Well Wisconsin Radio

About one third of the population in the United States is directly impacted by addiction. Join us as we talk with Dr. Adi Jaffe, a nationally recognized expert on addiction, mental health, relationships, and shame. Dr. Jaffe shares with us why talking about addiction is so important, the barriers people experience in seeking treatment, and the effectiveness of a variety of treatment methods. We also explore the keys to overcoming addiction and the impact of his work within Wisconsin. 

Resources referenced during the conversation:
The information in this podcast does not provide medical advice, diagnosis or treatment. It should not be used as a substitute for health care from a licensed healthcare professional. Consult with your healthcare provider for individualized treatment or before beginning any new program.  

What is Well Wisconsin Radio?

A podcast discussing health and well-being topics with experts from all around the state of Wisconsin

Overcoming Addiction with Dr. Adi Jaffe

The information in this podcast does not provide medical advice, diagnosis, or treatment. It should not be used as a substitute for healthcare from a licensed healthcare professional. Consult with your healthcare provider for individualized treatment or before beginning any new program.

Host: Hello and welcome to Well Wisconsin Radio, a podcast discussing health and wellbeing topics with experts from all around the state of Wisconsin. I'm your host Julie Cruz, and today my guest is Dr. Adi Jaffe. Dr. Jaffe is a nationally recognized expert on mental health, addiction, relationships, and shame.

He is a number one bestselling author of the Abstinence Myth and has a second book, Unhooked, that will be available in January of 2025. Formerly a lecturer in the UCLA psychology department and the executive director and co-founder of one of the most progressive mental health treatment facilities in the country, he is the founder of Ignited Recovery.

Using both his personal experience and his research and work with clients, Dr. Jaffe now writes for Psychology Today and has been featured in CNN, the Huffington Post, Insider, and the Los Angeles Times, among many other outlets. Dr. Jaffe has been working on projects with state agencies and other organizations in Wisconsin, as well as presenting at conferences and summits throughout the state. Dr. Jaffe, thank you for joining me today to talk about overcoming addiction.

Guest: Thank you for having me.

Host: Let's start our conversation by talking about how you came to be doing the work you're doing today. What is your experience with substance use and overcoming addiction? Can you share a little bit with us about your story and what led you to work in the field of addiction?

Guest: Yeah, absolutely. Um, I think like many kids in high school, I, I'm a…an immigrant. Uh, I moved to this country when I started high school. Um, wasn't really exposed to substances much when I was living in Israel, which is where I moved from, but moved into high school, you know, was trying to find the best way to fit in and inevitably ended up at a get together. An overnight kind of sleepover situation where somebody brought alcohol to the, to the event.

Uh, and after all the adults went to sleep, pulled out the alcohol, kids started drinking. And that was my first introduction to substances at all. I was 14 years old, and something clicked, you know, it was just, I'd always been anxious. People tell me now that they couldn't tell that at the time, but internally I always felt like I was working really, really hard to try to fit in.

Um, was always questioning what I was saying and whether, you know, I looked right or said the right thing, etcetera. And so, after getting intoxicated, you know, two, three drinks is really all it took when I was 14 years old. All those worries went away. And I really, really appreciated that feeling. I all of a sudden didn't care. I could talk to girls. I was really very, very, very anxious talking to girls before that I could talk to girls and at the party and not really worry about it. And so, I didn't really think much of it other than, oh, I just, I found something that fixes what's wrong. And, you know, from that weekend on, I would, I started getting invited to other parties, other, other events.

Like, now I was part of this crowd that drank, and so I got invited to other parties where people drank. Uh, fast forward a year and a half, two years later, got introduced to cannabis. Um, I went to college. By the time I got to college, I was drinking and smoking weed. Maybe not daily, but close to daily. You know, in college, it escalated.

You find like, find like, likes, uh, and so I ended up finding other people who were consuming like that. Uh, and you know, obviously in college, a lot of people end up upping their drinking and, and drug use. Um, I then ended up, uh, after a breakup kind of hitting this depression period that was new for me and found, kept looking for other things to fix the problem, right?

I'd sort of, I'd learn at 14 that my social anxiety was pretty well handled by alcohol, well, what will my depression be handled by? And that brought on stimulants and a lot of other substance use experimentation. And by the time I was, I didn't transfer to UCLA, so I, we were in New York at the time. I moved to upstate New York, Rochester and Buffalo.

I moved to, um, UCLA to finish my schooling. And just got introduced to a lot more in terms of substances. By the time I graduated college, which was in 2000, I was using anything somebody would put in front of me. But ecstasy, methamphetamine, cannabis to some extent still, alcohol were, were primary and then other things would just kind of fill in the gaps, but I was using a lot on a regular basis.

