Dr. Sarah Wakeman
speaker
484 appearances
2 recordings
2 series
first heard Jan 2025
last heard May 2025
Dr. Sarah Wakeman’s voice in public audio — every appearance, attributed to the second.
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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.
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.
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.
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.
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.
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.
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.
And probably give you so much empathy. A huge amount of empathy.
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.
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.
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.
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.
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.
Yeah.
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.
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.
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.
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.
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.
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.
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