And I'm the executive director at the Coleman Institute.
Cindy Stumpo:
Okay. And we also have with us-
Sammie:
I'm glad she knows who she is.
Cindy Stumpo:
Okay. And on remote, we have Dr. Coleman? Am I got that right? Dr. Coleman?
Dr. Coleman:
Correct. Yeah.
Cindy Stumpo:
Okay, so we have a one-second delay here, I think. So, Dr. Coleman is from the Coleman Institute. You're the founder of the Coleman Institute, Doc? Am I right?
Dr. Coleman:
Yes.
Cindy Stumpo:
Okay. Good. Let's go. Start talking to me. Rob, last weekend we were talking about your addiction and everything that's gone on. There are so many questions I still wanted to ask you, but we got cut out, we got cut down to three seconds and we had to get out. Okay, pick up.
Rob Zavaruka:
We were talking about how I thought Coleman's benefits a lot of people that don't want to do 30, 45-day programs, that it's very comfortable, the people there are extraordinarily talented. They put a lot of effort into the short period of time that they are there. You're in there for one day to do the heavy detox. They send you home that night with your medication, and you go back the next morning-
Cindy Stumpo:
So not to cut you down or cut you out or cut you off, but you went in first to the 30-day program somewhere in the west coast, you said.
Rob Zavaruka:
Seven weeks.
Cindy Stumpo:
And you realized you didn't have to do that anymore.
Rob Zavaruka:
Correct.
Cindy Stumpo:
Those days are long gone?
Rob Zavaruka:
Correct.
Cindy Stumpo:
Okay. And now, there's a program that you found, Coleman, that, obviously, you go for aftercare or whatever you do. And I'm sure Amanda will explain that to me.
Rob Zavaruka:
Well, what happened, though, Cindy, is that I had a relapse and instead of going back for another seven weeks to California, it made perfect sense. My therapist introduced me to the people at Coleman's and I was explained that it's pretty much like a home detox, which is, was very important to me. As I said, I went in there for one day-
Cindy Stumpo:
Okay, so this is completely something. Let me, do you mind if I ask Amanda a question?
Rob Zavaruka:
No.
Cindy Stumpo:
Is this something new or something that's not, it's going down a different wave here now? That you don't have to go for 30 days, 45 days, for detox and alcohol?
Sammie:
Why don't you explain your program?
Amanda Pitts:
I'd love to.
Cindy Stumpo:
Yeah, that would really help.
Amanda Pitts:
No, absolutely. So, in Massachusetts, this is really a very unique program because it is outpatient services. So it's an outpatient, ambulatory detox for alcohol and opiates. It's very, very new. It's the first of its kind in the New England area. So-
Cindy Stumpo:
And Dr. Coleman is the founder of all this.
Amanda Pitts:
That's correct.
Cindy Stumpo:
Okay.
Amanda Pitts:
So this is new to Massachusetts, but Dr. Coleman has been doing this in the Virginia area for the last 25 years.
Cindy Stumpo:
Okay, so you have places in Virginia? Because listeners, we're in 32 states. So, Virginia, Massachusetts...
Amanda Pitts:
Cleveland, Ohio, and 11 other affiliate offices throughout.
Cindy Stumpo:
Okay.
Amanda Pitts:
And so, the uniqueness is that people are able to come into the office, receive treatment during the day, return back home to their own home or to a hotel or Airbnb, and then be able to come back the next day. So they're with somebody that they love, that they care about, that's supporting them, that brings them to and from the office each day for treatment.
Cindy Stumpo:
And how many days is the treatment?
Amanda Pitts:
Well, for an alcohol detox, we can complete it in as little as three days.
Cindy Stumpo:
How? Tell me how. How are you doing that?
Amanda Pitts:
So the first day is our long day. So, we really want to focus on the safety of the individuals that are coming in and that are having these withdrawal symptoms. We use a medication called phenobarbital, which is a, it's a sedative that will really help with the symptoms related to alcohol use disorder and withdrawal.
Cindy Stumpo:
Yeah, phenobarbital's been around forever.
Amanda Pitts:
It's like a dinosaur of medications.
Cindy Stumpo:
Okay.
Amanda Pitts:
Absolutely. But it's highly effective. It helps to prevent any types of seizures, it helps to really just calm. Many people feel very anxious, irritable, restless-
Cindy Stumpo:
Well, that's me without being on alcohol. Go ahead. I'm calm. Can't complain. No, it is me, but go ahead.
Amanda Pitts:
So we administer the phenobarbital through an IV, throughout the course of that first day. It can be anywhere between six and eight hours. In addition to that medication, we're also replenishing all of the vitamins and nutrients that have been lost due to alcohol use. So we're doing that through the IV as well. Our staff is all medically-trained professionals, so nurse practitioners. We have our medical director, who's been with us for the last three years, a medical assistant. So it's a highly-trained staff providing care.
Cindy Stumpo:
Okay, and then what's the second day look like?