And I would say without fail, without, without question I was, um, addicted to methamphetamine. So that was the substance that was the, um, the basis of all my other substance use. I was, I was using daily at that point. And, um, yeah, and so, I didn't know anything about the addiction field at the time, right?

It's, this is 2000. It's not that the addiction problem was less prevalent. I think people were speaking about it a little bit less openly, uh, 20, some 30 years ago. And so, I didn't really know what to do about it. I just continued going about the way I knew how to manage my behavior. And one of those was, I started selling drugs because of my drug use was getting really, really expensive.

The only way I got to recovery, to the other side of things, was I got arrested for having a relatively large quantity of drugs on me. And it was after that arrest that I had to start figuring out how to get my life on track. Um, and I joke that the reason I'm, I do this now is because I ended up having to serve time for that arrest and when I got out of jail, I couldn't get a job. And so, the only thing that I could do is go back to school because literally nobody would hire me with felonies on my record. And so that became my next chapter was about five to seven years of schooling and ended up getting my PhD from UCLA in psychology. But, always with an eye towards addiction.

I was looking at why did I get in trouble. Right. How did I get my, you know, my dad was a physician, my mom was an HR manager in a bank and a real estate agent. I mean, I wasn't the stereotypical person you would have expected to end up where I did and yet I did. So, I really went deeply into the exploration of why. And I'd say probably 15, 16 years later I'm still digging into that more and more deeply.

Host: Yeah, keep asking that question, right? Why?

Guest: Yeah.

Host: Well, thank you for sharing your story with us. I appreciate that. And, you know, it seems like when you talk to people like most of us, um, you know, are affected by addiction in one way or another. Um, but I'm curious from your perspective, you know, why is it so important for us to talk about overcoming addiction today?

Guest: Well, first of all, I mean, you know, you said it, sort of offhand, most of us are affected by addiction in one way or another. And I think that is not the prevailing view. I think it's true, but I think the prevailing view is, you know, addiction is the thing that affects that small minority of people out there. We have to isolate them. We have to make sure that they don't hurt the rest of us, but, you know, the rest of us are fine. And I would say, I think that's a complete misjudgment. I mean, I think most of us are either individually struggling with some, I'll just go a little bit more broadly in this term addiction, could people get scared of the term.

Compulsive habits that are creating damage in our lives, right? And so, that could just be technology use, right? A lot of people I work with now, for instance, it could be like, technology use either by shopping, gambling, or porn use. Right? A lot of people wouldn't even consider that necessarily addiction, but they spend a lot of money there or they spend a lot of time or they end up giving up other life responsibilities or having substantial mood impact by those compulsive habits.

And then there's, you know, I work with a lot of really successful people know who you would really consider work addicts, right? Whenever. So, when we say everybody is impacted, I would say even by now, SAMHSA itself, um, the, the upgraded definition of what somebody struggling with addiction is has moved from 24 million Americans to 40 million Americans who struggle.

And I would argue that's still only looking at alcohol and drugs, right? Behavioral addictions are not really well recognized. So, my number for the number of total people struggling with any compulsive, addictive behaviors is close to a hundred million Americans, which is a third of the population. And then you talk about people who are indirectly impacted, family members, colleagues, um, you know, um, children, so neighborhoods, right, impacted by crime or by, by, um, negligent behavior, right? Driving, things of that nature. And all of a sudden you get to, yeah, I mean, it would be, you would be hard pressed to find somebody who has never been personally or indirectly impacted by one or two degrees of separation by compulsive addictive behaviors.

And so, part of the reason that I think this is really important to talk about is if we pretend that it's happening to people out there, we feel like we don't have to do anything about it, right? This is the problem with war. This is the problem with anything that happens too far from us. We feel like, well, it's not impacting me. It's hard to empathize. It's probably happening to you one way or another, if you look at it right now. So that's number one.

Number two, if it is, if it is that prevalent, you know, between a third and let's say a quarter of the population being directly impacted, right? Struggling with the issue in this moment right now, then it would be hard to say that it's really abnormal because you can't have something that a third of the population is struggling with and call it ah, an abnormal disorder if it's happening that prevalently.

So, the idea of overcoming addiction is I think it's, it's a…it's a process, it's a conversation we have to have with each other in order to say, hey, if you find yourself locked in a situation like this, where you are losing control over a set of behaviors in your life, we need to speak about it. We need to talk about it. We need to be open about it. And then we need to be very clear about specific methods, interventions, tools, and tricks and hacks that you can use to get control back in your life.

