How Do You Help Someone You Love When You Can’t Make Them Get Sober? (Steph guests on The Zac Clark Show)

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I'm here to tell you about a conversation I recently had with Zach Clark on his podcast, The Zach Clark Show. Zach and I talked a lot about the things my family and I wish we'd understood when my brother Harris was still alive. Addiction, treatment, relapse, medication, and harm reduction, and what it really means to love someone who is struggling with a substance use disorder. In this conversation, Zach and I dig into the questions I wish I'd asked back then and the things I wish my family and I had understood about what Harris was going through. It's a really great conversation. I loved talking to Zach. He's so knowledgeable and is doing so much good work in this space and has lived experience himself. It was just a really meaningful conversation. So if you love someone who's struggling with addiction, I hope this conversation makes you feel a little less alone and gives you some information that might help. Enjoy. Your work is inspiring. Your story is inspiring. I feel as though when doing my research, there's the micro, Harris, your brother that you lost, 2015. And there's the macro, which is the work that you're doing. Where do you want to start? I mean, let's start with the micro. Because I wouldn't be doing any of this work without him. It's like the kind of work, I'm sure you agree, that you don't plan to get into. I didn't think when I was young, you know what I want to do? I want to learn everything there is to know about opioid use disorder and treatment and overdose and harm reduction. That's really what I want to do with 10 years of my life. More than 10. More than 10, yeah. But then, yeah, life happens and you fall into these sort of pockets that are unexpected. So Harris was my way into this. My brother was, I mean, objectively the best, truly. Like, I think Sarah Silverman did say he was the funniest person who ever lived. And I think she is- Oh, shit, really? Yeah, yeah, yeah, for real. She gave him his first comedy job at 22, okay? He was fresh out of college. This doesn't happen. His resume was like the stuff of fiction, you know? Parks and Rec. Parks and Rec. Well, yeah, so he starts with Sarah. He does that show for like a year or two. Then he goes on to Parks and Rec. He starts in that writer's room. He does that for seven seasons. He plays the animal control guy on the show. Yeah. Harris, who's always high in the show. Very funny. He coined the term humblebrag. Like, he made that word up. That's him. That's him. Humblebrag. He created this Twitter account and he would retweet offenders. That's how it started. So somebody would like tweet like, oh, I'm so tired. I was like on a red eye to Italy. He'd like retweet it. Right. So it was just like a brilliant, he was a brilliant person. And, um, but more than that, he was like, he was my only sibling. He was my lifelong buddy. Like, he was my, my lifelong sidekick. Like, I know some siblings have relationships that are not close, I hear. But ours was not like that. We were very close. And our family was very close and very, um, I, I thought we, I thought we had this very perfect childhood. Um, Dr. Gabor Mate, uh, would argue and, and, and taught me otherwise, which I mentioned in the book. But, um, but yeah, Harris was, uh, was amazing. And when he started having this problem, you know, he called me three days before my wedding. This was 2013. He told me he was addicted to Oxycontin and that he was spending $4,000 a month on pills. And I was like, what are you talking about? Like, what? Where were you guys living? So I was in Houston, Texas at the time. Um, and Harris was in LA. So I didn't see him every day. Like I, you know, like I couldn't see what he was going through. I didn't have like a line of sight into his daily life. I just knew that he was really succeeding. Like he was crushing it, you know? Well, 2013. So I got clean in 2011. It was getting harder to get, uh, pills. Totally. So yeah, he was, he was spending real money. Oh yeah. Yeah. Which is why he eventually turned to heroin. I mean, that's what happened. Like the pills were really expensive. They were harder and harder to come by. That was exactly his story. Um, you know, it, it was the kind of thing where like at the time I was just like, you have to go to rehab. Cause that's all I knew. That's all I knew. Well, that's all anyone knows. Right. Go, go. Go, let me Google where you should go and then go to this place that is wildly expensive for 30 days. And then you'll come out the other side clean like a car wash. Or to this place that takes your insurance, but it's an insurance-based program. So of course it can't be worth a damn. That's right. And he did go to the insurance-based program the second time around. Like he kept relapsing. Right. And so I was- Okay. Cause you started by saying it's a close-knit family. Totally. And in a close-knit family, I would hope there's no secrets. Don't tell mom and dad. Right. So, uh, there were secrets that I had to keep for him and that was one of them. And so I was carrying this, like, you know, I got pregnant like very soon after. So I'm like dealing with that. I'm like, first time, mom. I mean, it was just a lot. Um, the problem kept getting worse, you know, finally, like, I think it was about three months, maybe four months after he had told me that I finally like told my parents because I just couldn't, um, I couldn't carry it on my own anymore. I just felt, I was just terrified. I was just so scared, you know? In this book, Last Day, How to Stop Losing Our Loved Ones to the Opioid Crisis, I have said on many accounts that I believe it's harder to be the family member than the identified patient a lot of times because the identified patient actually gets to go to that rehab or gets to go get the help they need 24 seven around the clock and be in community and not be alone. And for you as a sister who loves your brother dearly, knows nothing. And you're over here like waving the flag, like, Hey, what about me? Can you talk a little? Cause I can still feel it's heavy to you. This is still, I mean, yeah. 11. I mean, it's been 11 years. Yeah. Any other illness, chronic illness, disease, whatever somebody has your, your family member gets cancer. Your family member is grappling with something like that. There's so much support