How could my son become an alcoholic? How could my 18-year old daughter become a heroin addict? Why does my husband keep using cocaine when he knows it's ruining his life and his family?
Hear a brief explanation from Mark Winsberg, MD about the disease of addiction and how it affects the brain. Also, learn about how
this is a very treatable disease from which many people can and do recover.
Selected Podcast
Addiction – It Happens In the Best of Families
Featured Speaker:
Learn more about Mark Winsberg, MD
Mark Winsberg, MD
Mark Winsberg, MD is board certified in both family medicine and addiction medicine. He spent the first 17 years of his medical career as an Emergency Room doctor at Clifton Spring Hospital. For the past 8 years, he has been working with people suffering from the disease of addiction in both inpatient and outpatient settings. He is currently the clinical director of Park Ridge Chemical Dependency Services where he continues to treat patients in inpatient and outpatient programs.Learn more about Mark Winsberg, MD
Transcription:
Addiction – It Happens In the Best of Families
Bill Klaproth (Host): Addiction--it can happen in the best of families, but how? Here to lend his insight is Dr. Mark Winsberg of Rochester Regional Health who is board certified in both family medicine and addiction medicine. Dr. Winsberg, thanks for your time. According to statistics, 22 million Americans abuse drugs or alcohol. Why is that number so high?
Dr. Mark Winsberg (Guest): That's a complicated question. It kind of goes to the biology of addiction and also is reflective of our culture, as well, in which medications are sought almost immediately for all different kinds of conditions. But, the fact is that probably 1 in 7 people in the United States will have to deal with a substance-use disorder at some point in their lives and that's based both on biology, because it looks like addiction is about 50% inherited and it's also is a nature versus nurture; the living situations and the society in which a person lives.
Bill: Well, that's interesting. One in seven. So, you say 50% is inherited, so if you have an alcoholic father, chances are you have a higher chance of becoming an alcoholic, yourself?
Dr. Winsberg: Yes, and that's important in the way you phrased that. You have a higher chance. If you've inherited whatever genetic predisposition to addiction, it doesn't necessarily mean that you are going to become an addict, it just means that your pump is primed and if you encounter the right societal or social conditions and the right substance, you're more likely to become addicted to it than the person that doesn't have that predisposition.
Bill: Well, that's where your nature versus nurture comes in and lifestyle, too. If you're in an unhealthy environment and you do have a predisposition to drugs or alcohol, boy, that really does increase your risk factor then.
Dr. Winsberg: Yes. Yes, it does.
Bill: So, Dr. Winsberg, are there signs that parents or husbands or wives--because this can happen to anybody at any age--we should be looking out for? That might be a red flag or a tip off that something is drastically wrong? Because people can hide this pretty well. What should we be looking for?
Dr. Winsberg: Yes, you're right about that. It's sort of dependent on which substance a person is using, but overall, sort of generally, if you notice behavior changes where somebody's becoming more secretive or if your spouse or son or daughter is suddenly not . . . is spending a lot of time out of the house when that is not their normal behavior. Or, if it's a son or a daughter, if they're grades suddenly start dropping in school, and you note that they're hanging around a different crowd. If it's an adult, their work habits can change. They'll suddenly start calling in sick a lot more often, their temperament might change, normally, the person is real gregarious and gets along with people well, suddenly they're turning into somebody who their co-workers don't recognize or family members don't recognize. So, that would be how you recognize it from the outside. For a person that's experiencing, that’s falling into addiction themselves, it's a lot more difficult because denial is one of the prime symptoms of addiction, meaning that most people that become addicted to whatever substance, whether it's alcohol, cocaine, or heroin, don't realize that it's happening. The drugs and alcohol have a funny way of working in the brain such that the person will rationalize behaviors that are becoming progressively more irrational.
Bill: Is that how the disease, then, affects the brain? This disease of addiction?
Dr. Winsberg: Yes, it's interesting. What the addiction affects is the areas of choice in the brain, so some people will say you choose to be an addict, and that isn't right. Addiction is a disease of the choice-making areas in the brain and for the one in seven individuals that are affected by addiction, when they're exposed to that, whatever substance it is, all of a sudden, their brain kicks in with this craving for that substance and they're no longer able to rationally decide, "Okay, I've had enough. I'll stop.” That's why you'll see one person who doesn't have the predisposition for addiction drink a beer, two beers, maybe even five to ten beers on a weekend and just put it down, and the person who has that predisposition to addiction, once they start that process, they can't stop.
Bill: You know, as you talk about that, I'm thinking about kids, then . . . I'm just thinking about we hear these teenagers that are heroin addicts and they're 16 years old and they're from well-to-do families. Obviously, they're craving it; they're addicted to it, it's a disease of the brain, but how do they get introduced to heroin? How does a nice family that lives next door, you know, a well-to-do family and their daughter is a heroin addict? Is there a gateway to get to that point? How does this happen?