Because anybody who struggled with this directly, and I know we'll get into this conversation a little bit later, will agree with this. The people struggling with the addiction don't want it either, right? It's not as if, you know, there's this again, this mischaracterization of people who are addicted or have addiction issues don't care about anything except their substance use.

I think that is a complete mischaracterization of what's happening. And if we don't talk about it openly, it seems as if, well, this is what they want, right? They want nothing but their drug use. But that's not true, and we'll talk about why. And so that's, to me, why these conversations are so important.

Host: Yeah. Yeah. Thank you for sharing all of that. I, that whole perspective, not just on, um, you know, alcohol or substance abuse, but the larger topic of addiction. Um, I really appreciate that kind of explanation and discussion of it. So, thank you. And, you know, I guess kind of piggybacking off of what you were just saying, you know, what are some of the primary reasons people who consider themselves in need of help for alcohol or substance use do not seek out help or what are those barriers for them, um, in, in seeking out treatment?

Guest: Yeah, this, this is a great question. I think the number one is, uh, an offshoot of what we just talked about and that is shame, right? If we think of people who struggle with addiction as the others, nobody wants to be the other. And so, it's really hard to stand up and say I struggle with this when you know that you are going to be characterized as being flawed or damaged or, um, um, broken, which is how we look at people who struggle with addiction, right?

The idea we have of somebody who struggles with alcohol disorder is, um, a homeless person who's unshaven, unkempt, um, walking around with a, you know, a fifth of something in a, in a paper bag, living under a bridge. That's the idea we have. And I'm not saying that those people don't exist, that, that, that version of alcohol and drug struggles absolutely does exist, but it's a small percentage compared to the people who are fully functional employees, employers, family members, etcetera, who you may not see the severity of the problem, but that's because people are hiding it so much.

So, shame is a huge barrier. But then even beyond that, cost, logistics, um, I deal so often, and, you know, we were going to talk about some of the work we're doing in Wisconsin and, you know, I'll, I'll just use a really quick example, but, you know, we'll go into a DUI court with IGNTD™ and we'll try to get people help.

And there will be individuals who are struggling to get the recovery support that they need, even though they've got arrested for an OWI, let's say, but they're employed single mothers, let's say. And I say this to professionals all the time. You know, if you, I've got three kids, right? And I work, if you give me the choice between getting help for myself or taking care of my kids, keeping them safe and feeding them, I know what I'm choosing and it's not getting help for myself.

Right? I'm going to take care of my kids. So, you tell a single mother who's working to keep her kids safe and housed and fed that she has to go to 10 hours of groups every week. And she has no car cause she got an OWI. Logistics are a problem for her. Money is a problem for her. She's going to choose taking care of her kids first, even if that means noncompliance, right?

And so, we haven't made it easy to get help. We've made it really, really difficult to get help. And then we blame people for the obvious fact, which is people only get help right now when they have to. When your back is against the wall and the world is showing you there's no way forward, some people get serious.

And we, the, the belief when we talk about barriers is that everybody who is not committed, who is not motivated, um, is just not serious about understanding that they need help. But I haven't found that to be true. I found it to be more true that those people, they want help, but they don't understand how to bridge the gap between what they have available to them - time, money, transportation, resources, etcetera, um, and the help that is available. And so, they choose what they can until they can't choose anymore.

Host: Yeah. Yeah, that makes so much sense to, you know, thinking about it. Um, thank you for sharing that example, just thinking about it from that perspective. Um, really puts a different twist on it, a different way to approach, um, thinking about it. So, thank you. And, you know, a lot of people are familiar with some of the abstinence-based treatments used for recovery. Um, what can you tell us about the effectiveness of those treatments and what alternatives are there? What other recovery methods are available to people?

Guest: So, before we talk about, um, effectiveness, I want to go back to these numbers. So, it used to be SAMHSA's, um, the definition of addiction used to suggest that there are about 25 to 30 million people struggling with addiction. That number has gone up to 40, just above 40. Of those 40 million people, about 2. 5 to 3 million actually get professional treatment every year. So, if you think about it, less than 10%, about five to six percent of the people who struggle with addiction every year get professional help.

First of all, there is no other condition we know, medically recognized condition, that has that low of a treatment engagement rate. I'll give you an example of cancer. In cancer, for instance, it's in the 80%. So, what that means is when somebody struggles with cancer and finds out they have cancer, about 80 percent of people get treatment.