Amanda Pitts:
So we do administer medications that evening that will help with those post-acute withdrawal symptoms, in addition to tapering than phenobarbital. So we do that through the oral taper. So, when individuals come back that next day, we're meeting with them to look at what their post-acute withdrawal symptoms look like, we're continuing to check vitals, making sure that, how did the medication go the night before? What do their symptoms like? So we continue the treatment through the next couple of days.
Cindy Stumpo:
And then the ending is what, for that one phase, the first phase of the program?
Amanda Pitts:
Well, what is very unique is that we use a medication called Vivitrol.
Cindy Stumpo:
I know Vivitrol.
Amanda Pitts:
Okay. And so-
Cindy Stumpo:
So, but that's for more opioid I thought, Vivitrol.
Amanda Pitts:
It's actually used for both alcohol and opiate. So, it's greatly beneficial in terms of helping people to cut down their desire to want to use alcohol.
Cindy Stumpo:
So do you keep alcoholics on Vivitrol for the rest, for a long period of time, like opioid addicts?
Amanda Pitts:
We see people do really well. We have a six-month program. So we look at six months, just like that first initial program. Most people do really well between six months and a year.
Cindy Stumpo:
And Vivitrol's supposed to stop the cravings, correct?
Amanda Pitts:
That's-
Cindy Stumpo:
The mental cravings-
Amanda Pitts:
... That's correct.
Cindy Stumpo:
... of, I know opioids, because we've done so many shows on opioids, right? So you've heard...
Sammie:
Mm-hmm (affirmative). Megan.
Cindy Stumpo:
Megan, thank you. Talk about Vivitrol in life.
Sammie:
Okay, you're turning into Aunt Eleanor.
Cindy Stumpo:
I know I am.
Sammie:
Okay.
Cindy Stumpo:
My mother, my grandmother. Okay. It kind of goes with the... Do you forget stuff now, Rob?
Rob Zavaruka:
All-
Sammie:
I'm waiting for the day you call me and say, "Joe, Ray, Jesse, Rosie, maybe Sam, I'm talking to?"
Rob Zavaruka:
I forget what my cat's names are sometimes.
Cindy Stumpo:
Listen, when we were working together, you didn't skip a beat up there. Now you're in the studio, you're like... Okay. That's not how you talk. So we'll put part of it into nervousness. Okay, so, Dr. Coleman, you're here, right?
Dr. Coleman:
Correct, yeah.
Cindy Stumpo:
We didn't lose you right, Doc?
Dr. Coleman:
No.
Cindy Stumpo:
Okay. Tell us, with Vivitrol, and is this a new way of dealing with getting... I understand it's been around for opioids for a long time, but is it new with alcohol?
Dr. Coleman:
Yes and no. People first started realizing that oral naltrexone actually helped with cravings way back about 1998, which was radical, because naltrexone's a blocking drug for opioids, as you pointed out. So why would it help alcoholic patients? Well, some people did studies on rats, lab rats, and alcoholic rats. Turns out you could breed rats to become alcoholics. And if you give them naltrexone, they drank half as much. And when they started giving it to humans, even when they weren't trying to stop, they drank half as much alcohol. So they thought there was something here.
And so, it turns out that one of alcohol's effects in the brain, in this complex, beautiful organ that we have on top of our heads, is to actually work through the opiate receptors, through the endorphin receptors as well. So people started using oral naltrexone. When Vivitrol came out, we found that it was twice as effective as oral naltrexone, because there's something about giving somebody a shot for a whole month, where it's just in their system. It's almost like them emotionally, sort of psychologically getting on the bus, where it's like, "Okay, I've had my treatment for a month," and the cravings go down dramatically. It doesn't prevent them from drinking, like Antabuse, which is the drug that makes you sick as-
More like this: How Long Does Naltrexone Last & How Can It Aid in My Recovery?
Cindy Stumpo:
Wait, Doc can you-
Dr. Coleman:
... a dog if you drink on it.
Sammie:
... can youse hold that thought for one minute? I just got to take us out to break. I'm sorry. I got to go to break always at the bad times. I'm Cindy Stumpo, and you're listening Tough as Nails on WBV NewsRadio 1030. Be right back.
Cindy Stumpo:
And welcome back to Tough as Nails on WBZ NewsRadio 1030, and I'm Cindy, and I'm here with...
Sammie:
Sammie.
Cindy Stumpo:
And I'm here with...
Rob Zavaruka:
Rob.
Cindy Stumpo:
And?
Amanda Pitts:
Amanda.
Cindy Stumpo:
And who's on the phone with us?
Dr. Coleman:
Dr. Coleman.
Cindy Stumpo:
Yeah, go ahead.
Sammie:
Dr. Coleman.
Cindy Stumpo:
Thank you very much. Dr. Coleman's on one-second delay here, okay? I feel like I'm on happy hour, okay? Without alcohol. Okay, so Dr. Coleman, you were talking, go ahead.
