58: A Clarifying Conversation with Addiction Researcher Dr. Joshua Gowin Pinpointing Why Some People are More Vulnerable to Addiction than Others
“If we face it like we want to make this better for everyone, then that’s when we come to the solutions that are going to… focus on the big picture, which is saving people’s lives.” –Dr. Joshua Gowin
Nobody wants to fall prey into addiction. However, certain factors can increase a person’s susceptibility to addictive substances. Today’s podcast sheds light on these aspects that are sometimes not emphasized. Dr. Joshua Golwin also shares his research on the brain’s physiology and how this relates to possibility of relapse. This episode also teaches us an important lesson: Don’t let stigma and general opinion stop you from finding solutions. Focus on the big picture.
Highlights:
02:31 Looking into the Human Brain
06:38 Addiction as a Brain-Based Disease
17:50 How Much of Biological and Environmental Factors Contribute to Addiction?
22:38 The Role of Stress and Family Patterns
29:59 A Look at Brain Regions as a Determinant for Relapse
36:51 A Message of Compassion
39:50 How Recognition Can Help
42:05 How to Deal with Addiction
What really determines the probability of addiction and relapse? Join @TFRSolution and @joshuagowin in a clarifying conversation about brain functions. #brain #addiction #genetics #environment #stress #relapse #compassion #MAT #recognition Share on X
About Dr. Joshua Gowin
The brain has always fascinated Dr. Joshua Gowin. He spent the last 10 years of his career on research about brain functionality and behavior, specifically around addiction. He is currently associated with the National Institute on Alcohol Abuse and Alcoholism as a postdoctoral fellow. He also authored You, Illuminated which was nominated for Best in Show: Blog Award. His passion is deeply engraved in his studies as he hopes for a better future through the windows of his works.
Connect With Dr. Joshua:
Blog: https://www.psychologytoday.com/intl/blog/you-illuminated
Facebook: https://www.facebook.com/brain.alcohol.research.laboratory/
Twitter: https://twitter.com/joshuagowin/
Quotes:
20:21 “Even people that have the same genetic information, if they’re exposed to different things, are going to have different outcomes.” –Dr. Joshua Gowin
22:00 “People can come from a treatment center, back into their family, but if nothing has changed in the family, relapse rates are higher.” –Jeff Jones
25:19 “The stress in our world is a big enabler of addiction.” –Dr. Joshua Gowin
36:58 “I think probably the most important thing is just delivering the message from a point of compassion.” –Dr. Joshua Gowin
43:29 “I would rather have someone alive and have a possibility to solve the problem rather than someone that overdoses and can no longer be a part of the solution.” –Dr. Joshua Gowin
43:52 “If we face it like we want to make this better for everyone, then that’s when we come to the solutions that are going to… focus on the big picture, which is saving people’s lives.” –Dr. Joshua Gowin
44:33 “I think that it’s so important to consider and I think it is important to acknowledge that there are still people that wield power in terms of allowing those types of treatment to occur that are reluctant to accept them because of whatever implications they have or whatever stigma they have about how addiction should be treated. And I think that kind of narrow thinking can lead to loss of life.” –Dr. Joshua Gowin
45:03 “I don’t think we should accept any deaths that we can avoid. If we can avoid those deaths, I think we should.” –Dr. Joshua Gowin
Got ideas? Perhaps a future podcast? Schedule time with Jeff here: https://meetme.so/jeffjones
Transcriptions
Jeff Jones: So welcome everyone, this is Jeff with the Podcast Families Navigating Addiction And Recovery. And today my guest is Dr. Joshua Gowin, and I am just getting to know him. He is a professor, a researcher specifically with addiction, and he has done numerous research projects which I will learn more about. So welcome Joshua. I appreciate this conversation.
Dr. Joshua Gowin: Yes, thank you very much. I’m excited to be here.
Jeff Jones: Yeah, thanks. So if we could start just by you sharing a little bit more about yourself, so that people listening can have a better sense of who you are.