Even for mental health disorders like depression, anxiety, it's about 60%. So, number one, why, why are only 5 percent, 6 percent, 7 percent of people with addiction getting help? Um, to me that gets to the effectiveness of the system that we use. And so, we talked about the barriers, and we talked about why some of those are there. You know, interestingly, one of the ways you mentioned abstinence-based treatment, the, the keystone, the kind of gold standard we use for measuring success in recovery is a year of full abstinence.

Okay. Um, and so that's one of the reasons, well, it's, it's kind of a cart or the horse sort of thing, right? Um, uh, chicken or the egg kind of problem. Is it that we define it that way because the only programs we've had are abstinence-based only? And so, we only think of recovery from addictive disorders as abstinence.

Now by the way, that may work for alcohol. It may use, work for drugs. How does that work for sex addiction? How does that work for compulsive eating? Right? Uh, what do you end up doing? I mean, are you supposed to then just not eat at all? Are you supposed to, you know, be fed, um, through alternative methods?

So, you never have to go buy food. I mean, it's just, these things don't really make sense and they don't make sense when we go into mental health. If we, if we think addiction is part of the mental health spectrum, then it makes no sense for depression, right? You wouldn't say to somebody, look, the only way you can be successful after depression treatment is to not feel blue at all.

Right? That just wouldn't make sense to us. Um, and so right now success is a one-year abstinence. That's the metric in most studies that you look at. Um, and the bottom line is a very small percentage of people ever meet that criteria. Of a full year of abstinence. Even by self-report measures by the way.

So, when you literally just ask somebody. So, we're talking about five to ten percent success rates at best. Even when you look at people going into traditional inpatient treatment, somewhere between 30 to 60 percent of people complete those successfully. So that means even going in, paying exorbitant amount of money for a month-long treatment, about half, at best, of the people succeed in one month of abstinence, right?

So, by the time you take it to a year after treatment, the success rates are incredibly low. Some of the other treatment approaches, harm reduction is one of the ones I'll just talk about right now, but harm reduction means a lot of different things and we can dive in more deeply for what that means, is how do we talk to a client about reducing the problems that the addictive behavior is causing for them?

One of the ideas that is aligned with that is to reduce their use. And abstinence only programs don't consider reductions in use as a success at all. Right, so you could have somebody who's gone, and we've had a client, let's say at IGNTD™, uh, this is a very specific example, but it speaks to what you're talking about, who went from drinking about two bottles of wine every night to drinking about two to three bottles a week.

It's a reduction of about 90 percent in drinking, about 85, 90%. And her therapist, even though she was experiencing this over months, kept focusing only on the amount of remaining drinking. Right? So, imagine if you were depressed every day and through treatment and therapy, you got to a point where you were experiencing depression only one day a week.

And instead of celebrating the other six days of the week that you weren't depressed, your therapist keeps saying, yeah, but we still have that one day. So, we're still failing, right? That caused the client that we're talking about to feel like she was failing in her treatment, even though she had experienced a 90 percent reduction in her problem.

That's to me, a result of the abstinence only approach. Now, I just want to be clear. I'm not saying that reducing that last two to three bottles a week, would have not been great. It would have, but where else in our lives do, we have such black and white thinking where we only allow 100 percent success to count as success and all the way up to 99 percent success to count as failure, right?

If you just think about that anywhere else in your life, right? Imagine if your boss, if your kids, um, I don't know if a traffic cop said, look, if you did one thing that is not aligned with traffic rules, you deserve to not get, have your license, right? Which is essentially what we're saying. You fail driving.

Um, it makes, it would make absolutely no sense in other arena. So that to me is one of the biggest reasons to reduce, um, remove our dependence. So my first book was called The Abstinence Myth and it was all about this. We have made abstinence as a de facto single characterization of success and recovery which means that anybody who's not abstinent, no matter how well they're doing outside of that single metric, is considered a failure.

Host: It really gives it like, I just I listen to you talk about it and that perspective just really brings it to light kind of how this is looked at so differently from so many other things that are a part of our lives, right? So, thank you for sharing that. You know, as you talk about that, so if we're talking about abstinence or, you know, talking about having alternative, um, recovery methods, what really is the key to creating change and overcoming addiction and those addictive habits that cause some of the negative consequences in our lives?

Guest: Yeah. So, you mentioned, uh, I have an upcoming book that's coming out. I guess now in about six months. Um, and I call the book Unhooked because people talk about being hooked on alcohol or hooked on a single drug or hooked on a TV show or hooked on a, on pizza, whatever, right? They say, oh my God, I'm hooked on...

