Dr. Sarah Wakeman
Appearances
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The amount of alcohol it takes to begin to cause health-related problems is much lower than you think. Okay, so if I have this glass of wine every day... You'd be in what we call moderate risk, which is associated with pretty much every form of cancer. So say that I'm drinking... If you're drinking two of those glasses, we're talking like a 40% increase.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Totally. I mean, it makes me think of a patient I saw this week who really wants to stop drinking and is able to go for a few weeks, but his life is pretty empty. Like, he's not working right now. He doesn't have a lot of relationships. So when he's not drinking, he's sitting at home, like, watching TV by himself.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And it doesn't take very long for him to think that, like, you know, the thing that's going to give me relief is having a drink. And so... Then the question becomes less about the molecule of alcohol and more about like, how do we fill up people's lives? How do we form connection and build community and build a sense of identity and purpose and engagement outside of the relief of substance use?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. I think like many people, I had kind of a personal threat. I had a family member who was impacted by addiction who actually died when I was in medical school.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so that was sort of a pivotal moment, I think, that coming at the same time that I was learning all of this science, I was realizing like, wow, I wish I'd known this when I was younger and dealing with family members and friends who were affected by this and that we've gotten it so wrong. And most people don't have the kind of tools and knowledge to do things differently. And so...
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You know, you sort of, there's that saying, when you know better, you do better. And I think I kind of wanted to put out into the world what I wished was there for other people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Mm-hmm.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Probably 24 or so.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yep.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, I think you feel powerless. You feel like you want to do something and you either don't know what to do or feel like everything you've tried hasn't worked. I think, again, because people have been exposed to this idea that it's an issue of willpower or choice, which really implies that if people wanted it bad enough, they could just stop.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so if you're a family member, then that's easy to feel like, oh, they don't love me enough, you know, that they're not choosing me over this substance. And so I think often people feel deeply hurt and they've, you know, been through experiences that have created trauma for themselves. There's a lot of trauma within families who are experiencing this.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then they're sometimes given really bad advice, you know, that you have to like kick someone out or this whole concept of kind of tough love and that people need to hit bottom, you And so sometimes people, you know, either do that and then wrestle with the guilt of was that the right thing or not, or they feel bad even like being kind or loving to their family member.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I think there's a whole mix of feelings. And of course, if you lose someone, you always wonder what if, like, could I have done something differently? Could something else have changed? And I think people can feel angry and sad and guilty and be left with that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think they needed science-based treatment and compassion and empathy. And I think they needed a world where addiction was not seen as something to be ashamed of or something that we judge, but rather something that is a problem. You know, the shift from, like, you are the problem to, like, you have a problem and we can help you with this.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think too often we have approached it as if, like, you the person are the problem.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Absolutely. I mean, I think about that all the time. And I think of a friend, I lost overdose. I think of the family member, I lost alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And not only things that I could have done differently, but also those people, they saw their doctor, they were in the hospital, they had all these touch points, all of these reachable moments where someone could have engaged with them and offered them kindness and actual effective care that's backed by science, and they weren't. And
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So there are all of these like missed moments and missed opportunities. But the other thing I think about is like how much time I lost with them because I think often in this model of like tough love and kicking people out or thinking like I'm not going to see you until you stop using or stop drinking because I think that's going to help make them make that change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You lose out on like all of these moments of time with people that you love and you can't get those back. And so there is this problem sometimes.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think in that binary model of like you're either like sober and in recovery or you're actively using and this is good and that is bad is that we lose the fact that like people who are struggling with addiction are amazing, funny, loving people who have a problem that they're dealing with. But if someone was dealing with cancer, you wouldn't like not want to spend time with them.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You know, you miss all of that time. And, you know, both cases that I'm thinking about, like I'll never get that back, you know.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think that there are those times, for sure. It's not to discount that, and I hear those stories too. But I think there are, from evidence, what we know, there are probably more times where people just endure the pain again and again and again until they never change. And I think the part that we don't see are the folks who change happens when they're
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
They begin to get enough hope that things could be better for them, that someone loves them, someone cares enough that they're reaching out a hand in the darkness, that there actually is a path forward. I think people stay stuck when they feel hopeless, when they feel like nothing could ever – that they're never going to get this. They're never going to be able to change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Their life would never get better. And so – You know, take the example, I'll often hear from family members when their loved one is in jail that they're like, thank heavens, you know, they're in a safe place at least. Like there's actually this sense of relief. There's even a term for it called a rescued that people feel. I think it just goes to the desperation that families are dealing with.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But this idea that like that's a safe intervention. And you hear these stories, right, of someone who they get locked up and like that's their eureka moment.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And yet, if imprisonment were an effective intervention for addiction, for example, we wouldn't see that actually the time after getting released from prison, there's 130 times increased risk of dying from a drug-related cause after people leave prison. And that your risk of dying ever from addiction is much, much higher if you've ever been imprisoned.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But even drinking that amount, your risk of breast cancer would increase by about 5%. This much?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so I think there are those stories, but we tend to elevate those like amazing narratives. And we miss the fact that so many other people are going to die in pain and alone and isolated because they have no hope. And so it's not to discount those moments. And some people are incredibly resilient and against all odds, even with the most trauma, they can, you know, make it through.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
My mission is really to change the way people think about and understand alcohol and drug problems, and also to give people the evidence and the facts, both to understand addiction, which are sort of problems related to alcohol and drug use, but also to just understand the science around, for example, how much should you drink? Is drinking healthy? Is it not healthy?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that's incredible. But that doesn't mean that we should like create a system that makes it as hard as possible on people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Absolutely.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And it's about effective treatment.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It depends on the type of addiction and their situation, but in most cases it's some combination of psychotherapy and medication.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, yeah. So, I mean, the journey of alcohol is fascinating. So first, I think we think of this as a relatively modern thing, but, you know, archaeologists have discovered, like, beer-making equipment in hunter-gatherers' cave dwellings from 13,000 years ago. That's wild. Wow. Like, 13,000 years of people figuring out how to make beer. You know, you look at China 9,000 years ago.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It was really about like a spiritual journey or a social thing. It was never really about health. At some point, we started talking about this as something that is good for your health. Like drink red wine. It's going to improve your health. And that's where I think we got wrong. And the reason why was actually from how we were looking at the data.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So first, if you look at only one health condition, there are some health conditions where a moderate amount of alcohol actually improves your health. But it was also how people were conducting the studies. So in most of the studies, what people do is they take like a massive population, tens of thousands of people, where we have some data where they're reporting how much alcohol they used.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then we look at health risks over time. And scientists would lump people into sort of non-drinkers versus light drinkers, moderate drinkers, or heavy drinkers. And what they were finding is that people who were drinking even up to the moderate level were actually doing better than the people who weren't drinking at all.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so that was where that concept that drinking is good for your health came from. And so people talk about this like J-shaped curve, meaning that moderate drinkers actually have lower risks of health problems. And then it's really only when you start drinking very high levels that you start having more risk of health problems than people who don't drink at all.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
What they realize is wrong with that is that in the people who don't drink at all, many of those people are not drinking because they're actually really unhealthy for another reason. Like they might have heart failure and they like don't want to drink because they don't want it to mix with their medication. Or they might have had a history of alcohol use disorder and they're actually in recovery.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There's a lot of misinformation out there, and I want to give people the tools to make the right decision for them in their lives.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So they've already had some damage from alcohol and they are not drinking because of that. And so when you change the reference group, you actually make the sort of group that you compare people to, to people who very rarely drink. So it's not that they're not drinkers at all, but they drink, you know, very, very light levels.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Then you start to see that those like health benefits of alcohol go away, especially if you look across all conditions.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes, I would never say drinking alcohol is good for your health. That doesn't mean that drinking at what we call low-risk levels can't be a part of a healthy lifestyle. So it's a slight shift that, like, don't fool yourself into thinking that drinking that glass of wine is, like, going to exercise for 30 minutes. Like, it's not something that's going to promote your health.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think of it more like having dessert, eating bacon, going out in the sun. There are risks associated with all those activities. It doesn't mean that I would say you can never do any of that, but you need to understand what the risks are and then make choices for yourself.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yep.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yep.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Well, so part of the challenge is what we think of as one drink. So I think much like, you know, if you learn to read the serving size on a food, you realize that like a serving of ice cream is like a half scoop. It's not like a giant ice cream sundae. The same is true with alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So in the UK, the kind of low risk drinking limits talk about units of alcohol, which is the equivalent of eight grams of alcohol. So how much of a drink has eight grams of alcohol? And to be in that low-risk category, you have to be below 14 units. The problem is that glass of wine, just eyeballing it, has several units of alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I'm a medicine doctor by training. So I still do some general medicine like in the hospital, take care of pneumonia and heart failure and in the outpatient setting, take care of people's diabetes and depression. But I train especially in addiction medicine. So I'm board certified in addiction medicine. And that's been kind of my life's work.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So it is not a – even though we think of it as a single drink, it's probably – I mean, I have to guess, but it's probably like three units of alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You'd be right at that limit. The problem is most people don't drink just one glass. If you have two glasses one day and then one glass one day and then three glasses one day because you're at a social function, all of a sudden you're actually quite a lot over that limit.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And you get 14 a week.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So yes, you're over if you're drinking that size. Yep.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Lower risk drinking.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You'd be in what we call moderate risk, which is associated with pretty much every form of cancer, which I think people don't know.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. So the data is growing and really worrisome. So for breast cancer, so there's really, there's a few cancers that even at low risk limits, you see the risk begin to increase. So where we would say there's kind of no healthy, or there's no even like low risk amount. So breast and esophageal cancer, two examples of that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So breast cancer, if you were to drink below those low risk limits, so in the US that would be fewer than seven drinks, but a drink in the US is five ounces of wine, which is smaller than that, or in the UK is below that 14 units. So it would be fewer than seven of that size glass of wine. We still see a slight increase in the risk of breast cancer. It's about a 5% increase.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So that means your risk of breast cancer would increase by about 5%. And that's not huge. So I think percent increase is kind of hard to do the math on. But if you think in the US, for example, the average woman has a 13% likelihood of getting breast cancer in their lifespan.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Really? Yeah. Wow. Really high. So 5% increase would increase that to like 13.6 or so.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
