overcoming addiction in young adults with humility, empathy and grace with Hazeldon's Dr. Joseph Lee
Host: Brenda Zane, brenda@brendazane.com
Instagram: @the.stream.community
The Stream Community: online and app-based community for moms of kids experimenting with or addicted to drugs or alcohol
Free ebook: “HINDSIGHT: 3 Things I Wish I Knew When My Son Was Addicted to Drugs, by Brenda Zane. Download here
Guest: Dr. Joseph Lee, Hazeldon Betty Ford
Resources:
Recovering My Kid: Parenting Young Adults in Treatment and Beyond
C.R.A.F.T. parenting resources
NIDA’s Monitoring the Future Report
High School & Youth Trends DrugFacts (NIDA)
Pareto Distribution articles & information:
Washington Post infographic & article
Paying the Tab: The Cost and Benefits of Alcohol Control (Cook) - alcohol consumption statistics
Show Transcript:
SPEAKERS
Brenda Zane, Dr. Joseph Lee
Brenda 01:49
Welcome. Today I had the great privilege of being able to spend almost an hour talking with the Medical Director of The Hazeldon Betty Ford Youth Continuum. His name is Dr. Joseph Lee and I have to tell you this was just a really amazing conversation not only because Dr. Lee has volumes and volumes of experience and education, but because you can tell in in the way he speaks and the way he thinks about addiction and about treatment and recovery, that he is somebody who very, very deeply cares about each of the people that he works with. He's the guy that I think everybody if you could pick one person to work with your kid, he would be the one.
02:40
Dr. Lee is a thought leader on all matters related to youth addiction, families and mental health. He is a triple board certified physician. He completed his adult psychiatry residency at Duke University Hospital and his fellowship and Child and Adolescent psychiatry from Johns Hopkins Hospital. And he's also a diplomat of the American Board of Addiction Medicine and a member of the American Academy of Child and Adolescent Psychiatry Substance Abuse Committee. So I'm pretty sure there is nothing that he does not know about addiction and treatment and families. And that's one of the reasons I really was excited to have him on because he spends quite a bit of his time also dealing with parents and with family issues.
His experience with families from all over the country, and even abroad really provide him with an unparalleled perspective on emerging drug trends, co occurring mental health conditions, and really the the ever changing culture of addiction was which we all know, has changed quite a bit recently with the introduction of COVID into our worlds and given his unique degree of special and powerful messaging Dr. Lee has been featured in numerous media venues and national academic conferences. And he is also the author of a book called recovering my kid parenting young adults in treatment and beyond, which is just an amazingly down to earth and really honest guide for parents and, and to help them learn how to be the leaders in a time of crisis. So without further ado, I will let you listen into this great conversation that I had with Dr. Joseph Lee from Hazelden Betty Ford.
Brenda 04:39
Welcome Dr. Lee to Hopestream. I'm so thrilled to have you here today and to bring your expertise and your viewpoint to my parent listeners. So thank you very much for being here.
Dr. Lee 04:49
Yeah, it's an absolute pleasure. Thanks for the invite.
Brenda 04:52
Well, before we get started, I'd love to give my listeners just a little inside glimpse to you and into all my guesses. Just a person and so I have a fun question for you before we get into everything that you do professionally and that is what did you have for breakfast this morning?
Dr. Lee 05:07
Boy I had these almond breakfast cookie things. I had two of them because I was hungry but I had to grab that and coffee and run so that's what I had for breakfast.
Brenda 05:21
That's that was it that was it. Are they intentionally made for breakfast or they just something to eat?
Dr. Lee 05:27
Yeah, they're some kind of almond flavored biscuit kind of a thing. Like a looks like a little cracker thing. I don't even know the name of it. I just grabbed it in the cupboard and and then dropped off my, my eight year old at his school. And then, yeah, that was my morning.
Brenda 05:45
Well, so you're you're dealing with this pandemic and your work with two small children, which I can't even imagine is must just be such a struggle to juggle.
Dr. Lee 05:57
Well, I think that a lot of people are going through the same thing. Right now and you know what it's like is on the one hand, you you value the extra family time you get so i don't i don't miss the traffic prior to COVID I don't miss one appointment after another one activity after another just really getting time to spend with kids on the other hand, you know, when you have young kids, you have these fantasies about how a bike rides gonna go, how a picnics gonna go. Never really goes that way. And that every day is also COVID. And so every day you're like, I'm going to spend this beautiful time with my family and get close to my, my boys and you know, and then they're fighting or crying or they fell down or I don't know something happened and hey, but that's life. A lot of people are in the same boat and a lot of people have it a lot worse. And so my wife Jill, and I feel pretty blessed given the circumstances.
Brenda 06:47
It's true really this time has given us a lot of I think interesting perspective. No matter where you are with your kids. It's it's just sort of a new awakening of the realities and the struggles and the joys the little things that we probably didn't appreciate so much before. So it's all good. Well, before we jump in, I'd love to just sort of get some background on you and how you know, you came to be doing what you're doing with this interest in youth and working at Hazelden. What was your path to getting there obviously went through medical school and something kind of led you in this direction. If you can just give us some context for that, that'd be great.
