Katie, thanks for sharing your story. A deeply courageous move, there is still stigma and shame around alcohol (or any substance) misuse even after all we know. I found great value in Gabor Mate's work, and I'm very much looking forward to your book!
Really looking forward to Katie's book, it's amazing to me that this subject is being treated as of no interest by mainstream media and the substance abuse industrial complex. Alcoholism is such a heartbreaking scourge that touches so many people, why would we not try everything? I hope Katie is also covering semaglutide and the GLP-1 drugs too (Ozempic, etc) given that they are showing tremendous potential for addiction/impulse control.
Very proud of Katie for a lot of reasons - pushing through the years of struggle, being willing to try the drug, stick with it, and then for her inability to just keep it to herself once she freed herself of her problem. Her willingness to reveal a painful, private thing in order to try to bring this topic to the people who need it is really admirable. A lot of people wouldn't.
Listening to this had me wondering if the normalization of Ozempic will help to normalize Naltrexone. However I also wonder if one thing that stops Naltrexone from being prescribed like Ozempic is the fact that a doctor can easily bring up the option of Ozempic since a patient cannot hide their weight like they can hide their alcohol use
It's not easy to get insurance to cover Ozempic, so I doubt that. They're not the same, but from the sound of it, the GLP-1 drugs may end up being BETTER at curbing addictive behaviors. I think we're a long way from people being able to use them for addiction alone, though.
Ozempic is not covered by the Medicare PBS in Australia if you're using it for weight loss so I pay 100% out of pocket, but it's only $150aud a month (around $90usd).
There is no consensus on this. Same story for opioid treatments like buprenorphine and methadone.
Most sources set a minimum amount of time for which treatment is recommended. The family medicine organization says 3 months and up (https://www.aafp.org/pubs/afp/issues/2000/0315/p1891.html). Where I was working until recently,we usually take a full year of medication as the baseline and then would start discussing coming off of it if everything is going well. Of course, not everyone is willing or able to do that.
It depends on what you mean by short term. Three months is longer than most people would be on a medication for an acute illness, but very short relative to a lifetime condition.
In all seriousness though, I'm especially interested in whether research has shown why it works for those who it does / doesn't for those who it doesn't. My husband had an alcohol problem and tried the Sinclair method a couple times before giving up. But then, AA hadn't worked either. He's sober now but Naltrexone definitely didn't work. I have a theory that maybe because he was using it more for "obliteration" than to get a buzz?
I'm also not sure about the statistics for awareness of these treatments - as it sort of depends on how you define alcohol abuse spectrum. Like some medical authorities argue a glass of wine a day, or drinking a few beers on the weekends only makes you a problem drinker, and that type of drinking is very common and (I'd argue) not the type of problem we're discussing a need to use Naltrexone for.
While the story was interesting to hear, I'm reminded how much I dislike this format for podcasts. The soft, sad music fading in as Katie's saying how bad her life got, the cuts between sentences as she talks about her lows. It makes it feel manipulative to me and cheapens the experience.
Yeah I hope Reflector grows out of the NPR-isms as they develop. I think they have the potential to do interesting stories. That said the recent episode with Killer Mike was a mess
I enjoyed the two episodes (first with Helen Lewis) following up on The Witch Trials of J K Rowling, although they’re far too generous to Contrapoints disingenuous criticisms. I get why they felt the need to do it, but it really needs pointing out that Wynn exists in a money making echo chamber and isn’t interested in good faith dialogue. I bet they do regret appearing on the original podcast but only because they don’t get to slickly make their arguments unchallenged for an audience that laps up anything they say.
I do get why they did it. There thing is to present themselves as champions of good faith conversations and I think they’re genuinely trying to do that.
Given that Wynn has clearly realised that from her business model pov appearing on the podcast was a mistake, they were never going to actually engage further, I think Reflector felt they still needed to be the more grown up party.
If they’d at least addressed the nature of the Breadtube ecosystem and why it’s not really a good faith engagement would have helped. Also, they didn’t address the obvious point that Wynn’s long trains of thought collapse like a house of cards if you don’t buy the premise that Rowling is a transphobic hate monger.
This Radiolab sound is pretty much Andy Mills’s trademark - so many mid 2010s podcasts sound like this because they were copying him - that I think it’s unlikely that he’s going to change it.
I guess, but I wish he could see that it doesn't add anything. The entire episode could be nothing but the three interviewees talking about it would hit the same, except I wouldn't be annoyed at the YOU FEEL SAD NOW music inserts.
I remember reading the Atlantic article when it came out back in 2015. I shared it on FB and ALL the 12 step true believers came out of woodwork to comment. It was a genuine pile-on, albeit respectful. Anecdotal, obviously, but not one person who commented was willing to believe there could be another way besides AA. It's a quasi religion. I know it works for some people (including a few in my extended family), but it doesn't work for a lot of people (including a few in my extended family).
I've always been wary of the program as one-stop shopping for addiction. My husband was going to meetings when we met way back in the midst of time. About five years into our marriage he started socially drinking and it's truly never been an issue. So I've seen first hand that it is possible to come out of the other side of drinking too much and still having a beer with the boys without it spiraling into a wrecking ball.