In their life, yep.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, and so the reasons for that are likely environmental because your genes don't change over that time period. So the risk factors, you know, if you think about breast cancer, it's alcohol, it's obesity, it's, you know, age when you have children or don't have children because it's a really hormonally driven cancer. Same thing if you think about colon cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That's a really scary one where we're seeing more and more cases in younger people. Some of the drivers of that, eating meat. So processed meats increase your risk of colon cancer. So, you know, these very sort of normal behaviors. There's probably other environmental things, honestly, that we're not yet measuring or able to measure.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I work in a big academic medical center in Boston, Massachusetts, where I would say my kind of focus professionally has been thinking about how do we bring addiction care back into the medical system so that it's not this separate and unequal and often very poorly done sort of siloed system, but actually just a part of the health care that people get. And then I train people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Just given the rate of acceleration, when I talk to my colleagues who are oncologists, you know, things like plastics or other things that we don't yet know, it's clearly something in the environment that is driving these increased cancer risks.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So that would be one unit. So that would be fewer than 14 of that. So you could see like, you know, if you had double that, it would be a decent pour of wine. You could not have more than seven of those in a week to be in low risk. But even drinking that amount, your risk of breast cancer would go up a little bit.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There's really sort of no safe amount of alcohol when it comes to breast cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
which for many people is very normal. So there's a lot of misinformation out there about how much should you drink, which I think people don't know. But I can take you through everything, so. Dr. Sarah Wakeman is a Harvard professor and addiction expert. Leading the charge against one of the biggest public health crises of our time. Addiction, bringing facts, empathy, and hard-earned truth.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So that low-risk category, so these big cancer studies categorize people as sort of low-risk or light drinkers, moderate or heavy. And for pretty much every cancer, once you get to the moderate category, we start seeing increases. And there's what we call a dose-response relationship. So the more you drink, the higher your risk of cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There's only a few cancers that the risk seems to increase even at that very low level. And breast cancer is one of those. And then esophageal cancer is one of those. So there are certain cancers where even a small amount of alcohol will increase your risk.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. So colon cancer, we're seeing that in a lot of young men. Liver cancer. Yeah. Prostate cancer, which is obviously a male cancer we don't think of as much as being sort of an alcohol-sensitive cancer. But most cancers, because the way alcohol impacts your risk of cancer is not really on a specific organ outside of the liver. It's really about how it changes our DNA.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So it's about inflammation and what are called reactive oxygen species that sort of change our cells and increase the risk over time of the mutations that lead to cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If you're drinking two of those glasses, yeah, you'd be in the heavy category. Okay.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Which would surprise most people, right? Like that for many people is very normal.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, so it varies by cancer, but roughly we're talking like a 40% increase in cancer depending on the cancer type. And the more you drink, the more that's going to go up. So, you know, these are scientific studies where it's not precise to you as an individual. They're based on large populations, but definitely the more you drink, the greater the risk.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, exactly.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Exactly. If you smoke. So one of the main drivers of alcohol, too, and cancer is that it actually makes you more susceptible to the cancer-causing effects of tobacco. So if you drink and smoke, your risk of cancer is going to be even higher.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I'm program director of our fellowship program. So I train doctors who want to be specialists in addiction medicine.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The thought is like if you take esophageal cancer at like the cellular level, it makes you more susceptible of the carcinogens, which are kind of the cancer-causing compounds in tobacco. And so rather than just seeing like an additive risk, you actually almost get a multiplied risk in terms of the risk of cancer. So smoking and then obesity is the other big one.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So a lot of cancers, your risk goes up if you have an increase in your body mass.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, I mean, there's lots of different mechanisms. I mean, maybe starting just with what does alcohol do in your body? So you ingest alcohol. The fancy name for that is ethanol. It's a molecule. And it basically gets absorbed pretty quickly from your stomach. And so it hits your bloodstream usually within 10 minutes or so of having a drink.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
How much it hits your bloodstream depends on how much water you have in your body. So alcohol doesn't penetrate into your fat. It just kind of diffuses into the water parts of your body. So that's actually why for many women, they will get more sort of drunk or more of an effect from alcohol at a lower level than men because women have more body fat than men.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But that's going to depend on you as an individual. If you have more body fat, you're going to have a different impact. So alcohol gets in your bloodstream. Alcohol can instantly cross across what we call your blood-brain barrier. So it impacts your brain instantly.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that's where you feel the initially pleasurable effects for many people of feeling a little relaxed, feeling more social, feeling a little bit less anxiety. If you keep drinking and that level keeps going up, then you start having impaired judgment. You might have lack of motor coordination. So we've all seen this in Many people have probably experienced it.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You know, you may be stumbling, not able to drive safely. You're not going to make the same decisions you would make if you weren't drinking. And then if you keep drinking, then you get, you can actually lose consciousness. So pass out. And people have experienced that. Your body is going to try to break down alcohol as quickly as it's able to.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Oh, how much time do we have? Where do we begin? I mean, I think at its core, the biggest problem is that we've all been taught and sort of infused in this idea that addiction is an issue of behaving badly, that it's an issue of morality, that people really need to kind of knock it off and pull themselves up by their bootstraps.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Like anything, we want to kind of excrete any abnormality and get back to our normal functioning. And so that process happens mostly in your liver, which is why the liver is so sensitive to alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes. I mean, you know, I know you talked about this, Dr. Lemke, but your body always wants to restore what's called homeostasis. Your body's always going to fight to get back to what it feels its normal is. And so ethanol is not something that belongs in your bloodstream. Your body's going to try to excrete it as fast as it can.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then it converts it into something called acetate, and then you can pee that out and breathe that out and get rid of it. So to eliminate the alcohol in your body, you have to go through this process. And part of that process includes this toxic molecule that's going to be floating around and causing damage to your cells. So that's one way that alcohol can cause cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The other is just general sort of inflammation. People have probably heard that inflammation is just not good for the body and increases the risk of cancer. And alcohol generates a lot of that inflammation in the process of getting eliminated. And so it can actually change your cells that over time that can lead to cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, great question. So here's our little mannequin. So just to orient people to the body. So we're looking at the inside of the body. So like the ribs are gone. The outside of the skin is gone. These two pink things are the lungs. They kind of encase the heart. You can see the hearts behind the lungs pumping your blood. The liver is this brownish organ.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It's on the right side of your body, right under your ribs. It's quite large. It's big. And it's an amazing organ. It is quite big. It processes much of what any kind of toxins that we take in, things that we eat, your glucose, alcohol, 90% of it's metabolized by the liver. So the liver is sort of the clearinghouse, getting rid of byproducts in your body.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The other are the kidneys, but the liver plays a huge role, especially in alcohol. So it sits right here.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, yeah, it is.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it's a giant organ. And it's an amazing organ. So you can actually cut out 80% of the liver and it would regrow itself. So kind of like those lizards that you cut off their tail and they regenerate a tail. The liver is fascinating. It's why we can do living liver transplant. So I could take half of your liver and give it to someone who needed a liver.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You would still be able to live and they would get a second chance at life from that part of your liver. So it's this really cool organ that can regenerate. But it can only regenerate up to a point. So once you get to a level where you have a lot of scar tissue in your liver, we call that cirrhosis, you sort of reach a point of no return where at that point the liver can't heal itself.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I sort of think of it like, to use a baking analogy, if you're making muffins or a cake, You're going along, you're mixing all your ingredients and you realize before you put things in the oven, like, oh, I forgot the eggs. You can still add the eggs in and like whisk it all together and it's going to be okay.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If the muffins are baking in the oven and you forgot the eggs, you can't like pour the eggs on top and make the batter the same. And the liver is sort of like that, that up to a certain degree, you can actually completely repair the effects of things like alcohol or obesity, other things. But once you pass that point into scar tissue, the liver can't regenerate anymore.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that this is like a criminal legal issue, that it's an issue of willpower. And so if you believe those things, then why would you think that someone should get medical care? Or why would you treat them with compassion and kindness if you think that they're doing something wrong?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so when you think about that graph or just the rising rates of liver disease, the main drivers of liver disease are obesity and two is alcohol. And so those are the leading causes of liver transplant. And the thing that is so sad is, I mean, I see this all the time working in the hospital is, first of all, we're seeing younger and younger people coming in and liver failure.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So people in their 20s coming in and fulminant liver failure from alcohol and then dying in the hospital. And the terrible thing is that they often didn't even know that this was causing a problem in their health. And by the time they get to the hospital, they're so sick, it's too late. And yet all of that could have been prevented or even repaired if it was caught sooner.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so that's where I think this education of understanding, like, what really are the health harms of alcohol? And that we have normalized binge drinking on many occasions, especially in young people, as being totally normal. And yet there are very serious health consequences.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. I mean, so first, every person is different. One blowout weekend, you probably would be fine. Anyone would probably be fine. The challenge is one blowout weekend then leads to like multiple blowout weekends. And then over time, that can actually accelerate the damage to your liver.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
as long as you haven't gotten to that scarring phase. So once you get too far down that path, even if you were to stop drinking, your liver won't recover. The hard thing is that we don't totally understand who and why that happens so young too. So this is an active area investigation because there are people who've been drinking for 60 years and their livers don't show signs of scarring.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then we're seeing these young people at 25 who come in and die in the hospital. And so there are individual factors that you don't have any way of knowing that are gonna impact your risk of developing liver inflammation and scar tissue. And so the safest way to prevent that is to not drink in these really high ways that we know are going to lead to harm.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so really reframing how we think about addiction based on all of the science we have and what effective treatment looks like, which often is very different than what people may have experienced if they were trying to access care for themselves or a loved one.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The other way is to get medical care because often we do detect these things through blood tests and we can do ultrasounds. And when we see those early phases, so what happens first is you actually get fat deposition in your liver. That's the first step. And then we see inflammation and fatty liver.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And if you don't stop the thing that's driving those changes, over time we see the development of what's called fibrosis, which is like scar tissue. And then that scar tissue gets more and more advanced to the point that your liver stops functioning and you either die or you need a liver transplant.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. So obesity. Food does. Yeah, food. So your liver is very involved in glucose metabolism. So our diet and our body weight impact our liver health. And the other medications, so acetaminophen or Tylenol, which is a very common over-the-counter pain reliever, above a certain threshold can cause... Serious liver damage.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So sometimes we'll see cases where someone didn't realize that like their cold medicine plus the Tylenol they were taking both had that ingredient and then they go out and drink heavily and that kind of combination effect can cause liver damage.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So again, it varies person to person. For liver damage, it does tend to be the moderate to higher amounts that cause damage. One thing is that having these big surges, like these massive binge episodes, is probably more harmful than drinking at a moderate level for a long period of time. Those big surges cause a big buildup of that toxic byproduct that your body has to clear.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so if you have several years of binge drinking heavily, that actually probably is going to cause more damage than a longer period of time of just drinking above the risk limit. So really trying to minimize and avoid those very heavy drinking episodes is incredibly important.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then keeping it to those low risk guidelines, which we just learned are kind of eye opening and how low risk they are is going to reduce the risk of liver damage.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
No, I mean, alcohol has effects across our body. So many parts of the body can be affected by alcohol. So kind of starting from the top, your brain. And we can look at this with pictures like an MRI. Oh, I've got one. Yeah, I think.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. To me. So when we do an MRI of someone's brain, we basically, this is like a cross slice. So it's almost like you're facing me and I'm cutting your face off and looking at your brain onwards. Healthy brain tissue is the gray and white matter. And you want it to be as plump and like taking up as much space as possible because that's where all of your brain activity is.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
When people get really old or have dementia, one thing we see is more and more the black space is essentially water. So we see the brain start shrinking and shrinking, and there's more water and less active healthy brain tissue. That process is accelerated with heavy alcohol use. And so you can see here, this is a 43-year-old person with...
