Opioid abuse has been very well covered in the media. Here on The Missing Conversation Robert and Dave will look at the other sides of opioid and medication use. Carefully dispensed and given to a properly screened patient who requires it for better health can be a life-changing solution. The reality is, that the longer we live, the more inevitable it becomes that we will need to introduce potent medications, which may include controlled substances, in our routines. If we can learn to cautiously view these substances as a major ally, our chance of having a long-term quality of life is vastly expanded.
Robert and Dave spend the second episode on the topic of medication reform, asking you to inquire into your own patterns. What is your medication personality type? Whether you have an addictive personality type, are medication-phobic, are an obsessed researcher, or are balanced, Robert will help move away from black-and-white thinking. Find a more balanced approach to advocate for yourself and the ones you love with more confidence and perspective. Optimize what will be best to ingest with the partnership of your well-chosen and trusted medical professionals.
Mentioned in this episode
Dopesick (TV miniseries)
The Global Bridge Foundation
Note: Below, you’ll find timecodes for specific sections of the podcast. To get the most value out of the podcast, I encourage you to listen to the complete episode. However, there are times when you want to skip ahead or repeat a particular section. By clicking on the timecode, you’ll be able to jump to that specific section of the podcast
The Missing Conversation, Episode 79.
On this podcast, we will propose critical new strategies to address world issues, including homelessness, immigration, amongst several others, and making a connection to how our individual psychology contributes and can help transform the dangers that we face. We will break from traditional thinking, as we look at our challenges from a freer and more independent point of view, your host Robert Strock has had 45 years of experience as a psychotherapist, author, and humanitarian, and has developed a unique approach to communication, contemplation, and inquiry born from working on his own challenges.
Robert Strock (00:43):
Glad to have you with us again at The Missing Conversation where we do our very best to address the most pressing issues that the world’s facing today, and where we look for the most practical and inspiring programs, innovative ideas and people to support survival on our planet. As we talk about the balanced use of medication, it’s critically important to understand that there are significant dangers on both ends of the spectrum being either too loose or too restrictive. Before prescribing medication, doctors need to exercise great care in determining if a person has an addictive personality and therefore may risk severe danger from being offered this prescription. Like many of us saw in the TV miniseries, Dopesick. In these articles, we’re focusing on the people who cannot access the medications they need for issues such as insomnia or severe pain because doctors are reacting too conservatively.
The side that has to do with saving lives and dealing with the abuse of opioids is very well covered in the media. In The Missing Conversation, we discuss issues that are often overlooked and not discussed. In this case, the other side of the opioid use is what we’re addressing here. It isn’t often that we’re asked to be able to hold both extremes together and see the serious problems on both ends, but that’s exactly what we must do to explore the opioid issue. Medication when carefully dispensed and given to a properly screened patient who requires it for better health can be a life-changing solution. We need to think for ourselves to support our doctors to support us. Please note that all content and media on The Missing Conversation is created and published online in our podcast for informational purposes only. It should not be used for diagnosing or treating a health problem or disease.
If you’re seeking medical advice, you should consult with a licensed physician or other qualified health provider regarding a medical condition. Today we’re really gonna be zeroing in on how we can have our best relationship to medications at our times of greatest need, where we’re suffering from chronic pain or long-term sleeplessness, and face the reality that this will inevitably grow more and more if we are fortunate enough to live a longer life. In other words, we’re all gonna face hard times, and if we view, even controlled substances as a major ally, our chance of having a long-term quality of life is vastly expanded. When we face ongoing pain, sleeplessness, there are potential solutions that will inevitably change our quality of life immensely, if we can learn how to be balanced. This is what we’re going to explore, which is making our best efforts to be open to experiment, and I do mean experiment at this time of great need and recognizing that while we’re experimenting, we’re using our wisdom. It’s not only our intelligence, this is wisdom to follow the parameters of safety from the medical profession and not go to either extremes of addiction or trying to go cold turkey without the help from these invaluable medications that have this capacity to change our very experience of life. I’d like to start off by introducing Dave, my partner at The Global Bridge Foundation and dearest friend for over 50 years.
