there's no one-size-fits-allapproach to achieving a sustained recovery from addictioneveryone develops their addiction for unique biological psychological and social reasons. theharm that addiction causes is specific to each individual too. successful treatment incorporates multiple components targeting particular aspects of theillness and its consequences the first step is abstinence. forsubstance abusers this may involve
medically supervised detoxification to relieve the sometimeslife-threatening physical effects of withdrawal some people in recovery may benefit frommedication that reestablishes normal brain functiondiminishes cravings or treats coexisting mental healthproblems. medication assisted therapies such as methadone, suboxone or vivitrol may be prescribed. mentalhealth therapy is another possible component in a successful recovery plan
and helps with modifying attitudes andbehaviors related to addiction common approaches include cognitivebehavioral therapy motivational interviewing, couples andfamily counseling and working with a recovery coach. peersupport groups can be an invaluable source of guidance assistance and encouragement forindividuals in recovery as well as for family and friendsimpacted by the addiction twelve-step programs like alcoholicsanonymous and its many offshoots are among thebest known peer support options
their approach doesn't work for everyoneand meetings may be geographically inaccessible so alternatives such as smart recovery,moderation management, secular organizations for sobriety andothers have evolved thanks to social media many of them areonline where they afford the added benefits of being available 24/7 allowing participants to remainanonymous the most important thing is to finda support structure that works best for the person inrecovery. to learn more
about recovery options visit theinformation center at blakerecoverycenter.org or carrierclinic.org
hi i'm doctor hackie reitman, welcome to anotherepisode of exploring different brains, we've got a super all star today dr. bankole johnsonfrom the university of maryland one of the worlds fore most authorities on addictionand so much else about the brain. in fact he is part of the whole brain institutedown there and he's going to tell you about at the university of maryland. bankole welcome. welcome and thanks for having me on your show. well thanks a lot. why don't you introduce yourself to our differentbrains audience bankole.
well my name is professor bankole johnsonand i'm the chairman of the department of psychiatry at the university of maryland. most the chairman in a few other departmentslike neurology and pharmacology, most importantly i help coordinate and direct the activityof the brain consortium unit, which brings all we know about brain science to a collectivetable to provide ourselves with the opportunity to develop these moon shot object that i'mgoing to hopefully radicalize treatments and the way we manage people with brain disorders. you know that is such music to my ears becausehere are different brains we're trying to get it all under one roof and everyone exceptfor you is in all these different silos where
you have mental health issues over here anddevelopmental here and neurological issues here and it's all the same stuff. wouldn't you agree with that? it is all the same stuff and i can give youa perfectly good analogy if you'd like to hear one. i would love it. lets say you were walking down the streetsof else where and unfortunately for you somebody punched you in the head. now you might well say when you got punchedin the head and you later became depressed
because somebody punched me in the head obviouslyit upset me because i wasn't very happy about it and i wasn't happy that i got punched inthe first place. but here is the other piece of it. could it be that when you got punched in theface that caused a swelling in your brain, that swelling in your brain changed specificstructures in your brain and it made you depressed and it had nothing to do with your psychologicalreaction to it which could have been a part but the primary issue is because you got punchedin the head. now also when you get punched in the headas you know, you have traumatic brain injury so you also have traumatic brain injury alsoseeded with it.