Dr. Coleman:
Yeah. So I was just explaining that Vivitrol is a one-month injection of naltrexone, and it seems to be about twice as effective as the oral tablets. And so, just our experience using it, really, for the last 16 years or so is that the patients report very few cravings and just feeling a lot easier for them to work a program and stay away from the alcohol. It's the most effective drug I've ever come across for alcohol use disorder.
More like this: Accelerated Opioid Detox: Explained Using The Coleman Method
Cindy Stumpo:
Okay. Now, can I talk to you, not as a host, just, okay, I come to you with my husband, right?
Dr. Coleman:
Yeah.
Cindy Stumpo:
... or if I was, had a wife or whatever, and I said, "Dr. Coleman, I have a question for you. We're going to get my husband off of alcohol or my wife off alcohol, and now we're going to put them on something else. And are they going to become addicted to Vivitrol, or is this going to be a problem? Because we're going from one to another." What's going to be your answer to me? Because I ask a lot of questions by the way.
Dr. Coleman:
I mean, that's first of all, a great question because the history of medicine has been often to substitute one drug for another. And when Valium first came out, or benzodiazepines, the sedatives, that actually happened quite a lot. People thought Valium was going to be a cure. But naltrexone is an opioid blocker, so it's not addictive in any way. There are no withdrawal symptoms, there's no high from it. It's just blocking those endorphin receptors, and so there's no way somebody can get physically addicted to it or emotionally or any kind of addicted to it. So, that's just not an issue at all. And truthfully, we're in the business of getting people off drugs and staying off drugs and alcohol. So, we're not about to give you a drug that you get addicted to.
Cindy Stumpo:
Right. So when they take, I mean there was, when... or kids, whatever, people coming off opioids and they put them on methadone, which that's just another, it's another opioid, just, what's the word I'm looking for?
Dr. Coleman:
Substitute. Yeah.
Amanda Pitts:
Medication-assisted treatment?
More like this: Medication-Assisted Treatment (MAT): Higher Success for Recovery
Cindy Stumpo:
No. Yeah, but no-
Sammie:
Or medication-assisted treatment?
Cindy Stumpo:
Whatever.
Sammie:
MAT?
Cindy Stumpo:
Artificial whatever, [inaudible 00:12:41] whatever. Right, exactly. And from there, went to, what was the next blockage? Suboxone.
More like this: The Truth About Suboxone® & How to Detox
Dr. Coleman:
Suboxone. Yeah. Yeah, I can explain-
Cindy Stumpo:
So, now, what's-
Dr. Coleman:
... a little bit about that.
Cindy Stumpo:
... the difference between Suboxone and Vivitrol?
Dr. Coleman:
Well, Suboxone is an agonist or what we call an opioid agonist. It's a partial agonist, so it does turn the switch on. So all of these drugs work through the endorphin receptor, and so heroin and fentanyl, and all these addictive drugs, turn the switch on a hundred percent. Suboxone turns it on about 70%. So it still is an addictive drug. Naltrexone blocks it, so it doesn't turn on the receptor at all, and so it's just not addictive. Does that make sense?
More like this: 3 Important Differences Between Suboxone and Naltrexone Therapy for People Addicted to Opioids
Cindy Stumpo:
Yes, it does. So Vivitrol is not in, really, in the Suboxone family or the methadone family by-
Dr. Coleman:
It's the opposite-
Cindy Stumpo:
... name. They're not [inaudible 00:13:32] probably.
Dr. Coleman:
... Yeah, it's the opposite of the Suboxone family. It's a complete-
Cindy Stumpo:
Got it.
Dr. Coleman:
... blocker. And Vivitrol is pure naltrexone. It's just mixed into a formulation that lasts a month.
Cindy Stumpo:
So do you find that a lot of people that when they take this Vivitrol, it really actually stops them from wanting the cravings of opioids or alcohol?
Dr. Coleman:
Well, stops completely is a strong statement. I would say that it dramatically reduces thoughts and cravings, and there have actually been studies of PET scans [crosstalk 00:14:06]-
Cindy Stumpo:
So if you had to give me a scale, of one to 10 on a scale, how much-
Dr. Coleman:
Yeah, I'd say-
Cindy Stumpo:
... is the work of the patient and how much is the work of the Vivitrol?
Dr. Coleman:
I would say-
Cindy Stumpo:
Because it's got to be both working together.
Dr. Coleman:
... I would say a good 7 out of 10. It cuts the cravings down seven out of 10. But cravings-
Cindy Stumpo:
So 70% and then 30-
Dr. Coleman:
... have a lot to do with a lot to do... Yeah, cravings have a lot to do with a lot of different things. Like memories will trigger cravings really strong. It's one of the biggest reasons people relapse because they go visit old friends or they're around places where their memory circuits and their brain get triggered. And we know that when you see something or you smell something or you hear something, you just think about it, your brain starts releasing dopamine in the pleasure center, just like when you have a drink, and so the patient experiences cravings. So, there are PET scans and camera pictures of the brain that shows that naltrexone, Vivitrol, cuts that down dramatically. But it, depending on what activities the patient does, they could still get cravings if they're going to not use their common sense. You know what I'm saying?