And the idea is, uh, again, missing the point to my mind. And that is, you know, I talked about my own exposure to alcohol. When I, when I was drinking regularly. My problem was still not technically really with alcohol. Alcohol was a solution to my problem, which was low self-esteem and social anxiety. The, the medicine, the, the elixir, the, the substance helped put a band aid over a problem that I was having.

And what I try to explain to people is whatever it is you're doing as a, as a compulsive behavior is an escape. It's a, it's a, it's a way to leave behind, or at least forget or numb, other areas in your life, in your psyche, in your experience, in your environment that you're unhappy with. And what we have to do is we have to dig into those.

So, the real hook, the way I talk about it, you're not really hooked on alcohol. You're hooked on pain relief from social anxiety or you're hooked on, your trauma has a hook in you. Early life experiences have a hook in you. Your relationship is hooking you, right? Because, uh, how many people know of individuals, again, this could be, if you're listening right now, this could be something you're experiencing or you know other people who are experiencing this, they have a job they hate.

And so, they come home every day and they drink the moment they leave work. I mean, I've literally, I've known clients who they drive from work to a bar in order to deal with the impact of having to go in every day. Into an environment they hate, you know, that's, you can think of that as chronic stress, which is a traumatic experience to have over time and causes massive problems for us psychologically and physically.

Uh, so that's one example, or how about being in a relationship, a marriage, that is really problematic. And the problem is the marriage, right? You need to go to couple’s therapy, or you need to go do deep work, or maybe you actually even need to separate, right? But that is the core. But because that is such a scary proposition for so many people and understandably so, I'm not making light of it.

What they do instead is they go home, and they use substances, or they escape, or I know a lot of men who escape to porn, right? Instead of even trying to connect with their partner, they escape to this fantasy online world and that becomes their addiction. But their problem is not really porn, although porn has all of its own ways of hooking you and making you want to continue going there.

The real hook is not knowing how to communicate with your partner or having a toxic relationship or being, um, conflict averse and not being able to engage in deep, intimate conversation to resolve those issues. And that may sound really, really scary to a lot of people who are listening right now. And they say, you know, I'd rather drink than do whatever it is you're suggesting right now.

And that's fine. And I'm making no judgment about it. But I just want to be clear, you're drinking to escape something else. And you can try to fix the drinking, but this is the problem. Even if you succeed, and we can talk about, I can tell a really short story about why that's normally a problem. Even if you succeed, if you succeed in removing the drinking, the relationship is still problematic.

So tomorrow you're going to wake up and the relationship is a problem. So, unless you figure out how to fix that relationship, you're going to have to find another way, right? It's like a pressure cooker. You're going to have to find another way to let off that steam. Or you're going to blow up at some point.

And we all know what that looks like. It looks like anger. It looks like violence. It looks like many, many depression. It looks like anxiety. It looks like a lot of symptoms that you don't want to experience either. Um, and so for me, you know, when you talk about creating change, there are two pieces here, fixing the underlying problem and then replacing the addictive behavior with what we call adaptive behaviors, right?

Yep. Too many people focus on stopping themselves from drinking. But if you think, and you talked about this, Julie and I think we'll get to it in a minute. Let's say you drink every night, and you drink five drinks. Okay. Which is heavy drinking for sure, but definitely within the confines of many of the people I've worked with.

Okay. So, let's say you have four to five drinks every single night. That is hours of drinking. You're spending at least three or four hours drinking those four to five drinks and then having the impact. When you stop drinking, you just left a big void in every single evening you have. If you think for a second that you're going to be able to eliminate that behavior without replacing it with something else, you're going to be left with a serious challenge on your hands.

So, the best ways are to address the underlying issues, number one, and then replace these compulsive, uh, behaviors that are problematic with more adaptive, healthier coping strategies.

Host: Thank you for joining us for our podcast. We are taking a short break to share information on Well Wisconsin resources. We hope you will stick around for the rest of this informative episode on overcoming addiction.

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Thank you for hanging in there with us for our break. Now, let's hear more about what Dr. Jaffe will share about overcoming addiction.

Host: So I want to go kind of take a step back here and go back to, you know, in our introduction, I shared that you're working with a couple of state agencies in Wisconsin, as well as some other organizations in the state. And, um, tell us a little bit about who you're working with and the work that you're doing.

Guest: Yeah, sure. I'd love to. Um, so we didn't really mention this at all, but we, you know, we've talked about the methods, but one of the other things that happened for me about seven, eight years ago is I realized that because of the gap of how many people need help versus how many people are getting help, the only way we're going to really affect this, and have impact is, uh, technology, right?

In order to get 20 more million people, help, we can't just open up more offices. I mean, the idea that we would be able to take our current addiction industry and grow it 10 X in order to support the needs of people was just I, I, I didn't believe that there's a path to that, but technology allows us to scale our health.