around you, but with something like addiction, you're holding that alone. There's stigma, there's shame. You're not like talking to your friends and family about it. This is you as sister in 2000. This is not you now with 11 years of having done the research. Totally. When you're thrust into this, it's not like, Oh, let me go to work and talk to my friends at work about my brother who is using heroin and see what, what their experience has been with this. Anybody in your family injecting heroin? Do you, do you guys, can we talk about that? You don't do that. It's very shameful. And so you feel very alone with it. There isn't some sort of like, here is what you do. Here are the best practices. That is what I wanted to do with this book. I mean, I literally wanted to write the book that I wish somebody had handed me when I was in that moment. I want like somebody to have, like I say, like, I want you to like highlight it, dog ear it, you know, go, go to the places you need and then like pass it on to somebody else. And I want you to like highlight it and then like pass it on to the next person that needs it. From 2013 to 2015, the sister, Stephanie. me. Did you learn anything? Do you feel like there was information or trainings or education available to you by the time he passed? No. And he had been to treatment how many times? So he was in treatment three times. The first one was a very fancy one. The second one was the insurance program. The third one was a program where he started and then went into like a sober living after. But he was a very, very charming person, the most charming. And he had somehow conned them into letting him leave to do various things. Anyway, he was writing on a TV show, which was Master of None. Which was the Aziz Ansari show. And then he had just gotten cast as his best friend in the show, which Eric Wareheim ended up playing because he died. But he was leaving and essentially like went and did a comedy show and went home and used while he was living at this sober living facility. So his was a return to use. Goes back to the same dose. And every time what I would notice was he would get out and then the problem would get worse. It was like each time he got out, he relapsed immediately and then it would get worse. And I was like, OK, there's something about this thing that's not working. And I don't know what it is because nobody's taught me how to do this, but there's something that's not working. And I was so. Angry at him. I was so. And we didn't have that kind of relationship. I didn't typically feel angry at him, even though he was like very frustrating. He was like, he would argue about things that didn't matter. But I thought it was so adorable. I mean, it didn't. But during this period of our lives, I just was like just full of rage, full of it. Was there ever a moment where you felt like he was sober, like he was going to. Achieve long-term abstinence, long-term sobriety? Was there hope? Did you ever have hope? The first time he went, I had hope. Right. Because I was under the assumption that this would cure the problem. This would fix the problem. I was certain of it. And he was such a good. He was like a star rehab student. Like his therapist there would talk to us about how wonderful. He was. And we were like, yeah. That's the person I worry about. The person that comes in is like, I don't want to fucking be sober. I don't want to be here. Fuck you and your 12 steps or whatever they say. Totally. I'm like, this guy's got a shot. Totally. Because he's being honest. Yeah, yeah, yeah. No, that makes a lot of sense. But this was the thing. I was noticing it's just not. It's not working. None of this is working. Does anybody see that we're doing the thing, but it's not working? No. And what really snapped me out of this was when I saw him going through detox. I saw him very, very sick and going through acute opioid withdrawal. And it was like somebody slapped me in the face. And I was like, oh my God. Okay. He's not doing this to me. He's sick. Did you understand? That's it. I want to double click on that because I've been through opioid withdrawal. It's terrible. You would not wish it on your worst enemy. No. Did that give you compassion and understanding as to why people use again? And that it's actually the medicine. Totally. I've described this whole process of my journey of understanding this as these moments where the. Tectonic plates kind of shift, you know? Where like the reality is, you know, it's sort of like, you know, you're like standing there in a movie and it's like, whoa, whoa, whoa. It's like all sort of like, you're like, oh my God, everything I thought that was is not. And I get it now. Like that was one of those moments for me. Just like these huge moments of like, aha, where I was like, okay, this. He is very, very ill. This is not a willpower issue. This is not him being selfish, him ruining our lives, him doing all of the things that I was accusing him of doing. He is sick. He has this thing that needs. It was like, at that point, I was like, wait a minute. You don't need to go to a rehab for 30 days. You need to go to a medical, to a hospital. You need a doctor. You need medication. It just sort of rewired my brain. What's interesting, I mean, the big book in AA, which is an archaic book, actually talks about that. Like the person must be medically detoxed. They must be before they can even absorb any of the therapy, any of the spirituality, any of. And that's the part that I think we oftentimes miss because we get them into detox and we, as the family members, expect them to. Yep. When Harris. When he died. When did you get that call? Where were you? So it was the day before my birthday, which I. When's your birthday? We have dark humor. February 20th. So it was February 19th. Like he was stealing your birthday? I know. I was just like, this is like. Of course. I was just like, respect. You will never have a birthday again without thinking about how I am not here. I didn't laugh at the time, Zach, but now. I get it. No. I mean, look, this is. Laughing is part of the healing. It's a savior. It's how you keep going, truly. And it's. Harris is with you. Oh, 100%. Like in our family, I mean, we. That's how we get through everything. That's like our native language is laughter, you know? Jokes. Like if you're not funny, you're out. Like my kids, I'm like, I don't care. Whatever. I don't care. If they're