Cindy Stumpo:
I do. Doc-
Dr. Coleman:
Yeah.
Cindy Stumpo:
... I have a question. What makes one person that can go out and have just a glass of alcohol or a glass of wine-
Dr. Coleman:
Yeah.
Cindy Stumpo:
... to the person that is set out to go out and they want to just get drunk. They, I know people that can socially have a scotch or a martini, and call it, that's it that's, it's over, right? They have the martini, their dinner comes, that's it, they're eating their food, and they don't want another one. Then you go and you sit with people that's one drink after another. What is the difference? What's in one person's brain against somebody else's?
Dr. Coleman:
That is a great question-
Cindy Stumpo:
Have you figured that out yet?
Dr. Coleman:
... and it's a question... Yeah, and there's a lot an awful lot of research being done on this now, and I think we've got pretty clear answers. First, it's complicated. But, by far, the biggest factor seems to be genetics. It seems to be your family history. We almost never treat someone with an opioid or an alcohol problem that doesn't have a family history of some kind of chemical dependency.
And the way the brain works, I can just give you a little lesson here, is that you have an area called the nucleus accumbens, which is also called the pleasure center, and it's full of a chemical called dopamine. And when you activate this... This dopamine is activated in order to keep our species alive, for survival. So we release dopamine when we eat food and have sex, and those cravings-
Cindy Stumpo:
Okay, I was going to ask you. That's why some people are sexaholics.
Dr. Coleman:
Well that's right. So I mean, so we all get a craving for sex and food. And without that, we wouldn't survive. And those cravings, those desires, are so strong that we've got 7 billion people on the planet and we've got a huge amount of obesity because we've got so much food around. Well, it turns out that alcohol and all drugs release about 5 times as much dopamine as the pleasure center was ever meant to get. So people really like it. It's why alcohol's probably a $200 billion-a-year industry. People like that feeling. So, that's all interesting. What's interesting, too, is that 90% of the population can get that dopamine experience, that spike, and they don't really go crazy for it.
They like it, they say that's fun, maybe I'll have another glass of wine sometimes, next time I go out to dinner. But 10% seem to be born with a brain that's a little deficient in dopamine. And when they get that dopamine spike, they immediately start thinking, "Wow, that is the missing piece. I am doing that again, and I don't care if I have a hangover or I break the law or if I make my wife angry or whatever," they put it in the category, like it's worth it. And that's what causes alcoholism and addiction. It's this vulnerability that was there, really, from birth, because they were genetically like that. And then, once they experience that dopamine spike, the addiction takes off on its own. And so, we tell our patients-
More like this: What Is Dopamine & How Does It Keep Me Using Opioids?
Cindy Stumpo:
Can I say something to you, Doc?
Dr. Coleman:
... it's your fault. What's that?
Cindy Stumpo:
I just want to say, I want to bring you back for a minute.
Dr. Coleman:
Yeah.
Cindy Stumpo:
When I started with what they call panic disorder, panic attacks, at 26, and I asked the psychiatrist all these questions, could they be genetic? Could they be... Because my mother had them, my grandmother had them. And when she said no, panic attacks are from post-traumatic stress, I said, "What about alcohol, drugs? You don't think that is genetic, genes?" "Absolutely not." So I'm going to ask you this question, have we found a lot more in the last 30-plus years than we knew 30 years ago? Because you-
Dr. Coleman:
Oh, absolutely.
Cindy Stumpo:
... just said a lot of this is genetic, right?
Dr. Coleman:
Yeah, absolutely.
Cindy Stumpo:
But 30 years ago they didn't believe that. Now, they do believe that on a lot of mental illnesses, right?
Dr. Coleman:
Yes.
Cindy Stumpo:
So I look at drug addiction, alcoholism, depression, anxiety, panic, sex addiction, shopping addiction, it's all coming from the same part of the brain. Am I right to say that? Or am I wrong?
Dr. Coleman:
Well, addiction comes from the same part of the brain. Things, like anxiety, panic attacks, OCD, and depression, come from slightly different parts. It's close, but it's more of the serotonin system rather than the dopamine system.
Cindy Stumpo:
And do you believe there's-
Dr. Coleman:
But again-
Cindy Stumpo:
... any affiliation? We're on a second here. Do you believe that some people, there's an affiliation with some kids that are shy or have anxiety, that they self-medicate at a younger age with drugs and booze to get out of their own uncomfortable feelings in their body? And that starts, also, the future of what's going to hold for these kids, or not?