Dr. Joshua Gowin: Absolutely, yeah. So I am someone who has been interested in what makes people tick for a long time, but started with an interest in psychology that I pursued in my undergraduate career. And then I decided to enroll in a program in neuroscience. And my big interest there was to better understand how the brain relates to behavior. And so I got a PHD in neuroscience at the University of Texas Health Science Center in Houston. And a lot of the things I did there was look at how various neurotransmitters and chemicals in the brain could relate to behaviors that people were doing and how, you know, modulating brain function through changing, you know, neurotransmitter activity could change the way people behave. And from there, one of my big interests was really to, I always thought one of the coolest tools that we have available to us to understand brain function right now is MRI. So I really liked the idea that we can look at someone’s brain in real time while they’re doing something, and we can get a sense of how their different brain regions are more or less active when they are doing various tasks and thinking about different things. And so that was what I put a lot of effort into after I got my degree, was really learning how to apply that technology. And what I was specifically applying it to was to substance use disorders. So people that had problems with substance use, some of them were in treatment programs, some of them were just people that used heavily, that they were willing to engage in some research projects to help us better understand how substance use is related to brain function, and how brain function can tell us more about what types of things people are experiencing. And so that’s what I’ve really been doing for the past, about 10 years now. I’ve been focusing on how brain function can relate to cognitive processes, and other things that are important for substance use, and especially problematic substance use that can really impact someone’s life.
Jeff Jones: Yeah, wow. I mean that’s, that seems like a huge topic, a fascinating topic to me. And so, I mean, are there, I’m not sure how to phrase the question, but are there like several points, like learning points that you’ve gleaned here specifically from, you know, brain functioning and you know, going into addiction as a strategy to deal with something that’s happening, or not happening in the brain?
Dr. Joshua Gowin: Yeah, so I mean it’s a huge topic, and there’s so many things that we don’t know. There’s also some very important things that I think I’ve learned over this process that have been influential in my way of thinking about, what the role of the brain is?, And what areas of the brain are important in addiction? One of the, I’m going to say, one of the coolest things I learned, this is by one of my kind of heroes in addiction neuroscience. She’s currently the director of the National Institute of Drug Abuse, Nora Volkow and she–
Jeff Jones: Ehmm.
Dr. Joshua Gowin: –Her early work looked at dopamine receptor availability. So dopamine is a neurotransmitter that, is probably one of the more well known neurotransmitters and it’s highly, a lot of the narrative around dopamine is, one of the chemicals that is involved in addiction. And so dopamine has receptors in the brain. So basically one neuron releases it into, then another neuron receives it and there’s like, you know, there’s receptors for that reception on the second neuro or the neuron. And so, what she showed was that people that have problems with cocaine use, so people that use cocaine really heavily, men have fewer dopamine receptors available on those second neurons that are receiving the signals, and specifically in reward related area of the brain called the nucleus accumbens. And so, I thought that was very fascinating to learn that people that have years use of cocaine, of heavy cocaine use actually have changes in their brain. They’re associated with that cocaine use and that may be important for their continued use of cocaine. And so, I mean her bottom line, the reason why she thought that was so important was just to show that, there is a brain difference in people that have problems with addiction. And so she, her summary is that addiction is a brain-based disease, and I was really fascinating and informative.
Jeff Jones: Yeah, yeah. And I think a lot of the national organizations, they will say the exact same thing.
Dr. Joshua Gowin: Right, and so the thing I find fascinating really, and really important about that is, this is one concrete example that we’ve seen that, and not just some of the original study that she did, but in the following studies, we’ve continued to see pretty much the same patterns. I really find that valuable to see like, here’s something that we can point to, that we can see a difference that is related to both brain functions. And the likelihood of using substances in a heavy pattern, there’s still some unknowns about it. You know, we don’t know if that change in brain function and brain structure was present before a person starts using cocaine or any other substance, or if it follows from years of heavy use. There are some questions that remain, but just the fact that there were these differences that we can point to and pinpoint that really fascinating.
Jeff Jones: Yeah, yeah, yeah. Well it’s, I think broadly accepted that, you know, there’s this, brain impairment component to addiction and specifically what it is. Sometimes that’s, I mean, in a very basic way, I’ve seen that manifest in different ways with different people obviously, and I’m sure you have as well. But it’s also, I’m just curious, how addiction being a brain disease?, How? I’ve seen ways that’s helpful. But I’m curious like, from your perspective, how you see that has been helpful?