Dr. Lee 07:25
Yeah, I actually don't have a very cool story. Unfortunately, a lot of people in the field, do they have just a passionate story of redemption or loved ones getting help or losing loved ones and I know you have a powerful story as well there. And I was born in Seoul, South Korea. My dad was a chemical engineer wanted to be and so he brought our family to the state of Oklahoma when I was seven. And so I grew up in Oklahoma. It's kind of where I call my first home really, and then I did college there. I was a philosophy major and Which meant I had long hair and I was in a fraternity that you know, so I don't have a recovery history myself. I pasted some of the lifestyle, let's say when I was young, and so I can relate to kids very well. And then I went to medical school in Oklahoma then I was really torn between internal medicine because of hematology oncology and psychiatry, and ended up doing Psychiatry at Duke University, where I met my wife. She's a tar heel, I'm a dukey. So it's a bit of a rivalry. Yeah. And then I did Child and Adolescent Psychiatry training at Johns Hopkins, and then, and then I didn't want to do another fellowship. And at the time, you could get grandfathered in if you did some clinical practice, you get an addiction certification. board certification, so I chose to join Hazleton people thought at the time I was very strict, you know, strange for going to Minnesota because everyone who doesn't live in Minnesota and sees Minnesota thinks it's very cold and that's all they remember.
09:00
So this is the story I tell is just that I was. And I say this and when I give talks everywhere is that one day in the winter in Maryland, I was just I got lost and I kept driving and I had to fill up my gas couple times I'd get super lost. And then my car got stuck. And these people rescued me and they, and they built a shelter for me. And then when the when the I thought in the winter, I was in the spring, I mean that I was in Minnesota, and I've just been here in Minnesota ever since. And so my kids are Minnesotan as far as my passion for, for addiction, I think it's informed by a number of things. I had a great experience at Duke. There's a little treatment center called the fellowship hall in North Carolina. And it was amazing that some of the patients that I saw in the emergency room who were very angry, and I'll just be honest, I didn't like them very much. They were they'd come in high on cocaine, they were combative. Everybody in the emergency room blame me like as if I'd like I advertised and brought these patients to the emergency room because I was a psychiatrist. So it's like a double double whammy of both the pressure of dealing with patients who were inebriated or intoxicated, and everybody in the hospital kind of blaming me for the patient being unruly.
10:14
So I didn't have a great initial flavor about addiction, but then I'd see the same people later in recovery at a treatment center or later on, in recovery. And the transformational change was amazing. So that sense of humanism that that story of redemption, it's everything I wanted, going into the field of medicine, you want it to see those stories of personal change and empowerment. And that's what I saw. So I focused on young people in adolescence for a while really cut my teeth in inner city Baltimore, which I'll never forget, it was great for my training, working with families, you know, and then then came here and now I do addiction work and I'm able to see that humanism and that redemptive quality of recovery has every day, so I'm very, very blessed to have kind of muddled my way through this path and to be a part of a very small part of other people's lives that way.
Brenda 11:09
Hmm, that's such a good point. Because I think and this is something I try to impress upon the moms and the parents that I work with is, yes, there is a lot of ugly, but there's also such redemption and such amazing transformation. And, you know, I try to share my son's story because I don't think you hear enough good positive recovery stories. And I know that there are a lot of them and maybe you I don't know if you know, a percentage, you know, or if there even exist a statistic about what percentage of of youth do end up recovering sort of long term, but it can happen and so anytime I can get somebody to talk about that I'm always excited because it's really important to give people hope.
Dr. Lee 11:56
Yeah, absolutely. I think in terms of sobriety, and maybe not recovery, some people don't believe there's a difference. Some people define recovery differently. But when you just look at sobriety, statistically, there are a number of people who don't ever go to treatment. And they don't ever seek help and who knows what they go through in life, but at some point or another in their own life, they decide to reduce their use significantly or stop using altogether. And, and so we know that that happens even kind of with the bare minimum. But what we try to do is there are a lot of hopeful stories, there are millions of people around the country who are in recovery, and lots of young people. And I think what we try to do is, even if people change their lives and stop using without treatment, when I hear their biographies and their stories, they've had a lot of pain. And if there's a way where we can shorten that trajectory so that they can live their life faster, sooner, they don't lose some of their dreams, they can maintain the hope. That's what we really try to do with the young people here is to change that trajectory. So I see happiness. stories all the time. You know, I have kids hit me up for letters of recommendation to graduate school and medical school or they touch base to say, oh, look what I'm doing now.
13:09
And I think for the parents who are listening, they wouldn't believe who those kids were five, six years ago or eight years ago, right. And I've been, I've been here, you know, 12 years and so, so much change, so much hope. But that isn't to say that every case has to be like that. I think the treatment field is also changed to embrace lots of ways for people to recover. And, and to also just emphasize, you know, being safe, not overdosing, you know, staying in the game, staying alive, staying engaged, and that also has tremendous value. And so I think it doesn't have to be a home-run, you know, right out of the gate. That's not what we even aim for, you know, when people come to residential care, I tell them, you know, one of the goals of residential care is to try to not come back to residential care, you know, meaning you want to try to develop skills so that you can do things on a long journey, with ups and downs and analysis. Patient setting. And so there are tons of inspirational stories, a lot of stories in the middle. But they also are on the ascent. And what I noticed is the longer people stay engaged in some kind of help, and have a sense of community, the better and better they do every year.