Dr. Winsberg: Well, probably I would say in the over 90% range of the patients that I see coming in addicted to opiates at this point were introduced to them either through a doctor's prescription for, you know, somebody has their wisdom teeth removed, or suffers a knee injury or a shoulder injury in their sports at school and are giving an opioid medication, and if they're one of the one in seven that are predisposed to addiction, they like the medication and begin seeking it. That craving gets turned on and they can't stop and there's a natural progression from the opioid pills to heroin. The way it goes, almost I mean, very frequently, now is that the person either gets the opioid pills from a friend at a party that the friend got from their parents' medicine cabinet, or they got it prescribed and they like it and start seeking it and they ask their doctors for more pain medication. The doctor, if isn't aware of what's going on will continue prescribing more and more and then, all of a sudden, they realize that they have a person that's addicted to the opioid on their hands and stop and just cut off the pills and that's a disaster for an opioid addict because at that point, they're physically dependent and they're addicted to the medicines and the pills are very expensive on the street now. In New York State, we have a prescription monitoring program that's helped decreased the amount of pills that are making it to the street. So, what happens then is the pills get too expensive and heroin is everywhere now and it's much cheaper than the pills. The person just naturally then go to the heroin to avoid going to withdrawal, and that's how you get a nice girl or boy, a nice neighbor, using heroin. You know, nobody did it on purpose. It's just the way that this goes.
Bill: So, this over-prescribing of opioids, or opioid addiction, I mean that's why this problem has become such an epidemic. Dr. Winsberg, can you quickly share with us treatment options?
Dr. Winsberg: There are a number of ways that people can get treated for this. In the Rochester area, with Rochester Regional Health, we have a chemical dependency programming both outpatient and inpatient, which is available at various campuses throughout the system and we also have inpatient chemical dependency treatments here where I work at the Unity Campus of Rochester Regional Health. So, that's one way. There's also 12-Step meetings, which a lot of people have found useful. AA, Alcoholics Anonymous, and Narcotics Anonymous, and there's also groups, community groups, that are helpful for family members who have a loved one who's experiencing addiction that provides support in addition to Al Anon, which is a long-time 12-Step program for family members.
Bill: Dr. Winsberg, thank you for that. For a family or individual suffering addiction, could you wrap it up for us? Why should someone choose Rochester Regional Health for their addiction treatment?
Dr. Winsberg: Well, I think what we have here is a long-standing program of good chemical dependency treatment and there are a lot of people in the Rochester community who have benefitted from the services that we have here, as I mentioned, both outpatient and inpatient, and we're just experienced with dealing with this problem. I think it would be a good choice for anyone that's dealing with it. One thing that I didn't mention previously is that the Office of Alcohol and Substance Abuse Services for New York State, commonly known as OASAS, has a website that is very, very useful for families or for people that are suffering from addiction to go to and figure out how to access care for their addiction, and the website is oasas.ny.gov. It's a really good place to start if you've contacted us and still aren't satisfied or have any questions at all, it's very helpful.
Bill: Dr. Winsberg, thank you for your time today. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to www.rochesterregional.org. That's www.rochesterregional.org. I'm Bill Klaproth. Thanks for listening.
Addiction – It Happens In the Best of Families
Bill Klaproth (Host): Addiction--it can happen in the best of families, but how? Here to lend his insight is Dr. Mark Winsberg of Rochester Regional Health who is board certified in both family medicine and addiction medicine. Dr. Winsberg, thanks for your time. According to statistics, 22 million Americans abuse drugs or alcohol. Why is that number so high?
Dr. Mark Winsberg (Guest): That's a complicated question. It kind of goes to the biology of addiction and also is reflective of our culture, as well, in which medications are sought almost immediately for all different kinds of conditions. But, the fact is that probably 1 in 7 people in the United States will have to deal with a substance-use disorder at some point in their lives and that's based both on biology, because it looks like addiction is about 50% inherited and it's also is a nature versus nurture; the living situations and the society in which a person lives.
Bill: Well, that's interesting. One in seven. So, you say 50% is inherited, so if you have an alcoholic father, chances are you have a higher chance of becoming an alcoholic, yourself?
Dr. Winsberg: Yes, and that's important in the way you phrased that. You have a higher chance. If you've inherited whatever genetic predisposition to addiction, it doesn't necessarily mean that you are going to become an addict, it just means that your pump is primed and if you encounter the right societal or social conditions and the right substance, you're more likely to become addicted to it than the person that doesn't have that predisposition.
Bill: Well, that's where your nature versus nurture comes in and lifestyle, too. If you're in an unhealthy environment and you do have a predisposition to drugs or alcohol, boy, that really does increase your risk factor then.
Dr. Winsberg: Yes. Yes, it does.
Bill: So, Dr. Winsberg, are there signs that parents or husbands or wives--because this can happen to anybody at any age--we should be looking out for? That might be a red flag or a tip off that something is drastically wrong? Because people can hide this pretty well. What should we be looking for?