So, I created IGNTD™, and it's called IGNTD™ because I believe in purpose. So, it's like, how do we get somebody fired up, right? To, to move to the next phase in their life. Cause again, the addiction is not about the substance, it's about getting people to feel like they have purpose and they're moving forward in a deliberate way.

And so, I created IGNTD™ as an online platform. Um, we've been, we've helped thousands of people and that was all well and good. And I ended up speaking, doing a harm reduction talk actually for the Wisconsin DOC about three years ago now, I think two or three years ago. And one of the things that I hadn't realized but was so beautiful to learn is that all of these barriers that I'm talking about are substantially more problematic in more rural or dispersed areas.

So, you know, it's hard to get treatment, even if you live in, let's say, Green Bay or Milwaukee because of all the reasons we talked about. But it's much harder if you live in the northern part of Wisconsin, for instance.

Host: Right.

Guest: Literally because sometimes there isn't somebody to help you, right? You may have to drive hours, think like two, three hours to get to the next clinic that has space.

Now, you still have to find somebody to pay for it. All the other stuff is still relevant. But now think of what if three, four times a week you're supposed to go to this clinic and it's two and a half hours away. You know, literally, it's like a full-time job just to get help. And again, up until now, maybe not now, up until recently, people who didn't go seek help in those arenas were considered not motivated.

And it's, I mean, that's a little crazy to me if I, if I can use a very clinical term, right? Um, that we would think that it was reasonable to ask somebody to essentially take on another full-time job for their self-care is, it's, it's nothing and nobody listening right now could have, could spend 20 to 30 hours a week taking care of themselves right now.

Even if you need it, right? I mean, you can, there's massagers, there's workouts, you can go sauna, you can, you can take vacation days, but I promise you everybody on this, everybody who's listening right now would have a really hard time figuring out where to find an extra 30 hours a week to take care of themselves.

We just don't have time. We're busy. So, what we found, uh, and we started working with the Department of Corrections, we're actually working with the CCS system in Wisconsin, which is the Comprehensive Community Services, that is a bridge between Medicaid and um, and people getting non-medical services, uh, and also many departments of health services and human services within different counties in Wisconsin.

So, I think we're now in about nine counties and the Department of Corrections. Um, and we started being able to provide virtual support. What does that mean? It means you can log in on your phone. You can log in on a tablet or a laptop or a desktop. If you have it at home and get help literally where you are so you don't have to go anywhere. That doesn't sound like a big savings, but you know, if you're even 40 minutes away from getting help, that could be hours of savings every single week. And what we found is we're getting help to people who would not be getting help otherwise. And so, a lot of people were actually really wanting support, but didn't know where to get it.

So, that's number one. Number two, by offering people a lot of flexibility, both in terms of timing, so, do you want to get your help early in the morning, late in the evening, during your lunch hour, uh, has provided even more support. And finally, you mentioned this in your earlier question, we use harm reduction as an approach.

And so even for people on parole, even for people on probation, even for people who, um, are deemed as people who would benefit most from abstinence, what they found at IGNTD™ is just a place where they can work gradually through that instead of being told that unless they report that they're perfect and they're in full compliance and fully abstinent from day one, then they're in trouble.

And I think that was another piece that was missing before for many of these departments, there was, there was not enough allowance, right? And we found great judges in Wisconsin that will work with us, with a client. Let's say they got an OWI and technically they're not supposed to drink, right? Okay. But you asked before about success.

The success was abysmal. Abysmal. I mean, people were failing left and right, staying in OWI court for two, three years at a time because they were failing constantly. And what we found is that through this method, and so the way IGNTD™ works is we have online groups and individual sessions, and our own little like addiction related and mental health Netflix.

You can kind of watch videos that help you feel better about or, uh, get support and, uh, teach you about specific tools. And so, we're actually really excited. We're about to grow our Department of Correction contract to go almost to the entire, uh, northern half of the state, uh, and be able to support there.

We've, we've supported a few hundreds of people in Wisconsin to date and are and are growing it out all the time. But my dream is that one day you'll be able to just pick up your phone and just get any mental health or addiction related help that you need. That is so fully customized to you. You know, we all, we all hear about AI now and, you know, chat GPT is the one that's capturing most of the interest, but we've gotten really, really smart with technology and I think we can deliver groundbreaking help to people who really, really need it in areas where they were never going to be able to get it for a cost that would have been unthinkable before, because again, right, You think of somebody who lives in Northern Wisconsin. How expensive is it to have to drive that long? How, how much time does that take out of your life? And, um, and I think technology can help solve those problems. So that's what we're currently doing in Wisconsin.