not funny, they have to leave. They're not. They can't be a part of the family. Yeah. Thank God they are so they can stay. So yeah, we were at the audiologist because my daughter was 13 months at the time. And she was born with like a permanent hearing loss also. So like we were dealing with her. We were dealing with her health issues. And it was a really hard time. Like Harris was dealing with the addiction. She was doing this. I was just scared all the time. I was just like literally choked. By fear and anxiety. I just felt like paralyzed. Like even when I like talk about it now, I get choked up because it was such a traumatic time. Like I was just a wreck, you know? And I felt so powerless and I felt so helpless. And I'm like an active. I'm an action-oriented girl. Like give me a task, I'm going to do it. Like I'm a. I'm a CEO of a company now. Like I'm like highly efficient. And to not have a solution, to not be able to fix this, either of them, was like horrible. A horrible feeling. So we were at the audiologist. She had just finished her appointment and she had got this, you know, they were like, she is doing so amazing. Like she's thriving, right? Like she got hearing aids when she was three months old. And, you know, her verbal skills were like that of a three-year-old when she was one. I mean, she was like, you know, a star. And I was so proud of her. And, you know, it was a beautiful day. She was doing great. My birthday was the next day. We had planned to go to this like tiki place with my friends, you know, we were like going to do a thing. And I was changing her diaper after the appointment. It was like about to be five o'clock. And I got a call from an unknown LA area code. So I like pressed ignore, changed the diaper. The phone rings again. And I was, you know, I just knew. Yeah. Yeah. Because it's like, I mean, you imagine the call. Like it's so interesting because you imagine it, but then you can't imagine it. You know, it's like you imagine, okay, this is something that could happen. But then when it does, you're like, how is this happening? Right. You know, and yeah, it was a detective and she told me. He was alone. Yeah, he was alone. Did he ever find any community or was he resistant to that? I think he found some community in the sober living where he was. Yeah. But it is an insidious disease. So. 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balanced and comfortable whatever you're lacing up for stay out there with ultra shop now at ultra running.com that's a l t r a running.com do you drink and do drugs like do you like how did you because oftentimes i feel like that is a coping mechanism for you to be able to do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs and do drugs uh-huh and i've talked to family members that actually carry guilt and shame around that yeah i mean we we did a lot of drugs together as kids like you know for fun it i mean for me i was able to have you know i was able to do something and then not do it again for a month and i think he was too but that gives you an even more um of a fundamental understanding of this thing the fact that you can say that honestly is going to help a lot of people oh yeah for sure if you really listen to what you just said whatever the drug we'll call it cocaine for this conversation i'm not saying she did cocaine but we're going to call cocaine here mom he's not saying i did cocaine go being able to go out and do a line of cocaine on a saturday night and then not look at it or think about it or need it for three months is a pretty good indicator um that you don't have a substance use disorder nope i have other problems and this is and and my my my good my good doctor friend dr gabor mate taught me real fast i brought him i mean i brought him on my podcast i was like listen i know that you say that trauma is the root of all addiction but we had a perfect childhood and so you are wrong and literally by the end of this conversation he was like ma'am um in his very thick accent like you don't use drugs that's not your drug of choice but you have other addiction you have another addiction and mine happens to be work like i am a bona fide workaholic like it's a very productive addiction like i have you know what i mean like it's like very socially accepted for me to work 18 hours a day and tune everybody out in my life and you know i mean there's consequences of that and i think it's a very productive addiction for sure so everyone who's who's watching this everyone has something that that they do to the detriment of other things so when he sort of reframed it for me i was like okay i see like yeah it's not drugs for me but achievement success all of that dopamine dopamine dopamine dopamine control oh my god control this is why when when this is why i'm so happy to be here the two people like harris and iris both of them when they had things i couldn't control i was like out of my mind um you can't outwork it totally and i mean i wrote my first book in the nine months after my brother died like the way that i was able to cope with that grief was by writing an entire book can we talk about the grief because there's a lot of people that are in your shoes yeah and i feel for you i have great compassion for you working in behavioral health care obviously i've lost a ton of people yeah i guess my first question is how is the first book this book the podcast lemonada do you ever step back and say like i'm just trying to fill this void and i would need you to answer honestly like like is this all just to make like be able to forgive yourself i mean obviously because like i can't i mean i don't i don't step i just keep going i mean i just i just do do do do do do i mean maybe i need to i need to understand the ever-living shit out of this issue because i lost my brother and yeah i couldn't i couldn't save him then so but i don't know i haven't i haven't thought of it like that oh that's a good one what are you thinking about that for a few days well i want to give you permission to know that you you cannot get him high and you cannot get him sober we know that i do know that now so so so i do know that now actually i do know that yeah it's not my job it's it's not my job you're right families come we treat a lot of people most of our families are amazing and loving we get some tough families but most of them you're like we get some families and i'm like i understand why you're using drugs