Dr. Winsberg: Yes, you're right about that. It's sort of dependent on which substance a person is using, but overall, sort of generally, if you notice behavior changes where somebody's becoming more secretive or if your spouse or son or daughter is suddenly not . . . is spending a lot of time out of the house when that is not their normal behavior. Or, if it's a son or a daughter, if they're grades suddenly start dropping in school, and you note that they're hanging around a different crowd. If it's an adult, their work habits can change. They'll suddenly start calling in sick a lot more often, their temperament might change, normally, the person is real gregarious and gets along with people well, suddenly they're turning into somebody who their co-workers don't recognize or family members don't recognize. So, that would be how you recognize it from the outside. For a person that's experiencing, that’s falling into addiction themselves, it's a lot more difficult because denial is one of the prime symptoms of addiction, meaning that most people that become addicted to whatever substance, whether it's alcohol, cocaine, or heroin, don't realize that it's happening. The drugs and alcohol have a funny way of working in the brain such that the person will rationalize behaviors that are becoming progressively more irrational.
Bill: Is that how the disease, then, affects the brain? This disease of addiction?
Dr. Winsberg: Yes, it's interesting. What the addiction affects is the areas of choice in the brain, so some people will say you choose to be an addict, and that isn't right. Addiction is a disease of the choice-making areas in the brain and for the one in seven individuals that are affected by addiction, when they're exposed to that, whatever substance it is, all of a sudden, their brain kicks in with this craving for that substance and they're no longer able to rationally decide, "Okay, I've had enough. I'll stop.” That's why you'll see one person who doesn't have the predisposition for addiction drink a beer, two beers, maybe even five to ten beers on a weekend and just put it down, and the person who has that predisposition to addiction, once they start that process, they can't stop.
Bill: You know, as you talk about that, I'm thinking about kids, then . . . I'm just thinking about we hear these teenagers that are heroin addicts and they're 16 years old and they're from well-to-do families. Obviously, they're craving it; they're addicted to it, it's a disease of the brain, but how do they get introduced to heroin? How does a nice family that lives next door, you know, a well-to-do family and their daughter is a heroin addict? Is there a gateway to get to that point? How does this happen?
Dr. Winsberg: Well, probably I would say in the over 90% range of the patients that I see coming in addicted to opiates at this point were introduced to them either through a doctor's prescription for, you know, somebody has their wisdom teeth removed, or suffers a knee injury or a shoulder injury in their sports at school and are giving an opioid medication, and if they're one of the one in seven that are predisposed to addiction, they like the medication and begin seeking it. That craving gets turned on and they can't stop and there's a natural progression from the opioid pills to heroin. The way it goes, almost I mean, very frequently, now is that the person either gets the opioid pills from a friend at a party that the friend got from their parents' medicine cabinet, or they got it prescribed and they like it and start seeking it and they ask their doctors for more pain medication. The doctor, if isn't aware of what's going on will continue prescribing more and more and then, all of a sudden, they realize that they have a person that's addicted to the opioid on their hands and stop and just cut off the pills and that's a disaster for an opioid addict because at that point, they're physically dependent and they're addicted to the medicines and the pills are very expensive on the street now. In New York State, we have a prescription monitoring program that's helped decreased the amount of pills that are making it to the street. So, what happens then is the pills get too expensive and heroin is everywhere now and it's much cheaper than the pills. The person just naturally then go to the heroin to avoid going to withdrawal, and that's how you get a nice girl or boy, a nice neighbor, using heroin. You know, nobody did it on purpose. It's just the way that this goes.
Bill: So, this over-prescribing of opioids, or opioid addiction, I mean that's why this problem has become such an epidemic. Dr. Winsberg, can you quickly share with us treatment options?
Dr. Winsberg: There are a number of ways that people can get treated for this. In the Rochester area, with Rochester Regional Health, we have a chemical dependency programming both outpatient and inpatient, which is available at various campuses throughout the system and we also have inpatient chemical dependency treatments here where I work at the Unity Campus of Rochester Regional Health. So, that's one way. There's also 12-Step meetings, which a lot of people have found useful. AA, Alcoholics Anonymous, and Narcotics Anonymous, and there's also groups, community groups, that are helpful for family members who have a loved one who's experiencing addiction that provides support in addition to Al Anon, which is a long-time 12-Step program for family members.
Bill: Dr. Winsberg, thank you for that. For a family or individual suffering addiction, could you wrap it up for us? Why should someone choose Rochester Regional Health for their addiction treatment?
Dr. Winsberg: Well, I think what we have here is a long-standing program of good chemical dependency treatment and there are a lot of people in the Rochester community who have benefitted from the services that we have here, as I mentioned, both outpatient and inpatient, and we're just experienced with dealing with this problem. I think it would be a good choice for anyone that's dealing with it. One thing that I didn't mention previously is that the Office of Alcohol and Substance Abuse Services for New York State, commonly known as OASAS, has a website that is very, very useful for families or for people that are suffering from addiction to go to and figure out how to access care for their addiction, and the website is oasas.ny.gov. It's a really good place to start if you've contacted us and still aren't satisfied or have any questions at all, it's very helpful.
Bill: Dr. Winsberg, thank you for your time today. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to www.rochesterregional.org. That's www.rochesterregional.org. I'm Bill Klaproth. Thanks for listening.