Host: Yeah. Wow. Thank you. And you talked about how your contract with the department of corrections is growing. Um, you know, and you've shared a little bit about some of the things that are happening with the work. What else can you tell us about the impact of the work that you've been doing in Wisconsin and how it's helping people here overcome addiction?

Guest: Yeah, um, thank you. So, you know, it's, it's really funny. I joke that two and a half years ago, I'd, I'd only been to Wisconsin as, as, uh, I, I lived in Illinois for a while, but then a stopover state for me most of the time.

And now, I'm in Wisconsin four to six times a year. We're really involved with the drug courts. We're involved with the OWI courts and Department of Corrections. And as I mentioned, also with some, some other programs. Um, the impact is, is twofold. Number one is just increasing access, right? We talked before about the fact that it was only 5 percent of people getting help.

I want to get it to like depression, where 60 to 70 percent of people can get help. So, we're seeing more impact there. Um, that woman, that single mother, and that's a very specific person I'm thinking of, that single mother who was employed and had been in OWI court for two and a half years not being able to get out of it, was finally able to get out because, she was able to go to these online sessions and graduate course.

So that even, even those successes to me are massive, right? Uh, we had a couple of other participants who just literally one of them was telling a story where in the winter she would have to ride her bicycle. Cause she didn't have a license, right? She had her license taken away. So, in the, in the winter, riding her bicycle to a group in order to still stay compliant, right?

Whereas now she was able to, I mean, to me, that's a safety issue. The way weather goes in Wisconsin sometimes, riding your bicycle is more hazardous, maybe, than drinking. Uh, so that's one impact. But in terms of real data, I like to talk about it like this. So, overall, when we look at all the information, people in about 30 to 90 days, the range is somewhere in there, uh, cut their drinking with us by about half across the different, um, programs that we've offered. Right? So again, it's that non-abstinence, but, still very, very harm reduction informed way of thinking about it where, you know, they're drinking either half as much, half as frequently or a combination of both.

But again, because that's over the entire population that we worked with, some people have gone completely abstinent, and some people have only reduced by five or ten percent and some people have had no success. So, I'm not, I hate people who purport that they have found the silver bullet that has fixed everybody's problem. That is not what I'm saying, but we've just we've given access to more people about cutting their use by half. Um, as I mentioned, we've made it easier for people to get the help that they need. And so, my favorite stories are the ones where we take people who felt left alone, they felt abandoned, they felt, um, isolated.

Uh, maybe they didn't want to go to meetings in their very, very small town because they knew if they walked in, they're going to have to see other people that they know. And that's shameful enough by itself. So.

Host: Well, thank you for sharing all that. I actually grew up, um, in a very rural Wisconsin community. And so, you know, I, I, I know about, you know, those people that you're referring to that, you know, it's, it's hard to have to go a couple hours, you know, to receive treatment. And so just really, really grateful to hear about all that work that you've been doing throughout the state. It's fantastic. And I, I want to end our conversation today with a really important question about, you know, if there is someone out there that's listening to this today, who is struggling with addiction themselves, how can they start that journey to find help and healing? Where do they begin?

Guest: I love this question. Um, first of all, if that, if that's you listening right now, I just want you to know that there's a way out. Right? Um, this is not something you're gonna have to struggle with for the rest of your life, but it's going to take some work to get out. And so that's, that's the number one message that I really, really want people to understand, right?

You're talking to a guy who was a daily, heavy, heavy drug user. And that's not just, not part of my reality right now. It hasn't been part of my reality for decades. And if I didn't share my story, nobody would know that it was part of my story in the past. And I just want everybody listening right now to know that future is available to you.

I'm not going to lie to you and tell you it just happened. I had to do a good amount of work to get there, but the life is worth it. The life you get on the other side. So that's number one. Number two, there is no single standard treatment that would work for everybody. So really, the biggest challenge here is, and I talk about this a lot in my next book, is finding the right combination of help that you need.

Now, if you think about it, that doesn't make as much sense if we consider all addiction the same, but all addiction is not the same because the alcohol is not the problem. It's what you're struggling with underneath it. So, for you, it may be trauma, and then you need trauma focused therapy. It may be anxiety, and then you need anxiety therapy, right?

It may be relationship based. It may be work based. It may be self-esteem, right? There could be so many underlying issues, and so the specific therapeutic approach that you need will be like your own toolkit, right? You can almost imagine like, um, like a carpenter with all the tools that they have, right?