and they if their love could have healed this person it would have happened 10 years ago totally so i want to give you permission to know that but also i'm feeling a lot of identification like i'm feeling the workaholism in my life i'm feeling like why do people do this work why do people work in behavioral health care it can be scary totally like we're all just trying to do this work to fill some whole or god complex thing where oh i couldn't save that one so i'm gonna go right save the next i'm gonna write the book to hand to the person and then she's gonna call me in three years and say stephanie you changed my entire family's path and and and that would be a great outcome but yeah well people have they've they've written me from the the podcast you saved my life you saved my person's life like yeah i've got i've gotten those messages and i'm like what do you mean you saved my life you saved my life you saved my life you saved my person's life what you know like wow like that is but but it's it's it's the the knowledge gap right like i i did not know in 2015 that overdose was preventable i did not know that addiction was treatable i didn't i didn't know and and i think like it's interesting like i've talked to many different people over the years i've talked to people in long-term recovery you know people who did the 12 steps uh you know people who call themselves addicts doctors who say don't ever call somebody an addict the language thing kills me say say they have a substance use disorder say that you know it kills me don't why tell me why i just there's like the language police yeah that'll come on my instagram or thing and like don't say drug addict but i'm like what if drug addict is the one thing that the person who's seeing this actually identifies with like i right that's the problem with all this stuff no one knows we don't actually know totally that's my conclusion yeah that's your conclusion we don't know yeah we know some things at work yeah i am not i went to treatment yeah i went to sober living i was in a residential place for eight months okay i was on vivitrol yeah i went to therapy i did 12-step work yep i still do therapy i'm still in 12-step like i don't know like was the shot in my butt yeah for the first nine months yep the thing that's i don't know what saved me all i can tell you is i'm here totally and my brother turned down the vivitrol shot turned it down and i and i do remember his reason i mean i'm sure his reason was i want to get high you know no but do you remember his outward reason no i didn't even know he did turn it down i didn't know until after he died when i treatment center and they told me that he turned it down. what are they gonna do like strap him down and give it to him i mean it's like he's a grown man but that's to your point like you we i can't save anybody i like i can't make him get sober on my timeline which was frustrating to me because i was like bro like can you please not ruin christmas like can like like this is this is the baby's first thanksgiving like would you just show up and not be a fucking asshole yeah it's not you know like but it's like it's and that's what when i saw him sick i was like okay you know and that's why i think the vivitrol stuff like i've kind of become like the language police whatever put that aside i do think that for families specifically it is helpful to think of this as a disease and that's why like in the book i start with like first things first things first things first things first things first things chapter addiction is a disease because if i think that my brother has cancer i have empathy i have compassion one of the smartest addiction medicine doctors i know who i've you know i just i love her i love her work um taught me early on like five years is in is what they sort of say like from from last use to sustained remission takes five years to get to the baseline sort of population level right like that's 1825 days so like you saying like i show up i do the 12-step work like it's a it's time like it takes a lot of time and i wanted him to be done and over in a month and it was just like completely unrealistic so i think the vivitrol shot what it does is it helps early on at least to curb cravings to like mitigate withdrawal you know like those kinds of like physical symptoms that you're literally experiencing because your brain is like needing the opiate like oxygen it's like the same as oxygen i've learned yes um i think those medications are really useful in those early months where like you said you're not ready for the spirituality you're not ready for the community like you are sick that has to like there is a physiological thing happening and so i think for the family like if i had known harris has a disease he needs treatment he needs long-term treatment it would have helped me to like support him through that and early on like i've gotten to the point now where i would rather he call me and say hey i'm about to use and me sit in his house in the other room with narcan so that if he ods and goes into respiratory depression like i can be there and i can revive him for sure like the alone the using alone when you are using opiates is so fucking dangerous like call and over call a hotline like phone a friend don't use alone but then we go down this stigma road that is another thing that drives me totally because a real ally doesn't ask questions shows up doesn't try to convince him of anything and just says hey i'm going to be in the other room 100 go get high totally and that's really hard especially for families that's really fucking hard do you blame i mean i'm sure you've blamed yourself i'm sure that's come up but do you blame anyone else for this have any of your efforts gone towards specific providers or people or things that happened or you know it's so interesting like i i don't know like you know how like we all have like colors in our in our palette like in our crayon box that are like our favorite colors blame isn't a crayon that i that i use that's amazing it's just not like it's not one of my my dominant ones that's gonna make you a very powerful person in this work that you're doing i think it's why i maybe i'm able to do it because i i yeah i don't actually blame anybody um that's all that's awesome i think that he had a disease that killed him is what i think and it you know what i mean and i think he was like i had this guy um one of the