AA is purposefully and explicitly decentralized. There are some extreme ideas circulated through AA in many cases, but it might be that another meeting has a completely different culture.
Personally I think the religious undertones are a universal problem that manifests to a different extent in each group.
AA worked for my dad, not for my mom. He stopped drinking in NY, and they moved to North Carolina and when my mom tried to quit she was turned off by the fact that most AA groups in her area were very Jesus based, and she is an atheist (still closeted). I think the Sinclair method would’ve worked for her by allowing her to drink socially without getting to the point of blacking out, falling, etc.
This is proof that drinking doesn't actually kill braincells and it's just a saying, unless of course, thanks to substance abuse, the world has been spared from a Katie Herzog with a super villain level of intelligence.
Everyone should go watch the three-part documentary about prohibition by Ken Burns. It’s by far my favorite documentary ever!
A few things I remember:
- the Midwest corn boom had gotten started in the lead up to prohibition, but there is no corn syrup so imagine every bit of corn syrup you consume today was cheap corn whiskey making the entire country into alcoholics
- the suffragettes formed an alliance with the prohibitionist movement
- most breweries were run by Germans, who didn’t get around to opposing prohibition because they couldn’t imagine it would apply a beer
Katie, just wanted to say that I really admire your bravery coming forward with a story that I believe will help a lot of people. I am a long time fan of Blocked and Reported and you and Jessie feel like friends, although we don’t know each other. I’m really looking forward to your book!
Great episode. As someone with friends or family that struggle with addiction, I really appreciate you using your platform to spread science based approaches to treatment/recovery.
Also looking forward to what other shows you post here during the tour. I know some didn’t, but I liked the better angles cross-post.
We’re being dogsat!
Moose gets better than this, for sure
Katie, thanks for sharing your story. A deeply courageous move, there is still stigma and shame around alcohol (or any substance) misuse even after all we know. I found great value in Gabor Mate's work, and I'm very much looking forward to your book!
I don't remember authorizing any PTO.
I PAY YOUR SALARY.
Really looking forward to Katie's book, it's amazing to me that this subject is being treated as of no interest by mainstream media and the substance abuse industrial complex. Alcoholism is such a heartbreaking scourge that touches so many people, why would we not try everything? I hope Katie is also covering semaglutide and the GLP-1 drugs too (Ozempic, etc) given that they are showing tremendous potential for addiction/impulse control.
Very proud of Katie for a lot of reasons - pushing through the years of struggle, being willing to try the drug, stick with it, and then for her inability to just keep it to herself once she freed herself of her problem. Her willingness to reveal a painful, private thing in order to try to bring this topic to the people who need it is really admirable. A lot of people wouldn't.
Wait. Katie is writing a book??? I thought she would NEVER.
Listening to this had me wondering if the normalization of Ozempic will help to normalize Naltrexone. However I also wonder if one thing that stops Naltrexone from being prescribed like Ozempic is the fact that a doctor can easily bring up the option of Ozempic since a patient cannot hide their weight like they can hide their alcohol use
It's not easy to get insurance to cover Ozempic, so I doubt that. They're not the same, but from the sound of it, the GLP-1 drugs may end up being BETTER at curbing addictive behaviors. I think we're a long way from people being able to use them for addiction alone, though.
Ozempic is not covered by the Medicare PBS in Australia if you're using it for weight loss so I pay 100% out of pocket, but it's only $150aud a month (around $90usd).
Also, ozempic is life long so ka-ching. Meds for alcohol abuse are short term.
People can stay on naltrexone for alcohol indefinitely.
Really. Isn't the idea that you'll eventually stop?
There is no consensus on this. Same story for opioid treatments like buprenorphine and methadone.
Most sources set a minimum amount of time for which treatment is recommended. The family medicine organization says 3 months and up (https://www.aafp.org/pubs/afp/issues/2000/0315/p1891.html). Where I was working until recently,we usually take a full year of medication as the baseline and then would start discussing coming off of it if everything is going well. Of course, not everyone is willing or able to do that.
It depends on what you mean by short term. Three months is longer than most people would be on a medication for an acute illness, but very short relative to a lifetime condition.
I very much look forward to reading "The Quick Fix" by Katie Herzog when it comes out!
In all seriousness though, I'm especially interested in whether research has shown why it works for those who it does / doesn't for those who it doesn't. My husband had an alcohol problem and tried the Sinclair method a couple times before giving up. But then, AA hadn't worked either. He's sober now but Naltrexone definitely didn't work. I have a theory that maybe because he was using it more for "obliteration" than to get a buzz?
I'm also not sure about the statistics for awareness of these treatments - as it sort of depends on how you define alcohol abuse spectrum. Like some medical authorities argue a glass of wine a day, or drinking a few beers on the weekends only makes you a problem drinker, and that type of drinking is very common and (I'd argue) not the type of problem we're discussing a need to use Naltrexone for.
I imagine you’re onto something with the ‘why’ people are drinking.