Brenda 14:15
That's so important. Because when you're in the thick of it, it's easy to lose sight of the fact that this is temporary, and that there can be a really positive outcome. And then those kids, you know, like you said, if they're coming back, and they're going to medical school, or they're going into the, the field of treatment that they have, that's part of their story. So yes, it's incredibly painful to have a kiddo who's going through this, but it's part of their story, and it's going to be part of who they become. And it's very easy to lose sight of that sort of longer term because you're just trying to survive the moment, day by day of what's going on. And I have some sort of specific questions, but I thought just you have such a unique vantage point having, like you said, been like, boots on the ground and Baltimore, which I can't even imagine what that must have been like. And then sort of now being able to zoom out to its, you know, 50,000 foot view of what's going on, what do you think we should be thinking about? Or what should parents be thinking about right now, in light of kind of where the opioid epidemic is, and with Coronavirus, and I know, what are you seeing when you have that? Because we're, we're kind of in the moment. We're very myopic, you know, in our view of what's going on with our particular kid and our town, our city. What do you see going on?
Dr. Lee 15:39
Yeah, I think we're in a moment where, you know, history happens all the time, but we're in in this specially historic time and it and it's on the heels of an opioid epidemic, which still has ups and downs, and it's with COVID, but it's also with with the killing of George Floyd and and all the social change That needs to happen. And there's a lot of dialogue about that. Now, there's also a backdrop of cultural change, our economy is shifting. Some segments of our economy are going away or have for decades and we're wrestling with that, especially like manufacturing it the on ramp for adulthood is not what we were promised when I was young or generations prior, the whole idea of 18 years old and you live your own Manifest Destiny and you know, two chickens in every pot in the car in every garage.
16:32
We're like most of the world now in we have a very extended on ramp to adulthood. And 18 years old doesn't mean a lot. And because they're still living in your basement, and they're still coming home after they graduate from college, you live in your basement and they're still on your health insurance and housing is more expensive. And so I think all the stresses of the now make this a very kind of watershed moment, and it's good to take a step back To see, you know, what's really happening here? And what can we learn from it. And that takes a lot of, I think humility to just kind of break out our own patterns and not take ourselves so seriously. But it takes also a lot of empathy to walk into a lot of shoes and try to see things from a lot of vantage points. And I think what we're seeing is that there's something about society that multiple variables has made life more stressful. And in each of those kind of stress, stress driven moments, you see an increase of people who are vulnerable for addictions genetically converting and actually having problems with us or bad outcomes. And so you see, these deaths of despair rise like suicidality, you see overdose deaths, deaths rise, and I think historically, there's, there's a signal to our society about our fabric, our culture, our dialogue, about our family units. And it's gonna I think, in history, speak volumes as the time we're in as a real time of change and I hope we can seize the moment And change in the right direction
Brenda 18:02
It is so overwhelming to think about all of the people who are now like you said they had the kind of the predisposition and the tendencies and now are experiencing you know full blown use and and really not having necessarily all the same resources. I know you guys Hazleton are open and, and taking new patients to work with. But there's probably a lot of people who are just floundering and looking for what kind of help do I need? And as a parent, what kind of help is it, you know, is accessible right now for my child. So yeah, I agree. It's historic and looking back, it's going to be really interesting to see because it feels like the opioid epidemic was finally getting to the front burner, right, like awareness and we were starting to see a lot of motion and now I just feel like it's it's, you know, put on the backburner again while everybody deals with with COVID.
Dr. Lee 19:00
Yeah, the, you know, economically when there's a downturn or when there's other crises, substance use tends to go up. So we know there's a lot of pent up demand around the country and a need for help. And I think families feel really stuck, where on the one hand, they're seeing their son or daughter or husband or father's addiction, they're seeing it in all its glory at home, you know, and we see young people who go through their families alcohol supply in three, four days, you know, when they were supposed to socially distance and, and so we see the increased rates, and we actually see the increased demand.
19:37
And we're, and we're fortunate because I think when times get tough, people tend to trip trust, you know, brand names and people with that tradition. And so, we've been incredibly busy. But we also know that there's a lot of brick and mortar that's no longer around and so the access that people have for help so we have increased use on the one hand, decreased access, a part of the solution for that has been very Virtual care. And that's helped some and I think one great thing about virtual care is that it's here to stay. So we've moved thousands of patients onto virtual care because the brick and mortar intensive outpatient cares, the more intensive outpatient treatments aren't there anymore. And, and I think that's been great. And we need to seize that opportunity more. But it's not just because of driving distance in rural areas. I think there's some, some something positive to the virtual platform being available to people there are, for example, people who are ashamed or introverted, they don't want to come to a doctor's office or a therapist appointment. They they feel more safe and assertive talking on their couch or in their pajamas. They just feel more comfortable that way. And so I think there's good that comes out of it. But from a treatment supply access standpoint, yeah, we're in you know, we have to we have a lot of work to do in the country to make sure that family's needs are getting met.