guys i talked to many times this guy stamps sam snodgrass which is that not the most amazing name it's incredible um he's from arkansas he also has this killer accent um but he the first time i talked to him and he's like a behavioral pharmacologist he had a you know heroin addiction for decades i mean this guy is like fucking total genius on every side of this lived experience educational experience all of it all of it he the first time i talked to him he was like this is a disease a brain structure and function and and i said well what makes you a disease and he said being human and i was like whoa like i was just like okay we live in human bodies we're susceptible to a bunch of shit you know like that's what it is to to live in this world and like how do we help people through these moments where you know you're doing so much work in this space i love that because i feel like i in a different way try to say the same thing people family members will come to me and say why i said i don't know manufactured genetic like for me i had a brain tumor and then i'm in a hospital and they're injecting me with dilaudid which is legal heroin people like that's what that's what sam snodgrass loved the dilaudid yeah totally who doesn't though totally i mean same with harris he had a back thing he was prescribed oxycontin blah blah blah blah like there's so many stories you know the thing for me because you're talking about thanksgiving and the holidays and that's like the family of a substance use disorder haver questions 101 is can they come home for the holidays and when i say that those people's it's not on them it's what you can tolerate that's right it's what you can tolerate if you can live in a world where you know that harris might come home he might be high and he might be an asshole that's right you want him there more than totally him not being there then that's a yes yep but if you can't tolerate that then you have permission to say harris i love you you and i are going to celebrate thanksgiving on black friday or i'm going to come see you totally again yeah it's those expectations i think is what's really hard i think expectations are like the thing that kills us in every aspect of our lives that's crazy hey it's julia louie reifus from the wiser than me podcast among other things and i've got a little 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many co-pays as low as 15 for eligible members visit better help.com cost and coverage may vary ultra running shoes are all about space the space to go to go further, to feel better, to do something you never thought possible and this space starts with ultra fit unlike traditional running shoes ultra fit gives toes more room to move naturally so every step is strong balanced and comfortable whatever you're lacing up for stay out there with ultra shop now at ultrarunning.com that's a-l-t-r-a running.com so how long after harris passed did you decide i mean you wrote the book within nine months i'm smiling because i know i know a little bit about your story like i know what you've done in the world which is incredible ceo media company met your is it your business partner is that the proper way or like thought partner what like is yeah yeah yeah we started the company together yeah who had a similar experience and it's called lemonada which is basically tell me about the name yeah so lemonada my business partner and i met because she lost her brother to an overdose also and she was also like a type a workaholic and uh she heard me on a podcast talking about harris and like stalked me in a positive way not a negative way uh and yeah we got on the phone and she was basically like do you want to do a podcast about the opioid crisis i was like no i'm good i hate them they ruined my life i don't want to i don't want to think about them talk about them you know whatever this was like 2018 um yeah it's 2018 because it was a week before i gave birth to my second kid so i was very pregnant iris and iris and harry so my harry yeah harrison um actually named my son harris and he went to the NICU for a few hours after and i called the NICU to check on him and i said this is harris's mom and i burst into tears and i was like we have to change his name because i can't cry every time i say my son's name so we we went with harrison did that help yeah yeah yeah yeah it was i i wanted to give him harris's name because harris was the best person in the world you know but i just couldn't do it um so anyway we she and i you know joined forces and we started this podcast and the idea behind lemonada was like lemons lemonade out of lemons but like it was right when beyonce released her lemonade album so like obviously we couldn't step on those toes um so my partner was a half italian so she was like lemonada is like the italian and then for me i was like lemons nada no more lemons and so we were like lemonada so that's how we came up with the name and uh you know we started with lemonada and then we started with lemonada and then we started with lemonada and then we started last day but now we have over 100 shows um we our brand statement is make life suck less that's what we that's all of our podcasts do that in some way shape or form um and we you know now we get to do wiser than me with julia louis dreyfus and you know you know sarah silverman program and it's a big deal lots of lots of lots of cool shit that's not sad and and tragic um did sarah she knew that i mean like oh yeah yeah oh yeah yes yeah and she was like his she was like his mentor i mean loved him so much and he loved her i mean their relationship was so so cool so beautiful and um he was you know a very just very beloved was the funeral massive yeah yeah it was it was packed packed full house i mean listen like a 30 year old uh shouldn't die like that is just never something that should happen like it's so fucked up i've been to a bunch yeah i've been the ones that aren't packed that's sad yeah no i mean that's the thing like i've heard from a lot of people over the years and harris had a pretty charmed experience like even when his addiction was at its very worst he was still going to work i mean you know what i mean like he he wasn't like 10 years living on the street you know like so many people that experience this i'd love to know the numbers behind that like if if there were a thousand opioid use disorder cases how many of them are showing up productively in