272 - ANGIE HAMILTON from FAMILIES FOR ADDICTION RECOVERY (FAR)

[00:00:00] [SPEAKER_05]: We have family members who talk to authorities and say,

[00:00:06] [SPEAKER_05]: my loved one is at serious risk of harm to themselves or others,

[00:00:09] [SPEAKER_05]: or I've just been assaulted by my loved one.

[00:00:12] [SPEAKER_05]: And they can end up being formed and taken to the hospital to be evaluated.

[00:00:17] [SPEAKER_05]: And I'm telling you, all kinds of them, almost without exception,

[00:00:23] [SPEAKER_05]: get released within 72 hours and the family's told, you're wrong.

[00:00:27] [SPEAKER_05]: They're not at serious risk of harm to the, you know, go get, go get what?

[00:00:32] [SPEAKER_05]: Go get a restraining order.

[00:00:33] [SPEAKER_05]: So we have families torn apart by substances.

[00:00:39] [SPEAKER_02]: Hey guys, so that was just a bit from Angie Hamilton, our guest from FAR today,

[00:00:43] [SPEAKER_02]: that's Families For Addiction Recovery.

[00:00:44] [SPEAKER_02]: In this episode, we covered a lot of things and going back to what is unfortunately a debate

[00:00:49] [SPEAKER_02]: between harm reduction and abstinence and all the things in between,

[00:00:52] [SPEAKER_02]: I think Ang just does a really good job of articulating things.

[00:00:55] [SPEAKER_02]: Maybe that's the retired lawyer in here coming out,

[00:00:59] [SPEAKER_02]: but she's a really great guest to have on.

[00:01:00] [SPEAKER_02]: I'm really proud to be partnered up with FAR.

[00:01:02] [SPEAKER_02]: On that note, the title sponsor for today's episode is ARC.

[00:01:05] [SPEAKER_02]: That's the Alberta Adolescent Recovery Centre located in Alberta.

[00:01:09] [SPEAKER_02]: We're doing some amazing things treating adolescents who suffer with SUD,

[00:01:12] [SPEAKER_02]: but catching them early.

[00:01:14] [SPEAKER_02]: And they do it with this kind of crazy peer-to-peer support thing

[00:01:17] [SPEAKER_02]: that is really next level and is not being done anywhere else in North America.

[00:01:21] [SPEAKER_02]: So check them out guys at arc.ab.ca.

[00:01:24] [SPEAKER_02]: And in the meantime, here's a show.

[00:01:26] [SPEAKER_02]: Hello everybody, watchers, listeners, supporters of all kinds.

[00:01:28] [SPEAKER_02]: Welcome to another episode of The Weekend Ramble on the Ashland Strow Awesome podcast.

[00:01:32] [SPEAKER_02]: I'm your host, Chuck LaFlandre or Chris Horter.

[00:01:35] [SPEAKER_02]: With me in virtual studio, halfway around from the world for me in Krabi, Thailand,

[00:01:39] [SPEAKER_02]: is my lovely co-host Lisa.

[00:01:41] [SPEAKER_02]: How are you doing today, Lisa?

[00:01:42] [SPEAKER_03]: Very, very good.

[00:01:44] [SPEAKER_03]: It's Saturday, the sun is shining.

[00:01:47] [SPEAKER_03]: I'm here with you guys.

[00:01:48] [SPEAKER_03]: It's good.

[00:01:49] [SPEAKER_02]: It is a good day.

[00:01:51] [SPEAKER_02]: It's funny, after not having you on for three weeks and then of course having you on for last week,

[00:01:57] [SPEAKER_02]: it was like this sense of, oh yeah, we're back to normal.

[00:02:00] [SPEAKER_02]: I really missed you.

[00:02:02] [SPEAKER_02]: I still miss you even though I've seen you since.

[00:02:06] [SPEAKER_02]: And of course a returning guest and partner to the show is Angie Hamilton from FAR Canada.

[00:02:11] [SPEAKER_02]: How are you doing today, Angie?

[00:02:13] [SPEAKER_05]: Good.

[00:02:14] [SPEAKER_05]: I'm also really happy to be here all.

[00:02:16] [SPEAKER_05]: I will say I am also exhausted sort of because of what's happening in Ontario in the last week,

[00:02:23] [SPEAKER_05]: which we'll get into.

[00:02:25] [SPEAKER_02]: Absolutely, we will.

[00:02:26] [SPEAKER_02]: And why don't we just dive right into that?

[00:02:27] [SPEAKER_02]: I mean, we were starting to record and there's a peek behind the curtain for people that are watching or listening.

[00:02:33] [SPEAKER_02]: Quite often we get into these long conversations pre-record and I call it burning content.

[00:02:38] [SPEAKER_02]: So I stopped the conversation kind of mid-sentence on edge and said,

[00:02:43] [SPEAKER_02]: OK, let's record so that we don't burn all this content.

[00:02:46] [SPEAKER_02]: So why don't we just jump into it where we were and talking about some of the deficiencies in the health care system as we often do.

[00:02:55] [SPEAKER_02]: So where were you at there, Angie?

[00:02:57] [SPEAKER_02]: What's on your mind?

[00:02:59] [SPEAKER_05]: So what's on my mind?

[00:03:00] [SPEAKER_05]: There was just sort of this, I'm just going to go with really distressful announcement in Ontario on Tuesday

[00:03:11] [SPEAKER_05]: from our provincial government basically announcing a whole bunch of cutbacks in the middle of an opioid crisis,

[00:03:23] [SPEAKER_05]: a whole bunch of cutbacks to harm reduction.

[00:03:26] [SPEAKER_05]: Now, the announcement, to be fair, is not all bad.

[00:03:31] [SPEAKER_05]: They said they're going to increase spending on treatment and recovery.

[00:03:38] [SPEAKER_05]: They're going to focus on that and some housing too I saw there as well.

[00:03:44] [SPEAKER_05]: Yes, there's like three hundred and seventy five supportive houses, which is a drop in the bucket.

[00:03:49] [SPEAKER_05]: But let's go with not much better than nothing.

[00:03:52] [SPEAKER_05]: So three hundred and seventy five new supportive housing units.

[00:03:55] [SPEAKER_05]: And they're going to create 19 heart hubs, which is a heart homelessness and addiction recovery treatment centers.

[00:04:07] [SPEAKER_02]: Yes, guys, before the episode gets too far, I've just got to interrupt with the all too important PSA.

[00:04:13] [SPEAKER_02]: Today's PSA is brought to you by FAR, that's Families for Addiction Recovery.

[00:04:16] [SPEAKER_02]: They are a nonprofit doing wonderful things, offering complete services to the families of people with SUD.

[00:04:22] [SPEAKER_02]: You can learn more about them if you go to FAR Canada org.

[00:04:26] [SPEAKER_02]: And in the meantime, here's Jamie Tall with your PSA.

[00:04:28] [SPEAKER_00]: Hey, my name is Jamie Tall and I want to talk to you about something I never leave home without.

[00:04:33] [SPEAKER_00]: This right here is nasal naloxone.

[00:04:37] [SPEAKER_00]: There are a couple different name brands of it.

[00:04:39] [SPEAKER_00]: This one is called Revive.

[00:04:42] [SPEAKER_00]: It is an emergency treatment for opioid overdose.

[00:04:46] [SPEAKER_00]: You might think, well, I don't use opioids.

[00:04:48] [SPEAKER_00]: Well, you never know whose life you could save.

[00:04:51] [SPEAKER_00]: Someone who loves and someone who is love.

