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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

You may decide, you know, never to keep alcohol in the house or not to drink because the risk is too great.

You may decide, you know, never to keep alcohol in the house or not to drink because the risk is too great.

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

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

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.

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.

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.

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.