so the neurological is associated with thepsychological and is also associated with the behavioral and it's all in one brain. brilliantly put, brilliantly put and i willnot take offence that you were describing some of my 26 pro heavy weight fights wherei took a good beating bankole. i think you won some too. it keeps you humble. now bankole you have no idea, this is suchmusic to my ears it's like a kindred spirit where you get it. now why is it? and i'll quote here steve ronik,he happens to be the head of henderson behavioral
systems down here at behavioral health hendersondown here in florida they have 800 employees, they serve 30,000 patients a year, he saidhackie why is it when you go to a cardiologist or an oncologist there is no stigma but ifyou go to a mental health professional there is a stigma attached and we get better results. we get better results and what you're doingthere, it sounds like it may help get rid of the whole stigma to all of this. i couldn't agree with you more and i thinkit dates back to a few hundred years where people tried to separate the mind from thebody as if it were two components of a system that never really talked about another andat least my angle is going to be some higher
order type of cognitive thinking and the bodywas meant to be basically the mechanics and they were not connected so if you're goingto see someone if you have mental health issue people believe that it must be due to thisnebulas concept of a mind and that its some how your responsibility or at least partiallyyour responsibility and it has nothing to do with your body. well we know now that this is completely incorrect. the brain is the most complex organ in theuniverse, it has connections with you heart, it has connections with basically everythingelse and to give your friend the heart analogy we now know that individuals who have heartdisease often also have mental manifestations
of that heart disease and brain stress ordistress in the brain is also associated with cardiac arrest and cardiovascular disease. it's one system. i think some people like to make it simple,but as my professor used to say it can only be as simple as it really is. that's a naturally segway into the gut brainwhere the gut has more neurons than the brain i think and can really affect the neuroplasticity. you know that has been a fascinating journeyand i would say if you went back 30 years ago and you had talked to people and saidwell what's in your gut can influence what's
in your brain, well that doesn't really makesense because the gut has no direct connections with the brain except for some of its largenerves. the real issue here is we now know that theseneurotransmitters in the brain or these micro bio can provide signals in the brain and certainparts of it. these signals are very important. so maybe we're going to go back to believingwhat we did thousands of years ago, i want people to say well it's my gut feeling. well maybe it might be the best feeling youactually have. maybe its good thinking about and one of thefascinating parts of all of this development
so i can bring back to neuroscience is thatit could be possible in the future for us to be able to understand how these gut organismsprovide signaling in the brain and therefore changing aspects of the gut, either throughdiet or medicines or drugs, that we will be able to influence the affects of the brainwith out having to actually having to get into the brain itself. that would be fascinating. it opens up a whole area of even trying tocreate vaccines in the gut that influence brain inflammation processing and signaling,it's unbelievably exciting. well this is a segway into, lets call themlack of a better term, the traditional approaches
to alcohol addiction and the dr. bankole johnsonapproach. well i hope you don't call it just the dr.bankole johnson approach, i hope you call it the evidence-based approach because i hopeit's evidenced based. there are several myths about alcohol andi usually write about 100 of them when i teach my students, but one of the most importantthings is to realize that alcohol abuse disorder and alcohol dependencies are actually farmore biological disorder, about 60% of what makes you become and alcohol is inherited. therefore, that doesn't mean everybody whohad an alcoholic parent becomes an alcoholic, but it does mean there is a huge susceptibilityfactor.
the other thing that is important to knowis that if you have a biological disease that is altering your genes, altering the way youthink, well maybe it's a good idea to have medicine as well, that also works with someof the psychological components to be able to help treat the disease. another thing i will say is psychologicaltreatments are great, they work, very effective, but medicines work really well as well. andyou have to have both. you can't just simply have psychological treatments. that’s like as you would say fighting inthe ring with one hand tied behind your back. or having one hand by your hip.
it's not really effective treatment, the mosteffective treatment combines medicine and psychological treatment. that's very well said and i often tell peopledon’t buy societies big lie that things are mutually exclusive, you don't just haveto do this or that, combine and take the best of all worlds. i was delighted by the way, my daughter rebecca,who is kind of my hero who is now half way through her masters in applied psychology,the text book she is using right now is biopsychology where they get into the actual anatomy andphysiology explaining different behaviors which may be i don't know, maybe 10 , 20 yearsago you never would have found that in a psychology
class at all. well congratulations to her and congratulationsto the course. i think that one of the sad problems thatwe have is what is currently known is to people who are informed in the field. it can take 10 to 15 years before the averagefamily practitioner or average practitioner gets hold of this information and there foresome people do not get the best treatment. not because they're not going to see theirdoctor but because their doctors are not well informed. this goes to a whole aspect of training.
i want to touch on something really very quicklyif i may. sure it is absolutely important if you have analcohol problem or a substance abuse problem to go and see your doctor because we knowfull well have not usually seen their doctor for a tremendous amount of time and they usuallyhave a multitude of physical problems, blood pressure, diabetes, heart disease, and it'sreally one stop. you go to your doctor to look after your wholehealth whether it's alcohol, your heart disease, your blood pressure, your diabetes, and thedoctor is not meant to compartmentalize one and ignore all the other aspects of your diseases.
