Westword: Why did you choose to focus your career on addiction?
Dr. Drew Pinsky: I didn't decide -- it just sort of happened to me as I moved through my career. I'm an internist. I was doing general medicine and during residency, I moonlighted at a psychiatric hospital and became very interested in the medical care of psychiatric patients. A lot of the medical problems were down in the drug unit and all of a sudden I was seeing lots of drug addicts and alcoholics. There was a guy then who had made a really critical discipline out of drug withdrawal, and that was fascinating to me because I was training at a county hospital at the time and the way we got (patients) off the drugs was very haphazard and really there was no systematic approach.
I got good at it and then I got to see lots of addicts and alcoholics, and then I saw young people go from dying to better than they ever knew they could be -- and that was amazing. So I became interested in what was happening in those rooms with those twelve steps on the wall and I started realizing as I was drifting into this that it was becoming a massive problem in our country. So I always had a tendency to move into what I thought was the medical problem of our time.
What prompted me to be on the radio in the first place was HIV, which at the time we were calling "GRID" (gay-related immunodeficiency.) We didn't have HIV -- we hadn't identified the causative agent yet. But I knew it was a big problem and no one was talking to young people about it so I just thought I should do that. The addiction treatment was a similar impulse -- like, this is a big problem and I wanted to get rid of that.
It is interesting with something like drug abuse is that it seems to have trends or comebacks based on the particular drug -- but drug abuse is always there.
There is a rise right now because of the pill addiction and people getting cut off from their pills and no one is then treating them, so they are turning to the streets. That's where the heroin increase is coming right now. Back then, there was an increase in drug use and it was becoming a massive problem. There was now an approach to it and it was being managed, but it became huge.
What is the biggest misconception about addiction for people who aren't addicts themselves?
That it's some sort of choice and that they have control over what they're using. It fits in with the umbrella of misconceptions about brain disorders generally -- we just don't like, particularly in this country, the notion that conditions of our brain can effect our judgment, our thinking and our free will. We want to blame people who have brain disorders -- they should somehow be able to magically rise above it. It's a profound misconception. Usually when I give lectures on this, people will come to understand that it's a brain disorder and they kind of grab around that. Or you can show them the science and then they'll go, well, why would someone drink in the first place? That's a more complicated issue, which is the new problem of our time, which is childhood trauma. Childhood trauma is really what puts the rocket fuel behind addiction.
You're coming to Colorado and you've been here before...
Oh, and let me gush about that for a second. Since I was there two years ago, I have referred to Arapahoe House a number of times, both personally/clinically and in the media. I am going to tell you something -- that is an unbelievable place. When I was there last time, I was surprised by the depth of support from the community that they got and how autonomous they were in their ability to provide resources to patients. I have not been disappointed. It is an amazing place and it is such a privilege to speak on their behalf.
As a recovering alcoholic, I write a lot about addiction. That's how I came to find out that Arapahoe House even existed.
How did you come to write about addiction? Because you are seeing it from the inside?
Did you go through twelve steps?
No, not me personally. But I have close friends who have and it has been very successful.
The Twelve-Step program is under attack right now -- if you have a bad-enough addiction that you need to see someone like me, and I don't know how bad your alcoholism got, but I know that my patients don't get better without Twelve-Step. The reason is -- aside from the fact that it works -- there is a really important part when you're really in addiction, which is that you need 24-hour, seven-day-a-week supervision. You need to be sat on for months and you need to be sat on by someone who really understands the distortion, the BS, the emotional component. All of the elements that go into being an addict in early recovery, you really have to be watched by someone very insightful into your condition.
There's just not enough money on the earth to put enough professionals together to do that. There's no place that insurance companies will cover that. People in the Twelve-Step program who have been through this and value what it has done for them -- and by the way, are kept sober by virtue of being of service to other people in this condition. They are happy to do it; their own recovery depends on doing it for other people. It is something that you just can't find any other way for people who are way, way down the road with this condition.
You make an great point, which is that something like Twelve-Step isn't covered by insurance or even given as an option. People who use the program have to find it themselves, which is often the hardest part for addicts.
How did you get sober?
I decided to stop drinking because I woke up one day and had an injury that was still bleeding and I didn't remember how it happened. I was in a safe, supported space and sort of found my way out from there. I just stopped.
See, there is such a thing as that. I mean people will deny that you can just "stop" drinking. It's actually called natural recovery. But at certain stages, you can't; my patients can't. You would not have made it to me. We would worry,though, about you having a relapse. And what I would encourage you to do is to get a therapist. You should work with somebody who can really watch you and see how your thinking goes and see what issues are unregulated and what is reactivating you back to your next drink.
I have actually gone to a couple therapists and didn't like them.
You must have been raised in an alcoholic family and those traumas have to be processed or they are a constant problem.