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
severe alcohol use disorder where their brain looks the way, you know, a 90-year-old with dementia would look because of that brain damage over time from alcohol use. And so we can actually, a form of dementia is related to alcohol use. And so your brain can be hugely impacted with alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, well, remember I said ethanol, which is the molecule, crosses the blood-brain barrier. And so especially when you're having these high levels of blood alcohol, that ethanol is sort of bathing your brain. And if you think about what we talked about, inflammation and changes to cells and to DNA and proteins, that is happening at the brain level.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it's a great question because we use that term colloquially a lot. You know, I'm addicted to Netflix or whatever. So addiction is really defined by use despite consequences. So continuing to do something in your life despite bad things happening to you because of it. So we talk of addiction, we talk of the four C's as a way to remember it.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The other thing that can accelerate the brain damage we see with alcohol is actually nutritional deficiencies. So people may be drinking a lot, and they're actually not getting really crucial nutrients in their diet. And that can accelerate the process of brain damage.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We can even see a very like sudden onset amnesia from heavy alcohol use in the setting of not getting enough nutrients in your diet.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That's the brain. So the brain, for sure. The next is the mouth and your esophagus. So obviously, you're drinking alcohol. It's bathing your mouth. It's bathing your esophagus and your stomach. So we do see an increase in cancer, like we talked about, and that's accelerated by smoking. But we also see benign but annoying and problematic health conditions, most notably acid reflux, so heartburn.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So if you notice, like, I'm always having heartburn. I'm having to pop all these antacids and take this medicine. you might want to think, like, how much am I drinking? Is that contributing to my heartburn? So that's a very common thing. The heart is affected by alcohol. So, you know, the heart is an organ where at low risk levels, there doesn't seem to be harm from alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But once you get into the moderate and high, we see harms. And the harms can be A couple folds. One is something called atrial fibrillation, which is basically where your heart starts beating really irregularly. So in your heart, there's four chambers, the two chambers at the top. So this is really showing the ventricles and the atrium. So there's two chambers that blood flows through.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And in a normal heart, your electrical activity comes from the top of your heart, goes down to the bottom of your heart, and tells the heart to pump. And so you get a single impulse that goes to the bottom of the heart, says pump, and that pumps blood out to your brain and your body and your organs and your liver. Right.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
In atrial fibrillation, the top of the heart is just kind of quivering with this abnormal electrical activity, and so the heart can't pump in a normal way. There's a term in medicine called holiday heart because we see sometimes people drink a ton over the holidays and will end up in this abnormal rhythm just from that binge drinking pattern.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then over time, if you're drinking at high levels, your heart actually dilates, and you can end up with congestive heart failure from a cardiomyopathy, which means the heart muscle gets kind of weak and thin and floppy and can't pump the way that it needs to.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, because they have less body water, and alcohol doesn't go into your body fat. So essentially, it's like if you took a glass of water and you dropped red dye in it, you're going to diffuse into that water. So the more water you have, the more diffuse it'll be and the lower your blood alcohol content. So if you have very low body fat, you probably have more body water.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so two drinks for you is going to diffuse into a larger amount of water.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So one C is loss of control, meaning like you've tried to change and you haven't been able to. So you've tried to cut back or you've tried to stop and you couldn't. The other is compulsive use. So your use is like spiraling out of control that you're kind of using in a way that isn't really attached to your rational thinking. The next is consequence.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
No. I mean, so first of all, I think the interesting story there, one is not just the body fat, but also that people metabolize alcohol at different rates. You probably, I don't know if you found this feature, you probably had fewer hangovers than your friend because hangover does seem to be related to the amount, how high that your blood alcohol level gets.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So people who don't metabolize alcohol as quickly tend to have worse hangovers. So that may have been something you experienced, but it doesn't protect you from the other health harms of alcohol, like liver damage, like cancer. like over time, you know, heart problems or esophageal problems.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, hangover is a fascinating thing that people are, you know, there's a lot of emerging evidence about it and trying to understand what happens. It seems to be most related to how high the ethanol concentration in your brain gets because they've actually done a ton of studies with mice and with people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It was initially thought to be due to the byproducts of alcohol, like that acetyl aldehyde molecule we talked about, but it doesn't seem to be related to that. It seems to be related to ethanol. But essentially, it's this syndrome where after you drink, once your blood alcohol content comes down to zero, you feel sort of apathetic, you're tired, you have a headache, you often feel nauseous.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so it's sort of that sequelae of your brain essentially being bathed in this ethanol. And then as it leaves, you just feel totally crappy.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it is not just being dehydrated. There's actual sort of effects of ethanol on your brain that lead to the hangover. I think if you are drinking at an amount that you're getting a hangover, it is a good sign that you're drinking above a limit that would be considered okay for your body.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There is some element of dehydration, don't get me wrong. And that's partly because, right, if you think, again, alcohol is diffused in water. So if your total body water is contracted because you're dehydrated, your ethanol level is going to be higher. So drinking is going to help you sort of flush it out and feel better. I'm drinking water. But it's not only because of dehydration.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So continued use despite negative consequences either in your life, your job, your relationships, your health. And then the last C is craving, which is this sort of strong psychological urge to want to use. Like you can't get the idea of having a drink out of your mind. And so it's really those four Cs that we think about.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Well, first, like there's no judgment here. So a molecule of ethanol is not more moral or immoral than a molecule of glucose. You could say the same thing about diet. We have lots of awareness now about processed foods and white flour and white sugar. That doesn't mean that everyone's going to live this like ascetic lifestyle where they never eat dessert.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I think it really is like you need to go in with eyes wide open and understand what are the risks, what matters to you, and how do you make that calculus. So if you decide it's a choice you want to make, you want to set yourself up for success.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, 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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then we make the definition based on how many criteria people meet out of this 11 list of different criteria. And then based on that, people can have a mild use disorder, moderate or severe. And so moderate severe is really what we think of as addiction. But it's that use despite bad things happening to you.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
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.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so someone named Sinclair actually in Europe did some fascinating experiments of even just using it as needed. So rather than taking it as an everyday medication, if you know that when you go to like a holiday event, you're going to drink way more than you want to drink. You take it like 30 minutes before you go. And then what people find is they have like one drink and they're like, I'm good.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I don't have that same urge to want to drink more and more because I didn't get the same sort of tickle of feeling better and feeling relief.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, one of the most like groundbreaking trials in the last couple of years for alcohol use disorder was psilocybin. So there's a big study of psilocybin-assisted psychotherapy for alcohol use disorder, which showed really remarkable effects.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So people took psilocybin, actually compared it, folks came in and they either got a big dose of Benadryl or psilocybin, and then they sat with the therapist for like eight hours for this guided psilocybin journey. And they found that people drank much less after it. So it does seem to have some effect. And the thought is that
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Part of the way psychedelics work is they increase neuroplasticity, meaning the ability for the brain to form new pathways and kind of retrain itself. And so it does seem to be a potential therapeutic for alcohol use disorder.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes, exactly.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I have, yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes. People have looked at Ibogaine for opioid use disorder. Those studies have been less promising than psilocybin, although it hasn't been tested in the same kind of rigorous ways recently. Partly for opioid use disorder, we have really effective medications that have been shown to improve recovery and reduce death. And so it's sort of hard to be better than that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
One really interesting, like, new whole class of medications for alcohol is medications that are being used for weight loss that people have probably heard of. So, like, Wagovi, Ozempic, that whole class of GLP-1 medication seems to also reduce alcohol use, which is kind of interesting.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, lots of things. I mean, I focus mostly on alcohol and drugs. So alcohol, obviously, probably most common. I think we'll talk about that a lot today, which I'm excited about. And certainly when we look worldwide, 400 million people have an alcohol use disorder, meaning addiction to alcohol. That's a lot of people. The other are drugs.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. So they, well, first of all, there's, I mean, there's whole like Reddit threads and online communities about this where people were prescribed it for diabetes or for weight loss. And they all of a sudden were like, I don't really want to smoke or drink. Like that kind of urge has gone away entirely. And for some people, they really describe it as being like miraculous.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
They've been trying to stop drinking for, you know, years and years. And for the first time, they don't feel that sense of like craving and urge anymore. And there recently have been some actual clinical trials where they've done placebo-controlled blinded studies and have shown that it does reduce drinking.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so it's a really interesting area where it seems like those medications kind of reset craving and appetite more globally and not just for food.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. When I read the headlines of someone dying, I mean, to me, it's gutting and heartbreaking. One, because obviously it's a human life that was someone's mother and sister or brother, and people cared about a public figure that people looked up to and cared about. But mostly that it was a totally preventable death, like really no one should die from a substance-related death.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We have tools to treat addiction. We know how to prevent the harms of drug overdose, for example. And so the fact that someone can die, especially someone that everyone has watched for so long, is, I think, just like a tragic example of what the mismatch is between what we do around addiction and what science says is actually helpful.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So that can be opioids like heroin or pain pills or fentanyl. It can be cocaine or stimulants like methamphetamine or prescription stimulants. sedatives that people may take for anxiety, like benzodiazepines, cannabis. And so there's a whole sort of range of substances that can be addictive. And how addictive a substance is, is really related to sort of how much dopamine is released in the brain.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think, you know, when I see someone who actively is showing signs, like, it's just sad to see that happen so publicly without people being able to support that person. And it's not a magic fix. It's not going to be like, you know, you have an intervention, the person goes to treatment, gets better forever, that I think is often in people's minds. It is a process, a journey, like any change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so... Really, it is around where we began, that idea of how do you begin to understand with this person how is their substance use getting in the way of what they want for themselves and how might their life be better for them based on whatever they believe better is if they were to make changes to their substance use.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And probably give you so much empathy. A huge amount of empathy.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
One in three people may have a problem with alcohol at some point in their lives. And globally, 2.6 million people every year die from alcohol-related causes because pretty much every organ in the body is impacted by it. You can see here, this is a 43-year-old person where their brain looks the way a 90-year-old with dementia would look because of that brain damage over time from alcohol use.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And you said something really important that was a slight shift in words. You didn't say he failed treatment. You said the treatment failed him. And that matters so much. Because I think too often we've made it seem as if people are failing. Like if they go to rehab and they don't get well. Yeah. It's their problem, you know? And actually, the treatment wasn't right for them.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If someone had cancer and their cancer came back or didn't get treated by chemotherapy, we wouldn't say, like, oh, they failed. You know, we would say, well, what's the next treatment? How do we get them to the right doctor? And so there is this, like, personal blaming.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that gets at stigma, which is one of the main reasons that people don't share that they're struggling with substances, that they don't seek treatment. And so we have tremendous stigma towards drug and alcohol addiction. It's one of the most stigmatized kind of social conditions globally.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so, of course, then if you're a person who starts to think like, oh, maybe I do have a problem, like maybe my alcohol use is getting in the way of things, it's really hard to then say anything because you worry that you're going to be judged, you're going to be labeled, you're going to be misunderstood. In some cases, terrible things could happen to you.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You might get your children taken away by, you know, child welfare. You could lose your housing or lose your job. And so that stigma has like played into this terrible cycle where people, you know, have to whisper it to someone. It shows how much he trusted you to even be able to say honestly what he was going through because there's so much stigma about the condition itself.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Oh, goodness. So many. Yeah. You know, so one gentleman in particular, he was, struggled with heroin addiction for a long time and had been, like we talked about, had been kind of a chronic illness for him. He'd had periods where he'd done really well. He'd had periods where he had struggled and had always stayed safe through all of that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And he actually, his like one really meaningful relationship in his life that kind of kept him together was a relationship with his mom and he lived with her. And he And they lived in public housing. They were dealing with economic insecurity like many people. And someone found out that he was staying with her and it would have put her at risk for her housing.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I know you've had a wonderful episode with Dr. Lemke about dopamine. So you've talked about that a bit. And there are different sort of addictive indices of different substances. So cannabis is less addictive than methamphetamine, for example. But all of those substances can cause addiction in people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so he didn't want her to lose her housing. So he left, but he was newly homeless. And all of a sudden, because of just social barriers, was dealing with the stress of homelessness and being alone. And even with kind of all of the connection he'd had with his mom and With treatment, he was found dead between two parked cars and overdosed alone in the street.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I always think, like, if... And you knew him. Oh, yeah. The cascading effects that, you know, that it didn't have to be that way. And I think there are so many deaths like that where I just think it doesn't have to be like this. You know, really no one should die like this. And... And there are so many things that, you know, in the moment feel so out of our control.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think that's part of what generates my passion for this work is I can't always save the person in front of me or change issues around homelessness or housing policy. But I can try to work on a broader scale to make things different for the next person. And I think that kind of that for me counteracts some of the distress of losing people that I care about.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. I mean, starting upstream, the biggest thing would be building resilience and building connection early on. So, you know, I think these things that feel so not related to addiction per se are actually deeply related when we think about adverse childhood experiences.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So when we think about prevention for children, you know, often people have looked at like education, like, you know, telling people, telling kids that drugs are bad, that doesn't work. What does work is actually building resilience among young people. So building resilience, building connection. So what does that look like? That looks like affordable housing.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That looks like parks where people can get outside and play sports and exercise and build relationships. That looks like supporting families so that families can stay together. And so those early relationships and attachment can be well-formed.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That's like the true prevention work is trying to break the cycles of intergenerational trauma, poverty, substance use, and actually supporting families, communities at the very start.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes. Yeah, Rat Park is a great example of that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, so Rat Park was a series of experiments that were done where essentially they took, they're trying to understand kind of drivers of addiction using rat models. And so they took rats and they had one model where rats were isolated in their own cage with nothing to do and no human connection.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And they had access to a substance like morphine or cocaine where they could push a lever and get more of it. And those animals, when they were deprived of connection and isolation, anything to do, used more of the drug. It gave them relief. It gave them pleasure.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
They took those same animals and they put them in this amazing cage with, you know, areas to play and like wheels to climb on and lots of friends and other rats. And all of a sudden they saw the same animals were no longer kind of pushing the lever and trying to get more of the drug.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so, you know, it's a somewhat simplified model that there's lots of – it's probably oversimplified, but it demonstrates that so much of addiction really is around this idea of connection, restoring sort of the world around us, the community, the interrelatedness that we all have, the opportunities and purpose and meaning and hope. So I think that's the real prevention.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then there's how do we actually address folks who are having a problem? Yeah. And I think, you know, what I would do there is first make addiction treatment widely available immediately when people need it.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, well, there's, you know, a couple important pieces there. Is your coffee drinking causing harm in your life in any way?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So the minute you walk into your general practitioner's office or an emergency room, you get treated with compassion, with science, with people asking you what can they do to help and offering you effective care the same way they would if you had a new cancer diagnosis or a new diagnosis of a heart problem.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then we really reframe treatment entirely to look like the way it looks for any other health condition.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that we stop punishing people who use substances where, you know, a lot of times people are still sent to jail for substance use, which, you know, is a confusing mixed message if we're saying this is a health problem on the one hand, but we're going to put you in prison or jail at the same time. Those two things don't necessarily align.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It may be helping you, right?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, so it's not addiction. So there's a difference between physiologic dependence, meaning, like, if you don't drink your cup of coffee, you're going to get a headache. And addiction, meaning that you're spending all your day and all your money buying more and more coffee.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I mean, I don't think human beings were meant to live this way, and it's a relatively new thing, right? We often lived in a village or a community. We lived in these multigenerational households.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I mean, I have little kids, and I think having kids was such an eye-opener of that of like, well, that makes sense why people live with their parents and their grandparents and have these big families to create, you know, community and a sort of extended family around you. And we have lost that in a lot of ways.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think the ways that we used to get that, like religion, maybe that still resonates for some people. For others, it may not. And so finding other ways of engagement, of meaning, of purpose, that can be through lots of different things. You know, I think people are finding creative ways of doing that. It can be through, like...