[00:04:55] [SPEAKER_00]: So don't leave home without it.

[00:04:56] [SPEAKER_05]: So they're called heart hubs.

[00:04:58] [SPEAKER_05]: So they're going to create 19 of those.

[00:05:00] [SPEAKER_05]: So, you know, everybody's in favour of recovery for sure.

[00:05:04] [SPEAKER_05]: Everybody's in favour of spending on treatment.

[00:05:08] [SPEAKER_05]: There's some dispute about what constitutes evidence based treatment or not.

[00:05:13] [SPEAKER_05]: But people aren't opposed to that.

[00:05:16] [SPEAKER_05]: The thing that always seems weird is it always seems to be put against like harm reduction.

[00:05:23] [SPEAKER_05]: And, you know, most people in the area would say we need a balance and we need both of these things because some people are going to use substances.

[00:05:33] [SPEAKER_05]: For example, they might want treatment and not be able to get in because let's get real.

[00:05:38] [SPEAKER_05]: There's long wait lists for residential treatment.

[00:05:41] [SPEAKER_05]: And so a lot of people needing residential treatment or and they have to wait for detox.

[00:05:46] [SPEAKER_05]: And then even worse between detox and residential treatment, they have to wait, which is like for most of them.

[00:05:54] [SPEAKER_02]: In my mind that's probably the biggest chink in the armor.

[00:05:57] [SPEAKER_02]: Right there because in between.

[00:06:00] [SPEAKER_05]: They lose their tolerance and then you say, well, we don't just wait six weeks, three months, whatever, for your placement.

[00:06:09] [SPEAKER_05]: And here's the truth of that.

[00:06:11] [SPEAKER_05]: If they could wait that long, they probably wouldn't need residential treatment.

[00:06:15] [SPEAKER_05]: They're there because they don't feel safe in community and they feel that in order for this to work for them, they really need to work full time on their coping skills.

[00:06:23] [SPEAKER_02]: And for some salt on that wound, typically you have to pass your analysis before you get into that residence.

[00:06:29] [SPEAKER_02]: So I have to stay clean on my own after two weeks in detox or whatever.

[00:06:33] [SPEAKER_02]: I mean, it's Saskatchewan where I tend to detox because a two week program.

[00:06:37] [SPEAKER_02]: So I'm supposed to stay clean for the next eight weeks, average eight weeks before I get to treat the thing that I'm having control.

[00:06:49] [SPEAKER_02]: Yeah, you know, like to me, that is by far the biggest chink in the armor in the system.

[00:06:54] [SPEAKER_02]: There's a lot of there's a lot of those, but I think that to me is kind of the biggest gap or biggest problem anyway.

[00:07:00] [SPEAKER_05]: I would say if you were trying to create a system to kill people, this would be it.

[00:07:07] [SPEAKER_05]: Am I wrong?

[00:07:09] [SPEAKER_02]: I wouldn't disagree with you.

[00:07:11] [SPEAKER_05]: So anyway, so it's great that they're going to spend more money and create treatment hubs.

[00:07:17] [SPEAKER_05]: Nobody is opposed to that.

[00:07:18] [SPEAKER_05]: Another part of it is the what how they phrased it was we are existing supervised consumption sites or consumption and treatment centers.

[00:07:32] [SPEAKER_05]: I think they're called now if they're within two hundred meters of a school or daycare, they have to close.

[00:07:40] [SPEAKER_05]: Furthermore, we are not going to allow anybody to open a new one anywhere else.

[00:07:45] [SPEAKER_05]: So these places, if they have to close, they can't move.

[00:07:49] [SPEAKER_05]: But what they can do is they can convert to one of these heart hubs.

[00:07:52] [SPEAKER_05]: But here's the kicker.

[00:07:54] [SPEAKER_05]: The heart hubs are not allowed to do safer supply, supervised consumption or wait for it.

[00:08:00] [SPEAKER_05]: This is mind blowing needle exchange.

[00:08:03] [SPEAKER_02]: That was that's ridiculous.

[00:08:05] [SPEAKER_02]: So that one component particularly is ridiculous.

[00:08:10] [SPEAKER_05]: So, you know, I have to say.

[00:08:13] [SPEAKER_05]: I just oh and so and this all has to happen by May 31st of next year.

[00:08:20] [SPEAKER_05]: So May 31, 2025.

[00:08:23] [SPEAKER_05]: So I honestly believe they're going to have to change their minds.

[00:08:29] [SPEAKER_05]: I also feel very strongly that if they don't, they're going to change their minds as soon as they see what happens because.

[00:08:39] [SPEAKER_05]: They're assuming everybody's what going to get treatment and want to go. We know neither one of those things is happening.

[00:08:45] [SPEAKER_05]: They're not going to have treatment on demand the kind that everybody needs, and there's still going to be a lot of people who aren't ready to go.

[00:08:54] [SPEAKER_05]: And they haven't addressed that at all. They're not saying involuntary treatment.

[00:08:57] [SPEAKER_05]: They're not saying anything. They're just saying, well, now we don't have a voluntary treatment and now we don't have harm reduction.

[00:09:04] [SPEAKER_05]: And, you know, someone asked our minister of health.

[00:09:07] [SPEAKER_05]: So what are you going to do for the people like how aren't people who are being kept alive right now by harm reduction going to like die?

[00:09:16] [SPEAKER_05]: And she basically said, no, they're going to get treatment.

[00:09:20] [SPEAKER_05]: Well, I find that intriguing.

[00:09:23] [SPEAKER_05]: I really hope that she answers what that looks like to her.

[00:09:30] [SPEAKER_05]: Because to me, and you know, a month ago, she said no to involuntary treatment when she was asked this time.

[00:09:35] [SPEAKER_05]: She said something like all options are on the table. So that was kind of interesting.

[00:09:43] [SPEAKER_05]: But even as someone who believes in that involuntary treatment has a place for some people, some of the time.

[00:09:50] [SPEAKER_05]: I do believe there are quite a few people who will be able to stay safe with harm reduction until they're ready.

[00:10:00] [SPEAKER_05]: It is very unique to the individual. I also believe there's lots of people who harm reduction is not going to save and that's why we need involuntary treatment.

[00:10:10] [SPEAKER_05]: So it's just we just see swing. We swing.

[00:10:14] [SPEAKER_05]: The other thing, the other thing that's crazy.

[00:10:16] [SPEAKER_03]: It's very, very true, right?

[00:10:17] [SPEAKER_05]: Yeah. And you know what somebody pointed out was like, well, all of these places have been set up since 2017.

[00:10:27] [SPEAKER_05]: Who made the rules about where they could go? Well, the Ontario government.

[00:10:32] [SPEAKER_05]: So they're backtracking on the rules they provided for where these places could go.

[00:10:39] [SPEAKER_05]: You know, their existing rules are you could be within 200 meters of these places.

[00:10:45] [SPEAKER_05]: You know, so, you know, I don't really oppose places having to be further away from schools and daycares.

[00:10:54] [SPEAKER_05]: I think a lot of people don't oppose that either. So there are a couple. There are some good things about this, but this.

[00:11:02] [SPEAKER_05]: Delusional idea that everybody's going to be just fine when you cut this out drives me crazy.

[00:11:11] [SPEAKER_03]: It's so ignorant and it's either ignorant or they don't actually care.

[00:11:19] [SPEAKER_03]: They know and don't care.

[00:11:22] [SPEAKER_05]: That's yes, so I'm not going to speak for them. I don't know. I do think that they are influenced by the general public.

[00:11:28] [SPEAKER_05]: And the general public have kind of a lot of people in the general public have kind of had it.