Brenda 20:55
I guess that is one positive that's coming out of this is that where were they might have been hesitancy to try a virtual model, we've just sort of been thrown into it. Like there was no choice. And so here we go. And now Yeah, some of that's really good and it can stay. And it's, especially for younger people that might be intimidated to go to a live group. I do think that joining a group virtually could be a lower barrier to entry just to say, Hey, you know, let's try it out. Like you don't even have to turn your camera on. You could just be there. Do you guys see that are people getting sort of warmed up to this idea of, of showing up just from wherever they are?
Dr. Lee 21:36
Yeah, like, you know, sometimes I'm doing things and kids are outside for their virtual visits, they're at their job site, you know, the fact that they can just pick up anywhere like you know, in their car and not while not while driving, but you know, they're right. They can pick up anywhere and and talk to their, their provider or therapist or doctor is, is pretty amazing. And then it's I think the thing that you know, we take for granted is one it also affirms just how important connections are. So there are some people who don't like to do therapy, but all of a sudden with virtual care, they're into it because it's another opportunity for them to connect with somebody, maybe not as good as in person, but, but almost as good sometimes. And the other part is just patient empowerment is it is is that people have told me verbatim, just how comfortable they feel in their home not having to go through the whole rehearsal of getting dressed and, you know, then the parking and you know what I mean?
22:31
And just to, you know, roll up out of bed, you know, eat some Cheerios and get on your computer. Yeah, there's something special about that, that it's not just for the addiction field is just like a human thing, I think, for medicine, to further break down more of a kind of a patriarchal model of helping people to just empower people to call from the living rooms, whether it's cardiology or something else. I think we're going to make more of this virtual care and I think it took something like COVID for us to say, man we should have done this years ago. And our organization actually, we were lucky, there was a lot of serendipity in that before COVID happened the year before, we were already planning and piloting our virtual intensive outpatient care. So group meetings, we wanted a privacy law compliant because an organization of our size, we get a lot of scrutiny, of course, and so we want to do things the right way for patients and families. And so we were already building this. And so when COVID hit, we just had to beta test and roll this out, instead of, you know, relying on Zoom or you know what I mean, and those things had become safer, but we didn't have to rely or wing it on Skype or something. We had a platform with a company called Mend that we were already using. And so we kind of lucked out in that respect. But our reasons for doing it were to help people in rural areas who couldn't come to treatment, you know, or to give Suboxone to someone far away who couldn't make it through appointment. And so it wasn't what our imaginations is definitely have been opened with COVID in a positive way.
Brenda 24:02
I can imagine. And just the legalities and HIPAA and all that that you have had to deal with. And like you said, to have to already have checked those boxes so that you could just test it and roll is just amazing. And just the number of people that were able to, I'm sure continue on with their treatment, just you know, without a big, big downtime is just huge. And I know that you've talked a bit about, and I'd love to go back to this, that addiction really is about people and not drugs. And I'd love to have you just talk a little bit about that because there is so much focus on drugs and on fentanyl and heroin and we get so wrapped up in, you know, the actual substance. But I really love when you talk about that. You know, really addiction is about people. So maybe you can share with us a little bit of your thoughts on that.
Dr. Lee 24:51
Yeah, so this comes actually from a number of different pieces of data. One of them is a book that was written somewhere in the 2000s, it's by a guy named Philip Cook, who's an economist. And he was adding some data that other people have also espoused is that I think he said like 30% of Americans don't drink alcohol, another 30% of Americans drink less than one drink a week. So over half the country drinks less than one drink a week. But on the other end of the spectrum, 20% of Americans consume 80% of the alcohol in the country. And 10% of Americans consume over half the alcohol on the other in the country.
25:35
This is called what they call a Pareto distribution and this is a simple mathematical cheat, if you will, to look at things to say that not everything is distributed in a bell curve manner, you know, and in fact, most things are not, you know, so if you look at, you know, food production or wealth in society, it's not in a bell curve distribution. It's in a skewed distribution where a minority If people you know what I mean, have most of the apples are most of the. And so that's what you find with what I call societal vices. Things that people get carried away with. So no moral judgment, but things that people consume, possibly the excess, generally all follow the alcohol model. And the numbers are somewhat different. But there's a lot of data pointing to the same thing and whether it's marijuana or other drugs, but it also extends to gambling and lottery tickets, and nicotine and video games, even that things that are overly consumed. There's a minority of people that tend to consume most of them.
26:39
And it's interesting then on two fronts, one, as we talk a lot about, you know, policy for drugs, alcohol, opening casinos, all kinds of things. One of the things you come become aware of is that all of these economies are in some ways predatory meaning they have they kind of know that the margins are built on people who consume too much. And so that's one kind of painful, capitalistic truth in it. And then the other thing that you see is that it's about people not drugs, because the individuals who are in that 10 to 20%, let's just say, are also more likely to use more than one device. And we see that with young people that the kids who use nicotine vapes are more likely to smoke cigarettes later in life is what the data says and the kids who smoke marijuana are more likely to try other things. But it's not marijuana's fault. It's bi-directional. It just happens by convention in our culture that our kids pick up, you know, cannabis and alcohol and nicotine, you know, I mean, because it's more tolerated, but it's really about the individual and that also marries with other epidemiologic studies.