Dr. Coleman:
Yes. Well, yes and no. There's an awful lot of anxious, shy kids who try alcohol and it does relieve their symptoms, but they don't become alcoholics, because they weren't born with their genetic-
Cindy Stumpo:
Okay, Doc. Hold for one second. I just, hold that thought. I just got to go over a break. I'm so sorry, we'll be right back. I'm sorry. You're listening to Cindy Stumpo, Tough as Nails, WBZ NewsRadio 1030. Be right back.
Cindy Stumpo:
Welcome back to Tough as Nails on WBZ NewsRadio 1030, and I'm here with Sammie, I'm here with, your name is Rob.
Rob Zavaruka:
I am with Rob, but you took my microphone away.
Cindy Stumpo:
Because you were breathing into it. And you are?
Amanda Pitts:
Amanda.
Cindy Stumpo:
And we're here with Dr.-
Dr. Coleman:
Dr. Coleman.
Cindy Stumpo:
There you go. Okay, finish off what you were saying, Doc? Since my sponsors rudely interrupted you. Go ahead.
Dr. Coleman:
So, some... Yeah, the relationship between depression, anxiety, and other mental health disorders and addiction is really that they're two separate illnesses. So, we see an awful lot of people who are born with that genetic vulnerability become alcoholics just because they like partying. And we see some people who are anxious and they use alcohol, and it feels good to them. It relieves their symptoms, and they can become alcoholics if they're genetically vulnerable. But if they're not, they tend to just outgrow that and don't keep doing it more and more and more. So, we look at them as separate illnesses. They interact with each other, but one doesn't cause the other.
Cindy Stumpo:
Okay. So let's just play this, we do a hypothetical here. One of our kids is 15, he's using alcohol. He likes the feeling. He can't talk to girls, he can't socialize without feeling a little drunk or high or whatever. There's definitely no affiliation to that leading the way in the course if you're not genetically predisposed to being an alcoholic or a drug addict?
Dr. Coleman:
Well, that's a good question. And you're getting into the real gray areas. Because it's hard to be a hundred percent black and white. So, sometimes the switch that starts the disease going takes a lot of exposure. So, if somebody keeps drinking alcohol over and over, they may kick off the disease because of their shyness and because they've done it over and over. What you hope for with kids, is that as they grow up, they become more self-confident as they mature, as their brain matures, and they find other ways to deal with stress rather than just taking a pill or a drink for it.
And remember that no one's found the gene for alcoholism or addiction yet. So, in fact, I was at a conference with a geneticist from the local medical college, and she said we've identified at least a hundred genes now that have some effect, but not one of them is the only effect or the main effect, it's a combination of all these things. So, we still have an awful lot more to learn, just like we've learned a lot in 30 years, there's an awful lot more to learn as well.
Cindy Stumpo:
Okay, Doc, what if we just say everybody just does one thing, just stop selling alcohol and stop drinking.
Sammie:
That's so easy.
Cindy Stumpo:
It is.
Dr. Coleman:
Well, we tried then.
Sammie:
Okay.
Cindy Stumpo:
And what happened? Oh, it was called Prohibition.
Dr. Coleman:
Yeah.
Cindy Stumpo:
But no, really? What if we just took alcohol away? Look, if you're a drug addict, you're not going to go to every restaurant and see drugs on the counter to buy, right?
Dr. Coleman:
Right.
Cindy Stumpo:
So, it's got to be even harder for an alcoholic. I can only imagine, because no matter where they go, there it is. So, their way of life has to change. Because, I'm asking you, Rob, this. Did all your friends change? Going for dinner, doing things that you love to do, did all that change? Did you have to turn things around for a while? Maybe not now, but at the beginning?
Rob Zavaruka:
No. It never affected me. I could go out to dinner with people and, for some reason, it didn't, looking at somebody have a drink, and if I was trying to not drink, it really didn't have an effect on me, to be honest with you.
Cindy Stumpo:
No. So, if you go into a restaurant, you see all that liquor lined up, you're not craving it.
Rob Zavaruka:
No. But I will tell you that the worst temptation for me is driving by a liquor store.
Cindy Stumpo:
So that's your trigger?
Rob Zavaruka:
That just works in my head. It's like a light going off. But sitting with somebody and watching them drink wine... And I was just down in Florida with my brother, he was drinking wine, didn't bother me a bit.
Cindy Stumpo:
So it's triggers. It's triggers. It's like me with cigarettes, right? I don't want a cigarette till I get on the phone and talk to somebody. Then that's a trigger-
Rob Zavaruka:
But-
Cindy Stumpo:
... I need that cigarette while I'm on the phone, at night, for whatever reason.
Rob Zavaruka:
But I did want to add this, while the doctor's on the radio. Why is it that I have certain, triggers that start at 4:00 in the afternoon? And if I can get by from 4:00 to 7:00, Dr. Coleman, after 7:30, 8:00, my desire to drink completely dissipates.
Cindy Stumpo:
Okay.
Dr. Coleman:
Triggers, like what Cindy's talking about, with cigarettes are to do with anything that's created a memory circuit in your brain. So, when you drive past the ABC store, that's a strong memory. And so, it triggers a craving, and it's actually triggering a little release of dopamine in that pleasure center without you even knowing about it, subconscious. In fact, they've shown that the-
Cindy Stumpo:
But if you remember what he just said.
