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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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.
So those are kind of the two groups that had the biggest increase in their substance use during the pandemic.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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?
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.
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?
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.
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...
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.
Mm-hmm.
Probably 24 or so.
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