27:47
So if you look at Monitoring the Future, which is probably the best survey of use for young people, what they find is that even with all the legalization talk and whatnot, about 38 to 40 percent of high school seniors have tried marijuana at least once in the past year. And that's far lower than the kids I see predict. The kids I see say, Oh, no, no, no Dr. Lee at my high school it's like 90%. And then only about 6% of high school seniors have smoked daily in the past month. And so it's the same kind of Pareto distribution. But what happens is that the the people who are in that, you know, small percentage, they hang out with each other. And so if all your friends play Fortnight, you're gonna think everybody in the world plays Fortnight. And so there's this self selection, there's social norming that happens, where you think everybody uses like you because your friends use like you. So we use this on a lot of different variables. We use it to break their ideas about social norming. But we also have them in a non judgmental way kind of empathize with themselves that it's not which drug is worse, but it's more Who are you.
28:53
And then the final piece of proof and that is, there's a lot of research that shows you can pick out young people who might be prone to developing And when they're in grade school years before they use substances, so it really is about, there are some differences for people who are more prone genetically or otherwise to develop substance use disorders. You can pick out some of these traits psychologically and people who are fairly young. I've been able to verify that in I don't know how many thousands of biographies I've done, you know, seeing seeing patients, and, and it's not so much is alcohol good or bad? Or is nicotine good or bad? Or is marijuana good or bad? They all have pros and cons. It's more Who are you in that spectrum? And that's what we try to teach young people is not some puritanical way to look at substances, but to understand that they may not be in that population that can just, you know, mess around here and there. And it's something they come to realize on their own through their own evidence through their own heartache and suffering.
Brenda 29:56
Right. That's really interesting. So I think you're right when you are If you are in either in that 10 or 20%, or you're a parent of a child who's in that, it seems like everybody is that and so that, that social norm like you were talking about just becomes so skewed when you are looking at it from that from kind of inside the bubble, I guess you could say is, it's so great to hear that there, there's just a massive amount of, you know, young people who are not using substances and then that that must be encouraging to for the kids that you're working with, for them to realize, like there's a whole life out there that I can live without using substances. I just have to be able to get there.
Dr. Lee 30:39
Oh, yeah, I mean, that's, that's what they find out on their own. And I and so we use it for a lot of purposes, but one of them is, you know, in the kind of the community reinforcement approach for getting young people well from substance use disorders and this is a kind of a scientifically validated therapy method. They you know, they want you to find other competing things, fun things to do that you can do as alternatives for using. And, one, it helps to know that the majority of the population can have fun without using very much, you know, and so that just kind of, you know, because they think they're going to join a nunnery or something like that.
31:20
And another thing that reinforces that that kind of delusional thinking is that when you use you know, as human beings we get used to any reward and and then our threshold for what we expect for reward changes. So it put it another way, you might love a song, but if you keep listening to it, you're gonna get sick of it. And we're all like that we all kind of adapt to our situation. So what happens when people use a lot is that the reward of using outweighs kind of natural rewards in life. And then the rewards of using even the rewards of using don't become rewarding anymore. You kind of almost used to get to normal or to catch back up because you feel miserable if you don't. And so it's skewed - your enjoyment you get from hobbies like you know mountain biking or rock climbing or whatever you want to do. And so once you've stopped using for a while you naturally recalibrate you know and once you recalibrate you know what young people tell me is they have fun laughing with their friends, you know, going out and fishing or hanging out just doing normal kid things, but when they're using, it's very hard for them to fathom life being enjoyable because the dopamine rush of course, doesn't isn't gonna match heroin, you know, and in the short term, but but that's also that kind of episodic, intermittent, lower reward is what we're designed to find nurturing as human beings. That's what we get satisfied with.
32:42
Because the rest of the the whole deception of addiction is a lot of reward early on, that skews and messes with your own adaptability. So then it's never enough. That's what it is. And so then, there's an it's like buying things on a credit card, and then the bill comes in. It's of course, always horrible. And it's teaching that to young people to say, let's acknowledge the things that drugs and alcohol did for you because those things are true in the short term. But let's also then acknowledge that the things that you struggled with because of that and so you know, a lot of the kids it's like they've been in the hot tub. They've been hot tub for a while. They're used to the hot tub and then they jump into the swimming pool when they get sober. And they cry foul. Of course, the waters super freezing, but it's not really freezing. The only perceive it is freezing is because they've been in the hot tub and it's that recalibration that happens naturally, whether they kick and scream, whether they, you know, don't want to, you know, do this or go to outpatient therapy or whatever. It'll happen naturally. And so many young kids tell me just a couple months later, like, hey, I just, you know, watched a movie with my friends. We went for a walk, we did normal friend things and hung out. And I've had a great time, and I don't remember laughing like that in years. And then when you start to see that Dave internalize the value of having fun in their own way, then you don't have to classify it as like, you too. Can Have a life when you're sober, almost like it's conciliatory. You mean or like, and, and all that goes out the window. They just they just love life.
Brenda 34:08
And in they can love life without the negative consequences because they think you've got, you know, when you are using a substance to get that dopamine, there's a lot of downsides to the substances and you hear it all the time. And you know, we hear it as parents is, yeah, there's some great things about that. But like you said, then it catches up and I need more to get that same feeling. But then there's all the bad things that go along, like, I get arrested, or I get in trouble with my parents or I get kicked out of school. And so when they can replace that, that feeling with positive things, then you don't there isn't a downside of going on a walk with friends or going waterskiing or rock climbing or whatever it is, you're not going to get arrested for that. In general for the most part.