[00:11:35] [SPEAKER_05]: And I'm going to be perfectly honest.

[00:11:40] [SPEAKER_05]: I think some in the harm reduction community have been deaf.

[00:11:48] [SPEAKER_05]: To community concerns, it's all about the rights of the person who is using illegal substances, and they are not meeting.

[00:11:57] [SPEAKER_05]: Frankly, either families or community where they're at.

[00:12:03] [SPEAKER_05]: Why? Why do we just have to meet the user where they're at? What about the families?

[00:12:08] [SPEAKER_05]: You know, the families are at a place called Wits End, you know, and a lot of the communities live there too.

[00:12:16] [SPEAKER_05]: And so we how hard is it to say everyone needs to be safe? The community, the families and the person using.

[00:12:26] [SPEAKER_05]: And then let's have the conversation of what that looks like.

[00:12:30] [SPEAKER_02]: You know, I think if I can interject there.

[00:12:36] [SPEAKER_02]: You said it perfectly when you messaged me yesterday and asked, you know, if I've been paying attention and of course, I did go and pay some attention to it.

[00:12:45] [SPEAKER_02]: My first thought, and you just you articulated it so well was that.

[00:12:49] [SPEAKER_02]: Families and communities have a right to be safe and to feel safe.

[00:12:57] [SPEAKER_02]: So even if there's if there's evidence to say that when these when the safe injection supervised consumption sites, sorry, go into a community that you're actually reducing some risks.

[00:13:08] [SPEAKER_02]: I think that it's. Even if a family just gets to feel safer.

[00:13:13] [SPEAKER_02]: You know, even if the evidence doesn't back that up 100% that they are safer, even if a family just gets to feel safer.

[00:13:21] [SPEAKER_02]: These are the people that are paying the bill as well for all of this.

[00:13:24] [SPEAKER_02]: The tax, the government does not pay for things communities do like taxpayers do.

[00:13:31] [SPEAKER_02]: And I think if mom wants to feel safe in her community, walking her child around or when her kids going to school, she has every right to feel that.

[00:13:40] [SPEAKER_02]: Right. And I think we've you said it so well, we've lost track of that with the rights of the of the people that are using and and and it's unfortunate.

[00:13:50] [SPEAKER_05]: It is funny, Chris, because when when I said families, I meant the families who have the loved ones who are have problematic youth.

[00:13:59] [SPEAKER_05]: I didn't mean the families and community, although we are in the community.

[00:14:02] [SPEAKER_05]: But here's the thing. Okay, so I'm going to come back to involuntary treatment because to me this is an integral part of all this that is rejected by largely by the harm reduction community that view a core principle is no one should ever be coerced ever no matter what.

[00:14:21] [SPEAKER_05]: And that's more important than whether they would disagree with me on this, but I would say their interpretation of that is it's their right not to be coerced is more important than their right to life as more important than the right not to go to jail for an illness.

[00:14:36] [SPEAKER_05]: Okay, because like families want the same thing. We don't want our loved ones to die or go to jail and I know harm reduction.

[00:14:44] [SPEAKER_05]: And they don't want people to die or go to jail, but we have very different opinions sometimes of how we make sure that happens.

[00:14:54] [SPEAKER_05]: And I would say families would say if they're at serious like the mental health act if they're at serious risk of harm to themselves or others due to untreated addiction and they don't want help then we need to intervene just like we do with every other mental illness.

[00:15:08] [SPEAKER_05]: And a lot of big part of the drug policy reform harm reduction community would say no so you say well, is it that you think they're never harming other people because they kind of know they are.

[00:15:19] [SPEAKER_05]: And it isn't that they end up with shirts like nice people do drugs and I'm like, great but you should turn around on on the back say and then they do bad things they can harm other people and that that's it's like so beside them.

[00:15:32] [SPEAKER_05]: So, like, what is their solution. We have family members.

[00:15:37] [SPEAKER_05]: Who talk to authorities and say, my loved one is at serious risk of harm to themselves or others or I have just been assaulted by my loved one.

[00:15:47] [SPEAKER_05]: And they can end up being formed and taken to the hospital to be evaluated. And I'm telling you all kinds of them.

[00:15:55] [SPEAKER_05]: It almost without exception get released within 72 hours and the families told you're wrong. They're not at serious risk of harm to the, you know, go get go get what go get a restraining order.

[00:16:08] [SPEAKER_05]: So we have families torn apart by substances.

[00:16:14] [SPEAKER_05]: They don't want to have a restraining order against their loved one. In fact, many of them would like their loved one to live under their roof.

[00:16:23] [SPEAKER_05]: We are the original housing first.

[00:16:26] [SPEAKER_05]: We're the original first responders were the original case managers and no one is listening to us when we say they're at serious risk of harm to themselves or others due to untreated addiction.

[00:16:39] [SPEAKER_05]: And they must be detained and treated for their own safety and other people's safety.

[00:16:45] [SPEAKER_05]: We are routinely ignored psychiatrists do not call to get the facts. They do call sometimes to say, well, you know, they're on their way home, you know, because here they come and we haven't helped them.

[00:17:01] [SPEAKER_05]: This is literally what is happening. And so the families and then families are stigmatized for saying this.

[00:17:09] [SPEAKER_05]: You know, it's like stigma only happens because of other people's perceptions. No, if someone's harming someone else, if a loving mother had to take a restraining order against her kid because he broke her nose.

[00:17:25] [SPEAKER_05]: She's not supposed to say anything because it might stigmatize her son. How about the fact that he broke her nose stigmatizes him and she doesn't want that.

[00:17:33] [SPEAKER_05]: She doesn't want that stigma. She wants to intervene before that happens. And we're told no. So then they go out and they harm themselves.

[00:17:41] [SPEAKER_05]: They could end up with, you know, a permanent brain injury and in the long term care home. Who does that benefit?

[00:17:48] [SPEAKER_05]: At all, you know, or they harm somebody else and then they're in jail or we just ignore it more likely because they can't be held accountable like.

[00:17:58] [SPEAKER_05]: You know, you can't suck and blow at the same time. You know, you can't say it's OK for them to break laws and harm other people because they're sick.

[00:18:12] [SPEAKER_05]: Because we shouldn't they shouldn't be punished for this. The whole thing that treatment is punishment.

[00:18:18] [SPEAKER_05]: It could be you could really just, you know, you could make it like that. That's not what families are advocating for.

[00:18:27] [SPEAKER_05]: That's not what we want. We want compassionate evidence based treatment and that could include OAT.

[00:18:33] [SPEAKER_05]: No one's saying it has to be like horrific withdrawal. Nobody wants that.

[00:18:38] [SPEAKER_05]: You know, and so. Part of me there, there are a lot of parents who will look at these restrictions on harm reduction and say doesn't affect me.

[00:18:53] [SPEAKER_05]: Why? Because their loved one, let's start with this, their loved one smokes and doesn't inject.

[00:19:00] [SPEAKER_05]: And there's like very, very, very few inhalation sites. So.

[00:19:04] [SPEAKER_02]: Doesn't make a difference. It's almost negligible to even talk about inhalation sites or so few of them, right?

[00:19:09] [SPEAKER_05]: I think, yeah, and I can tell you there are a ton of parents who will tell you their children would never use.

[00:19:17] [SPEAKER_05]: A harm reduction site. What I know for a fact is a lot of the people who are not seeking treatment and need it are the same people who are unwilling or incapable of practicing harm reduction.

[00:19:31] [SPEAKER_05]: So this idea that we have harm reduction to keep them safe until they're ready is BS for some people.