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You know, finding a volunteer activity, finding some other type of social group. Some people do it through sports. You know, they find connection and engagement with people they don't really know over the shared love around an activity or a team. But really sort of seeing that as a priority the same way you'd prioritize other things in your life and your health.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Absolutely. Yeah. I mean, I think one of the problems is that too often therapy has been like forced on people. I think that I'm much more of the approach of like we need to make treatment available and welcoming and high quality so that people get value out of it. And therapy is a huge part of that. You know, it's about a lot of things. It's about connection.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It's about figuring out those reasons why people are using in the first place, addressing and healing those traumas. It also matters that we have good, well-trained, empathetic therapists. So there's been a lot of interesting studies looking at actually how empathetic your therapist is is probably the strongest predictor of whether you make changes to your alcohol or drug use.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Which is so interesting because we often think like, You've probably heard someone say, like, I don't really like my therapist. And I think someone's reaction to that is like, oh, like, you're not that into therapy. But they've actually done a lot of studies showing that a therapist who is less empathetic, their client is more likely to use more substances at the end of that course of treatment.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We don't really see this, but buying more and more coffee despite, you know, your girlfriend nagging you about it and you're late to work because you're purchasing coffee. We don't really see that so much with coffee, but that would be sort of addiction.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So actually having a really well-trained, compassionate, evidence-based workforce is hugely important, too.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. Yeah, I think empathy is really powerful. Those kind of things that we think of as soft skills actually matter tremendously.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, I mean, this is this concept of like enabling, which I think is nuanced. I would say at its core, it's really deeply problematic that for the most part, love and support are never going to be harmful. And when I talk to patients... Often the thing that caused them to ultimately engage in treatment was not some terrible consequence.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It was the idea that someone cared enough about them in a moment where they didn't love themselves very much and felt hopeless that someone was willing to sort of lift them up and believe in them. And it's these small moments of kindness. I'll tell you a story of a patient that we took care of in the hospital who was there for a really life-threatening infection related to their drug use.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And a year to the date after he was hospitalized, he wrote a letter to our team. And he said, you know, I'll never forget the moments you guys came in and just sat with me and talked to me. And he now sends an email every single year on the anniversary of when he got out of the hospital.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And it's those moments of humanity, of connection, again, that connection idea that often are the catalyst for change, the kind of hope and belief that your life could be better somehow. Yeah. as opposed to this idea of like increasing someone's pain and suffering. And that plays out in different ways.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So in families, one of the most effective tools we teach people is something called CRAFT, which stands for Community Reinforcement and Family Training. And it's very different than the like, people may have seen like shows where you're supposed to stage an intervention and tell someone all or nothing. But craft is very different.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It teaches people, first, how do you understand the science of addiction, family members? Second, how do you get support for yourself? Because it's really tough to deal with addiction in a family. And then how do you start to learn about consequences in a different way?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That if you're a parent and your kid is missing school because they're using, you don't want to cover for them and sort of reinforce their pattern. Right. But you also don't need to kick them out of your house, that there are sort of gradations of consequence that can actually help people change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And one of the biggest sort of motivators for change is actually positive reinforcement of the behaviors you want to see. So that's been called contingency management in the kind of treatment world. You know, health insurance companies, lots of companies have figured this out, right?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So if you get money back because you joined a gym or you get those, you know, you get reimbursements for doing something that people want to see, people do more of it. It's true in human behavior. It's very true with addiction. But we often do the opposite.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We try to punish people into getting well instead of reinforcing kind of the healthy behavior, what we want to see more of, if that makes sense. Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, well, first, it is just so hard to be there as a family member or friend. So for anyone listening, I've been there. It's incredibly impossible. So have grace with yourself. I think that's a different decision you're talking about is at some point, you have to make a decision to protect yourself. So let's say you have someone...
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
in your home who's dealing with addiction who you know gets aggressive or stealing money or is you know causing trauma to the people living in the house at some point you may need to decide that for my well-being for the rest of the family's well-being i can't have this in my life right now that's very different than saying kicking them out is going to make them better
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So the distinction there is that it's okay to protect ourselves. Sometimes we have to do that. And sometimes there's only so much you can do. But to not sort of fool yourself into thinking that the action is to help the other person, and that's okay. I think the other piece is, you know, at the end of the day, first of all, it's easier to be a treater. So I've been a family member.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I've been a clinician. As a clinician, I can truly be unconditional. So I'm going to be someone's doctor whether they continue to use heroin or continue to drink or don't. And there's something really beautiful in that. Like my engagement with someone is not premised on whether they make changes or not.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
As a family member, that's harder, especially if you're a kid dependent on someone or you're in a marriage or a relationship. So you may have to make different choices. But I think at the end of the day, people don't change because of why we think they should change. They change because they think their life is going to get better in some way.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So the key then becomes figuring out, like, why might this person's life get better if they were to make changes to their alcohol or drug use? So it's a shift where you become sort of on their team instead of trying to drag them towards water, you know, drag the horse towards water. And there's this fascinating kind of human instinct that none of us like being told what to do.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So there's something called the writing reflex, which is it's really hard for caregivers. It's hard for parents because we love to tell people like our great advice and why what they're doing is wrong and they should take our like brilliant doctor advice. And this can be like telling someone like, don't you see what you're doing is causing harm? You should make changes. It can also be subtler.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It can be like lecturing someone or trying to educate them. But when someone shoves something down your throat, your instinct is to resist. It's just like natural human behavior, even if it's a great idea. If someone's like shoving an ice cream cone in your face and like, eat it. Even if you like ice cream, you might be like, wait, wait, I don't know if I want this ice cream.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so the key then is not to sort of tell someone what to do. It's to understand why might they want to make changes. And so once you do that, then you all of a sudden realize, like, it just feels better. You're not trying to drag someone towards something.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You don't have, like, personal skin in the game about what choice they make, but you're really a partner with them and figuring out how is this thing causing problems to you and why might your life get better if you were to make changes to your alcohol use or your drinking or your substance use.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Well, I guarantee that many people listening have been touched by addiction, either personally or in their lives. Because of stigma, we tend not to talk about that. But the scale is huge. So globally, 2.6 million people every year die from alcohol-related causes. So that's 7,000 people today will die from an alcohol-related death. Another 600,000 people die from drug-related deaths annually.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, very different. So in kind of like medical speak and therapy speak, we talked about something called motivational interviewing, which is it becomes almost like a mind trick. But it is basically a way of trying to identify from the person their reasons for change and reflecting it back to them.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so it's not you telling them you think they should change, but you are trying to elicit their motivation and amplify it. And then at the end of the day, you're turning over the power back to them. So that might look like something someone says, you know.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It sounds like your alcohol use is causing some problems at work and in your relationships.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It sounds like you're worried about your safety at work and also how your drinking is starting to affect your job and your relationships.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it sounds like that's really scary that you're really worried your alcohol use could cause even like a serious or life-threatening accident at work.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, and your job sounds really important to you.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Alcohol's starting to get in the way of that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. And so what are your goals looking forward around your job or your relationship?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it sounds like you're really committed to thinking about making a change to your drinking and that you're looking forward to finding a partner and family and you're worried that alcohol might get in the way of that.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, there's like a little bit of like a Jedi mind trick thing where you're... So essentially, it's actually really – it's a little tricky when you're first learning how to do it because what I'm trying to do is I'm listening for what's called change talk. So any little nugget you're giving me about making a change. So you're saying like, oh, I'm starting to get this misconduct.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I'm worried about this thing with safety at work. I want a partner. Those are like – it's a goldmine of little kernels of change. And I'm ignoring all of your sustained talk. So anything where you're arguing for the status quo, it's not a big deal. Drinking is not that big a deal. I can't make a change. I don't even acknowledge it or address it.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that's actually hard because I think most of us pay attention to the negative stuff. So if you think about like a performance review at work or someone telling you any kind of feedback, we tend to amplify and remember like the one bad thing that someone said to us and forget the millions of good things. So you have to change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You have to like train yourself to do the opposite, to hear those little kernels of change talk. And then I'm basically being a mirror, but I'm amplifying it. So I'm taking these little kernels of change talk. I'm reflecting back to your own words. So I'm not telling you that you should stop drinking because it's unsafe at work.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So that's like 1,600 deaths today from drug-related causes. And then when we look at the criteria of sort of meeting criteria for a substance use disorder or addiction, it's about 400 million people worldwide for alcohol and 80 million people for drug use. So it's incredibly common.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I'm reflecting to you like you're starting to get worried that you might have an accident at work and that's really serious. And that's kind of guiding the conversation forward. The other key is that if you meet a point of resistance, you want to pivot. Because once you start arguing, whether it's about politics or anything, people dig in.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So if you start arguing with someone, you got to find another way. You just got to pivot and roll to a different tactic. Because the more you argue, the more people dig in on their point of view. And it's more about like winning the argument than it is about moving forward.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That's what I say all the time. What's your why? I think that's so exciting. Like we all want to live our best lives, whatever that means to us. And so having a purpose, having a goal is probably the most important thing. Motivation is important. We talk a lot about motivation. But motivation is fleeting. It can slip and slide over the course of one day. So you may take kind of a mundane example.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You want to get in shape. And you're feeling super motivated one day. And then the next morning, your alarm clock goes off at like 5 in the morning. and you're tired and it's cozy in your bed and maybe you stayed up a little too late, your motivation's gonna be flagging, right?
