Dr. Sarah Wakeman

So if you decide like I want to cut back on how much I'm drinking but I'm going to go to happy hour every night with my friends and just try to like not drink while I'm there, you're probably not going to be very successful because you're going to be in a situation that's constantly like reminding you of alcohol use and everyone around you is using alcohol.

So if you decide like I want to cut back on how much I'm drinking but I'm going to go to happy hour every night with my friends and just try to like not drink while I'm there, you're probably not going to be very successful because you're going to be in a situation that's constantly like reminding you of alcohol use and everyone around you is using alcohol.

So try to make some different sort of structural changes in how you set up your life and your week and your day. And you may find that actually you don't miss it that much, that you could cut out three or four days of drinking and still get that social pleasure two days out of the week, and your overall health risk is going to go down significantly.

So try to make some different sort of structural changes in how you set up your life and your week and your day. And you may find that actually you don't miss it that much, that you could cut out three or four days of drinking and still get that social pleasure two days out of the week, and your overall health risk is going to go down significantly.

Generally, no. So, you know, rehab is this idea that you go away somewhere for a week, a couple weeks, and then you're kind of cured, right? It's almost like people have thought of addiction as an infection where you need like two weeks of antibiotics and then you're done.

Generally, no. So, you know, rehab is this idea that you go away somewhere for a week, a couple weeks, and then you're kind of cured, right? It's almost like people have thought of addiction as an infection where you need like two weeks of antibiotics and then you're done.

What we really understand is that for many people, addiction is more like a chronic illness or even like cancer where you need a lot of treatment up front for the first few years. And then over time, you get into stability and remission and you're almost like a cancer survivor. You're in long-term recovery.

What we really understand is that for many people, addiction is more like a chronic illness or even like cancer where you need a lot of treatment up front for the first few years. And then over time, you get into stability and remission and you're almost like a cancer survivor. You're in long-term recovery.

And so this idea that you go somewhere for a couple weeks and then you come out and you're all better really doesn't match what we know of addiction. The other problem is that much of what happens in rehab is not all that therapeutic most of the time. So the things that we know are most effective for addiction, one are medications, which there's a lot of stigma and misunderstanding about.

And so this idea that you go somewhere for a couple weeks and then you come out and you're all better really doesn't match what we know of addiction. The other problem is that much of what happens in rehab is not all that therapeutic most of the time. So the things that we know are most effective for addiction, one are medications, which there's a lot of stigma and misunderstanding about.

And then two are, like, evidence-based psychotherapies. So things like cognitive behavioral therapy, motivational enhancement therapy. you know, working on your underlying trauma. Often in rehabs, the model is really built around this idea of like you remove yourself from this environment. You do some groups while you're there. Sometimes often they're based on more of like a peer support model.

And then two are, like, evidence-based psychotherapies. So things like cognitive behavioral therapy, motivational enhancement therapy. you know, working on your underlying trauma. Often in rehabs, the model is really built around this idea of like you remove yourself from this environment. You do some groups while you're there. Sometimes often they're based on more of like a peer support model.

Sometimes the therapies that are offered are frankly not very evidence-based. Like we actually did this study. It was a secret shopper study where we called rehab programs across the country to like ask about what they offered. And many of them offer things like, you know, horse therapy or like dolphin assisted therapy, which like I'm sure it's

Sometimes the therapies that are offered are frankly not very evidence-based. Like we actually did this study. It was a secret shopper study where we called rehab programs across the country to like ask about what they offered. And many of them offer things like, you know, horse therapy or like dolphin assisted therapy, which like I'm sure it's

very nice to swim with dolphins and to work with horses, but it's not something that's been studied and effective, and many places don't offer the things that we know are actually effective, which are trained clinicians doing evidence-based treatments or medication treatments. So it's a combination of this short-term fix for a long-term problem

very nice to swim with dolphins and to work with horses, but it's not something that's been studied and effective, and many places don't offer the things that we know are actually effective, which are trained clinicians doing evidence-based treatments or medication treatments. So it's a combination of this short-term fix for a long-term problem

And not actually getting the treatment that you need. So what does work, like for alcohol use disorder, most people don't know we have very effective medications that can help you. Even if you just want to not drink as much. So there's this medication I mentioned at the beginning that actually blocks your opioid receptors.

And not actually getting the treatment that you need. So what does work, like for alcohol use disorder, most people don't know we have very effective medications that can help you. Even if you just want to not drink as much. So there's this medication I mentioned at the beginning that actually blocks your opioid receptors.

Which seems kind of funny that it works on alcohol. But the reason it does is that for people who part of the thing that drives them to drink is that they drink, they feel this like pain relief pleasure sensation from the release of opioids in their brain. And that makes them want to drink more. That if you block that, people don't get sick if they drink, but they just don't find it as rewarding.

Which seems kind of funny that it works on alcohol. But the reason it does is that for people who part of the thing that drives them to drink is that they drink, they feel this like pain relief pleasure sensation from the release of opioids in their brain. And that makes them want to drink more. That if you block that, people don't get sick if they drink, but they just don't find it as rewarding.