[00:19:40] [SPEAKER_05]: For some people, I believe it's true. It comes down to the individual.

[00:19:44] [SPEAKER_05]: So we need the harm reduction. We need involuntary treatment.

[00:19:49] [SPEAKER_05]: And the biggest thing we need is compassionate evidence based treatment on demand.

[00:19:52] [SPEAKER_05]: And I'm telling you right now, we got not enough of any of those things.

[00:19:57] [SPEAKER_02]: True story. True story.

[00:20:00] [SPEAKER_02]: Lisa, was it Devon?

[00:20:02] [SPEAKER_02]: We recorded an episode with a harm reduction advocate that used to partner with us on the show.

[00:20:07] [SPEAKER_02]: And Devon. And it was an amazing episode really.

[00:20:14] [SPEAKER_02]: And I was going to title it or I was I was used the term harm reduction versus abstinence.

[00:20:21] [SPEAKER_02]: And was it Devon who corrected me and said it's not a versus thing?

[00:20:24] [SPEAKER_02]: I think it was. Right. And the conversation so often, if you are abstinence, a proponent of abstinence,

[00:20:35] [SPEAKER_02]: as soon as you hear something like supervised consumption or or needle exchange or whatever,

[00:20:43] [SPEAKER_02]: instantly your kind of your walls go up and you go into fight mode.

[00:20:46] [SPEAKER_02]: And the same is true for the other side of that, which shouldn't be another side at all.

[00:20:50] [SPEAKER_02]: And I guess that's a plan right now.

[00:20:53] [SPEAKER_02]: As soon as somebody from harm reduction hears the word coerced, all hell break.

[00:20:58] [SPEAKER_02]: Like it's just an instant conversation stopper. Right.

[00:21:02] [SPEAKER_02]: And so many great conversations don't happen because of those extremes and their inability to just listen to the other person and know that like we're all we all care.

[00:21:12] [SPEAKER_03]: And it's silly when we all talk about how complex this problem is.

[00:21:19] [SPEAKER_03]: If anybody out there thinks that there's some single solution that we just haven't figured out or haven't identified, that is the solution.

[00:21:30] [SPEAKER_03]: It's just ridiculous. Like there isn't you know, it's not one thing.

[00:21:34] [SPEAKER_03]: It's not like, oh, if we just had all the harm reduction in the world, everybody would be all better.

[00:21:38] [SPEAKER_03]: If you know, if we took everybody that uses substances and mandated them into treatment, we would be all better.

[00:21:45] [SPEAKER_03]: Like it's just this idea or this desire to oversimplify this massive problem into this idea that there is one magical solution is so ridiculous.

[00:21:59] [SPEAKER_02]: It's funny.

[00:22:02] [SPEAKER_02]: It is simple.

[00:22:04] [SPEAKER_02]: It's simple in that whatever works for the individual is what we're going to do or whatever is appropriate for that individual is what we're going to do.

[00:22:11] [SPEAKER_02]: And it is it is that simple. You make it complex and you know what I mean?

[00:22:14] [SPEAKER_02]: But it is it's just understanding that there is no one size fits all.

[00:22:19] [SPEAKER_03]: And I don't remember if it was last week, and I do feel like a broken record a lot of the times.

[00:22:26] [SPEAKER_03]: But like, you know, Angie, you touched on it today. I think it was last weekend. It came up again.

[00:22:32] [SPEAKER_03]: I feel like I've been repeating it for a year and a half now.

[00:22:36] [SPEAKER_03]: But we do this in all the other mental illnesses. Like if someone comes in with depression, sometimes they need therapy.

[00:22:44] [SPEAKER_03]: Sometimes they need antidepressants. Sometimes they need electroconvulsive therapy.

[00:22:51] [SPEAKER_03]: Sometimes they need ketamine therapy. We figure it out.

[00:22:56] [SPEAKER_03]: We don't go, oh, you're depressed. This is all we can do for you.

[00:23:01] [SPEAKER_03]: So again, this idea that somehow and it's so funny, right, because we always talk about how people in addiction think they're special, right?

[00:23:09] [SPEAKER_03]: It's like, well, I don't need to do the thing from the other person with addiction needs to do. Right.

[00:23:14] [SPEAKER_03]: But like, but I feel like the medical system also treats it like it's this little special disease.

[00:23:20] [SPEAKER_03]: It's not. It's not a special disease. It's a mental illness. We have processes in place.

[00:23:27] [SPEAKER_03]: We understand that any mental illness does not necessarily respond to one single treatment and we figure it out.

[00:23:36] [SPEAKER_03]: And why is this different? Like, and that's where I feel like it's simple. It's simple in that.

[00:23:40] [SPEAKER_03]: I think that we have processes available. We don't need new processes.

[00:23:45] [SPEAKER_03]: Like, there's people like, oh, we're creating new acts to allow us to mandate people with addiction into treatment.

[00:23:50] [SPEAKER_03]: And it's like, well, that's great. But why?

[00:23:54] [SPEAKER_05]: They could totally be using the mental health.

[00:23:56] [SPEAKER_02]: Absolutely. And I think it was in your first appearance on the show that you really brought that to my attention anyway, like that idea that why are we talking about it? Coerced treatment.

[00:24:05] [SPEAKER_02]: We can do that. There's already an active place right now in Ontario.

[00:24:11] [SPEAKER_05]: We are finally starting to use our mental health act just for substance use disorder, right?

[00:24:18] [SPEAKER_05]: To detain someone when they either if they don't have capacity to make treatment decisions and or their serious physical harm to themselves or others.

[00:24:27] [SPEAKER_02]: Do you know what that process looks like, Ange?

[00:24:31] [SPEAKER_02]: Yeah, absolutely.

[00:24:32] [SPEAKER_05]: So what happens is first in the hospital, the examining physician has to decide you lack capacity to make treatment decisions and or you are at serious risk of harm to yourself or others.

[00:24:45] [SPEAKER_05]: And so they form you to keep you and they have in Ontario, they have very good guardrails to ensure people's human rights are protected.

[00:24:59] [SPEAKER_02]: So I think that's in Alberta as well. Right? Lisa just just so we don't have to circle back. Yes.

[00:25:04] [SPEAKER_05]: It's very different in BC. The people in BC aren't happy, but so they want it was long story anyway.

[00:25:13] [SPEAKER_05]: In so in Ontario when that happens, they have to be advised of their rights to appeal that decision and they have to go to court. I think within 7 days.

[00:25:24] [SPEAKER_05]: And they will be appointed a lawyer and this is the so I don't have a problem with any of that.

[00:25:30] [SPEAKER_05]: The problem I have is families don't even have to be advised if they don't families don't get legal representation and you know what?

[00:25:39] [SPEAKER_05]: You know, unless they've been homeless for a very long time or were completely clueless.

[00:25:43] [SPEAKER_05]: Usually we've got a tremendous amount of the facts on which decisions should be made by the doctors about whether they pose a serious risk harm to themselves or others.

[00:25:53] [SPEAKER_05]: But there's no obligation to inform family. There's no obligation to include them and that's wrong and they don't get representation. I think a balanced system would be the family would have equal rights in those situations because if they'd lack capacity in our laws.

[00:26:10] [SPEAKER_05]: If it's a child who isn't married, the parents are the substitute decision makers.

[00:26:16] [SPEAKER_03]: So it is like that in Alberta Angie. I don't know if it's not like that in Ontario, but in Alberta.

[00:26:22] [SPEAKER_03]: There's a difference between certifying somebody to remain in hospital.