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So if you don't have a goal or a reason or a why or a purpose, it's gonna be really hard to actually get up the energy to get up. And so figuring out what that purpose is And then trying to find ways to enjoy the process, because if you're always working towards a future goal, some people are very goal-oriented and that works for them, but finding joy in the process will help you.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So I'll take alcohol, for example, like not an addiction issue, just like making changes to your drinking in your life. So if you're just like, oh, I should stop drinking because drinking is bad for me, that's like a relatively vague goal, right? It's not really about anything that matters specifically to you, and it's going to be hard to stick to that.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If instead you think, okay, I, you know, started to realize that when I drink every single night, I don't get the work done that I want to get done because I'm too tired and I fall asleep. I don't feel refreshed in the morning because I'm not sleeping very well. I'm not getting up early to exercise and that's something that really matters to me.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I'm not like as present with my family as I wanted to be. Then it's all these little micro goals that make it much easier to make a change. So you may decide, you know, I'm not going to drink. I'm only going to drink two days out of the week. And when I do drink, I'm going to keep it to this amount. But the reason why is not some vague recommendation from some doctor.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If you think about alcohol, some studies estimate that the lifetime prevalence, meaning over the course of your life, how likely are you to at some point develop alcohol addiction, is somewhere between 15% and 30% in some studies. So one in three people may have a problem with alcohol at some point in their life. So this touches all of us.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It's because you're working really hard at work, and it feels good to be productive after dinner. And you're training for a race, and you want to get up in the morning and run. And so you actually notice those little steps, like, wow, it feels great. I woke up this morning, and I feel so refreshed. You're reinforcing your goal right there.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You're not working towards some abstract thing that doesn't really matter to you. So you want to make these really focused, personalized goals. and really anchoring it on what is your why. And your why may be very different than my why or someone else's why. So it may be, you know, sleep really matters to you. Or, you know, you may have a different relationship with alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So the other kind of example I'd give is people are different, right? We respond differently to things. So some people can open a bag of, like, potato chips and eat two and walk away. Some people, like, they open the bag, they're going to eat all of the chips. And so it's just easier not to open the bag. And alcohol is like that too.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Some people might find if they open a bottle of wine or they have alcohol in the house, they're going to drink all of it. And the idea of like trying to keep to these small amounts of alcohol is actually really hard and it's simpler and easier to just avoid it completely or to only drink at a restaurant or something.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So you do have to understand like how your goals, your why, your purpose interacts with your response to whatever it is that you're working on and that's going to be different for everyone.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. Yeah, there's a bunch. I think first, any behavior change, whether it's alcohol or other, if you're feeling like depleted and tired and not your best self, it's going to be harder to make a change. So if you think about like any big decision you made to change your job, to start an exercise routine, to leave your partner.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You probably didn't choose like the day that you were exhausted and feeling anxious and stressed and not your best self to make that change. Like change is hard. So you want to try to boost up other things in your life, eat well, you know, get enough rest, try to exercise, things that are going to help you feel healthy in your best self when you're trying to make a change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, because, I mean, so our natural reward system, the thing that triggers it is exercise, food, sex, connection. So, you know, trying to have healthy other ways of positive dopamine release. And so I think for many people, alcohol or substances can feel like a way of doing something nice for ourselves. Like I'm going to – this is going to help me reduce my stress after a bad day at work.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So the goal then is not that you just like white knuckle it all night and feel really stressed after work. It's that you figure out like what are some other things that help me reduce stress after work. Maybe it's going to a yoga class with a friend. Maybe it is, you know, spending time with my family. Maybe it's getting a massage or meditating or watching a show I like.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We just don't talk about it because of stigma and because of these mental images of kind of othering that it's only those people who are injecting heroin who have addiction or that person who has the shakes every morning and is drinking as soon as they wake up who has a problem with alcohol.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So you want to – it's not just you're removing the thing that you're trying to change. You want to fill up the empty space with other things.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But we see that all the time. So that's like replacing things. And, you know, I was reading an article. People have probably heard of dry January, this idea of like not drinking for the month of January to rethink your relationship with alcohol. I was reading an article that dry January has become high January because people are just smoking a ton of weed instead of drinking.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so it's very – I think you want to be cautious that you're not just replacing things. The thing that you're trying to change is something that's also going to cause health problems.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Now, having dessert once in a while for this, you know, you're not getting calories from alcohol and having a nice ice cream cone once a week is a way of sort of treating yourself that's healthier and maybe more aligned with your goals. That's fine.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think thinking about these things, actually thinking about alcohol the way we think about dessert, sunbathing, eating processed meats, all of these things have risk and benefit in our lives. I think where we've gone so wrong with alcohol is this idea that it's like a health-promoting behavior. That you shouldn't be drinking for your health. It's not going to make you healthier.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And also, much like many things we do that are not health promoting activities, there are ways of reducing the health harms of that activity so that it's okay in small amounts in your life.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So it turns out the brain is amazingly plastic, meaning it can change. We see that over time. So the first thing is even adverse childhood experiences are not a done deal. So we talk a lot about ACEs. We don't talk a lot about pieces or PCE, positive childhood experiences. But actually, you can reduce the risk that someone
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, great question. The pandemic was not kind to addiction, so we saw rates of alcohol and drug use and deaths related to those increase significantly after the onset of the COVID pandemic. That has started to level out. So for drug use related deaths, we're now back at the pre-pandemic levels. But there was a very significant increase during the time of the pandemic.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
develops addiction by increasing the number of positive childhood experiences. So take someone who's experienced some terrible adversity. Their parent has died, or they have a parent who's in prison, or they have addiction in their family. If that kid has one single adult figure that they believe cares about them, that reduces their risk of addiction.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So there are a lot of positive ways that we can actually change the trajectory, even in the midst of terrible trauma. When you think about someone who's had a substance use disorder, we actually have good data on this that after five years of recovery, and often that is fits and starts.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So most people think of like this is one fell swoop that you like decide to stop drinking and then success is that you never drink again. For most people, What we find is that's actually like a series of steps. So I always like to think of progress, not perfection and not have this kind of all or nothing mindset that for many people, they may early on have a month where they go without alcohol.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And then maybe next time it's three months and then maybe it's a year. And these recurrences happen, but ultimately they get to this place where they go into long-term recovery. After five years of recovery, a person's risk of subsequently developing addiction is no higher than the general public. So your brain actually does change. And we see this on functional imaging.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We see this in longitudinal studies that follow people over time. So you actually can overwhelm those things and get to a place where you don't have a higher risk than other people.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It's not so much about personality, but we do respond differently to substances. So, you know, take alcohol or opioids, anything. People feel differently the first time they ever use it. So often if you talk to someone who then develops addiction, they tell you that first time they used the substance, it was like this amazing feeling.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It felt like I've had people describe it as falling in love or, you know, a warm hug or like a relaxing bath, these like incredible comforting experiences. Other people, they get prescribed like an opioid for a tooth extraction. They feel nauseous and kind of like not like themselves and they don't like the feeling.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So how we respond to substances is definitely based on our neurobiology and is different for different people. So some people are, both from a genetic reason and their own brain, are just more wired to be at risk of addiction. And that's important to know about yourself because then you can make different choices.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You may decide, you know, never to keep alcohol in the house or not to drink because the risk is too great.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Food, sex, gambling. I think there are a lot of similarities. It's not my particular area of focus, but I think there are a lot of overlaps. I mean, I think many of the things you just listed, you could talk about, one, dopamine, obviously, but two, this idea of
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
needing to fill yourself with something else, either, you know, thinking about trauma, thinking about untreated mental illness, thinking about just kind of the deficit of connection and of meaning and reward and reaching to these external solutions.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And that's really not surprising when we think about what are the things that drive people to use alcohol or drugs in a problematic way.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, yeah. I can think of many patients, but one in particular who, you know, I knew that he'd experienced hard things in his life. He'd been in prison, for example, which is a traumatizing experience. He'd lost his parents, another thing. I never truly understood the depth of his trauma.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And he had struggled his whole life with substance use disorder and using lots of things, mostly opioids, but also alcohol and cocaine and just had had a really, really hard time. And After, I mean, years of knowing him, one day he broke down my office and shared that he'd actually been molested as a young kid.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so sometimes there is that thing that people have never felt like they could share with anyone that really is at the root of so much of what they've been dealing with.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But what drives people to use substances is probably the most important question. And if we look at studies, one is about 40% to 60% genetics. And the other half of the equation is trauma. And so we hear someone talk about alcohol gives them pain relief, whether that's emotional or physical. That's a very real thing. That's because your sort of natural painkiller system is activated by drinking.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And like the person who whispered to you, I think the pain of keeping that inside, not only the trauma of experiencing that as a child, but then holding that secret and feeling like you somehow are damaged or that this thing inside you is there and not being able to heal it, talk about it, share it with people, I think, is just this well of pain that lives inside people.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
He actually passed away.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
From substance use, yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, I mean, I think a couple things. One, there are so many stories of hope that I think counterbalance that for me. So I think the other stories in my mind I carry with me and still care for and are in touch with people who are living these amazing, vibrant lives in recovery. I mean, in the U.S. alone, there's 24 million people living in recovery.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So there are these stories of people who have overcome just trauma, tragedy, hardship, and are doing awesome. They're parenting. They're working. You probably don't even know they're around you. You know, they don't tell people necessarily that they're in recovery. And getting to be sort of a part of that process with someone and
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
watching you know there's nothing in medicine where I can actually see as dramatic of a change as with addiction where someone can be you know in a moment where they're dealing with all of these health consequences and relationship challenges and then they get better and it's just like the most beautiful thing to be a part of and so I think the hope from that the sort of
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
positivity of it is what keeps me going every day. Obviously finding ways to care for myself through that and family and connection, exercise, I run, I write, you know, you have to keep yourself whole through it all too. But I think I get tremendous purpose and mostly like a lot of hope from working with people and seeing them recover.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I think one thing is language. It's like this subtle thing. I sort of mentioned an example where you did it really well, where instead of saying someone failed treatment, you said the treatment failed them. But a lot of the language that we use with addiction actually subtly and not so subtly worsens stigma.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And sometimes it sounds like I'm being politically correct or it's like an issue of semantics, but there's actually really good data on this. So if you think about words we use for addiction, one is substance abuse, right? So the term abuse, what does abuse refer to? So it actually comes from an old English word that means like a willful act of misconduct.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And it's a word that we use for child abuse, for sexual abuse, for domestic abuse. Like it's only for these like terribly violent acts of commission that are very stigmatized because they're like terrible things. And yet we use it for this thing that we're saying is a health condition, that you're like a substance abuser or you have substance abuse.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so there have actually been these elegant studies that took like PhD level psychologists, really highly trained clinicians, and they described a person as either a substance abuser or as a person with a substance use disorder. And the clinician was actually more likely to recommend a punitive intervention for the person described as a substance abuser.
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How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So in this case, they were given like an option. You read this paragraph about like a fictional patient, and they don't really know what the researchers are testing. And they're given a bunch of different options for intervention. And one is this like send them to drug court or send them to jail. One is like offer them, you know, outpatient effective treatment.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There's a bunch of different choices. When they hear someone described as a substance abuser, they're actually more likely to recommend the like jail-based intervention. So words actually like very, they influence how we think, even how we make clinical decisions. They've also done this to the public.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So if you describe someone as a drug addict, the public has a more negative view of them than if you describe them as a person with addiction. So there are these subtle ways there's been this shift in addiction to really using what we call person-first language, which has been true across medicine. So, like, we used to use terrible words.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Like, we'd refer to someone as, like, the schizophrenic, you know, or really labeling them as their health condition. And thankfully, there's been a change from that to realize that people are people first who have an illness or not defined by it. So I would never say, like – I'm going to go see the lung cancer in room 204. I'd say, I'm going to see, you know, Mr. Smith who has lung cancer.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And so with addiction too, like people are more than that. So to say, you know, person with addiction, person with an alcohol use disorder, rather than saying they're an addict or an alcoholic. And then even terms like clean and dirty, which are commonly used when we talk about addiction. So, you know, take the word clean. It sounds really positive. Like you're saying, oh, you're clean.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Like, what are you really saying? So you're saying, like, if you're clean now, when you were actively struggling, what were you? You were dirty. And so I always remember an example. A friend of mine who's in recovery was interviewing for jobs in the recovery space. And so people on the interview trail would say to him, like, how long have you been clean for?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, so obviously COVID was one driver. One of the main other drivers was substance-related deaths. So actually immediately following the onset of the pandemic, so beginning March, April of 2020, we saw a 23% increase in alcohol-related mortality, and we saw the highest rates ever we've seen of drug-related overdose deaths. And that actually impacted U.S. life expectancy up until this year.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And he would say, well, I've been bathing since I was a newborn. So I've been clean my whole life. And I've been in recovery for five years or whatever. So I think these little things actually matter that we should use terminology that we'd use for another health condition.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
If we're labeling people with active addiction as dirty or people with addiction as the same as child abusers with that sort of language, we're really sort of subtly increasing stigma. So that's a small thing that we can all do is just try to use language that's a bit more humanizing. Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, it's hard to change. But, you know, like everything, you just want to be humble, curious, and keep trying. I mean, there's lots of language that we've changed. Like, think about so many terms we use for...