the world and how many are on the street homeless i bet we would be shocked yeah i think you're probably right yeah that most of those folks are showing up each and every day i think that's right yeah it's interesting i talked to this guy steven murray who has become a really good friend and he runs a an overdose detection hotline the only government-funded hotline and it's kind of wild you can call and somebody will stay on the phone while you use and then if you stop responding they'll call emt um and he was telling me like when you think about alcohol use like that is a spectrum you've got your people who never drink because they either don't like it or they're pregnant or they get migraines whatever then you've got your like people who just drink on special occasions you've got your weekend warriors you've got your people who drink a glass of wine every night for dinner you've got your people who drink a bottle of wine every night and then you've got your friends who are waking up and drinking in the morning and going to work and you would never know like it's all a spectrum and we think about it like zero to a hundred right you're either like clean and you're like a functioning member of society or you're like fucking completely destroyed at rock bottom you know but like there's so many people who are showing up every day and struggling with something and nobody knows can i build off that do you do you i mean do you believe in abstinence do you believe i mean let's go i believe in abstinence do you believe in abstinence do you believe in abstinence do you believe in when it comes to opiates so the other thing is like i am not an expert in any other addiction like i did a ton of research about this one thing and i think that with a drug supply that is as contaminated as it is currently with fentanyl and all of the synthetic opioids that are out there it is very difficult to find a drug that is as contaminated as it is currently very dangerous um to have nothing in your system and then to use so like a lot of people will get out of rehab they'll go use they'll use even at a dose that is lower than what they thought and they'll overdose so that's why i think like these medications that we have available you mentioned one of them there's also like buprenorphine you know methadone you know there's agonist antagonist there's a whole sort of naloxone yeah of them narcan medication i mean like that's right if you want to you know throw that in the mix that's right that is uh the yeah the opioid reversal drug um so i think i think it's i think abstinence when it comes to an opioid use disorder can be um can be dangerous why because of because of what i said because of overdose i mean because of because people die it's death yeah i mean it's just like very it's like going from zero to like that it's just the effects of the opiates and what they do and how they depress your breathing and people using alone because it's shame and stigma and all of that and why would they want to call somebody and say i'm about to shoot heroin like you don't want to make that call um that's why so i think if you can be on some kind of medication and like there's a lot of people there's a lot of debate about this in the 12-step world too like some 12-step programs don't consider you sober and clean if you're on suboxone right or on buprenorphine or something like that or xanax or adderall or vivance or i mean i've heard of stories where a sponsor will tell their sponsee that they're not sober if they're on a antidepressant and so that is 100 and i'm a 12-step guy i want to be very clear yeah yeah yeah yeah yeah so it's it's none of this is perfect totally yeah i mean i interviewed this lady in the book who had probably the most traumatic childhood i think i've ever heard from somebody um you can read about her her name's courtney in the last day yeah yeah yeah yeah so her chapter is called life can be beautiful so courtney is on suboxone and has been for years and she's in 12-step and has been for years and has never told her sponsor that she takes medication for opioid use disorder because she doesn't want to be kicked out she doesn't want to be told she's not clean she doesn't want to have to start over so she's keeping the secret from her sponsor and like the thing is she gets so much out of the meetings she gets so much out of 12-step recovery she's read the big book like I mean, she's quoting it to me. She's gotten so much out of that and she feels safe taking her medication. And like ultimately isn't the goal, like I talk about this in the book, the goal is not clean or abstinent or whatever. The goal is like a productive, good, healthy, fulfilling, fruitful life. That's the piece we miss. A 19-year-old comes into my care with a cannabis use disorder and I see him again when he's 25 and he is no longer smoking cannabis or ingesting cannabis, however he was. People even smoke it anymore, I don't know. But he has a couple of drinks on the weekend, married, first kid on the way, good job. Like I'd say we did a nice job with that case. 100%. That's a success story. That same case can come in. 19 years old is able to stop using cannabis, but at 25, they've replaced it with alcoholism. There's not one way. And I think that's why it's hard. This whole thing is very hard because there's lots of gray. And I think as people, we don't do well in that. We want a black and white answer. We want things to be. This or that. We love binary thinking. And I've talked to addiction medicine doctors who were like, if this person had a severe opioid use disorder and they want to have a glass of wine, that's fine. I'm fine with that. I'll take it. I'll take it if that means they're not using heroin or fentanyl six times a day. And my brother would grapple with this too. He'd be like, he'd be like, he'd be mad about it. He's like, I don't fucking have an alcohol problem. Why can't I have a beer? I think for him, he was like in a very delicate space and like, there's a million reasons. Yeah, I struggle with that one. Yeah, I bet. If you don't have an alcohol problem, then why is it so important that you drink? Right. Why are you holding onto that so hard? Yeah. So there's a lot of different. So what, so medication assisted treatment. I just don't think there's one size fits all is what I'm saying. And I'm with you. Yeah. And I think like that is. Because like I've, I had this one guy, he's also in the