Dr. Joshua Gowin: So one of the most important things about it to me is, I think, and one of the reasons why that messages is important is to reduce stigma. So I think that, one of the most important benefits of educating people and explaining some of the biology of substance use disorder is that, I think that people are best served if they have an understanding. And if them standing doesn’t, it’s not something to be ashamed of. It’s something that we can point to in the, in biology because they will look, here’s something in the brain that, that we know is different. And if we could do something about that, we could really help these people. And so I think helping to reduce stigma, open up conversation, and potentially open up new avenues for helping people. I think those things could really benefit not only the, you know, the people directly suffering from substance use problems, but society at large because these problems have a huge impact on society in terms of lost productivity, disrupted family relations, and cost to society in terms of, you know, dollars too.
Jeff Jones: Oh my gosh. Yeah, yeah, it’s really huge. And I mean from people that I know personally who are in their own recovery, it’s like knowing that it’s a disease is helpful for them to you know, mitigate their own kind of, like shaming self talk, and you know on the other side, one of the things that I’ve seen, and I’m just curious about this, but that is like, with addiction being a brain disease, that to me, somehow from the family’s perspective it’s like, their focus can become really narrow, and focus on their loved one. And you know, maybe with the thinking of, “Hey you got a brain disease, get your brain fixed, this is all about you.” And if they get their fixed then everything will be fine. And from my experience, specifically in a family, you know, everybody in the family has taken on impact and you know, just someone going into recovery, and into a healing process that heals their brain, that’s only a piece of it. And when we don’t see that there’s other factors that contribute are, I really like what you were saying about understanding and opening dialogue, opening a conversation. Because, I think part of the conversation is, it’s unfortunate from the family’s perspective that they have a narrow view and they totally, there’s other important factors that they miss.
Dr. Joshua Gowin: Yeah, so I feel like part of what you’re getting at here is that there can be a bit of a double edged sword that, there is a benefit to reducing stigma by, you know, describing things as a brain-based disease. But then there’s also, there can also be some determinism that can come from that, and there can also be some, you know, I might reduce the ability that people feel like they can be empowered by being able to change that can affect the outcome. And those are important points to consider. I think it’s the advantages of describing it as a brain-based diseases that I think it can reduce stigma and especially like shame. Like it’s not, it’s not just, you know, a failing, a moral failing.
Jeff Jones: Absolutely, and before, like, you know, back in the 50s, and 60’s, that’s what it was seen as a moral failing.
Dr. Joshua Gowin: Right, right, but it’s also, yeah, very useful to think that, you know, you have to continue to think that it’s a, just because we understand some aspects of it, there’s still a long road ahead and that doesn’t make it easy to fix because we don’t have simple, straightforward solutions. It requires hard work, dedication, and another, I mean, there’s so many things, this kind of opens up what you’re talking about here, but it’s such a heterogeneous problem too. I mean, everyone, you know, for the most part, I mean, people show up with these kinds of problems in very different ways. It’s not like–
Jeff Jones: Right.
Dr. Joshua Gowin: –The single problem and it’s, you know, it’s an addiction and it looks exactly the same and every single person, it looks wildly different in different people, and understanding that is also going to be really important for, you know, the solution because the solution is going to have to be tailored to the individual problem.
Jeff Jones: Yeah. Oh my gosh. Yeah. So this is a, I appreciate we’re having this conversation and you know, this is a huge ongoing conversation that optimally would include many people in the country.
Dr. Joshua Gowin: Yes, absolutely, yeah.
Jeff Jones: On many different levels, you know, that has been one of curiosity. And in my world working with families, what I try to do is to come at this from both kind of perspective, or a both kind of personal like, you know, it’s important to understand addiction, and understand the brain impairment, and understand, you know, that your loved one, it may feel like you’re living with a stranger, and in reality you probably are because their brain is impaired, you know? So it’s important to understand that. But it’s also, and one thing that I think as like, totally the information, there’s not a lot of information out there, but it’s like the impact of family members, the roles they go into, the strategies they try and some people may try over and over the same thing, and other family members may kind of like, disengage or avoid or you know, go for the juggler with blaming, or something like that. And to me it seems, and your point is very well taken, because even with addiction, it’s a very different process for different individuals. And then this family piece kind of complicates it, and makes it more difficult on top of it.
Dr. Joshua Gowin: Sure, yeah.