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
you know for you know people who are born with different abilities or for people of different races or other identities that we're really stigmatizing and we've like learned to use different language even if it feels a little awkward when you're first learning it I think understanding the science and the data behind the impact it has to use certain language I think is really useful yeah because that's helped me to understand just because now I understand the first principles of it I need to make sure I describe people as a person first yeah so a person with addiction addiction is much better than calling someone an addict yeah exactly
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And one thing people ask me will say, well, what if someone refers to themselves that way? Because people may do that. And that's fine. People can use whatever language they want for themselves. But I think as a healthcare professional, for sure, or someone who's trying to help combat stigma, like we can choose to use different language.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I've actually had patients sort of ask me like, well, why do you use that terminology when they use a different language? And it actually can be sort of empowering to be like, oh, yeah, I'm actually a person in recovery. I'm a person with addiction. I'm not going to label myself that way anymore. Yeah.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
You're like defining yourself as incapable of doing something instead of being like, I'm working on organization right now.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, you're sort of labeling them as that is the only thing that they are and that they will be that forever. And, you know, a friend of mine is a journalist who is in recovery and writes a lot about addiction. Maya Solovitz wrote this great New York Times piece that addiction doesn't always last a lifetime.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Because I think there's this idea in our head that, like, you know, people with addiction will always have addiction. And it's this, like – incurable thing and that actually people have lots of different journeys. And for some people, you know, that becomes something they deal with and then they move on in their lives. For other people, it's something that they actively manage.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But this idea that you sort of boil things down to like the only thing I am in this world as a person with addiction, you really limit everything else about yourself.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
This is the first year that we've seen that change.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I guess I would say, and I could think of lots of successful accomplishments I'd apply this to, but I'll take the example of medical training, which is a successful accomplishment. I think I would be more present that we are always like rushing to the accomplishment, to the finish line, to sort of getting to the next goal.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think back and wish I had realized what an amazing journey it was in that moment and I mean, even things with medical training that I was I was never going to be a heart surgeon. But to stand in an operating room and look inside someone's chest and watch a beating heart is an experience that I'll never get again.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think in this journey to always achieve and move forward and get to the next exam and the next thing, we sometimes miss like the miracle that's right in front of us. And so I think I would have been even more present.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
True for parenting, true for everything.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah. So that's a really great question. What drives people to use substances? It's actually probably the most important question, even in my work. If you don't understand what someone's substance use is about or related to, how are you ever going to address it or help them address it? So trauma is probably the single biggest driver. So you often hear things like cannabis is a gateway drug.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Spring of 27. So we have some time.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It is going to be about changing the narrative around addiction and about really reframing how people think about it to see it as a treatable, good prognosis illness and using some of the stories of people I've had the privilege of knowing to hopefully help people see things in a different way.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes, they can find me on LinkedIn, on Instagram. They can email me. Yeah, happy to connect and would love to come back after the book is out too.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
I would say trauma is the gateway drug. If we look at many, many studies, they're kind of Two different things that drive someone's risk of addiction. One is genetics. It's about 40 to 60% genetics, similar to diabetes in terms of someone's risk. That's not a done deal, obviously. There are people with strong genetic risks who never develop addiction and people without that who do.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The other half of the equation is based on kind of your exposures and your experiences. And one of the number one drivers is what we call adverse childhood experiences. So there's this famous study called the ACES study, which stands for Adverse Childhood Experience, and it's been replicated.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
There's a recent one done actually in Europe as well that looks at the number of adverse childhood experiences you have, and it's a linear track increase in terms of your risk of substance use disorder. So if you think about what's happening in the brain with substances, you know, when we use alcohol or drugs, all sorts of feel-good hormones are released, right?
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Dopamine, your endogenous opioid system, which is literally your natural pain reliever. And if you take someone who's experienced trauma, there's great relief that people can find in substance use. And so we saw that in the pandemic, like what was going on in the pandemic. People were scared. They were bored. They were lonely. They were stuck at home. They didn't have their usual routine.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Some people were losing people that they loved. And so we saw all of this escalating substance use. And it was actually most pronounced in people who are frontline workers. So that could be a health care provider. It could also be someone working in a grocery store or a convenience store who had to work through the scariest times of the pandemic. And also people who are caregivers.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
So those are kind of the two groups that had the biggest increase in their substance use during the pandemic.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yeah, well, alcohol is a really complicated one because alcohol has lots of different effects on the brain. So any drug or substance that can cause addiction is going to release dopamine. That's sort of a primary driver of many things that we find rewarding, whether it's sex or food or alcohol or drugs.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
It's an anti-anxiety and a pain medication sort of all in one.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But alcohol also, so it binds to the part of our brain, a system called GABA, which is sort of our anti-anxiety system. So it's the same system that anxiety medications like People may have heard of Ativan or lorazepam or Xanax, these medications that are kind of sedatives and anxiety meds. Alcohol acts on that part of the brain.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And it actually then causes a release of your endogenous opioids in your brain, so like your brain's natural painkillers. So that's actually why one of the medications that's effective in helping people stop drink actually just blocks the opioid response in the brain, which doesn't make sense when you first hear about it until you understand these neural mechanisms.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
that actually your sort of natural painkiller system is activated by drinking. So when you hear someone talk about alcohol gives them pain relief, whether that's emotional or physical, that's a very real thing. That's a powerful system in our brain that gets activated when you're drinking.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
The biggest problem is that people haven't been given the evidence and tools to understand addiction. But also many rehabs don't offer the things that we know are actually effective.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Totally. It's an anti-anxiety, anti-pain medication sort of all in one. And I think often this is part of the area where I think just getting more awareness and education about alcohol is so important because we see that as a way of treating ourselves, right? And it's very easy to have that get out of control.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And I think especially if in your head you think, as long as I'm not like drinking in the morning or missing work because of drinking or, you know, having problems in my relationships, I'm fine. But actually there's so many health problems and even life problems related to alcohol that people may make different decisions for themselves if they had that awareness earlier on.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
That's a great question. One of the most effective tools we teach people is something called... And they found that people drank much less after it.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
Yes, it's a great question. Trauma at any time can put you at risk for addiction. The earlier that happens, the more sort of long-lasting the impact can be. So when we think about the brain, you know, your brain doesn't really fully form until early to mid-20s. And so both in terms of trauma, but also in terms of early substance exposure, you're at much greater risk when you're younger.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
But that doesn't mean that trauma in later life doesn't put you at risk for developing substance use as well. So I've seen people who, you know, their first trauma was in their 20s or 30s or 40s, and they can still develop a substance use disorder. It's just the risk is even greater when you experience those adversities as a child.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
And the interesting thing is, you know, trauma is not so much about the experience. It's about... often being left alone to grapple with that experience by yourself. And so what's traumatizing to one person may not be traumatizing to someone else. And take the pandemic, for example. I've talked to people who like being stuck at home and alone and bored was deeply traumatic. Other people
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
were fine. They like were in their living room, you know, doing whatever and found ways to connect and to live their lives and did okay. It was the same experience, but it was experienced very differently by different people. So it's less about the actual experience and more about the impact on that human, how they're left feeling. And often it's about feeling disconnected.
The Diary Of A CEO with Steven Bartlett
How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman
We often talk about the opposite of addiction is not sobriety. It's actually connection. It's how do you build that connection with other people again?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I'm seeing people in their early 30s with cirrhosis in the hospital. And I think those are like some of the most heartbreaking cases because people thought like this wasn't on their bingo card. They did not even think this was a concern. You know, they were drinking heavily. They thought it was their social circle was doing the same thing.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then all of a sudden they're in their late 20s, early 30s in the hospital and liver failure. And, you know, there's very little we can do at that point other than an organ transplant, which is a huge deal and not something that's accessible to everyone.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, and there's actually a lot of studies showing this. So between, you know, 2010 and 2020, there's been a significant increase in alcohol related liver failure, especially amongst women. and younger and younger people. And even just after the onset of COVID, we saw somewhere around a 25% increase in alcohol-related death after the onset of the pandemic.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So the pandemic was hard for many reasons, but it certainly increased alcohol use across the country and with that, liver disease and liver failure.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
How does alcohol impact the kidneys? So alcohol, one of the main effects that people have probably experienced is it makes your kidneys less sensitive to a hormone your body produces called ADH or antidiuretic hormone. And so you pee more. So if anyone's ever noticed that when they drink, they sort of pee a lot more.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And it's not because you're hydrated, because that's what I thought is why you pee more is because, oh, I just have more liquid in me, but it's actually because it's blocking a hormone. Exactly. So even irrespective of how much volume you've drank, you pee more because of this blocking of the effect of a normal hormone function in your kidney.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so that can lead to dehydration, which is one of the many reasons you feel really crummy the next day because you get dehydrated from drinking. What about the gut microbiome?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So alcohol, I think there's growing research on how it impacts the microbiome. Certainly, again, at heavy levels, it seems to harm the microbiome. And we see this in patients with liver disease, but also just the impact of alcohol itself. The kind of two main things it does, one is it creates more leakage in your gut. So people may have heard of kind of leaky gut.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, the walls of your intestine become more porous so that things that aren't meant to come out of your intestine do and can actually cross the blood-brain barrier. So this whole idea of kind of the brain-gut axis. is a really growing area of research and knowledge. So alcohol can do that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It can also change the makeup of your microbiome itself, as can high fat, high sugar, white flour, sort of the Western diet. But there's now a lot of studies showing that that some of the modifiable things, if you want to improve your gut health, are decreasing your alcohol consumption and steering away from that kind of Western diet of high fat, high sugar, high carb.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, I'm sitting here listening to you and I'm thinking, why the hell do I even drink this stuff? Yeah, I think it is important to understand sort of what are the risks that we often don't talk about and assume that this is, you know, harmless thing that's just a part of life. My personal perspective is that every health behavior exists on a spectrum.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And it's really important to understand sort of what is that spectrum? Where do I fall? And then what are my personal health goals? And actually stopping to sort of think, how does alcohol fit in my life? Like, what do I like about it? What do I not like about it? What am I worried about it? What is this amount of alcohol doing to my health? Is there any health benefit to drinking alcohol?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
My opinion is that we shouldn't be thinking of it as a health benefit. So I would never, as a doctor, say to a patient, I think you should start drinking a glass of wine a day for your health. We used to people used to say that, you know, again, this idea of a glass of red wine is healthy. I think that framing is wrong.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think that doesn't mean that you can't drink any alcohol and we should talk through that. But thinking of it as a health promoting behavior is probably not the best way to frame it. Now, there are many things we do in life that the safest thing would be to do none of it.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if your goal is to have zero risk, you should probably never drive your car, never go skiing, never fly in an airplane, never eat bacon, never go out in the sun. And people aren't going to live that way. So I think it's really important to understand what are the risks? How does this fit into my overall life? And when should I be concerned?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And how can I actually make changes to decrease those risks? So if you're finding that you are really stressed in your life and you're reaching alcohol as a stress reliever, it's probably not going to be a healthy way of coping with that and may lead to longer term problems.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And especially if you're trying to live a life where you're being more mindful or more present or present for your kids or your partner or you're trying to get in shape and you want to wake up in the morning to exercise. If you're drinking every night, you're probably going to feel not refreshed in the morning. You're going to notice that you don't have the same exercise capacity.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So I think just figuring out sort of how this ritual, alcohol, what role it plays in your life. And it doesn't have to be that you stop drinking entirely. And I think that's a really important message because that may not be the goal for people.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But if you are feeling like maybe this is causing some problems to me, maybe this is actually counterproductive to my other health goals, making some changes, cutting back, taking a break. Those are all really healthy ways that you can start to really explore your relationship with alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So from a research standpoint, high risk drinking would be if you're having more than 10 ounces of hard alcohol a week or 35 ounces of wine in a week for a woman or for anyone over 65. So above that, we start seeing health risks like increased risk of dementia, impact on your liver, your digestive tract and other serious conditions.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, and I think there's so many important points buried in that. So first, we all lie. I tell my dentist I floss every day. I don't. We want people to like us and approve of us. So I sort of expect people will lie to me, especially if they don't know me. And for most people, because of the tremendous stigma around substance use disorder, there's a lot of shame and worry.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
For many people, their experience has not been that good things happen to them when they share that they're having a problem with alcohol or other drugs. And so as a doctor, I feel like it's on me to earn someone's trust and also to educate them.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I mean, there's nothing more heartbreaking to me than when I see someone in the terminal stages of liver failure, for example, from alcohol, and no one has told them beforehand what the risks are, that this could happen, what sort of lower risk drinking looks like.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
they've often never had that conversation so we'll see people in their 30s come in they literally die during that hospital admission and you look back and they had touch points with doctors they maybe were drinking heavily and no one stopped to sort of talk to them about it and i think that is a real testament to how in the medical system for so long we have seen substance use and addiction as something separate from the rest of health care is sort of not our job or a behavioral issue or a moral issue or a willpower issue
