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.

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.

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.

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.

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.

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.

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.

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.

This is the first year that we've seen that change.

This is the first year that we've seen that change.

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.

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.

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.

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 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 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.

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?

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?

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.

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.