What we’ve said about Substance use disorders

“it's like a boat with a gigantic hole in it that you're trying to fill”

“If you use a chemical defense, essentially, like in place of a psychological defense, you use exogenous chemicals in a manner where you're trying to rescue yourself from something or push yourself to some limit, that's a downward spiral”

“please consider what kind of substances, herbs, supplements, natural remedies, energy drinks, caffeine, medical conditions, other psychiatric conditions. Like I mentioned, the eating disorders, if you're not eating correctly, you're not going to be able to function correctly”

“So substances and then sleep. You figure out your whole life. Has there ever been a time where you weren't not yourself, et cetera, et cetera. Sleep disruption, decreased sleep with preserved or increased activity”

“you can't just assume that person doesn't have bipolar disorder, but you also can't assume that they do. So you'll have to really try to nail down periods where they were clearly sober from problematic substances that could likely trigger bipolar type disorder episodes”

“similarly, substances and trauma, you would hear about a more stepwise down of functioning and attention at an identifiable time”

“it is unfortunately the case that, at least up until recently, Most people don't use a lot of drugs regularly from a younger age, and I would actually say that that behavior is often indicated of problems with regulation of emotional experience”

“It's very hard to have that maintained in a person and have total absence of personality pathology because in a way it's just wrapped up. People who have good self-direction and emotional regulation, they find other ways of coping that are a little bit more productive”

“What makes people dangerous from a mental health standpoint? The number one thing is drug use. And I don't care if he's not interested in rehab. Do I really know that he's had enough time sober to actually reflect on what has happened to him and what the appropriate treatment is”

“What are the main risk factors for interpersonal violence? It's substance use and what I like to generally refer to as the criminal personality”

“Especially you see in a lot of the AA programs, mindfulness is a huge part of treatment for substance use disorder”

“oftentimes in therapy or change, there's things get worse before they get better. Because there's a period where now you don't have your coping skill and you You have to face all those things. And it takes a period of destabilization to rebuild something new”

“If your past relationships are all with people who habitually use substances, there is a huge risk in engaging in that kind of relationship again, unfortunately”

“I try to take a non... authoritative stance and that like, I'm not wagging my finger and saying this is, I don't have a moral problem with you going and doing these things. But you're saying you have a problem and I can see the problem”