Dr. Coleman:
What's that?
Cindy Stumpo:
If you remember what he just said, Doc, his worst time is between four-
Dr. Coleman:
Yes.
Cindy Stumpo:
... and 7:00, right?
Dr. Coleman:
Yeah.
Cindy Stumpo:
No, it's the delay, it's a delay.
Dr. Coleman:
So that's become a memory trigger for Rob.
Cindy Stumpo:
Because 4:00 to 7:00, Rob, was your time to get home and have a drink. And then once 8:00, 9:00-
Rob Zavaruka:
And started drinking.
Cindy Stumpo:
... 10:00 comes, you're fine. Oh, put the mic. Give him back his mic. Hold on.
Rob Zavaruka:
They keep taking my mic away. But yes, that's exactly-
Sammie:
He's a heavy breather.
Rob Zavaruka:
That's exactly... Well, we were just talking about dopamine and... But-
Dr. Coleman:
So go have a lot of sex between 4:00 and 7:00.
Rob Zavaruka:
No.
Cindy Stumpo:
Can you go to the gym between four and seven?
Sammie:
Stay off the road between 4:00 and 7:00.
Rob Zavaruka:
No, it just starts at 4:00 to 7:00. I've had this discussion. I try to occupy myself, try to do it with some kind of, take my mind away from it, whether it be going to an AA class, whether it be playing my guitar or something like that. I try to find something to distract me during those hours.
Cindy Stumpo:
Now, is that every day or just trigger points?
Rob Zavaruka:
Every day-
Cindy Stumpo:
... Maybe a Thursday, Friday.
Rob Zavaruka:
... It's been every day for a long period of time. It's just something I've been trying to deal with. And I use the best skills that I can use in order to avoid getting that temptation. And just minute by minute, as I said, it's just, you got to get through that timeframe. At least that is the way it is for me.
Sammie:
In a way, he's lucky that it only happens during those times versus all day long.
Cindy Stumpo:
Doc, for the Coleman Institute, what right now, and Amanda, maybe you can answer this or Dr. Coleman can answer this, is that what's the success rate with people coming through, on alcohol? Do we have like...?
Dr. Coleman:
Yeah.
Cindy Stumpo:
It was always a small-
Dr. Coleman:
So this-
Cindy Stumpo:
... percentage how people stay clean.
Dr. Coleman:
Yeah. There are two aspects-
Cindy Stumpo:
How long people stay clean.
Dr. Coleman:
... to that, because when we're talking about treating alcoholism, there are always two phases, the detox and then the rehab or recovery. And you need to go through the detox first before you even get a chance to do the recovery. So, we have a hundred percent success getting people off the alcohol. About maybe one out of a hundred patients we have to send to the hospital because it's not quite safe, and we want them to be a hundred percent safe, but we're able to treat the others easily and safely.
And then we've got case managers that follow people up for six months to make sure they get into rehab. So, we don't do the rehab ourselves, we send people out for that. And our job is to try to predict what level of rehab they need. Some people need another inpatient program as Rob did in the past, and some people do really well with an intensive outpatient program. And some people do well with just some individual therapy or just AA or some support groups.
More like this: Addiction Resources
Dr. Coleman:
So, we lose all control of how people do after they finish with us because we can't make them go to treatment. We can give them the best advice and find the best things and hold their hands and make appointments and all that stuff, but at the end of the day, the patient has to be the one that works their program and puts the effort forth stuff like that. So, that's just the reality on the ground of what, of how this disease works.
Cindy Stumpo:
Well, I'll tell you this, I did my homework on the Coleman Institute and, obviously, before you came on and I think it's phenomenal what you guys are doing. And I'll tell you why. You know, I know, we all know in this room right now, I can't speak for people listening, but probably a lot do, this is a very flawed system. Okay? It's a flawed system, it's frustrating. Parents don't know what to do when their kids get into this situation, husbands, wives, and vice versa. And your success rate seems to be very, very good. But I got to hold my own thought now because I got to go to break. They're waving, "Go to break, go to break, go to break." I'll be right back. I'm Cindy Stumpo and you're listening to Tough as Nails on WBZ NewsRadio 1030.
Cindy Stumpo:
And welcome back to Tough as Nails on WBZ NewsRadio 1030. And I'm here with Sammie, I'm here with Rob, I'm here with Amanda, I'm here with Dr. Coleman. So, Dr. Coleman, your success rate there at the Coleman Institute is good. But like you said, that you guys, it's like leading the horse to water, right? You can lead the horse to water, but you can't make them drink. What is it, when they leave the Coleman Institute, what is it that you try to implement for your patients to still work the AA, NA meetings? Is that still a big push?