Jeff Jones: So, I don’t know the answer, but I do, I mean, I have seen that it’s not just about one person going into recovery, specifically people who are still in a family and have a lot of family contact and, that kind of thing. But, you know, I really love having this conversation with you because you come at this from curiosity, and from research and science. And so I, I guess I’m curious like, from what you know, do you see any possibilities for both hand thinking around addiction?
Dr. Joshua Gowin: So, I just want to make sure that we’re on the same page by both hands, so you mean that in terms of, you know, kind of the idea of like, this is, you know, something that it comes from a biological basis and it also requires like, a kind of environmental piece. Is that kind of what you mean by both hand?
Jeff Jones: Yeah, yeah, pretty much that, yeah, there’s a biological piece of course, and there’s an environmental piece that contributes to sudden, it’s like genetics and epigenetics.
Dr. Joshua Gowin: Hmm, absolutely, yeah. No, I think that’s hugely important, and that’s something that better understanding both of those components is been really fascinating and important as well. I think one of these, you know, you mentioned genetics and I think that this is one of the other big fascinating things that I have studied with, you know, verve is a–
Jeff Jones: Aha.
Dr. Joshua Gowin: –the idea of how much of addiction is based on genetics. And I really have found it fascinating the way that scientists have tried to address this and come at it. A lot of it is based on twin studies, and there’s also some adoption studies. So twin studies, you know, the format of those studies is, you look at a bunch of twins, some of them are fraternal, and some of them are identical twins, and you want to see, so identical twins should share almost the exact same genetic makeup. Their DNA should be pretty much the exact same, whereas fraternal twins should share only about half the same genetic information. Just like you know, siblings should share about half the same. So there, there are no more, or dislike than sibling parents. And so, you can see if one identical twin shares, you know has a problem with substance use disorder than the, does the other one have a greater likelihood than if they were just fraternal twins.
Jeff Jones: –Right.
Dr. Joshua Gowin: –And so basically based on that research, they’ve done a lot of those studies with thousands and thousands of people. And the best estimate is that about half of the risk for substance use disorder is genetic, or biologically based. And the other half is from the environment, and that is equally as important. I mean clearly it’s 50/50, so you really have to consider that a lot if you want to understand things. And so that suggests that even people that have the same genetic information, if they’re exposed to different things
“Even people that have the same genetic information, if they're exposed to different things, are going to have different outcomes.” –Dr. Joshua Gowin Share on XJeff Jones: –Ehmm.
Dr. Joshua Gowin: –we’re going to have different outcomes. And that’s hugely important to consider. I think at all stages and the entryway into substance use problems. When people start developing problematic use, the environment is important in making someone more likely, or less likely if they’re in an enabling or if they’re in a place that was some sort of a situation that reduces their likelihood of using substances. And then all the way through the process of how heavily they’re problems with substance use continue, and then if, and then when you talk about recovery, it’s another important place where the environment is going to have a huge role there too.
Jeff Jones: Absolutely, absolutely. And I think that’s one of the huge benefits of, you know, being in a treatment center, whether it’s for 30 days, or 90 days in environment is set up as a structure specifically to encourage behavior that’s in alignment with recovery.
Dr. Joshua Gowin: Absolutely, yeah.
Jeff Jones: So, yeah, there’s a lot of, and you know, I feel like I’m kind of being redundant, but a lot of times even after a family program at a treatment center, family’s are, and I think some of it is because of the language, and stigma, and shame, and stuff like that. It’s, you know, people can come from a treatment center back into their family, but if nothing has changed in the family, relapse rates are higher, you know, there is more potential for conflict, there’s less potential to really have a method to, you know, communicate about differences today, or you know, heal things from the past. So, I guess I’m just curious how science can be a part of taking forward steps here.
“People can come from a treatment center, back into their family, but if nothing has changed in the family, relapse rates are higher.” –Jeff Jones Share on XDr. Joshua Gowin: Yeah, so that’s an interesting, there’s a lot of stuff to think about there. Well, one thing that I want to start with is just the role of stress and you know, circumstances that make people feel, you know, like I’m just in this really frustrated place and they need some sort of escape, and how that can be so triggering to wanting to use substances, craving substances as you know, some sort of way to relieve that stress.
Jeff Jones: Right.