Dr. Lee 34:53
That's right, it's going to be positive.
Brenda 34:56
That's really good perspective to hear. And it's great to hear, I think because you have seen that on scale. So a lot of us if you're just a parent and you're surrounded by, you know, some friends you don't see at scale that this happens over and over and over year after year, thousands of kids are doing this. So that's really encouraging. I think for a parent to hears, yes, not only is it possible that it happens all the time.
Dr. Lee 35:24
It happens all the time. And, and then, you know, some other things we've learned is, is emphasizing autonomy, even with young people. I mean, the parents are going to respond to where they're going to respond. But, you know, we inherently believe that the kids who are good kids and I don't mean that in a moral way, I just mean that that deep inside they have a compass and and they know what is right for them, and they can tune into their own values and, and our job is to kind of highlight that and so over the past five or six years we've been training all our staff in a kind of therapy called Motivational Interviewing. It's a it's a way of kind of positively getting young people to resolve ambivalence, like if they're on the fence about something, and it empowers them, and it makes them feel like they're making choices. And it also just harkens on there. Or it just asked them to look at their own values. And then and then ask them to choose if they want to follow their own wisdom or not, or their own advice for themselves. And it's such a such a great way to just do therapy and engage with young people with everything they have on their plates now.
36:27
So for example, you know, you might have a young person who says, you know, I'm going to I'm going to stop smoking heroin, I'm going to continue to drink alcohol and in the past, you know, way, way back when you know, people will be like, Well, let me tell you about everything that's bad about alcohol. And now what we say is why do you want to stop using heroin? And and the conversation takes such a shift. So instead of harping on the on the negatives, you you you capitalize on their change, talk like why did they want to change? And then they may come to find out later Well, you know what, if I'm going to stop using heroin, I might as well just be completely So we're and I can't tell you how many times that happens where the initial conversation is, no, I'm going to hang on to this, I'm going to make this minimal change. And instead of like, Oh, you know, you should change something else. I'm just like, hey, why do you want to make that change? And then they spout all these reasons, and they come back next time, and they're like, you know, what? I've decided, you know, for the next six months, I'm just kind of stay off of everything. And it's just these are changes they make because they're listening to themselves. So that's been the other really big, you know, thing, that it's been a shift culturally that we've made in the past decade that I think has been really promising.
Brenda 37:31
That is, and I and I've seen that in health coaching. We use motivational interviewing a lot, and it's really surprising sometimes to hear, like you said, people will say things that just shock you like, Oh, that's okay. That's what you want to do, or that's what you want to try. And for parents, you know, if they're not, if they're not really trained in motivational interviewing, is that something? Are there questions that they might ask their kids that would sort of get it that to help them see Or think about things differently. Is that a skill that a parent could use? If they're if they know their kids using and they're not able to get them into treatment yet? Are there questions that they could ask the sort of, like, help them along that path?
Dr. Lee 38:14
Yeah, so on an individual level, we do a lot of motivational interviewing. And then, of course, on the family level, we use a multitude of resources, but one of them we rely on a lot is a is a therapy called CRAFT. It's a Community Reinforcement and Family Training. And it's designed actually to get people loved ones to help without intervention, you know, what I mean, as a substitute for intervention to get them in to help in a positive way, reinforcing the behaviors that you like, you know, catching people doing something, right, so to speak in it. And there are a lot of procedures and skills, you got to learn it as a parent, but you don't have to be a motivational interviewing expert. And so increasingly, our family program which is really our strength, it's one of our strings and unfortunately, that's had to go virtual to reduce infection risks but we teach parents a lot of skills around communication and how do you reinforce positives and if you have to hold boundaries How do you do it? How do you think through it? How do you know that the why behind it is correct. You know, we also you know, have the parents will get their own happiness, you know, kind of what what how they're doing in their own lives. We have a lot of parents who can't go to the movies because they're worrying about hearing what their kid every day and so there's a lot of things that families need support on. And so so, you know, I have in in workshops, taught parents some listening skills for motivational interviewing, and they get a crack out of it, but they probably use it more on their significant others. But they find it very interesting and and so we do teach those listening skills. But there there are other kind of family based therapies that we we base a lot of our skill training off of, and that's also been very helpful and so that that avoids these, you know, tough love unnecessary kind of tough love situations where parents can set expectations and they know why they're doing it. Sometimes there are safety issues in the home, you know, like they might have young children in the home or, you know, there may have been domestic violence or all kinds of things, but we help them work through those things, and it empowers parents as well. And the good news about that is all the research says that parents being involved in treatment is is such a blessing. It does make a difference in terms of outcomes. Absolutely.
Brenda 40:28
I was gonna ask about that. Because you see the kids, but you also see the parents and it's so crazy when you have a child who's either using or even when they're in treatment, there's just still a lot of anxiety and and you've talked to about, I think, in your book, sort of this idea of being connected and having peace of mind. Because I think as a parent when you have a child like this, if you know the thought of being happy is just sort of ludicrous at times. Cuz you're like, how am I going to be happy my kids out shooting up heroin? But is that is it even possible for, for parents to sort of feel either a peace of mind? Or how do you kind of get to a place where you can survive each day and get through your life when your kid is, is doing this and when they're at risk?