There's hammers, there's nails, there's screws or screwdrivers, there's drills. Every tool is good for a different job. You are a unique job. And so, we've got to figure out the right combination of tools. Um, obviously I would be remiss if I wouldn't just say, if you want to go to igntd.com, uh, it's igntd.com, you can try us out. The nice thing about us is we're really, really easy to access, right? You get help the moment you sign up; you don't have to talk to anybody in order to make it awkward. Uh, and we also are pretty cheap. So that's, that's the number one kind of approach. Obviously, that's why I started it.

But you don't have to go to us. Go anywhere that feels to you like it may help with the things you're really, really struggling with. Um, one of the biggest tools, and I talk about this in my next book a little bit, that I love that most people have really never heard of, is to take an experiment called an abstinence sampling experiment.

It's a little bit of what I suggested for people earlier. Commit to one day, three days, one week and say, you know what, for the next three days, I'm going to stay problem behavior free. And now here's, here's the, the, the meat of why doing that could be helpful. Number one, it's a low-level commitment. A lot of people can at least in their heads, understand how to commit to one day or one week, right?

Uh, a year sounds absolutely crazy when you're starting this out, but a day or a week or three days sounds reasonable. But here's the lesson in the learning of this, and this is really, really important to hear. The commitment is number one, and starting the process is the most important part of it. You won't get the lesson without it.

But what I want you to do while you're taking on this experiment is not run away from all the times, you're going to want to go drink and do what you have been doing for years to cope. But I want you to take a piece of paper, or write notes in your phone, if your phone has a note function, and every time it comes up, I want you to write down what was going on.

Because a lot of us are so, are hiding so much from the causes of our drinking that we don't even recognize that going to work causes us massive anxiety, and we want to run away from it, or coming back home, or dealing with our kids, or our parents, or money issues, right? And so every single time you end up wanting to drink, and you are going to want to drink over those three, four, five, six, seven days, I want you to take out a piece of paper or your notes and say, you know, Monday, 4 p.m. about to get off of work and I'm feeling really, really anxious about going back home and all I want to do is go to the bar and drink. Write this stuff out and I promise you this, if you take this little experiment, even for as short a period as three, four days or a week, you will end up with a lot of information about what is actually causing your problem.

And then, you've got to get really diligent about going to fix those things. Now, here's the cool part. You can actually go about fixing those things, even if you haven't fully committed to not drinking anymore, right? You can go do the work that you need to do. You can go fix your relationship while not being abstinent.

You can go have the conversation with your boss or switch jobs or, well, all the different pieces that you may need to do on your way to recovery while not having your problem with alcohol fully fixed. But what I found is as you feel yourself making your life better, I equate it to like being in school, and you know, there was the class you wanted to get a hall pass from where every time you walked into that class, all you, all of a sudden you want to go to the bathroom. You want to go see your friends in recess. You don't want to be in that room because you hate that class. And then there were other classes that you just loved, and you never thought about going to the bathroom during that class because you really wanted to listen to the teacher and get engaged, right?

For me, math was the one I wanted to stay in. History was the one that I wanted to leave all the time. Well, if your life is like your history class, we got to get you into a better class and in a better mindset. It's not about stopping you from wanting to go to the bathroom, right?

And so, how do we create a life that you are excited about waking up to every day? And so, abstinence sampling is one of, one tool that I would suggest. And then last but not least, many of the people that I work with feel like they can't talk to anybody. Because of the shame and disdain, we talked about earlier.

I urge you, and I talk about this in my book too, find at least one person you can communicate with openly, and for two reasons, empathy and connection, but also accountability. It's amazing what can happen when you have one partner by your side, who actually knows what is going on with you. You trust them enough to keep the secret, and keep you both accountable, uh, but also, you know, keep, you know, uh, the, uh, the communication you're having private. And I really, really urge people, I understand shame, I really, really do, I've, uh, in my biggest TED talk that I did, we talk about “F” shame as a, as a big part of the equation. Shame will be your killer if you don't let it, if you don't let that, um, that hurdle, that wall down enough to at least connect with one other person, but one other person can make all the difference for you.

Host: Yeah. Well, thank you so much, Dr. Jaffe for having this really, you know, just insightful and important conversation about overcoming addiction today. Just so grateful for your time and that you were able to join us.

Guest: So happy to be here. Thank you so much for having me, Julie.

Host: Thanks for listening today. I hope you enjoyed the show. You can find our survey in the Well Wisconsin portal and our transcripts and previous episodes at webmdhealthservices.com/wellwisconsinradio. If you're listening to this podcast on your platform of choice, please be sure to subscribe so you'll never miss an episode.