Dr. Joshua Gowin: And so, that is a really important, you know, environmental factor that there can, you know, you can either maybe help someone better deal with that stress, you know, the stressful situation. Give them tools that prepare them for facing stress in a different way, or you know, figure out what those stressors are, and try and mitigate them, or remove them if possible. And you know, I think that’s definitely a situation. It’s very specific to the person in their circumstances.–
Jeff Jones: Yeah.
Dr. Joshua Gowin: –You have to really, I think, dive into what they’re dealing with to figure out how to address those stressors, where they’re coming from?, How they can be dealt with?, What are strategies for dealing with them?, Or how to reduce even facing them? The likelihood of facing them.
Jeff Jones: Yeah, yeah, yeah. And stress is such a big one because our world has more and more stress in it.–
Dr. Joshua Gowin: It feels like it.
Jeff Jones: –And it’s like different people have different abilities, different resources, internal resources, and different degrees of being resilient where you know, there can be this, like a dozen people at an event and they can have a dozen different reactions, and some people can end up in a, like compromised way, or like post traumatic stress, or have that diagnosis where other people, you know, they don’t, they actually, it motivates them to address the situation to make a change or something like that. So it’s very, stress is huge and we live in a stressful environment and yeah, I mean in some ways I’ve, you know, use this cliche kind of comment that the stress in our world, you know, is a big enabler of addiction.
“The stress in our world is a big enabler of addiction.” –Dr. Joshua Gowin Share on XDr. Joshua Gowin: Yeah, absolutely, yeah.
Jeff Jones: And you know, from the projects that you’ve done, the research that you’ve done, the one thing that you mentioned before we turned the recording on was a current project around family history and exposure to children.
Dr. Joshua Gowin: Yeah, aha.
Jeff Jones: And so like, can you say more about that?
Dr. Joshua Gowin: So the current thing that I’m working on, and I’ve just started it in the, you know, basically in the past six months, it’s a project where we are, what we’re really interested in looking at is, if we can look at brain function at a time in someone’s life before they’ve developed any problematic patterns of use. So maybe they’ve tried alcohol, or marijuana, or something like that. They’ve used it, you know, maybe semi-regularly or irregularly, but not to a point where it’s in any way impairing their life, or interfering with their normal things that they want to do. And so these are people in this study, they’re between the ages of 18 and 22, and we’re looking at how brain function when we first encountered them, might tell us how likely they are in the coming year to transition to heavier patterns of use that maybe come more disruptive in their life. And so one of the important factors that we’re considering is whether or not individuals have a history of substance use problems in their family. So if their parents, or siblings have problematic patterns of use that have maybe impacted them.–
Jeff Jones: Right.
Dr. Joshua Gowin: –That can be important. Again, for two different reasons. And I mean two primary reasons, many more possibly. But one is, because they share genetic, you know, similarities with their parents and siblings and two, so that, you know, that may be biological reasons that make them more susceptible.
Jeff Jones: –Right.
Dr. Joshua Gowin: –Two, because having a family member, especially a close family member struggling with substance use problems, could expose them to stress, could expose them to, you know, a variety of circumstances that just exposure to substance use patterns could, kind of teach them ways to use substance as a way to deal with various circumstances in their life. And so.
Jeff Jones: –Right.
Dr. Joshua Gowin: –I think that’s a really important factor, and I’m really curious how it’s going to be manifesting in brain function?,1 And how that will change someone’s likelihood of developing substance use problems in the year after we studied them.
Jeff Jones: Yeah, yeah, yeah. Wow. Well, and it’s like, it’s so difficult because, you know, alcohol is advertised a lot, it’s everywhere. How many social functions are there that have no alcohol? Probably less than half, probably quite a bit less than half. And when does alcohol use become problematic? And it’s almost like part of alcoholism, or you know, part of the disease of addiction. It includes, well it’s like this, there’s brain impairment and it’s the brain trying to assess, you know, is this a problem?, Is this not a problem? So on some level, it’s like asking the fox to guard the chicken house, or something.–
Dr. Joshua Gowin: Hmm.
Jeff Jones: –And so, another thing that I learned about you is that you have done some research or study with how challenging it is to recognize these problems. And so I’m kind of curious if you can shed light on some of the challenges there, and perhaps some strategies to deal with those challenges, or what might be optimal or warning signs, or something like that.