book, this guy, Jordan, who was like super 12 step abstinence guy, like beating that drum so hard and then started learning more and more about harm reduction. And then ended up like going to treatment centers and like training the providers about like medication. And this dude got into a fight, like was punched in a parking lot because people get so upset about it. And these communities don't need to fight with each other. Yeah. They really don't. There's, there's enough. Right. Right. And that's where I get, that's where, and, and I think part of the, I posted something on my Instagram. So we have this gala every year. It's a, it's our nonprofit and Narcan, we partnered with them this year. We gave out Narcan to everyone leaving the gala. Oh, that's amazing. We got a note from. Oh no. No one attendee that took the Narcan and used it on someone outside of their building. It was like, this is, this is why we do it. I have chills right now. Oh my God. I just got goosebumps. Yes. So it's like amazing. That's incredible. But I'll put something like that on Instagram, you know, like, or, or put it out there because I think it's important for these stories to be told. And people literally say, let them die. Well, that's the thing. It's like, it's like, it's like, okay, what's the alternative? You know what I mean? And that's, and I say that in the book. It's like the old, what is the alternative? It's like, if you want to clutch your pearls around somebody calling an overdose detection hotline or something, what's the alternative? They just, they die. That's it. Then what, what, what are we talking about? Well, I don't think as humans, we're able to comprehend that harm reduction could actually be a pathway or a roadway or a bridge to 12, 12 step recovery. Exactly. Or to therapy. Exactly. Or to DBT. Or to EMDR. Keep people alive long enough to fit, to, to, to want it themselves, right? Like, yeah, that's the thing. Cause what, what happens, right? Like, what do I see? Someone comes into our program and says, 12 steps are cold. I'm not doing it. Cool. Right. That's not an excuse to do nothing. Right. So you have your experience and we're going to support. Three months later, I walk into one of the residences and that same person sitting at the table, like doing their 12 step work. Yeah. So it's like. Yeah. They just needed some autonomy. That's right. It just needed to be there. That's their idea. Totally. I just think there's a lot of tools at our disposal and that's what I want people to know. There's not one way. There are many ways, you know, this is, this is treatable. This is, it's not a foregone conclusion. This is not a death sentence. If you could build Harris's treatment plan today, what would that look like? I would have gotten him connected immediately with an addiction medicine specialist that he could have a long-term relationship with. you know it's interesting like this one family that i've that i've talked to over the years he went to a methadone clinic right and like he would dose every day and you know and that's like how he and he would go to therapy there and and also was like very religious and did a bunch of that stuff as well and when he ended up relapsing a few years later he went right back to the methadone clinic that was five minutes from his house like there is something really important i think about having services near you that's why i kind of like going to some sort of rehab that's like in another state that's completely outside of your world isn't actually helpful for when you come back into your world where all the triggers are like there's something about outpatient treatment, you know, a recovery group that is local, that you build treatment resources into your life instead of going to a pristine bubble. And then when that pops, having nothing back where you actually need it. So I would have wanted him to have a doctor. I would want him to be on medication early on, at least. I'd want to make sure he understood harm reduction resources. I would want to make sure he knew that, like, using alone wasn't safe, wasn't smart, like, dangerous, call me, call a friend, you know. I would have, as a family member, wanted to understand that, like, relapse is part of any disease life cycle. Any disease life cycle. Like, asthma is going to relapse, you know. Diabetes, like, these are chronic illnesses. And like you don't get cured and then poof, it's cured forever. Like that's – you can treat it and then it's going to – you're going to have a recurrence. And so I think family members, I think it's helpful to know that. Like a relapse doesn't mean that it's over. It just means that like the disease is doing its thing. And like we need to hit it a little harder, you know. We need to try another treatment. I think that sort of frame is more helpful than using clean, period. It's going to be a process. It helps bring the temperature down a little bit. The chaos for me in this work keeps a lot of people unwell, the family and the identified patient. It's the chaos. It's that cycle. And so when we say to a family member, like, hey, like, we're actually going to challenge you to do some work. And then when they start saying, I don't want to do it. Yeah. I'll tell you this story. I do. I was. So one of our clinical folks left. This was about two years ago. And so I picked up our Wednesday night support calls, family support calls. I was just having fun with it. And I mean, if I could do direct care all day, every day, I would. But I'm out there with the macro with you now. That's right. And every week I would log on and the families, it's optional. It's optional. Every week I would log on and these families, we love you. We love Release, which is the company and the program and your case manager, my therapist. I was like, wow, these people, we're like 10 for 10. Yeah. We're really good at this. Totally. And I went home and I started looking at the identified patient and the family and the families that were showing up to the call their loved ones were doing really well the families that weren't on that call the loved ones were yeah so these importance of doing this work yeah well and i do you are do you um are you familiar with invitation to change yeah of course itc so yeah i i went to like a two-day training i've done it yeah and and i thought it was so I mean, I went just, you know, for the book and for part of my research, but like I never did any