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But this is a health condition like any other. And I think the medical system and doctors need to get comfortable talking to patients about it, asking them the right questions, giving them the right education and partnering with people around making healthy changes.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
that you would say these are all indications that this could be a problem yeah that's a great question so i'll run through kind of the checklist that i'm thinking when i'm talking to someone about alcohol so first um you know understanding how much they're drinking just the general quantity and how frequently is important as sort of a proxy for what their risk might be but then the really important questions are um are they drinking more than they want to so are they
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
They may have set an intention for themselves and they're finding they're actually always drinking more or spending more time on drinking or recovering from drinking than they intended. Have they tried to make changes and not been able to? So if you tried to cut back or tried to stop and you actually weren't able to, that's a really important sign that you may have lost control of your drinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Are you drinking despite the fact that people in your life are worried about it or your spouse has expressed concern or it's impacting your work or your ability to function in roles that matter to you? Are you drinking despite the fact that it actually makes you more anxious or it's worsening your mental or physical health in some way? And then we often think about
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
craving, which is sort of a strong psychological urge to want to drink. So like you can't get the idea of having a drink out of your mind. That's something that we can see with alcohol use disorder. And then there are two physical symptoms, which is that idea of like, do you need to drink more to get the same effects?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Do you need to drink four drinks now, whereas before one or two would give you that effect? And do you feel sick if you stop drinking? So that's sort of the checklist we run through and I think really gets at those kind of general areas of losing control, using compulsively, using despite consequences and then craving.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it's a great question. So one really common thing is worsened acid reflux. So if you have heartburn, that's strongly associated with alcohol, which actually relaxes the part of your esophagus that allows acid to come back up. So oftentimes people who are struggling with terrible heartburn and they don't realize that those two glasses of wine are probably having a direct impact on that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Other things we know that alcohol can make you dehydrated. So you may notice that your skin changes. It impacts how you sleep. So you may feel less rested when you wake up in the morning or wake up in the middle of the night and not be able to fall back asleep. So lots of little sort of day-to-day ways that alcohol may be impacting your health and your experience.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, you'll see a lot of really quick things. So when you'll sleep better and feel more restored, you may lose weight. There's a lot of calories in alcohol. So if your goal is to lose weight, you're drinking a ton of liquid calories. So you may find that that's better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You may find that your exercise capacity goes up because you're resting more and you're not having hangovers and you're able to exercise in a way that feels different. You may find that you're less irritable and more present for your loved ones, that your mood is actually better over time. Your skin might look better. You're less dehydrated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Your hormones are more regulated, so you may have less acne. So all of those benefits you can often see in a very short time, and that can be reinforcing as you decide what you want your long-term goals to look like to really see what life is like with less or without alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, this is, I think, an area of growing research and understanding. And I think people are really interested in sort of drinking during menopause as well and what to think about all of that. A couple things. I think many of the symptoms that people experience during menopause, like hot flashes, will be made worse by any amount of alcohol. Really? Yes, because alcohol dilates your blood vessels.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you may have experienced if you drink a couple glasses of wine, you actually feel flushed. Yes. Well, it's just going to amplify the experience you're having during hot flashes. So if you're trying to not have hot flashes, drinking is going to be your enemy in that because it's just going to make that worse. Same things like sleep disturbance are really common in menopause.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Mood changes and alcohol may impact all of those. And it can be a tough cycle because you may be drinking because your mood is actually low and you're having a hard time falling asleep. But then alcohol is actually running counterproductive and making those symptoms worse over the long haul. Let's talk a little bit about sleep because. Yeah.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Doesn't alcohol impact your sleep in a very negative way? Yeah. And people may be surprised to hear that because it makes you fall asleep quicker. So often people are like, oh, alcohol helps me sleep because I fall asleep so quickly. But when we think about sleep architecture, there's different cycles to sleep. People are probably familiar with REM sleep is that deep, rapid eye movement sleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But there's different cycles that your body, your brain naturally cycles through in the night. And the balance of those cycles is really important to get restorative sleep, which is when your body rests and heals. And what alcohol does is it changes the makeup of those cycles. So you go more quickly into deep sleep and you have less time in sort of the normal phases of sleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so your sleep architecture is disrupted and you don't get that same restful sleep. You may wake up at two in the morning, you know, after you've fallen asleep really quickly, but then you wake up and can't fall back asleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Or you may wake up in the morning and just feel not refreshed, even though you were completely, you know, asleep very deeply because your brain is not having the time to restore itself the way that it needs to. I have another question for you, Dr. Wakeman.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, hangover is fascinating, and I think people are still trying to understand exactly what is going on. Loosely defined, what we refer to as hangover often is a constellation of symptoms that include headache, feeling anxious, often actually having diminished exercise tolerance, so you don't have the same aerobic capacity that you did before, feeling irritable.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Those are all symptoms of hangover that people have probably experienced. There's an older school of thought that actually it was mild alcohol withdrawal. So withdrawal is when you are drinking so much that when you stop drinking, you actually get symptoms. Seems like that is likely not the case. The constellation of symptoms is quite different.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so the thinking is that it's a combination of really two things. One is dehydration. So we already talked about how alcohol make you, you know, make you pee more. And so you get dehydrated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then the other is actually byproducts from the drink that you're drinking itself, either the sort of breakdown products of alcohol, or there are certain types of liquors and drinks that have other types of molecules, cogeners that can build up and make you feel even crummier. So for example, clear alcohol tends to cause less of a hangover than dark alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that's probably because of the other substances that are in it. But it's really sort of toxic byproducts and dehydration, if I were to sum it up, of what's causing a hangover. Why is anxiety one of the biggest kind of symptoms of a hangover and alcohol withdrawal?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it's probably the effect of these byproducts that then, you know, are still impacting the way your body functions, your brain, and it takes a long time for your body to excrete them. And so we can see just feeling that really anxious, restless, kind of gross feeling afterwards.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it does, especially over time. And so what we see when people have been drinking over a long time is actually your body starts to adjust. because our bodies are very adaptable. So if your body's used to having three or four drinks every night, your body's going to start to accommodate to that. And so what we see is actually changes in the brain.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you see changes in the amount of receptors you have, the amount of hormones you have, your dopamine levels, your stress hormone levels. Your brain is actually adapting to the effects of alcohol. So one thing you may see is that you actually don't get the same effect. So it used to be that two glasses of wine made you feel a certain way, and now you need three or four to feel
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
the same way that's a concept called tolerance that your body is adapting to having that alcohol around all the time and your brain's actually changing the reverse of that is if all of a sudden you stop drinking you're going to feel all out of sorts you're going to feel shaky you may have a headache you may feel anxious you may feel nauseous and that's because your body's gotten so adapted to always having alcohol on board that it takes time actually for those changes to reset
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, there's a couple of really important things to know. First, alcohol itself can cause depression and anxiety. Even though you feel like in the moment it's helping relieve symptoms, there's actually something called a substance-induced mood disorder where you can look all the world like you have depression and it's actually caused by using alcohol heavily over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you may, if you're drinking heavily, you may actually be running, you know, working again at cross purposes with your efforts to try to manage your depression or anxiety. The other thing is there are some types of medications that are really dangerous when they mix with alcohol and anxiety medications in particular, especially any medication that also has sort of a slowing down effect.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So some people take medicines in a class called benzodiazepines, so things like Xanax or Klonopin or Ativan. Those when mixed with alcohol have sort of a combination effect that can actually slow down your breathing, could cause an overdose, could make you very sick, could make you more sort of impaired sooner. So really important to not mix those medications with alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
How does alcohol compromise your memory? So alcohol affects all parts of the brain, including the amygdala, which is an area that lays down memory. And it has complicated actions in the brain. So it increases sort of more slowing down hormones. So we think of it as a depressant because it sort of slows you down and relaxes you. And it decreases more excitatory neurotransmitters.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
In the short term, because your consciousness is being affected, you won't be making new memories. Over the long term, heavy alcohol use can actually cause dementia. It can cause severe memory problems.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
There's actually a unique condition that we only see with alcohol generally, where the part of your brain that lays down new memories gets damaged and people get basically an amnesia syndrome where they can't make new memories. So they can only remember things from the past, but they're unable to make any new memories anymore.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that's a very extreme example, but we see it in the hospital and it's really scary when it happens.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
We actually see brain damage on people who've had chronic heavy alcohol use over many years. So if you take a picture of the brain, like with a CAT scan or with an MRI, what we describe it as is volume loss. So normally you want to see a big, healthy, robust brain. And as you age and with types of dementia, One thing that we see is the brain starts to shrink.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So like the actual functional parts of the brain are smaller. We see that process accelerated with heavy alcohol use. So often take someone who's in their 50s who really shouldn't have volume loss in their brain at that age. But if they've been using alcohol at a very heavy amount for a long time, we'll often see their brain looks like a much older brain because of that shrinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then there are very extreme examples like this rare memory condition where we literally see that part of the brain almost die. Like you can see it light up that it's been severely impacted. That's scary. Yeah. It is really scary.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think these are such important questions. And one of the greatest tragedies to me around substance use disorder is often family members and the general public have been fed the wrong thing to do. And so I think it's a great thing to talk about. First, it's important to define sort of what is an alcohol use disorder, because that's sort of what we're getting at.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, there's there's heavy drinking where we're worried about the long term health effects. And then there is where alcohol has become a problem in your life. And really, the definition of an alcohol use disorder is losing control over your drinking, compulsive use of alcohol and using despite consequences.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you are continuing to drink despite the fact that your partner has shared that they're really worried about you or you've started to have problems at work because you're calling out sick or you're You're continuing to drink despite health problems related to it. So your doctor says, you know what, your liver tests are elevated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You really need to cut back on drinking and you continue to drink. Those are all signs that alcohol started to play a different role in your life. About 15% of the population will have an alcohol use disorder in their life. So this is a very common health condition, more common than many other conditions we see. The great news is that it's entirely treatable. Most people will get well.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think we often have in our minds that this is like a terrible stigmatizing recalcitrant condition that no one ever gets better from. That is not true. And that notion that this, you know, something to feel hopeless about, I think drives a lot of the stigma and shame. There is good treatment out there. People will get well, but they do need care and they need support.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think the first thing you can do if you're a loved one is just share your worries, not in a way that blames the person, not in a way that's judgmental, but in a loving way, just like you would about anything else with someone's health, that this is what you've observed. This is why you're worried. Explore what the person thinks.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that becomes really important because when it comes to addiction, it really doesn't matter at all why I think someone should make changes to their alcohol use. The only thing that matters is they think their life will get better in some way. And so really starting to sort of untangle what are this person's goals and how is alcohol getting in the way of them reaching it? That becomes the work.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And a partner can be a wonderful mirror for that. You know, I know you're working towards a promotion at work and you mentioned that you had to call it sick twice this week and your boss is frustrated at you. What do you think about that? So really exploring it.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And ultimately, you're sort of empowering the person to feel like they can make a change and that you're supporting them, but you're not forcing it on them, which is often what people feel caught up in having to do.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think people have heard these notions of like tough love, enabling, hitting bottom. Those are probably the biggest fallacies. So for people who aren't familiar with those concepts, the idea that tough love is that like you really should make things hard on a person that if sort of consequences pile up, the person will ultimately get better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Enabling is the idea that you're kind or caring to someone that you're actually hurting them in some way. And hitting bottom is this idea that people have to just fall so far and suffer some terrible consequence before they make a change. Those are all really problematic concepts for a couple of reasons.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So first of all, the definition of alcohol use disorder is not being able to stop despite bad things happening to you. And many people are drinking because it's a powerful coping mechanism. And some of the things that put you at risk for an alcohol use disorder are traumatic life experiences, untreated anxiety and depression, not feeling good about yourself.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So having the only people that you sort of love and trust in your life try to cut you down to size and tell you that you're doing something terrible and set some ultimatum is actually not going to help you get well. None of us make hard changes when we feel threatened or sort of punished or not supported. We do it when we feel loved and safe and have hope that our life could be better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so as a loved one, that's probably the greatest gift you can give to the person. Now, it's complicated because you're impacted by their behavior. So it's very easy as a provider.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
One of the things I love about doing this work, because I've been on the other side and had family members and it's a different experience as a doctor, like whether or not my patient continues to drink doesn't impact me personally. I can just be their partner, their champion, work with them.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