Robert. Thank you. And uh, as we start, I would encourage people to listen to the first podcast. I think it’s all important connectivity and I, I would strongly encourage that.
Robert Strock (05:18):
We’re gonna spend, perhaps this whole episode on asking you to inquire into your own pattern, as it relates to medication and whether you’re resistant, whether you are an abuser or perhaps whether you think you’re perfectly balanced. And of course you notice that I’m saying think you’re perfectly balanced. You may be or you may not be. In my experience, there’s a very high percentage of people in my practice, extended friendships, friends of friends, family members, their family members that are actually, what I would call phobic. And by phobic I mean they’re afraid of taking medications. Have you heard me talk about the commercials on TV? That would be enough to scare anyone, pardon the expression, shitless. If you say, oh, okay, I’m gonna take this thing to help arthritis, but it may kill my heart, may kill my lungs, may kill, may kill my kidneys. That you hear all of these protections from the pharmacies that would turn enough to make anyone be very afraid or phobic.
And so part of what we’re gonna explore is phobic is one of the three categories that you and all of us have attitude toward the idea of taking, not only controlled substances, but any kind of medications, ingesting anything. And I personally know, and Dave personally knows, many people that are hardcore saying, I don’t wanna mess with medications. If I do that, I know I’m gonna be on an endless trail of being addicted and I don’t wanna even risk that. And they are actually in a state of misery and they believe they’re right. They believe they’re balanced, they believe they’re smarter because you know what, I love my body and I wanna protect my body, I don’t wanna ingest any pills. I’m doing fine. Thank you very much. Now as we would look at some of these people’s lives, we might, may see that you know what, they’re actually profoundly depressed or they’re constantly wincing.
Or when they’re driving in the backseat of a car, they’re having a startle reflex every minute going, ha ha ha ha. Because they’re afraid that the car’s gonna hit the car in front of them and they’re suffering from anxiety. No problem. They think that’s fine. Take it something that would help them with the anxiety, no way, no way. I’m not gonna do that. I’m pure. I know what’s good for my body. There are a lot of you, if you look closely, that this category would relate to. I hope you’ll take the time during this episode, in particular, but way beyond this episode, for the rest of your life, to look at your attitude and see with the information that’s being provided here, are you really finding that sweet middle? And are you finding a doctor or a close friend with a doctor that is in accord with your understanding and is going to optimize what is going to be best to ingest, so that you can have a quality of life that will be like singing your favorite song?
I know at this point we’re not going to spend a lot of time here, but I want to acknowledge that these issues that we’ve been mostly talking about, pain, anxiety, psychological issues, sleep, are very overt issues. Some issues in my life I haven’t discovered, until I went for my physical feeling perfectly healthy and got a lab result and found out that I was a pre-diabetic, and I didn’t feel it. There’s nothing that told me I had that. And I was a phobic for sure, a hundred percent. I was told I needed to take a medication because of the potential downstream consequences of not addressing that issue. And totally invisible to me. And there are lots of things that are invisible that don’t impact us overtly.
Robert Strock (09:59):
Thank you for that personal example, and it makes me think of another one. I have a very dear man who earlier in my life I considered to be a teacher of mine and he found out in a lab test that he was pre-diabetic on the verge of being diabetic, much more severe than you. And he was convinced that through a alternative machine that was just shaking his body, not even an exercise machine, that he was gonna be able to cure it. Then went to Germany and attempted to try to use their machines that were all alternative, that were light rays and, and, and different sounds that were gonna be hitting his chakras in the right way that was gonna heal him. And he has been a chronically unwatched diabetic for now eight years. In the middle of all this, he got another test. He then was told that he had a heart disease and that he needed to be given a medication to control his blood pressure cuz he also had high blood pressure.