[00:26:27] [SPEAKER_03]: Versus deeming them to lack capacity, they're different certificates.

[00:26:32] [SPEAKER_03]: If we deep somebody to lack capacity, we need to have a substitute decision maker put in place.

[00:26:38] [SPEAKER_03]: And there's an order in which we have to sort of pursue people to take on that role and you know parents or a spouse would be sort of the first go to people.

[00:26:52] [SPEAKER_03]: If you can't find somebody, then you can go to the office of public guardian and there are people who do this as a job.

[00:26:58] [SPEAKER_03]: But if you go to them, they will say to you, did you call their parents? Did you call their spouse?

[00:27:04] [SPEAKER_03]: And if you have not, why not? And there's even cases where, you know, I've had people where I felt that the family were not appropriate substitute decision makers for a variety of reasons.

[00:27:16] [SPEAKER_03]: I have to present that information to the office of public guardian and they will sometimes do their own investigation to see if they agree with me.

[00:27:24] [SPEAKER_03]: So in cases of like the capacity piece, I would think like our families not also being asked to step into that role in Ontario.

[00:27:33] [SPEAKER_05]: Yes, but if the person says you're wrong, I have capacity then.

[00:27:40] [SPEAKER_05]: You can't treat them until there's a decision and if they, if they appeal that decision in Ontario, you can't treat until all the appeals are done.

[00:27:50] [SPEAKER_03]: And I can't treat, but you can get the data right? Because that's what we would do. Like, if they want to go to review panel, then we can initiate treatment, but I will still go into a review panel having had discussions with the person.

[00:28:02] [SPEAKER_03]: I think should be the substitute decision maker so that I can say to the review panel, you know, I've got mom ready to step in as substitute decision maker. And then in that phone call, I usually get that collateral information that you're kind of describing.

[00:28:18] [SPEAKER_05]: I would think that the psychiatrist here doing that, but I don't know that for a fact. Yeah.

[00:28:24] [SPEAKER_05]: Because because I do know families have not been consulted, but that could be like, maybe they didn't. They couldn't find the family. Maybe there was a spouse or, you know, spouse.

[00:28:40] [SPEAKER_05]: Oh, my God, what's wrong with me when you're not living together? Same thing. Oh, thank you. There we go. My God. I'm all anyway. So yeah, so it could be that right? So I don't know in every case, but I.

[00:28:55] [SPEAKER_05]: There's just horrible cases in Ontario where families were not consulted, didn't even know.

[00:29:02] [SPEAKER_05]: Didn't even know that they'd been apprehended assessed, you know, any any of this.

[00:29:09] [SPEAKER_03]: And I do believe that happens and I believe it happens here too.

[00:29:13] [SPEAKER_02]: Well, there was there was a case shortly after I got to Thailand that we were kind of close to Lisa. At least you were by.

[00:29:20] [SPEAKER_02]: By, you know, you're being looped into it. You weren't actually attached to it. But my friend who was my friend's niece, I should say, was found in a car.

[00:29:32] [SPEAKER_02]: You know, had soiled herself. She was, you know, cold. It was a really bad situation.

[00:29:38] [SPEAKER_02]: She'd also by that point.

[00:29:41] [SPEAKER_02]: No, she hadn't. She had her family hadn't tried to section her, but she was brought to the emergency room. Her family was told, go home. We've got her. She's safe.

[00:29:50] [SPEAKER_02]: Come back in the morning and we can talk about the process to keep her here. Five hours later, she's gone. Family doesn't find out.

[00:29:57] [SPEAKER_02]: 48 hours later, the family after trying after calling every you are in town, including that one.

[00:30:04] [SPEAKER_02]: Not being able to find their daughter or her niece, I should say.

[00:30:08] [SPEAKER_02]: And then eventually circling back to the originally are and finding out that yes, she had been there and she'd been released five hours after the fact.

[00:30:15] [SPEAKER_02]: If you can imagine, and that's anecdotal and it's a one hour situation.

[00:30:20] [SPEAKER_02]: But I don't think it's that uncommon. Right? It's not understand. It is not uncommon.

[00:30:24] [SPEAKER_05]: So I could give you an example of one of our members. This was years ago, but would it happen today? Absolutely. When her child was still a minor, so 17.

[00:30:37] [SPEAKER_05]: And he couldn't live at home because it wasn't safe, but he was so he, I think, was living with his grandparents, but not not with the family and he would disappear for periods of time.

[00:30:49] [SPEAKER_05]: The family, they found out he had actually been to the hospital. I'm going to blow this because I haven't looked at it, but probably eight to 10 times within a 18 month period.

[00:31:05] [SPEAKER_05]: And the reason the family found out in most cases was because their child's address was the parents home.

[00:31:16] [SPEAKER_05]: And in Ontario, if you go to the hospital in an ambulance, you get a bill for $45.

[00:31:22] [SPEAKER_05]: So they this is how they found out their son, their minor child had Odeid three times in one week because the next week they got the three $45 ambulance bills.

[00:31:38] [SPEAKER_05]: So like privacy is really important unless the hospital's not getting paid for the ambulance and then privacy is gone.

[00:31:43] [SPEAKER_05]: This is how this is exactly, you know, and they did get in all that period of time.

[00:31:49] [SPEAKER_05]: They got one call when they were out of the country from an ER that said your son is here.

[00:31:59] [SPEAKER_05]: We're concerned he's not going to make it. This is a minor and they're like, please keep him.

[00:32:04] [SPEAKER_05]: What do you think a parent's going to say? Please keep him.

[00:32:09] [SPEAKER_05]: And they're like, yeah, you know, if he recovers, we're not doing that.

[00:32:15] [SPEAKER_05]: Right. And that and that was the only time that they decided the family had a right to know was because the son might not make it.

[00:32:25] [SPEAKER_05]: What is wrong with us?

[00:32:27] [SPEAKER_05]: What is wrong with us? Family is actually treated like the enemy often.

[00:32:32] [SPEAKER_05]: The privacy laws need to change.

[00:32:36] [SPEAKER_05]: That's just garbage, you know, and if if the if it had been a grandparent or parent who had dementia was wandering the street and got hit by a car, they'd be calling.

[00:32:46] [SPEAKER_02]: They would they would go to the ends of the earth. Literally they would call all around the globe.

[00:32:49] [SPEAKER_05]: Right. But if it's a minor child wandering the streets with methamphetamine disorder and getting hit by a car, do they call the family?

[00:32:56] [SPEAKER_05]: Just ask them. I don't think so. I don't. It probably it's probably the discretion of whoever's got them in front of them and it shouldn't be.

[00:33:07] [SPEAKER_02]: Wow. That is so sad.

[00:33:10] [SPEAKER_02]: Anyway, you mentioned when we started down this road that things had people were starting to use the mental health act, which is I think an amazing thing.

[00:33:19] [SPEAKER_02]: Do you know what brought about that change?

[00:33:24] [SPEAKER_05]: So, in 2020 or 2021, a group of eight.

[00:33:30] [SPEAKER_05]: Doctors and a couple of the lawyers at CAMH, which is our main mental health hospital wrote a paper called rethinking and voluntary admission.

[00:33:40] [SPEAKER_05]: For you know, basically in the ER for people with substance use disorder, with severe substance disorder, and they kind of said like.

[00:33:49] [SPEAKER_05]: It's mind blowing for me because my background is law and it's like.

[00:33:55] [SPEAKER_05]: How is the penny dropping just now? That said, I'm just delighted they did this article basically said is.