Well, it is, but it's only a part of the overall treatment plan. We have case managers that meet with all of our patients on the first day, and then usually, each day, with the idea of doing a comprehensive evaluation, working with the medical practitioners, doctors, and nurse practitioners, to develop an individualized treatment plan for that person, to take into account all of the factors that help us determine what should be on that plan.
And so, that's their past history, how much they were using, what success they've had in the past, how much do they understand about addiction? What's their living like their home life, their depression, anxiety, other diseases? And at the end of that, what we want is a treatment plan that the patient agrees to and is willing to do, and then we help them implement that.
And then, we follow them for six months to make sure that they are implementing it. And when we first started working with the insurance company, Anthem Blue Cross down here in Virginia and told them we had the six-month program, they were just delighted. Because for a fraction of the price they were spending on an inpatient program, for 28 days, where the people, especially on opioids, would usually relapse as soon as they got back.
We're able to get them on the right track and follow them for a six-month period. So, that's what we're doing, is we're doing everything we can to develop a good plan for them that's tailored and individualized to them, and then follow them up to make sure that they follow it. And if there are any bumps or hiccups on the way, we can overcome those together.
Cindy Stumpo:
Let me ask a question, Amanda. So I had asked earlier, is there a correlation between anxiety, depression, and alcohol and drug use? And I don't think we went down that road, but you just said, you just use those as an example. So I do believe, common sense, I'm not using anything. I'm not a doctor, but I'm pretty sharp, even though common sense isn't common anymore. In my brain, it still is. I still think there's an affiliation. Genetic, yes, a hundred percent.
But anxiety, depression, I think fuels you into self-medicating, and alcohol is one of those drugs that's easy to get that you self-medicate with. And the other drugs, pot, opioids. Opioids are huge with doctors. Every doctor would take opioids if they could if there was no price to pay, they say, right? I've heard that from many doctors. But there is some type of correlation, too, between alcoholism, drug addiction, depression, and anxiety. Can we say that?
Dr. Coleman:
You can say there's a relationship. I don't even want to say a correlation because, in the addiction world, we look at them as two separate illnesses. We see lots of people with alcohol and drug problems who don't have any depression or anxiety. We see a lot of people with anxiety and depression who don't like drugs and alcohol. They can't stand them, they don't drink at all. And then, we see some people with both. So there's that kind of correlation.
The statistic I said to a patient yesterday is that when someone goes into inpatient rehab for alcoholism, about 75% of them meet the criteria for depression, right? So you'd think there's a correlation. Well, 28 days later, when they come out, they haven't had any antidepressants, they've just stopped drinking, and they've now started getting some counseling. Only 25% still meet the criteria for depression.
So, most of the depression, and anxiety that we see is related to their substance use. And if they just get some counseling, get their support groups going, and don't put chemicals, and addictive drugs in their brain, they don't have anxiety and depression. Our job in the addiction world is to figure out who's in that 25% that does have what we call a dual diagnosis. So that's the way we look at it.
Cindy Stumpo:
Right. And that's why it's called dual.
Dr. Coleman:
Exactly. It's two diagnoses that both need to be treated. Now, the good news is, working a program, going to meetings, getting a sponsor, seeing a therapist, doing an IOP or inpatient, that's actually a really good treatment for anxiety and depression as well. Because now, you've developed a new philosophy in life. You've found new friends, and you've got a fellowship in the 12-step programs. Your wife's happy again with you, and you're being a good dad and you're feeling good about how you're conducting your life, rather than always feeling guilty and angry with yourself. That's one of the best ways to treat anxiety and depression anyway. It's all good.
More like this: Bipolar Disorder and Substance Use Disorder: How to Get Help
Cindy Stumpo:
So, in your opinion, and Amanda maybe can answer this question, or anybody, when an alcoholic, and let's not use a drug addict right now, let's use the word alcoholic, okay? Because there are people that, are lawyers, doctors, everything, that are alcoholics and drug addicts, too. But we tend to, I don't know, it's okay if you're an alcoholic, but it's not okay if you're a drug addict. There's still that taboo, well, he's only an alcoholic. He's not shooting heroin in his arm, right?
But the disease is a disease, no matter which one it is, right? It's still the same. But for whatever reason, the alcoholic gets more of a pass, because he, maybe he's a lawyer or a doctor or whatever, holds a big title. But that being said, how hard do you think people get on themselves when they know they have a problem and they haven't come forward with this problem? How much are they mentally abusing themselves before they come out of the closet with this problem?
Dr. Coleman:
Well, it's a good question. And you're right, there is a lot more stigma using the word drug addict than alcoholic. And in society, there has been for a long time, and they're still is. Because if you just conjure up in your mind an image of what an alcoholic looks like or what a drug addict looked like, it's quite often quite different. And if so, we really look at it as one disease. It's the disease of chemical dependency. And so, we find people that if they try to get off alcohol, they can very easily get addicted to cocaine or to benzos or to even opioids, if they get put on it for a prescription. And if someone tries to get off heroin, but they keep drinking, then they just become an alcoholic. So it's really one illness, actually. And now I've forgotten what your question was.