Now I asked him, are you taking a beta blocker? Because some people when they take beta blockers will be depressed. And he said, I don’t know. I don’t know. And he reported to a mutual friend that was seeing him as a teacher that he felt like he was dying. And I asked through this friend, would you check out and see if he’s on a beta blocker? Because his feeling like he’s dying might be because his heartbeat is so slow now he feels depressed and dead. Cuz I had experienced that for three hours and I went off it immediately cuz I couldn’t tolerate. Now not everybody is like that. If you’re on a beta blocker and happy more power to you, it’s the best medication you can use for slowing down the heart rate and controlling blood pressure. But it also has these side effects we need to be attentive to.
And sure enough, two years later, six years ago he discovered he was on a beta blocker, went off the beta blocker, he’s no longer dying. So it’s so important that you recognize how many stories there are, where if you have this prejudice, it can lead to you feeling like you’re dying when you’re not dying. It can lead to you killing yourself when you don’t need to die. It can lead to you being in pain for the rest of your life when you don’t need to be in pain. I don’t know how much more passionate I could be about the importance of educating yourself in this area that none of us are taught. Even doctors are not taught thoroughly about the importance of this level of investigation, even though there are certainly many that have done their own educating.
Part of what you’re bringing up here is there’s so many elements and facets to looking after yourself and being attentive and attending to things that you either observe or are called out in tests that you may not be aware of because they don’t manifest in an overt symptom. And it’s the, this balance of taking care of yourself at the same time, not being a hypochondriac or obsessive about all the different kinds of symptoms and surveilling the horizon for every little thing that might come up, which I’ve had both extremes of that in my life. And right now I am coming out of the, what I would call extreme of surveilling for issues of those I love and myself, attending to them, but at the same time not feeling terrific emotionally because I’m spending time emotionally in my thought process and in my research online of how to attend to things that are unnecessary. Now I’ve done a good job stopping a lot of that, but I’m working on that as you know.
Robert Strock (14:11):
<laugh>. So we’re going to, we’re going to call this the Dave extra category. We’re going to make a whole extra category for you than what I was planning on doing. And we’re gonna call it the obsessive, you know, where, where you can become obsessed with the details and you can interpret, oh, well I’m not, I’m, in the normal range or, or I’m writing the edge of normal range and I’m uncomfortable with it. I’m gonna go on the Internet and I’m gonna look at six articles if I’m this close. And yes, you are reforming. But there are people that are worth mentioning. And if you are one of those people, then it is important that you maybe get a therapist to support you, maybe get a friend to support you that says, you know what, don’t spend a lot of time on the Internet looking up all these things. And especially on non-medical qualified sites, be careful that you’re not obsessive. You wanna try to do this in a way where you can find a good doctor, rely on your good doctor. If you’re a good researcher, do research but look at that fine line between being a good researcher and being a good researcher times six, and look at whether or not you’re obsessive. So I will add the obsessive personality type to our list in your honor.
I appreciate being on it as opposed to being the label of it. Thank you.
Robert Strock (15:37):
So the first type of personality with the asterisk, for the category before, is the easiest one for all of us to clearly see, which is the addictive personality type. I believe that virtually all of us have been exposed to this pattern with a friend of a friend or a family member or a family member’s family member or a grandparent. It’s frequently in our extended family somewhere that somebody is addicted to something. And these are individuals that have been in alcohol treatment or should have been or have used excessive drugs or they put themselves in life-threatening situations because of overdoses. There are also a number of other addictive personality types that are a bit under the radar, as they’ve, they’ve used more than the suggested amount of pills that the doctor has prescribed and have a hard time staying within the limits of sensible chemistry. Now they are not addictive-addictive, in the way I’m saying, but they have addictive tendencies.