Dr. Joshua Gowin: Yeah, so there has been quite a lot of interest in this idea, one of the functions of a couple of different brain regions is to just register when something goes wrong, and you know, it could be like losing money. How strongly do you get a brain signal that just lights everything up, and maybe this is a problem I need to address this. And so, so one of the ways that I have been involved in that, we looked at a risk taking task so people could choose to either play it safe, and get 20 cents every time they had an option to kind of gamble. They could just go for the safe option and guaranteed to win 20 cents, a small amount of money. It could go for a higher reward value 40 or 80 cents. But there is a risk that they were gonna, instead of gain that amount of money, they were going to lose that amount of money. And so, basically we didn’t tell the participants this, but we kind of rigged the game a little bit where it didn’t matter which option you chose, you’re going to end up with the same amount of money, about 20 bucks is what they made. But the thing was their preference was still guided by just, I think more there. Their comfortableness, how willing were they to go with that uncertainty, the risky option.–
Jeff Jones: Hmm.
Dr. Joshua Gowin: –And so we looked at, we did all of this while they’re in MRI scanner, and the participants that did this study, they were all in a treatment program. This is back when I was living in San Diego. So they were either at the VA hospital in San Diego, or they’re at a community hospital called Script Screen in San Diego.
Jeff Jones: –Ehmm.
Dr. Joshua Gowin: –And so we found something that was fairly interesting. So we followed everyone that did that study for one year after their treatment, and they did it in about the third week of the treatment program. So you know, withdrawal had subsided and they were kind of getting engaged in some daily activities, some things like akin to like narcotics anonymous programs and things like that. And then we followed them for one year. So they were released from the program about a week or two after the scan. And then they went back to their lives, and we wanted to see if brain function during the treatment program could predict which of the individuals are more likely to relapse to having problems with substance use again, and which ones were going to remain abstinent for the entire year that we followed them. So we looked particularly at a brain region called the Insula. So the Insula has been shown to be pretty important for risk taking decisions. So basically what it does is, the more risk that you take on, the more the Insula lights up and becomes active, and this, so the Insula is really a marker in the brain of how you’re feeling and how much danger you might be in. So when people are going for this risky option, that 80 cent option where they could lose money too.
Jeff Jones: Right.
Dr. Joshua Gowin: The typical pattern is that the more you go, the riskier the option, the more insulin activity you have. And then when you go from the safe option, you have less activity in the inside. Well, the people that relapsed in the year after treatment, they did not differentiate at all between the safe and the risky option in the insulin. They had the exact same amount of insulin activation, whether they went for the safe option or the risky one, but the people that remain abstinent for the entire year, they have a vast distinction between it. So when they went for the safe option, very little going on, but when they went for the riskier option, they really started lighting up the insulin. So, so it suggested to us that just being able to track, like how risky is this might help people make decisions that could be important for helping them maintain sobriety, and healthier patterns of substance use in the year after treatment.
Jeff Jones: So like just being able to assess risk, you know, if there’s a risk here, it’s not a good thing for me right now because, I will potentially be more vulnerable, kind of thing.
Dr. Joshua Gowin: Right, yeah. And if you’re aware of that, that’s great because you can, you can use that information to make better decisions. But if you, if you can’t track that and you can’t even be aware that you’re facing a potentially hazardous situation, I think that the implication is that you’re more likely to make decisions that could put you at risk.
Jeff Jones: Right, right, right. So yeah, I’m thinking potentially that may be a warning sign for family members to notice of their loved one if they continue to take risky decisions over and over again.
Dr. Joshua Gowin: Yeah. And I think also important in that is kind of, I think the implication also is like, are they aware of it?, And do they, does it really register with them, that I’m doing something that could be, you know, you know, if they’re, if they know and they’re still choosing it, maybe they have a rationale or something like that, or maybe they have a contingency plan that will help them. But if they’re going into it blindly, I think that is where the real risk comes in.
Jeff Jones: Right.
Dr. Joshua Gowin: That’s the more worrisome sign.
Jeff Jones: Yeah, yeah. And so, like from your research, and I may be asking like, impossible to answer questions and feel free to let me know, but that is, is knowing what you know about addiction, is there anything that a family member could do to raise awareness, or shine light on that risk? Other than, you know, we’ve had three of these conversations, you know, I’ve said this three times, you’ve done this other thing three times, and here we’re getting closer and closer to more problems, more risk, more debt, like whatever it is. And so I’m like, from what you know, is there anything that can be helpful to kind of, like take a pause or something? Help me out here (laughs).