[00:34:02] [SPEAKER_05]: You know, hey, we never think of applying the mental health act to detain somebody even with a severe substance use disorder, but maybe we should let's look at the criteria.

[00:34:16] [SPEAKER_05]: Are they at serious risk of harm to themselves or oh hell yeah.

[00:34:22] [SPEAKER_05]: Yeah, they can talk there. They're probably we let them go. They're probably going to die.

[00:34:26] [SPEAKER_05]: So they looked at the requirements and said.

[00:34:29] [SPEAKER_05]: Of course, they're meeting these is it a mental disorder? Yes, it's very clear under our laws. It is crystal clear under Ontario law.

[00:34:38] [SPEAKER_05]: That substance use disorder is a mental disorder for purposes of the mental health act.

[00:34:42] [SPEAKER_05]: And it's crystal clear that some people are going to die without treatment. So hey guys, like why aren't we applying this?

[00:34:52] [SPEAKER_05]: And then they said could it be basically stigma discrimination nihilism like we think it's hopeless and so they said hey guys, we need to start to look at this and then people started to make the case and and to give.

[00:35:11] [SPEAKER_05]: I would say comfort to people who get really uncomfortable with this in the context of opioids, which are so potent and losing tolerance and being back out.

[00:35:20] [SPEAKER_05]: There are there's a case where they looked at this and it was so limited.

[00:35:25] [SPEAKER_05]: The guy had a community act team, but they were going to release him like on a Friday afternoon and the community act team wasn't gonna be able to help them till Monday morning because that's when they start work.

[00:35:38] [SPEAKER_05]: And so the hospital wanted to detain him until then, so that he would be safe. So literally just three days and all the arguments were made.

[00:35:51] [SPEAKER_05]: You know, and I think they might have been followed that that hey if we let him go and he's been there for three or three days now and his tolerance has gone, he could die over the weekend.

[00:36:04] [SPEAKER_05]: Fortunately, the guy changed his mind and said I can wait till Monday morning and go which is a great outcome.

[00:36:10] [SPEAKER_05]: Probably the best outcome, but I'm saying they look at those things when they make these decisions. They're not stupid.

[00:36:17] [SPEAKER_05]: They have lawyers who are representing the person who may just want to go out and use again.

[00:36:23] [SPEAKER_05]: They have lawyers who make all these arguments. Hey, his tolerance has gone. He's going to go. He's going to use. You can't you know so these arguments are made.

[00:36:30] [SPEAKER_05]: The other case that I like for a lot of reasons and each case is so unique right, but often people have more than one disorder.

[00:36:41] [SPEAKER_05]: It was a mom very smart. She had young children at home.

[00:36:47] [SPEAKER_05]: What I liked as she had severe alcohol use disorder and other issues.

[00:36:52] [SPEAKER_05]: What I loved about it.

[00:36:56] [SPEAKER_05]: Doctors tend to think of serious risk of harm and it can even say like a bodily harm.

[00:37:04] [SPEAKER_05]: They think it's just like, are you about to die?

[00:37:07] [SPEAKER_05]: And it shouldn't be that it's actually never been like that.

[00:37:12] [SPEAKER_05]: If you look at the law, but most doctors don't know in Ontario, it includes psychological harm.

[00:37:17] [SPEAKER_05]: Okay, so it's very broad. What could be significant like severe harm to detain someone anyway this this one mom they said if.

[00:37:30] [SPEAKER_05]: We don't keep her.

[00:37:33] [SPEAKER_05]: Her family who love her dearly.

[00:37:36] [SPEAKER_05]: Are going to get a restraining order because her children aren't safe when she's around.

[00:37:41] [SPEAKER_05]: And she's going to be homeless.

[00:37:44] [SPEAKER_05]: So she's at serious risk of harm from being homeless.

[00:37:46] [SPEAKER_05]: And we're going to let you keep her.

[00:37:50] [SPEAKER_05]: And to me, that's it. If someone's at risk of being sexually exploited of being homeless of committing suicide, not dying by suicide.

[00:38:02] [SPEAKER_05]: You know of having some other severe harm.

[00:38:05] [SPEAKER_05]: Not just overdose other severe harm liver disease.

[00:38:10] [SPEAKER_05]: If they're at Syria, imminent not imminent within the next month or so harm of serious.

[00:38:18] [SPEAKER_05]: Harm they should be detained and the cases.

[00:38:25] [SPEAKER_05]: Are starting to show that but the doctors I'm sorry.

[00:38:29] [SPEAKER_05]: They're not educated in this. They're not following very closely and so we still have families that I'm supporting in peer support who say the psychiatrist told me he wasn't an imminent risk of harm.

[00:38:45] [SPEAKER_05]: So they're letting him go. This was a family that had a restraining order against their son.

[00:38:50] [SPEAKER_03]: And I can I just tell you in Alberta, right? The criteria on the form that you're referring to. Here's the wording in Alberta within a reasonable time likely to cause harm to others or to suffer negative effects.

[00:39:05] [SPEAKER_03]: I'll see substantial mental or physical deterioration or serious physical impairment as a result of or related to the mental disorder.

[00:39:17] [SPEAKER_05]: So again, like it's broad enough right? And you know this mom I said like if she could only have called me and had me on speed dial like that psychiatrist who told her I'm talking in the last six months told her.

[00:39:36] [SPEAKER_05]: Your kid has to be at imminent risk of harm.

[00:39:38] [SPEAKER_05]: That requirement for it to be imminent was removed from our mental health act in the year.

[00:39:45] [SPEAKER_05]: 2000 so only 24 years old that information he was applying okay and so what am I supposed to do?

[00:39:51] [SPEAKER_05]: I've had in the last three years talked to parents who were trying to form their minor and the psychiatrist.

[00:40:00] [SPEAKER_05]: This is in a GTA hospital said substance use is a choice they did get me on the phone and I said yeah it is addiction of course isn't right?

[00:40:11] [SPEAKER_05]: And then and then the next thing out of the psychiatrist mouth was well he could control how much he uses by just using less.

[00:40:21] [SPEAKER_05]: Oh and then I had to go through the whole chocolate number of chocolate chips in the chocolate chip cookie for you know illegally prepared you know.

[00:40:33] [SPEAKER_05]: Drugs in blenders where they could get 800 times the safe amount of opioids or none you know and this this psychiatrist assessing a minor right?

[00:40:49] [SPEAKER_04]: Doesn't know that.

[00:40:51] [SPEAKER_02]: I would like to think and maybe I'm optimistic maybe I'm naive maybe that's the word naive that that way of thinking is being cycled out with with newly with new physicians and new psychiatrists as they come into the profession.

[00:41:08] [SPEAKER_02]: I would like to believe that I mean at least is some living proof of that as well I mean you're hardly new but it you know you're a good example of how you know I mean obviously you weren't you weren't a psychiatrist 24 years ago.

[00:41:23] [SPEAKER_02]: engineer it still boggles my mind.

[00:41:26] [SPEAKER_02]: I know right overachiever.

[00:41:31] [SPEAKER_05]: Question for Lisa though and that is like what are you seeing because it still boggles my mind like I'm delighted that Alberta is looking at the issue of a voluntary treatment.

[00:41:48] [SPEAKER_05]: That said I'm a little stunned that they aren't just looking at tweaking their current mental health act right and you've said before you think so.

[00:41:58] [SPEAKER_05]: So my question to you is in terms of what's being taught to the new psychiatrist and the residents or whatever.

[00:42:08] [SPEAKER_05]: What are they being taught about involuntary treatment and how to assess and when to assess and and what the existing act allows you to do or not do?