So it’s important to see, as you’re looking at this, not only are you a classic addict or have real addictive tendencies, do you have even small addictive tendencies? Because if you do, you’re gonna need to be even more cautious and you’re gonna need to let your doctor know, or your psychiatrist or psycho-pharmacology or pain doctor know. And so they can keep a closer eye. Now if somebody has an overreaction to that and goes, oh my god, that means I can’t treat you, then you’re not with the right doctor because if you’re exposing that, then you’re showing signs that you at least have a witness and you’re honest about it. So you should get some points for your honesty and that means you have another part of you that’s looking at it. Now if you’re that person and you don’t wanna expose it and you’re running away from it, this is a time to see, no, I do have to be extra careful.
Can you address one other element of what I would call a healthy relationship to medications that may be needed, but our medications have elements that are physically addictive that do lose potency unless you can increase the amount you take and how to contend with that and distinguish that or talk about that in the context of addiction or an addictive type of relationship to medication.
Robert Strock (18:18):
This is absolutely a crucial element to be aware of. If you’re using a variety of medications that are known to be addictive, then they’re monitored by the doctor for short-term use. And so if you’re using an opioid for example, it’s well known that you can’t use that every day for long period of time or you’re gonna have to use it more. And a certain amount more is well within the normal range. But it’s also really well understood that a certain increased level of an opioid used for a certain period of time, that’s the end. It’s over. And you need to recognize that when you are using an opioid or you’re using an addictive drug, that means not that the drug itself is addictive, it means that if you have to use it over a period of time and a period of dosage, you can’t use that drug anymore, you have to find another way of taking care of yourself.
You either you need to find another medication that you can stay within the prescribed dose or you need to find a way of dealing with a medical procedure in your body or you need to, if there’s no other choice, you are going to have to suffer with that condition because medicine has not evolved enough to cover all conditions. So absolutely it’s important to recognize when you are using a drug that is addictive, it does not mean it’s addictive in itself, it means the combination of quantity, of how much you’re using, and length of time you’re using it is the warning sign that is the addiction, not the drug itself. So it’s very, very important point. The second group is a lot more subtle than the addictive group and needs more attention from the medical profession to observe, and by you and most of us, if you’re in this large group.
Now, I would say somewhere close to half the population is in this group. There is a very good chance you are in this group and they would be, what we were talking about earlier, would be accurately referred to as phobic. Now phobic doesn’t mean you’re phobic in general. It means that you’re phobic in relation to using medications. Now there happen to be a lot of people that are in the spiritual worlds, in the religious worlds, that are phobic. They feel like they’re purists and they can solve everything like Dave and I were when we were very naive and very young. Love could conquer all, meditation, could conquer all, prayer could conquer all, have faith in God, and God will take care of, whatever’s meant to be, is meant to be. There are all those kinds of rationalizations that don’t take into consideration that we can use medication to support God, to support us, or to support meditation or prayer to support us.
And it’s utterly consistent. The phobic person, regarding medications, has heard enough about the addictive tendencies of others or the side effects of others that they’ve exaggerated in their minds and have decided, perhaps at 18 or 25 or 28 or younger in life, I’m not gonna be like my addict grandmother or my addict father. I’m not gonna have anything to do with pills. And they think they’re smart, they think they’re balanced, but actually they’re a phobic. And because they’re not willing to see that medications are a healing tool when they’re followed in both the purpose of what they’re created for and within the parameters of how long and how much can be taken. When you follow the parameters of a sleeping medication or a pain medication and you have the guidance of the right kind of doctor, it is very similar to a miracle. It’s a chemical miracle.
And as much as there’s been abuse, which there has been enormous abuse in the pharmaceutical industry, they also are creating miracles. So much so that even though we might know that a certain drug might increase dopamine or norepinephrine or something that would be a sweetness to our brain, we don’t really understand why for one person it works like a charm for another person, it doesn’t work at all. The fact that it works and can improve a person that’s suffering from a severe condition to not suffering at all anymore or way less is from my vantage point, no less than a medical miracle. When I say medical miracle, it makes me think of my kidney transplant, another medical miracle. That medicine and chemistry can be a miracle and phobics are not letting in that medicine can be a miracle or it simply can just help. I’m not saying that everything that helps is a miracle.