it's very well said, and i'm learning of allthese new entities and work from different brains and all our bloggers and just peoplei'm meeting from all over the world, i just learned about something i was completely ignorantof, misphonia, where i've never even heard of it. jennifer jo brout was explaining it to mebecause she suffers from it and i started reading about it. these are people who are not just as you knowsensitive to sound but certain sounds like chewing or breathing drive them into a rage. now you can see on the scans that part ofthe brain and i guess it's probably near the
amygdala light up where it's not just thehypersensitivity it's emotion, it's violence, and they’re ready to go. well you know one of the interesting thingsthat we've learned in neurodiversity is and here is another myth that has come that iwould love to dispel for you. that everybody’s brain is the same, everybody’sbrain is not the same, it's not even close. in fact part of the problem, we all processinformation slightly differently, we may all depending on our genetic makeup, develop signalingpathways and response to different types of sensations and there for everybody’s brainis not the same. that's why the path for meds in the futureis this aspect of personalized medicine because
we finally realize that you can't treat everyonethe same and expect to get the same result and that treatments need to be individualizedand we have very powerful tools at the present time for individualizing medical practice. the question is how long is it going to takeus to educate all doctors to be able to do this. well a segway into artificial intelligence,but that's a story for another date, i suppose my daughter when she became one of nine womenthat year to get her discrete mathematics degree from georgia tech she then wanted totutor people like she always has one on one and i said rebecca why don't you want to teachin a classroom why do you want to tutor and
that led to the quote she told me on the coverof my aspertools book which is "every brain is like a snowflake, no two are alike "andshe gets that and i get that and some of the great scientists of the world being led byyou are starting to get that, everything makes more sense. now the university of maryland where you are,thanks to you in no small part, you've created a vision there, tell us the vision and aboutwhat's going on in the neurosciences at the university of maryland. thank you for that, but first of all i reallydo want to give credit and compliment to a lot of my colleagues.
one of the things that makes me lucky is thati'm surrounded by extremely brilliant people who are part of the brain sciences researchand contortion unit. this brings together a lot of the departmentand it's actually was part of the brain child of dean albert reids, brilliant man, and we'resurrounded by brilliant people, so the work we're doing is a collection of work from ateam. one of the over arching things to go withand go into your artificial intelligence piece, i know you may want to do this for anothertime but it's really important. what we're trying to do is understand, letssay you're a doctor and you go and train and want to treat x disease of the brain.
you can open up a textbook and it says youdiagnose x and you do y and z and you do that for everybody with that disease. we also have a tremendous amount of informationabout what actually happens to individual people. now we never apply that to modify the treatmentwe're giving to the individual. so one of the things we're doing is an artificialintelligence project which we try and assimilate information as well as specific informationand treatments about disease as well as outcomes of similar people to modify the treatment. if you like, if you watched hitchhikers guideto the galaxy, we would have our own marvin
robot, and i hope he won't be depressed walkingaround on the unit providing individualized treatment and he might well be that one personneeds a specific medication for 2 days but you need it for 3 days or 4 days. that kind of learning is only possible onan artificial intelligence platform. a human couldn't do it because there is fartoo much information to put at any one time. that always us to develop even more powerfultreatments. there are very important things in neurosciencei would like to know, for example going back to my analogy of someone getting punched inthe head swelling, you know neuroscience really doesn't understand why some people swellingin the brain comes down really quickly while
for some people it's very slow but we knowit's really linked to outcome. so one of the things we're looking to do withour neuroscience initiative in artificial intelligence is to look at all types of braininjury as if there was brain inflammation. now i say that in a very interesting way becausemost people when you say brain inflammation they think about the brain being inflamedor the brain being diseased and that is just a terrible and a bad thing. the interesting thing is certain types ofneruo inflammation seem to be actually good and protective for the brain and there foreit's very important for us to understand how the brain repairs itself, fixes itself, andunderstands itself.
if we can aid that in terms of insoleco modelsor artificial intelligence we are going to develop some very powerful neuroscience toolsfor the future. well i wish we had more time, i know you havea hard out here shortly and i just wanted you to tell all of our audience whether they'rereading this or watching it or taking in the captions or listening to it as a podcast,how do they get ahold of you and learn more about dr. bankole johnson at the universityof maryland everything you have going on there. well one of the things that person can dois either call or email interesting don't ask about my email address because i probablydon't remember it accurately but it can be supplied, but you can go to the universityof maryland website and you can find us out
and ask questions. also there is also a lot of reading materialthat has emulated from the work that we've been doing that you can actually get accessto and these are free. these are open and these are things that areavailable to the general public especially the works that we've done that are fundedby the national institute of health. but i don't want to go off the show with outcomplimenting you harold because one of the things that you're doing with your neurodiversityprojects is absolutely stupendous, i think it's fascinating and i think bringing informationto the public to help the general public understand the brain, how diverse it is and how theymay be able to address specific problems with
the brain, i think it's absolutely marvelousand kudos to you and your team for doing this. thank you so much for the kind words and iapologize that we weren't able to get to so many things today, we're going to save ourquestions for the next session we get together and thank you so much for being with us. dr. bankole johnson from the university ofmaryland. thank you so much. thank you to you and thank you for your showand thank you to your audience that has been listening and also your viewers.