If it’s obliteration or in response/a cover for other issues be they psychological or a life event then this medicine may not be useful.
It’s probably not going to deal with clinical depression or trauma.
Wow, Katie. Just wow. You've really amped up our parasocial relationship with this episode. Really a great episode.
My heart exploded. Beat me to saying just this.
Oh Katie ❤️
While the story was interesting to hear, I'm reminded how much I dislike this format for podcasts. The soft, sad music fading in as Katie's saying how bad her life got, the cuts between sentences as she talks about her lows. It makes it feel manipulative to me and cheapens the experience.
Yeah I hope Reflector grows out of the NPR-isms as they develop. I think they have the potential to do interesting stories. That said the recent episode with Killer Mike was a mess
I enjoyed the two episodes (first with Helen Lewis) following up on The Witch Trials of J K Rowling, although they’re far too generous to Contrapoints disingenuous criticisms. I get why they felt the need to do it, but it really needs pointing out that Wynn exists in a money making echo chamber and isn’t interested in good faith dialogue. I bet they do regret appearing on the original podcast but only because they don’t get to slickly make their arguments unchallenged for an audience that laps up anything they say.
The response to it seem rather pointless tbh.
The second one was very difficult to get through. Treating Wynn like a good faith actor only gives that narcissist a patina of credibility.
I do get why they did it. There thing is to present themselves as champions of good faith conversations and I think they’re genuinely trying to do that.
Given that Wynn has clearly realised that from her business model pov appearing on the podcast was a mistake, they were never going to actually engage further, I think Reflector felt they still needed to be the more grown up party.
If they’d at least addressed the nature of the Breadtube ecosystem and why it’s not really a good faith engagement would have helped. Also, they didn’t address the obvious point that Wynn’s long trains of thought collapse like a house of cards if you don’t buy the premise that Rowling is a transphobic hate monger.
This Radiolab sound is pretty much Andy Mills’s trademark - so many mid 2010s podcasts sound like this because they were copying him - that I think it’s unlikely that he’s going to change it.
I guess, but I wish he could see that it doesn't add anything. The entire episode could be nothing but the three interviewees talking about it would hit the same, except I wouldn't be annoyed at the YOU FEEL SAD NOW music inserts.
Mean, unhelpful opinion: Also, Andy Mills’ speaking style is annoying.
Great story. Baclofen rather than naltrexone for me, but similar principle.
Katie congratulations on your recovery
I remember reading the Atlantic article when it came out back in 2015. I shared it on FB and ALL the 12 step true believers came out of woodwork to comment. It was a genuine pile-on, albeit respectful. Anecdotal, obviously, but not one person who commented was willing to believe there could be another way besides AA. It's a quasi religion. I know it works for some people (including a few in my extended family), but it doesn't work for a lot of people (including a few in my extended family).
I've always been wary of the program as one-stop shopping for addiction. My husband was going to meetings when we met way back in the midst of time. About five years into our marriage he started socially drinking and it's truly never been an issue. So I've seen first hand that it is possible to come out of the other side of drinking too much and still having a beer with the boys without it spiraling into a wrecking ball.
Thank you so much, Katie.
AA is purposefully and explicitly decentralized. There are some extreme ideas circulated through AA in many cases, but it might be that another meeting has a completely different culture.
Personally I think the religious undertones are a universal problem that manifests to a different extent in each group.
AA worked for my dad, not for my mom. He stopped drinking in NY, and they moved to North Carolina and when my mom tried to quit she was turned off by the fact that most AA groups in her area were very Jesus based, and she is an atheist (still closeted). I think the Sinclair method would’ve worked for her by allowing her to drink socially without getting to the point of blacking out, falling, etc.
I believe atheist AA groups exist, although they maintain a spiritual angle (like NA 'higher power).
In Europe it is much less faith based. You can tell the difference in the English speaking groups with a lot of US Expats.
This is proof that drinking doesn't actually kill braincells and it's just a saying, unless of course, thanks to substance abuse, the world has been spared from a Katie Herzog with a super villain level of intelligence.
I promise you that it does, but like a lot of things the damage will only become apparent after it’s far too late.
Everyone should go watch the three-part documentary about prohibition by Ken Burns. It’s by far my favorite documentary ever!
A few things I remember:
- the Midwest corn boom had gotten started in the lead up to prohibition, but there is no corn syrup so imagine every bit of corn syrup you consume today was cheap corn whiskey making the entire country into alcoholics
- the suffragettes formed an alliance with the prohibitionist movement
- most breweries were run by Germans, who didn’t get around to opposing prohibition because they couldn’t imagine it would apply a beer
Wow, what a great and surprising episode!
Katie, just wanted to say that I really admire your bravery coming forward with a story that I believe will help a lot of people. I am a long time fan of Blocked and Reported and you and Jessie feel like friends, although we don’t know each other. I’m really looking forward to your book!
Great episode. As someone with friends or family that struggle with addiction, I really appreciate you using your platform to spread science based approaches to treatment/recovery.
Also looking forward to what other shows you post here during the tour. I know some didn’t, but I liked the better angles cross-post.