There also may be a fear of talking to doctors that I’m afraid I get befuddled and I’m afraid I’ll lose what my train of thought. And if that’s true for you, I highly encourage you to write it down, have it well organized, actually maybe even write up the whole thing and present it in a paper to the doctor so you don’t have to talk. Now you may be so tongue-tied, you may also be brain-tied and may not be able to write it either. In which case you will need an advocate. You will need somebody that’s gonna help you with this. This may be a therapist that’s well-informed, which by the way, most therapists are not well-informed in this area. But you may find one that is, or it may be a friend or a family member. I wish I could have a dime for that famous expression.
I don’t believe in using medication unless it’s after surgery or something close to life-threatening or I’d rather just suffer through it. And there’s often a subtle or not-so-subtle pride in saying, I only have taken very little or I don’t need medication. And that pride is hidden from the individual. So if that’s you, I’m asking you, deeply explore if you’re proud that you don’t use medications, if you feel that way, even subtly, there’s a very good chance you, you are a phobic and you will, especially if you’re in a teaching role, you’ll be passing on that phobia to the people that you’re teaching. So you need to be very careful that you are much more of a scientist through trial and error. Are you really experienced? Do you really know? Have you tried the various pills and the prescribed dosages for all the maladies that are happening inside you or people that you know?
So phobia is a contagious psychological issue. So I ask you to really explore, probably the main theme of these three categories is really looking at phobia because that’s the one that will really lead to the biggest changes. Because if you see that you’re a phobic and that leads you to experiment carefully with very intelligent doctors. And if you also are capable of doing some of the research yourself, you’ll realize if I take a safe dose of a sleeping medication or a pain medication with a guidance of a doctor within the timeframe that is allotted, I’m not in danger. And you’ll also see that almost every doctor starts off with the assumption that you are hypersensitive cuz a lot of phobics are also hypersensitive. But it’s important for you to realize that one of the areas that psychiatrists and pain doctors are usually very wise is they’ll start off with a half a dose.
They’ll assume that you’re sensitive. And so it’s good to tell them, but it’s also good for you to be reassured to realize that you’ll be given a half a dose of everything across the board. It doesn’t matter what category it’s in. It would be unusual for a doctor to give you a full dose of something right off the bat. They may very well say, let’s say if it’s a pain medication, try this very small dose, see if it works for you. And if it doesn’t work within two hours, take another one. That might be the case. But be reassured that medical doctors are really very savvy when it comes to starting with a small dose because they know that there are people that are extra sensitive to certain medications and not to others, so they have to assume everybody’s very sensitive. So the last group is one that doesn’t require a lot of elaboration.
It’s balanced. It means that you are committed to utilize medications when you’re in some kind of severe or even moderate discomfort when there’s this a medication that you can safely use according to your much more educated doctor than you. And a lot of people start off phobic and then they become balanced because it’s kind of, seems like it’s balanced, if you don’t need medication to believe you don’t need medication. But when you get older and you face severities, then it’s much more common to realize, okay, in order for me to be balanced, I need to use some medications within the allotted timeframe and the allotted dosages. So my hope and my request to you is that you continue to inquire, am I phobic? And you may be phobic regarding only certain types of medication, or you might be generally phobic. But phobic is almost like a pregnant, balanced person. It’s natural to be cautious, but the caution mustn’t be taken to the severe of permanent phobia. When you take that in, you can then say, okay, I need to trust and find a doctor and shop around until you find a doctor that you believe is balanced, that you can trust and keep educating yourself. And the goal and the priority here is to be a balanced person so you can optimize your quality of life, with the help of the medical profession.
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