Dr. Lee 41:20
Yeah, there's a thing that parents are given called a happiness scale where they rate their life. And it's a generic kind of happiness. But you're right, in my book, I am skeptical about our use of the word happiness. What it even means how, how flighty and temporary it is at times. And, and so I do ask parents to think more about peace of mind and what that means is, you know, one, reducing some errors we all make when we're very emotional. And and we were human beings and being empathic with ourselves and we can be human beings. We're not supposed to be Buddha or Gandhi. And so when we lose our cool though, with our children, because they've done something to, you know, they've stolen from us or, you know, I mean they've gotten in trouble or at legal issues, having them, you know, go through those motions and a more objective mindful way.
42:14
And then, and then secondly, coming out of that, and thinking about the longer term connection. And when parents have peace of mind, it's not that there isn't stress in their life. It's not that the young person is sober, maybe their continued to use, but they're very lined up as much as they can be. And no one's perfect, is they're very lined up with their intentionality. They know why they're doing it. They're purposeful in why they're doing it. And that gives them peace of mind and the parents who aren't able to do that. And there's a lot of grace, you know, for me too, I make mistakes every day as a parent. You know, they're, they're kind of on a what I call a pendulum, they swing back and forth, you know, going from one emotional extreme to another. And we want parents to kind of stay in that middle so that so that when they have to make tough decisions, Or if they have to have positive but difficult conversations that they feel good about it though not eaten with guilt and shame and, and anger, you know, so that they speak from the middle. And that also helps their loved one. And it's very consistent with, you know, the philosophy of staying positive as much as possible.
Brenda 43:17
Right. I think that's really good to point out that saying that somebody has peace of mind doesn't mean that everything is fine and nothing's going wrong, because things will happen and go wrong. But if you at least are you know why you're doing what you're doing. And that idea of a pendulum is really good, just sort of a visualization, at least for me to realize that you're not at one extreme, you know, yelling and screaming and having a lot of drama, because I know that goes on a lot in families. Or you're not burying your head in the sand and ignoring it and pretending like it's hoping it's gonna go away, but you're somewhere in the middle and that you're purposeful about being in the middle there and I think that that would help a lot of people. To realize if so peace of mind might just be I know I'm making this decision, you know, whether it's the right decision or not, at least I've made a decision because you're just never sure. You know, if you're doing the right thing.
Dr. Lee 44:13
That's right. I mean, I think peace of mind, part of it is mindfulness. Part of it is resiliency. And I think in psychological jargon, but you know, things can really be hitting the fan, and you can have peace of mind, and it doesn't mean you're calm all the time. And it certainly doesn't mean you're going to feel happy, maybe in any of those moments. But it's kind of knowing that if you have to do it over and over again, you'd probably make the same decisions. And you'd probably tell empathically someone else in your shoes to do the same thing. And, and that's very consistent with how we how we teach the kids to listen to their own wisdom as well.
Brenda 44:45
Right, and it probably helps kids. I mean, obviously it would help kids to have parents who are trying to be a little bit more stable in the middle. I know I spent a lot of years when my son was first, actively using at the high extreme of the online In the screaming, even though it didn't work, you don't really know what else to do. But for for the kid to see their parent have some consistency would would I imagine be pretty helpful?
Dr. Lee 45:13
Yeah, definitely. I mean, in just your presence and, and again, nobody's perfect, we're all going to lose our cool world's gonna get emotional because this is a very difficult situation for people to be in. So the threshold for getting there is not any kind of perfection, it's just an effort to stay mindful of that path. And the more we do that, you know, the less obstacles There are so that if if their loved one gets into trouble, it becomes a genuine conversation about hey, this has happened, would you like to get help, as opposed to it becoming, you know, derailed because there was an angry conversation or there was some blame or judgment in the conversation and now it's about that instead of the use and, and those things are not only horribly distracting, they're, they're exhausting for for parents, and they don't make them feel good about themselves, you know, and so a lot of what I do in my work with parents just comes off a very simple truth, which is, anytime something happens with our kids, the the deep secret thought that we have, and sometimes it's on the surface is what did we do wrong? And, and as parents, and we think that is just a given. And because of that parents need skills, because we are not objective at all with our kids, we love them and we feel overly responsible for lots of things in their life and the instincts and the sentiment is probably correct. But when something like addiction happens, how we manifest those instincts, sometimes becomes counterproductive. And it takes skills training to, to reverse that.
Brenda 46:46
It's so true. Yeah, you if you have one of these kids, you just have a lot of learning to do. That's all I can say is, there's just a lot of learning to do. But that all makes so much sense and I'd love to know just from your point of view and with with everything that you do and all the families you work with, if if we could give you a billboard in downtown Center City, Minnesota, that you could have to say anything to parents, what would you put on the billboards?