[00:42:19] [SPEAKER_03]: So yeah there's a lot in that question let me try to back it up.

[00:42:29] [SPEAKER_03]: I still feel so I do think for like it and there's various stages right because you've got medical school where you don't know if the person in front of you is going to be a surgeon a family doctor a psychiatrist or whatever.

[00:42:41] [SPEAKER_03]: And then you obviously have residency programs right so family medicine is two years everything else is five.

[00:42:51] [SPEAKER_03]: And I am not involved in the medical school a whole lot I do some small groups and stuff but more with the psychiatry residents is probably where I would see more.

[00:43:03] [SPEAKER_03]: I do think that it is being taught that this is a disease where I feel like the problem lies though is that people have so much stigma and biases that have been threaded into their belief system from the time they were kids.

[00:43:25] [SPEAKER_03]: That they're not even aware of that I still feel that as much as people are told these things or taught these things I still think that we have a long way to go.

[00:43:39] [SPEAKER_03]: In terms of things like mandating it's tricky like you know I just had a final year medical student with me for a month and one of the comments he had was that.

[00:43:51] [SPEAKER_03]: The interesting thing is a learner is there are different rotations every one to three to six months depending on their stage of training and he pointed out like there's there's a lot of subjectivity to this stuff.

[00:44:04] [SPEAKER_03]: You know it's like I am definitely more aggressive in my approach and more paternalistic in my approach to working with people and you can have psychiatrists in the same hospital on the same unit who would do things completely differently.

[00:44:22] [SPEAKER_03]: And so as learners I think the challenge is that they are going to be exposed to that.

[00:44:28] [SPEAKER_03]: And so much of how I think people themselves tend to practice medicine again is influenced by all of those like subtle ingrained biases that they have that they're not even aware of.

[00:44:42] [SPEAKER_03]: So it's like it's a huge struggle.

[00:44:45] [SPEAKER_02]: If I can speak to that Lisa real quickly just for a second.

[00:44:49] [SPEAKER_02]: And maybe this is maybe this is completely off my rocker but as you're saying that what comes to my mind is most of the people that you would see at the University of Calgary or University of whatever in medical school don't come from a background even like yours.

[00:45:06] [SPEAKER_02]: Right, like most of those people have lived a more sheltered life than say me.

[00:45:11] [SPEAKER_02]: I hate the way that I grew up and you know things that I participated in as a teenager, most certainly.

[00:45:18] [SPEAKER_02]: So, most I think it a fair ish assumption to say that most of those people are going to have those biases kind of ingrained into them. Right. Had your brother not gone on the journey he had.

[00:45:32] [SPEAKER_02]: Who knows what your biases would have been who like and you've spoken yourself to some of the stigmas that that you've overcome over the years or that you know you've kind of, you know, reformed in your mind.

[00:45:43] [SPEAKER_02]: Due to your brother struggle right. So I think you can't even blame anybody for it because it is what it is right these these people aren't growing up like that.

[00:45:55] [SPEAKER_03]: And you like this is like, it goes back to this thing that I think about at least once a week. This thought comes into my head is how do I impart to a learner things that I know today because I have a brother who has suffered.

[00:46:13] [SPEAKER_03]: Incredibly with this vicious disease like to me addiction is one of the most vicious diseases on this planet right now.

[00:46:22] [SPEAKER_03]: And I, I don't know that I have the answer. You know it's like yeah when you've got. And again like I'm stereotyping not everybody falls in this in this situation but like there's a lot of medical students who have mom and dad are both physicians.

[00:46:36] [SPEAKER_03]: You know who have grown up very privileged and again privilege doesn't protect you from addiction right we see plenty of privileged people who suffer with addiction.

[00:46:47] [SPEAKER_03]: But yeah a lot of them have grown up very comfortably financially.

[00:46:52] [SPEAKER_03]: And I think that's really, you know being able to grow up doing activities and sports and going to good schools and you know have been somewhat protected from you know Vancouver's downtown east side like they're not living that day in and day out.

[00:47:06] [SPEAKER_03]: And it's really difficult to figure out how to make people believe that that person in the emergency department who is unkept and dirty and homeless and hungry and thin and high and picked apart because they feel like their skin is infested with bugs that that could be you.

[00:47:29] [SPEAKER_03]: How do you convince somebody of that?

[00:47:31] [SPEAKER_05]: Well at the rate we're going I think everybody's going to know someone like because we're not intervening and we're known of treatment on demand so like that's happening right like how many people really don't love someone struggling with addiction whether and it's this you know so much importance placed on whether the drug is legal or illegal and it's completely irrelevant.

[00:47:53] [SPEAKER_05]: Your body does not know the difference right.

[00:47:55] [SPEAKER_05]: It's your body either you're going to have a problem or you're not based on you know your genetic makeup your you know your environment your personality traits.

[00:48:06] [SPEAKER_05]: But I like one of the one of the thing you're really talking about addressing stigma.

[00:48:15] [SPEAKER_05]: There's a couple things but I think it's really important and it's done for a lot of different illnesses but I think it's really important as part of the learning to have people in recovery come and explain their journey because there's all kinds of those people who were extremely successful lost everything and came back right.

[00:48:40] [SPEAKER_05]: And inspiring role models and the hard part is finding people who are willing to do that especially just going to say that now right.

[00:48:54] [SPEAKER_05]: Let's start I know physicians.

[00:48:56] [SPEAKER_03]: Yeah like I know if I know physicians who shared with me that they were in recovery because again of my interest and like I would share about my life and it would just kind of come up but I know.

[00:49:10] [SPEAKER_03]: I know a lot of people that like for example in my department alone who know those people very well and have no idea that they're in recovery.

[00:49:19] [SPEAKER_02]: Yeah, well that too. That's a result of stigma as well.

[00:49:23] [SPEAKER_02]: Really, right. It's the whole idea of anonymous programs.

[00:49:27] [SPEAKER_05]: Yeah.

[00:49:28] [SPEAKER_02]: Kind of bothers me.

[00:49:30] [SPEAKER_02]: It lends to it right.

[00:49:32] [SPEAKER_02]: Right like it really does because like that No.

[00:49:34] [SPEAKER_02]: You look at Nicole O'Brigge, she hasn't been on with us. She will eventually.

[00:49:41] [SPEAKER_02]: You can relate to her. She was a lawyer. She was a Crown Prosecutor in BC fell hard into addiction and is now like like on the streets all of it all the terrible things that happened to her.

[00:49:53] [SPEAKER_02]: She's been on the show and is now the executive director for the Elizabeth Fry Society in Saskatchewan.

[00:49:58] [SPEAKER_02]: Lovely.

[00:49:59] [SPEAKER_02]: I'm a great example of somebody who hyper successful, not so much you know went to the bottom and then has come back up to the top.

[00:50:06] [SPEAKER_02]: And without thinking too hard, I give you a dozen of those people right now.

[00:50:10] [SPEAKER_02]: Right just for just because of what I do and being exposed to so many of these amazing recovery content creators right.

[00:50:16] [SPEAKER_02]: You know, so there's people out there that are more than willing to share how that happens in a learning environment I don't know.

[00:50:24] [SPEAKER_02]: Right and if if that's even a possibility, but you know.

[00:50:27] [SPEAKER_03]: And you know I think another thing is that I do believe that you know the idea of addiction as a disease is something that is taught pretty openly.

[00:50:38] [SPEAKER_03]: But I don't think there's a lot of teaching around what we know about brain activity in the actively addicted brain.