Dr. Joshua Gowin: Hmm, it’s a great question, and I say it’s definitely a head scratcher.
Jeff Jones: Yeah.
Dr. Joshua Gowin: I don’t think that I have, you know, advice or, you know, any thoughts on here’s the best approach, beyond, you know what, you know, you probably would say, you know, without any, you know, knowledge of, you know, brain function or activity studies. I think probably the most important thing is just delivering the message from a point of compassion.–
“I think probably the most important thing is just delivering the message from a point of compassion.” –Dr. Joshua Gowin Share on XJeff Jones: Aha, yeah, yeah.
Dr. Joshua Gowin: –You know, here, I’m concerned about you, because you are important to me. I can’t really think of anything beyond that. That I think is a.
Jeff Jones: –Sure.
Dr. Joshua Gowin: –is likely, you know, successful strategy.
Jeff Jones: Yeah, yeah, yeah. Well, I really, I mean the whole science piece, we have learned so much over the last, I’m thinking, you know, 20 years, but actually we’ve learned so much in the last five years or something. And I guess my sense is that’s really important. But how can we combine science with real life dilemmas?–
Dr. Joshua Gowin: Hmm.
Jeff Jones: And I’m thinking about it from the family’s perspective, but you know, there’s plenty of real life dilemmas that we have around, you know, when addiction grabbed that person and dragging them down into a darker and darker place.
Dr. Joshua Gowin: Yes.
Jeff Jones: Yeah. So the science fascinates me. That’s not my expertise. I know it’s important and I, you know, just remain curious how to do this both hands. Like how to utilize this science specifically in this situation, I mean with families, one of the things that I’ve seen is that, you know, family’s nervous systems can become activated, and their baseline can go up and up and up. And when that happens, there’s less blood flow to the part of the brain, the cortex that can help them make the best decisions. And so a lot of times they’re in, you know, their limbic is lighting in there. It’s like all emotional, they take things personal and there’s big arguments that kind of, and that’s pretty much what happens with addiction a lot.
Dr. Joshua Gowin: Yeah, sure, yeah.
Jeff Jones: So, I’m just curious from what you know about the research, has there been any research about, you know, this kind of, I think they, like the family members, they may call it like the family members disease, or the family members symptoms, oftentimes can be very similar to, you know, the individual who is in significant addiction.
Dr. Joshua Gowin: Yeah, I’m not familiar with any, anything, especially in terms of like brain function that looks at that. But I mean, I think there’s a couple points that could be useful to think about even if they aren’t, you know, universally true they could be valuable to consider. And that is, like I said in terms of biology, there’s good evidence that there is a strong genetic component to substance use disorders in general. But you know, maybe 50% genetic, 50% environmental is the best estimate we have from all the studies we’ve done. And what that kind of suggests is the same tendencies and traits that might dispose someone to being susceptible to addiction in the first place. I mean, the way they respond to situations, the way they deal with stress. Those are likely be present in, maybe slightly different forms and family members too. I mean they’re going to be acing similar stressors. They’re going to be, trying to deal with it in their own way. And I think the optimal thing would be, if you kind of recognize, hey, I can emphasize with what you’re doing because, I can see that I’m doing some of that same thing myself. That’s interesting, you know,
Jeff Jones: That’s golden. What you just said is so important. You know, when family members can acknowledge that they’re struggling here too.
Dr. Joshua Gowin: Yeah. I mean, that’s a really huge, I mean, you’re facing something that is overwhelming–
Jeff Jones: Right.
Dr. Joshua Gowin: –painful. And how do you deal with something that’s overwhelming and painful? I mean, that’s a challenge that anyone can, you know, has to face and.
Jeff Jones: –Sure.
Dr. Joshua Gowin: It’s one of the fundamental human challenges, I think.
Jeff Jones: Yeah, yeah, human experiences. So from our conversation, are there things that you wanted to, you know, messages you wanted to put out there that we haven’t touched on yet?