Dr. Lee 47:14
Ah, gosh, I you know, I've never thought about this. And I tend to be an introvert. So I would probably never put up a billboard. I actually tend, you know, so the irony is I do a lot of PR for the organization, but I do it in my mind for peace of mind, out of the spirit of advocacy, I always do it for advocacy. Like I'm always in my mind. I'm always thinking I'm doing this news broadcasts are going to do this TV thing because I'm going to speak for people who don't have a voice. That's how I was always thinking about it, because if it's me, I'm just not going to I'd rather just be at home. And so I don't know what I put on a billboard, but I think it would be something something empathetic and something understanding, you know, but without promising Rainbows, you know? No, and I think it would just you know, I would say just, I would just say there's hope for you and, and we'll meet you where you're at. And it's just kind of an empathic. Hey, you know, if you're willing to have a conversation, let's talk you don't have to be on board with being sober. Let's just have a conversation. And sometimes that's the on ramp for people.
Brenda 48:20
That's amazing. Well, this is been incredible. I feel like we could probably talk for three hours about all this but this is such a great such a great message for parents in particular, I think to have hope and to know that there's so much help out there available and that just gaining a few skills can help them in dealing with with really a difficult situation.
What do you love most about what you do?
Dr. Lee 48:48
For me, like everything is connected. I think that the the work I do is how we try to help young people think how we try to help families get together. What I think in value, how it nourishes my own life, my own spirituality and faith, all of it is just kind of connected for me. And that's just very humbling. And it gives me a lot of gratitude in life. It's also a very stressful thing. So let me you know, not not discount that. It's it is it is stressful, but it's, but there's just a lot of love in it. And I think that that's something that I just feel so blessed to be a part of. I teach young people and in our organization, there's kind of a three stage process of thinking through things in recovery outside of not using substances of course, you know, I tend to emphasize humility first. You know, it's not take ourselves so seriously. It's not thinking less of ourselves, but thinking less. We're spending less time thinking of ourselves. I think I'm butchering that quote. But you know, once you started to place in humility, which is which is hard because in a capitalistic society, people want you to be authentic. visual and they want your Instagram background page to be different than someone else's.
50:03
So we live in a society where we're differentiate unnecessary differentiation that means nothing, right Instagram photo of the ramen noodles I ate at this cafeteria, like, who cares, you know. And so this, so this differentiation that happens that's artificial and unnecessary, it takes us away from humility. And so I think a grounding spot is instead of having a lot of shame that kids come in, they made mistakes, they feel really horrible about themselves. It's just to be humble, is to just not take ourselves too seriously. It's okay, you know, you're like other people, we're all kind of broken together. And that humility then allows for people to be empathetic towards each other because you can't walk in someone else's shoes if you're not the same if you think you're better than them if you think and so to start with that spirit first, and then once he will emphasize a lot, and they're humble, and then they're empathetic, and then they, I think, can experience and pass on what I call grace and it's it's a term that's been around forever. For me. It's it's informed by my faith, but even in a secular way, it basically just means getting breaks that you don't deserve, getting forgiveness that you don't deserve. And there's something about our human psychology that finds grace, incredibly powerful, and it's transformative.
51:15
And so what happens when you walk in other people's shoes through empathy, you recognize, hey, we all need second chances. We all need mistakes all of us I do. The patients I see the families I see. And that were sustained by grace we give each other breaks, we give each other love when there should be punishment or justice or whatever. And and that's what changes people. That's what wins hearts. And so we tried to lead our organization that way. We tried to work with parents that way we try to work with our patients that way. And in that kind of circle, my life has been very rewarded. And so it's still a journey for me. But yeah, I just feel so incredibly blessed to be a part a very, very small part of other people's recovery. I really feel blessed when people like you who've been empowered by your own story. are advocating and I can share a platform with you to help other people.
Brenda 52:05
Thank you. It's so great. And it's great for parents to know that their kids can benefit from people like you and from this community who really does want to show them that grace and has empathy with them that we're, you know, not judging them. They just have a different problem than other people, you know, their problem looks different than somebody who over eats or somebody who, you know, over shops. And so, I love that what you say about, you know, just really having the humility to say we all have our stuff we all have to deal with. You know, if the kids using heroin that's obviously more dangerous and life threatening maybe than a shopping problem, but it's still it's still just a problem that we can work with. So that's really important. So thank you so much. I can't even explain how great this has been for our parents to Listen in. And I would love to talk with you again sometime when we when we have the ability and dive a little bit deeper into some questions, but just thank you for being on today.
Dr. Lee 53:11
Yeah, it's been a pleasure. I'm happy to join you again and really glad people listen to this and and, you know, hopefully it gives him some comfort and and some guidance and so yeah, thanks again for having me.
Brenda 53:24
Absolutely. I'm so grateful to Dr. Lee for spending the time with me and they do want to have him back on the show because he has so much valuable insight from the young people that he's worked with. So look for a future episode with more from Dr. Lee. And if you have 30 extra seconds in your day right now, I would so appreciate it if you would just go to the home screen for the home screen podcast on wherever you listen to your podcasts and rate and review it that helps more families find This information.
And if you are a mom who's looking for some support, if you've got a kid who is either in treatment in some sort of program, or maybe they're not there yet, but they need to be, please check out The Stream, which is our online community for moms. You can find that at my website, BrendaZane.com. And from that site, you can also grab my free ebook that I wrote called HINDSIGHT, 3 Things I Wish I Knew When My Son Was Addicted to Drugs, so you might gain some valuable information from that. Thanks for listening and we'll meet you back here next week.