Cindy Stumpo:
That's okay. We all... Does anybody remember my question?
Amanda Pitts:
Well, I think that with the thousands of patients that I have spoken with, once they're able to really be able to break down those walls and be able to share with someone, their loved ones, or be able to just even say, "I'm an alcoholic," or "I'm struggling with substance use disorder." A big part of that is a huge relief, right? So there's so much shame and guilt, and there's so much that's being carried when you don't have anybody else that's involved in that circle. So I think that once somebody gets to that place, that's that motivation to change. They're an action pace.
Cindy Stumpo:
Okay. And my question was, how long and how much pain does somebody have to bear before they finally break down, they say, "I'm an alcoholic," "I am a sex addict," "I am a gambling addict," "I am a food addict," "I am a drug addict." How long does it take? What does that person go through mentally, every day, knowing that they feel this inside? They don't want to go cheat on their wife, they don't want to go cheat on their husband, but it's an addiction.
They don't want to get drunk and come home and act like a jerk-off, but it's an addiction, right? Anything that can alter the personalities even worse. The sex addict is not altering their personality, they're just doing something they shouldn't be doing. The drug addict, the alcoholic, is altering their personality. And then it can become, the environment can become toxic. It can become very painful for the other person. But all these addictions still flow together. Right? Am I correct on that? Sex, gambling, whatever-
Amanda Pitts:
You're correct-
Cindy Stumpo:
... It seems like all the bad things are an addiction, by the way. Some of these things are fun to really do, but they're an addiction. But how much pain is that person living with before they have to really say, "This is my problem and I got to go get help." Because a lot of people don't want to cave to that and they make excuses.
Dr. Coleman:
Yeah, yeah.
Cindy Stumpo:
"I'm not really a gambler," "I don't really shop too much," "I don't drink too much."
Dr. Coleman:
Well, Cindy-
Cindy Stumpo:
But you do, buddy?
Dr. Coleman:
... you're exactly right. Because the number one symptom of addiction is denial, which is that people don't actually see reality for what it is. So classically, the alcoholic is the last person to really admit that they have it, even though, by then, their wife and their kids and their boss, and everybody else knows they're drinking way too much. So, there's always some of that. So, there are little messages that the person's getting, "I shouldn't be doing this," but then the rationalizing part of the brain is like, "Well, it's not that bad. I'm not hurting anybody. I can stop anytime," et cetera. So, it varies completely from person to person as to-
Cindy Stumpo:
Wait a minute, Doc, hold that thought. We just got to go out to break. I got to go out to break. I'm sorry, just give me one second, one second. I'm Cindy Stumpo and you're listening to Tough as Nails on WBZ NewsRadio 1030. Be right back.
Cindy Stumpo:
And welcome back to Tough as Nails on WBZ NewsRadio 1030, and I'm Cindy Stumpo. And I can't leave this because we have too much on, more... so, I'm going to end this episode, but we're going to pick up the third week. We have to. There are people out there that need to understand this. There's too much information to get out in two weeks, obviously. We've done last week, we've done this week, ... do next week. Are we all good? Can you all come back one more weekend?
Amanda Pitts:
Absolutely.
Cindy Stumpo:
You sure?
Amanda Pitts:
Yep.
Cindy Stumpo:
We good, Sammie?
Sammie:
Yes, but how can you reach the Coleman Institute?
Cindy Stumpo:
How do you, we're going to reach the Institute? How do people today, right now, listening? How can they reach the Institute? Amanda, fast.
Amanda Pitts:
If you want to look us up on www.thecolemaninstitute.com, we have all of our numbers and information on there.Cindy Stumpo:
Boom. Okay. Dr. Coleman, I'll see you next Saturday. Thank you very much. Thank you everybody for coming in. I'm Cindy Stumpo and you're listening to Tough as Nails on WBZ NewsRadio 1030.
Conclusion
Stay tuned for Part 3 of the Coleman Institutes appearance on the “Tough As Nails” podcast on the Coleman Institute’s Facebook and Twitter.
Looking for the rest of the series? Check out part 1 below:
About Cindy Stumpo and “Tough as Nails”
On “Tough As Nails” radio, Cindy Stumpo talks about anything that happens between a roof and a foundation. Building a house, and building a life is what our show is about. In sum, we are a lifestyle show. What separates us from other lifestyle shows is Cindy’s raw, unvarnished view of the world, keeping the show, fun, fast, and interesting.
Laughing and learning makes for a broadcast that educates while entertaining. That being said, sometimes we cry and we’re ok with that. Cindy was the only woman in the room when she took and passed the General Contractor’s exam about 30 years ago. She has been building homes and shattering stereotypes ever since. C. Stumpo Development primarily builds luxury homes in Newton and Brookline, MA. www.cstumpodevelopment.com FOLLOW Cindy on Facebook, Youtube and Instagram.
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