For families, there are times where the behavior becomes so unsafe that people have to keep themselves safe and set boundaries. And that's OK. I think the distinction there is that it's not doing it for the person's benefit. So if you kick someone out of your house, it's not going to necessarily help them get better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But there may come a time and a place where people need to do that for their own emotional safety or well-being. But for that human being to help someone get well, and this is where earlier conversations are so important, is to really sort of love and support them and work together on it and make sure they find access to good treatment, which is out there and available.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, so many important pieces in there. I think there's so much stigma in our society about alcohol use disorder and substance use disorder. And people rightfully so feel really ashamed and secretive. And sometimes long after they've started to worry about themselves, They're scared to tell anyone else because they think someone will judge them or treat them poorly.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that stigma and fear of bad treatment or judgment actually keeps people from seeking help for a long time. I think the other really important piece is that when you're removing something that has played a powerful role in someone's life, you need to fill up those spaces with other things. I think our sort of Puritan roots as a society is we have this idea that like you're doing something bad.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You need to just pull yourself up by your bootstraps and knock it off and white knuckle it. And in fact, like it should be hard. You know, that's often our sort of these ideas of tough love and hitting bottom is like, well, you're you're like have done something bad and you, you know, you don't have willpower. So we're going to make it tough on you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
When in fact, like the broader concept is why would someone make changes and how is their life going to get better? And how do we make it easy to make a change? And so if you think about any change you made in your life, if you set yourself up for success, you're going to be far more likely to be able to make that change.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you're suffering from trauma, depression, anxiety, you're not going to be able to just stop drinking without help. You need help treating the anxiety, depression, trauma and also treatment for the alcohol use disorder. That's not because you're weak. That's not a failing. And if you're not able to sort of
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
meet your goals with whatever intervention and support you're getting, that's a sign that that support is not enough for you. So really shifting from this idea that the person is failing to thinking like the system, the treatment, the resources are failing. And how do we adjust that instead of blaming the human being who's suffering? I just want to thank you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think ideally it starts young. Like ideally you're having these conversations very early on with kids in a pragmatic, not in a scare tactic way. So we know that things like dare, you know, this like I'm going to scare you into this is what alcohol and drugs do to your brain. Actually, kids use more drugs after seeing that sort of stuff. It's not helpful.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Kids see right through adults when they're sort of all or nothing about things. So having these nuanced conversations like you're going to be around friends who are drinking really heavy. What do you think about that? What's been your experience? What are some of the worries you might have about that?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And talking about the very practical risks that are not necessarily like liver failure addiction, which are not going to be resonant for a 19-year-old. But, you know, getting into a situation that doesn't feel safe, you know, getting into a sexually vulnerable position with someone, doing something that you don't want to do, missing class the next day.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So talking about sort of relevant, personalized issues that may come up for that kid. And then importantly, that your child feels safe talking to you. You know, you want them to feel comfortable coming to you about small things so that they'll come to you about big things.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so you can share all of this in a way that doesn't feel judgmental, doesn't feel accusatory, really opens the door to ongoing conversations instead of making someone feel sort of, you know, like they're being blamed or judged by their parent. So for somebody that's never even broached this and
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Well, first of all, it is not too late. You have not failed. None of us are perfect in this. These are hard conversations and we haven't learned how to do it. So it is never too late. It doesn't matter how many times you've ignored it or had an unproductive conversation. I think in that moment, probably the most important things you can communicate are, I love you. I'm worried about you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I'm here for you. I know that treatment works. This is how I can support you. So like many things, you're sort of talking about yourself. You're talking about your care and concern. You're rooting everything and how much you love this person. And you're offering to be a partner and helping them find support and treatment. And it may not happen that day. It usually doesn't.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So often the journey to recovery is the circuitous journey of a thousand small steps. It's very rarely that dramatic leap we see on TV. And so to not give up hope and to know that those small moments of kindness and support actually are progress and are part of the person's journey to ultimately getting well. If you're the one that really just wants to cut back,
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you're listening and you want to cut back on alcohol use, I think first figure out your why.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think understanding first how alcohol fits in your life. And so people can do this at home by just keeping a drinking diary. So even just jotting down on your phone or in a notebook when you want to have a drink, sort of what activities you associate with drinking, what, you know, when you do have a drink, how many drinks you have over what time periods.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It's sort of like keeping a food journal where it actually just makes you more mindful. Like, oh, I'm like triggered to want to snack on this thing because I'm feeling really upset about this fight I just had. You can identify that with alcohol, too. Like you mentioned this earlier, I'm really stressed out at the end of the day. And so I come home and want to reach for a glass of wine.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Understanding sort of how alcohol fits in your life is an important first step. And then figuring out what are the goals you're working on right now. And that could change over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But again, if your goal is something related to fitness or wellness or health, you may find after learning more about alcohol and the role it plays in your life that actually you want to change how much you're drinking. And so then you have your why. My why is I'm training for a marathon and I found that when I drink, I have a hard time waking up and going for my long runs.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so I'm only going to drink on this day and I'm going to keep it to this amount. So it's very specific and that's important for behavior change. If you make this broad sort of general goal of I'm never going to drink again because alcohol is bad, you're probably not going to do it because that's hard and it doesn't really relate to you as a human.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So as much as you can make it specific, measurable, time bound. So it's like the next three weeks, I'm going to try this and then I'm going to reassess. That makes it much easier to actually make change and stick to it over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Exactly. And there's lots of tips out there, but you want to make it as easy as possible for yourself. So if your goal is to cut back on drinking, you don't want to have a week where you're packed with going out to happy hour with people. You want to really set yourself up for success. So organize your social activities around non-drinking activities.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Come up with a plan if you're going to be in a situation where you would normally drink, that you're going to have a glass of club soda in your hand the minute you walk in the door. You're going to have a friend who knows that you're working on this who's going to be your partner.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Setting those intentions and those ideas and tools and tricks ahead of time will make it way easier for you to ultimately reach that goal of cutting back.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Great question. I think first letting people know about your intentions. So sharing what your goal is, is really important because people can't support you if they don't know. And if you've always drank a certain way with your partner or friends and all of a sudden you're not, they're not going to be like, what's going on?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Whereas if you say to them, hey, guys, I know you love me and support Eat Me. I want to share with you that my new goal is to not drink more than one drink a day or only drink on Friday and no more than two drinks or not drink at all. And this is my why. I'm doing this because I'm worried about myself or I'm doing this because it feels counterproductive to my health.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And I really want your support. And this is how you can support me. So then you're really framing it as they get to be a partner with you. You're not criticizing their drinking because often people feel then like, oh, I'm a little self-conscious. This person's going to be judging me or they think I'm bad. You're just asking for their help.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so maybe that looks like instead of meeting for drinks, you meet to go to yoga class or you meet to go for a run or you let the person know why you're going to be ordering a soda water instead of a drink. And so you can be really concrete both for yourself and what those tools look like, but also for the people in your life to signal to them how they can help support you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And sometimes people can't do that. And that happens whenever we make any big change. People may have experienced that if they decided to have a weight loss journey or change their life in some way, that there are people that really fit in our lives for a certain point that can't journey with you through that transformation. And that's sad.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But if you find that despite those conversations, someone is actually destructive to the change that you want to make and not supportive, then that may be a broader question about sort of the role of that relationship in your life.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think I'd like to just talk for a moment about alcohol use disorder. I think we've been covering sort of the health harms of alcohol use, either at a low risk level or moderate level or high level. For anyone who is struggling with alcohol use disorder is worried they may be struggling with alcohol use disorder. Treatment works. You will get well.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Finding sort of a trusted health care provider that you can partner with is a part of that journey. But to really have hope, this is not a hopeless condition. It will not be with you forever. You will be in a place where you're free from this.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And there are treatments that are out there and just getting those much like you would for depression or diabetes or high blood pressure is the most important thing. And this is not an issue of shame or willpower or being bad. And I hope that people will feel like they can come in and get the help that they need.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It can be really hard to hear this, especially in a society that still stigmatizes alcohol use and alcohol use disorder. I think take this as a message of love. Someone loves you. They care about you. They're sharing their worries and they're there to support you. And they want to be a part of this journey to help you live the best life you can possibly live in whatever way that means.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And hopefully it will be a moment to pause and thank and get the support you need to make some changes.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Thank you, Mel, for having me. This is a true pleasure. And hopefully these words will reach people who are working to better their lives or worried about someone they love.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Sure. So alcohol is a molecule. It's a water-soluble molecule that is readily absorbed in your body through your stomach and your small intestine when you drink it. And it affects all different parts of your body and body systems, in particular your brain, which is why we feel the effects of alcohol pretty soon after you start drinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And we can talk through what those effects are, but it impacts our behavior, our sleep, our mood, and many other parts of our body system. Okay. You talked about alcohol as a molecule.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yes. I mean, the way alcohol that we drink... happens is through a process called fermentation. So something that has sugar like grape juice or you think about beer, barley or potatoes or other often starches are fermented. And in that transformation process, they form an alcohol molecule that then has a different effect on our body. Alcohol's found in all sorts of different things.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So obviously it's intentionally made through fermentation to ingest, but we also use it in cleaning products or like rubbing alcohol or mouthwash, hand sanitizer. So there are alcohols all around us and used for many different things. Huh.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It is. And in fact, some of my patients with the most severe forms of alcohol use disorder will drink hand sanitizer or rubbing alcohol or mouthwash if they can't get regular alcohol, which tells you really the power of addiction once someone gets to that level of severity. But it's the same molecule with the same effect.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Exactly. The actual alcohol molecule that we think of in a fancy cosmopolitan is not different from what's in rubbing alcohol, let's say. I never knew that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Absolutely. I mean, that it is so socialized and a part of culture and a part of celebrations and events that I think it just feels like a part of life.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So this is probably the most fascinating area of research where things have changed and gone back and forth over many decades of science. And it's actually a somewhat tricky question to answer, which is why I think there have been very confusing sometimes and conflicting studies about this.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you want to try to understand what is the impact of low risk drinking, moderate drinking, higher risk drinking, you have to figure out how do you study that. So you need to follow population over time to see what happens. And then you need to figure out how do we isolate the effect of alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so early on, there were lots of studies showing that low risk drinking or moderate drinking were actually healthy. I think I remember something about like a glass of red wine is really good for you, the antioxidants. I don't know if that's the red wine lobby telling us that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
One criticism of those studies showing that low risk drinking is healthy is that the group that is often used as sort of the comparison group are people that don't drink at all. But it turns out that many people who don't drink at all may not be drinking because they have chronic health problems or because they actually used to have an alcohol use disorder and they're now in remission or recovery.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And they may have health consequences that are leading to higher mortality compared to people who are drinking at a low risk or infrequent level. So a lot of the newer studies have actually used infrequent drinkers as the sort of control group or the comparison group. And I think that's really helpful to understand the data that way.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
There was a really big study actually this year that looked at hundreds of thousands of people that had been surveyed since the 1990s all the way through the mid-2010s and did a really elegant job of trying to answer this question. And the things they did differently than other studies is first they controlled for other healthy behaviors, lifestyle behaviors, chronic conditions.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Because one question is a person who's drinking a glass of wine a day, maybe they're also running every day and, you know, doing other sort of health promoting behaviors. And maybe that person who's chosen not to drink at all has lung cancer. And that's the reason they're not drinking. And so they actually controlled for all of that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And they did see that in the low risk category, there seemed to be a slight decrease in mortality. And it was not true for cancer. So any amount of alcohol is associated with an increased cancer risk. And that's a really important thing to know, especially if someone has a personal family history of cancer. Breast cancer is one that's strongly associated with alcohol use.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so factoring that in as you're making your decisions about alcohol is really important.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, it's different for every type of cancer. And I think we're just starting to understand this. If you take breast cancer, there are things that seem to increase hormone levels are often associated with a risk of cancer. So that's an area of active research to understand why alcohol and breast cancer in particular are so closely linked. Other types of cancer, it's a little more clear.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
They tend to be cancers of the liver or the gut that are strongly associated with alcohol. And that makes sense if you think of alcohol as a potential poison going into your gut, being metabolized by your liver, causing changes there. That's an area that we do see a lot of cancer risk. Can you talk about what you're seeing as it relates to...
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So one of the main health harms from alcohol, especially heavy alcohol use, is liver damage. And so what we see happen is this progression where the first thing that happens is inflammation of the liver. And when your liver gets inflamed, you start getting fat deposit in the liver. So the first kind of step is what we sometimes call fatty liver. So it's fat deposition in your liver.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
That actually can totally reverse if you stop drinking or you make changes. And that's the amazing thing with the liver. It's a really regenerative organ. So you could cut 80% of someone's liver out and they would be okay. But there is a point where you cross the threshold where you can no longer repair the damage. And that's when you get to a stage called cirrhosis.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So from fat deposition, then you start getting scarring. Your body lays down all this scar tissue because of the chronic inflammation in your liver. And when your liver becomes so scarred that it's really stiff and starts not functioning well, that's cirrhosis. And we often used to think of cirrhosis as something that happened to people like decades down the road.