Dr. Joshua Gowin: So there’s a couple of things that are important to me. I think we’ve kind of, we started off and I mentioned before we started recording, the two things that I wanted to hit home on was, that addiction, I think it can be seen as an, in many ways should be seen as a brain-based disease. And I think there’s a lot that we don’t know. And I think, you know, I think we’ve hit on both of those things to some extent in the course of this conversation. One of the things that I’m really, really important passion of mine is, you know, in terms of reducing stigma, I think it’s really important that we try and find solutions that can save lives, or help as much as possible. And one of the things to me, is really important in that vein is for Opioid use. We have some very effective pharmacotherapies that can be life saving, and that is Methadone treatment and also Suboxone–
Jeff Jones: Ehmm.
Dr. Joshua Gowin: –those drugs. I mean, they can save people’s lives. I mean they can reduce the likelihood of someone overdosing after spell of abstinence. And so, I know that there are people that have reluctance to, you know, support that kind of stuff. They think, oh well they’re just getting addicted to something else. But I think I would rather have someone alive and have a possibility to solve the problem rather than someone that overdoses, and you know, can no longer be a part of the solution. So I think that is one of the topics needed that is really important. And I think it really gets at the heart of how we deal with addiction in society, period. I think if we face it like we want to make this better for everyone, then that’s when we come to the solutions that are going to really want to focus on the big picture, which is saving people’s lives and help people’s lives.
“I would rather have someone alive and have a possibility to solve the problem rather than someone that overdoses and can no longer be a part of the solution.” –Dr. Joshua Gowin Share on XJeff Jones: Yeah, yeah, yeah. Thank you for naming that a Suboxone and Methadone, and you know, medically assisted treatment, and I know myself just within the last five years I’ve seen more and more acceptance of that, and it does save lives, or there are people in a situation that they probably wouldn’t be alive without it.
“If we face it like we want to make this better for everyone, then that's when we come to the solutions that are going to… focus on the big picture, which is saving people's lives.” –Dr. Joshua Gowin Share on XDr. Joshua Gowin: Yeah. I think that’s so important to consider, and I think it is important to acknowledge that there are still people, and people that you know, wield power in terms of allowing those types of treatment to occur that are reluctant to accept them because of whatever implications they have, or whatever stigma they have about how addiction should be treated. And I think that kind of narrow thinking can lead to loss of life. And I don’t think we should, you know, I don’t think we should accept any deaths that we can avoid. If we can avoid those deaths, and I think we should.
“I think that it's so important to consider and I think it is important to acknowledge that there are still people that wield power in terms of allowing those types of treatment to occur that are reluctant to accept them because of whatever… Share on XJeff Jones: Yeah, yeah, yeah. Well, I have been a member of the Boulder County Opioid Advisory Board, and Republican singer from Colorado has come in numerous times and he has done a phenomenal amount of work in getting laws passed to be able to increase the access for medically assisted treatment.
“I don't think we should accept any deaths that we can avoid. If we can avoid those deaths, I think we should.” –Dr. Joshua Gowin Share on XDr. Joshua Gowin: Yeah. Even in jails, which is a big deal.
Jeff Jones: Yeah. And then for people that want to learn more about your work, how would they do that?
Dr. Joshua Gowin: So one thing that we have started just fairly recently, but I’m happy to have this presence, we started a Facebook page, so it’s brain alcohol research, so facebook.com/brain.alcohol.research.
Jeff Jones: Wow.
Dr. Joshua Gowin: That’s one thing. That’s one way we’re trying to get, you know, kind of have a little bit more of an interface with the public. I also have a blog, I haven’t posted for a while, but it’s on psychologytoday.com, and the blog title is, “You, Illuminated.” And so, that’s one of the places where I’ve hosted some of my, some of my thinking and research on the brain, and a variety of things including addiction. I think those right now are the best places, and I’m on Twitter @joshuagowin, so I’m happy to engage with people there. I really, you know, that’s actually been one of my favorite places to learn more about science, and just engage with people that are interested and curious about the brain, about addiction, about you know, any other topic. But those are two of my favorites, so.
Jeff Jones: Wow. So the Facebook page, brain alcohol research, and then the blog on psychology today and it’s called?
Dr. Joshua Gowin: You, Illuminated.
Jeff Jones: You, Illuminated.
Dr. Joshua Gowin: Yeah.
Jeff Jones: And then Twitter @joshuagowin.
Dr. Joshua Gowin: That’s right, yeah.
Jeff Jones: All right, great. Well thank you very much.
Dr. Joshua Gowin: Yes, thank you very much.