of that when my brother was sick. You know? And like learning how to talk, learning how to not step on those like landmines, 'cause like the volume is so high. And like you said, the temperature is hot. It's just very hot. Everybody is like at a 10. And so like, it's like the way I compared like when I was 15, I had this like totally kooky like acting teacher who taught me I statements. She taught all of us like 15 I statements, when you I feel. Like I learned that as a 15-year-old. And it like wired my brain so that when I get into like a conflict situation, I innately know to not go, you suck. You're a fucking asshole. But when you don't show up for blah, blah, blah, I feel abandoned or whatever, right? Like you learn how to speak in ways that turn the temperature down. So I think like the ITC stuff would have been helpful. It wasn't because I didn't do it, but it would have been. Because when you as a family member see that your loved one is doing something that's dangerous and harmful, like if my kid before he knows how to swim gets near a pool, I am leaping to my feet and grabbing him with a quickness. That is instinctual to protect the people that you love. And the way like when somebody is using drugs and like fucking living this life that is so dangerous, you want to protect them. You want to grab them from the side of the pool. Like I get it. I totally get it. And so you have to figure out how do I talk to them in a way that keeps us connected? Because all the shit we've learned about like, you know, get out of my life. Like don't, you know, you can't have a relationship with me if you're using. Like that stuff is actually not productive ultimately. Like I get it, but like keeping that tether, keeping connection is actually, like you asked me like what would I, like that's what I would have done I think. Yeah. Done your own work. Yes. Made some suggestions to him. Yes. Done my own work. Found the language. Like cleaned up my shit, my side of the world. So that I could like be there for him and not have the savior complex of like I need to save you. I need to like mandate how you move through this world, but like I'm going to support you. When my ex-wife kicked me out of the house for like in between treatments and it was the last time she booted me, she said, Zach, I love you. I don't love this behavior. And I love myself more than both those things. So I'm going to be there for you. And I'm going to be there for you. And I'm going to ask you to leave. And she said it in a way it wasn't mean. It wasn't threatening. It wasn't in my face. I don't know where she got it. This was like 2011. Like it was from the top rope. And I just, I heard it. I knew she was serious. And like the way she said it, you know, and that was the last night. And I go on to, you know, burn it down for like eight more months, but she was the first person in my life. I don't even call it a boundary just to tell me the truth. Yeah. That's right. And I think that's a good, good point too, because I think people think, well, if I stay connected, that means that I am laying down like a doormat. That doesn't mean you can't have boundaries. You absolutely can still have boundaries. So I think like learning how to speak like your ex-wife did is really helpful actually. I'm really proud of you. I am. No, it's, it's because there's people that don't do the work and don't heal. And then that becomes a real generational problem. Yeah. Well, I, thank you. I'm, I, I've, I'm trying to get better at taking compliments. So thank you. Me and you both. So last day, I, I'm going to make sure that people know about this book. I'm going to get into it myself. What else should people know about you today? How do we follow you? How do we stay in touch? How do we follow your work? You can obviously support Lemonada Media. You can follow us on all the places you follow things. We're launching a new show this week, actually, Zosia Mamet's show, OMG Obsessed. Wow. If you were a girls fan, she played Shoshana on the show. Oh, wow. It is such a fun show. It's literally, it's my new favorite show. So, so definitely like and subscribe that one. And then you can find me online at Whittle Stephanie. I, I'm a very unserious person, actually. I'm, this is, this is less of what you're going to see. On the internet with me. If there was one episode of your podcast that you think people should listen to, like one, what do you think? What is that early on or what is that? Number 17, season one, last day, Dr. Gabor Mate. It's called Trauma. And it's the episode that people still to this day tell me they go back and listen to again and again. It's, it's like a, it'll, it'll break your head open. And that's a good introduction to you. Yeah. Yeah, yeah, yeah. And if you want to listen to, like the, the podcast, you have to go way back to season one. We started the show in 2019. And you can start from episode one and Sarah Silverman and Aziz Ansari are on that first episode. And I would listen to the podcast first and you can hear all these voices. And then if you read the book, you'll sort of hear all these people again, but you can hear them when you, when you read about them. I hate that we're just meeting, but I love that we're just meeting. Same. Well, now we're friends. Now we're buddies. Yeah. And I'm so glad for like all this stuff that you're doing. Like, it's incredible what you're doing. We're trying. We're trying. Long-term treatment. Yeah. That's the way. Getting people back into the world, letting them. It's like this whole, I mean, we don't have time, but it's just like these people, these therapists say, don't date in the first year. Like who made that up? Oh my God. Like go on the date, be uncomfortable and like come back and tell me that it was uncomfortable. A hundred percent. Oh my God. You're so like, totally go on the date. Some therapists like made that up. That's what I'm saying. Like you have to be in your life. With the stuff. You have to figure out how to go on a date and have the thing. Like it's all a big stew. People, places. Oh, okay. So people, my family, like you don't want me to, they're out for me to stay sober. Right. It's going to be tough. Yeah. It's going to be kind of hard here. Yeah, yeah, yeah. Exactly. You're awesome, Stephanie. You are too. Thanks for having me. You're welcome. For a limited time, go to stamps.com and use code podcast for a free welcome gift taxes and fees apply.