[00:50:47] [SPEAKER_03]: And how that therefore ties into things like capacity, which yeah so.

[00:50:54] [SPEAKER_05]: Which I don't get because you know like when I start talking about capacity, I point to all the things psychiatrists say that you know like the first thing is like addiction affects your executive functioning right and it's really super bad for adolescents whose brains aren't fully developed right.

[00:51:12] [SPEAKER_05]: But it seems like between that they don't do anything with it in terms of assessing capacity. Like I don't know if I told you Lisa, I got to send this to you.

[00:51:22] [SPEAKER_05]: There's a really interesting research piece by KMH.

[00:51:30] [SPEAKER_05]: They just published and they looked in Ontario.

[00:51:34] [SPEAKER_05]: So in Ontario, you know I told you there's a consent and capacity review board right when you say that you haven't got a capacity.

[00:51:43] [SPEAKER_05]: So they they look about only about 10% of those cases are reported a year so we don't know what happens in those other 90 you can't do any research but they looked they started reporting in 2003 they looked at all of the cases from 2003 to 2020.

[00:52:01] [SPEAKER_05]: There's like over 10,000 of them and they did a search for addiction terms and addiction medications and long story short there were only a handful of cases where people with addiction where they they assessed whether they had capacity or not to make treatment decisions.

[00:52:26] [SPEAKER_05]: Okay now that is what families have known for years but thank you KMH for putting that there and they know they got their limitations of you know they we shouldn't assume this is this and they're all right about that.

[00:52:37] [SPEAKER_05]: But I'm sorry that speaks volumes about what we're doing like we are not assessing capacity and so that's a physician issue.

[00:52:49] [SPEAKER_03]: Right.

[00:52:49] [SPEAKER_03]: And I think you know the struggle is that when you think about the patient who we people are pretty quick to pull capacity.

[00:52:59] [SPEAKER_03]: You know, think about somebody who's actively psychotic who will sit there and tell you that we live on planet Venus and aliens made their breakfast and you know you're looking at this person going okay this person does not have capacity like they don't know where they are who they are what species they are like kind of obvious.

[00:53:17] [SPEAKER_03]: The struggle with people who have addiction is that when they come out of a state of intoxication or withdrawal.

[00:53:24] [SPEAKER_03]: They can have a fairly reasonable organized conversation with you.

[00:53:30] [SPEAKER_03]: But again like with capacity it's can they understand information so I think somebody who has addiction, who has a normal IQ can understand information we can say to them, addiction is dangerous addiction is hurting your brain and they can sit there and say yeah okay

[00:53:47] [SPEAKER_03]: you know I know or I believe you or whatever.

[00:53:49] [SPEAKER_03]: The problem comes when the other element of capacity, do they appreciate how this pertains to them.

[00:53:57] [SPEAKER_03]: Now again somebody with addiction which is different than somebody who's actively psychotic, they can tell you that you know that they understand these risks verbally.

[00:54:08] [SPEAKER_03]: But when you look at their behavior, their behavior tells you that they do not appreciate these risks.

[00:54:17] [SPEAKER_03]: Is there everything they do?

[00:54:20] [SPEAKER_03]: Exactly and so again that's where I think we need to take that step is I think that yes capacity is capacity is capacity.

[00:54:28] [SPEAKER_03]: But what you look for when you're doing a capacity assessment in somebody who has psychosis is going to be different than what you're looking for once when you're assessing capacity and somebody with a normal IQ and active addiction.

[00:54:43] [SPEAKER_03]: And what they say and what they do can show you a very different picture and there's plenty of times when I have patients tell me something.

[00:54:52] [SPEAKER_03]: And when I have evidence through police reports or family collateral or whatever that tells me the opposite, then I will go into a review panel and say I know they're telling you this but listen to all this evidence.

[00:55:05] [SPEAKER_03]: And it's the same thing with addiction like because somebody can organize their words into a fluent sentence does not mean they have capacity.

[00:55:14] [SPEAKER_05]: Exactly.

[00:55:15] [SPEAKER_03]: But that's what's happening. It's like oh they can speak in normal fluent sentences so they get it and it's like their behavior tells you they don't get it, that they are not able to apply the information you've given them to their decision making.

[00:55:30] [SPEAKER_03]: Because they lack capacity.

[00:55:32] [SPEAKER_05]: Yeah.

[00:55:34] [SPEAKER_05]: And from the family perspective, I think they just think...

[00:55:40] [SPEAKER_05]: So when people are really not functional, it's terrible because they have to get their substance and it costs money.

[00:55:49] [SPEAKER_05]: So they may very well be stealing, trafficking, that kind of thing. Right?

[00:55:59] [SPEAKER_05]: In order to do...

[00:56:02] [SPEAKER_05]: I was looking for something where there's harm to others and that's harm to self, I would say.

[00:56:07] [SPEAKER_05]: But that's why I was making that distinction but harm to self for sure.

[00:56:11] [SPEAKER_05]: The families would sit there and say they do not want to go to jail and they do not want to die.

[00:56:21] [SPEAKER_05]: And their lifestyle is such that it's going to be one or the other. It's just clear, right?

[00:56:27] [SPEAKER_05]: Because they're involved in crimes that harm others and they're killing themselves.

[00:56:35] [SPEAKER_05]: And it would appear that the response from the medical community is, well, they're just ambivalent and that's okay.

[00:56:43] [SPEAKER_05]: It's this thing that I do believe psychiatrists have been taught.

[00:56:49] [SPEAKER_05]: Suicidal ideation is you want to kill yourself, you're trying to do it and you got a plan.

[00:56:55] [SPEAKER_05]: And those are the people we're going to hold.

[00:56:57] [SPEAKER_05]: So if you say, yeah, I understand I could go to jail or I could die and that's fine with me.

[00:57:03] [SPEAKER_05]: They go, oh, it's fine with them. Okay, see ya.

[00:57:06] [SPEAKER_05]: And the family's going...

[00:57:07] [SPEAKER_01]: What healthy person makes that decision? What healthy person says that?

[00:57:13] [SPEAKER_05]: That's offensive to me and it's part of the problem.

[00:57:17] [SPEAKER_05]: And I think that psychiatrists raised in whatever you want to say, privileged households or whatever, if they're coming from that background,

[00:57:26] [SPEAKER_05]: they think, oh, this is a drug trafficker.

[00:57:30] [SPEAKER_05]: This is someone involved in theft and whatever.

[00:57:35] [SPEAKER_05]: This is the lifestyle they choose. They're bad people.

[00:57:38] [SPEAKER_05]: And it's like... and the apple doesn't fall far from the tree.

[00:57:41] [SPEAKER_05]: So they must have been raised this way, you know, like in their DNA.

[00:57:47] [SPEAKER_05]: And it's no, they're not well.

[00:57:50] [SPEAKER_05]: And that's why all these things are happening.

[00:57:52] [SPEAKER_05]: And that's why the part of AA that I can really relate to, like Alanon, I should say, is that thing where they have children and parents say,

[00:58:05] [SPEAKER_05]: there's your loved one and your loved one on substances.

[00:58:08] [SPEAKER_05]: You love your loved one, hate the disease.

[00:58:12] [SPEAKER_05]: You separate the two.

[00:58:13] [SPEAKER_05]: Well, it's like I feel like the psychiatrists aren't getting that memo.

[00:58:20] [SPEAKER_05]: And what that is, is a lack of capacity.

[00:58:24] [SPEAKER_05]: And what where stigma comes in is... and there are a lot of moms now talking about this.

[00:58:31] [SPEAKER_05]: So when someone has anasognosia, very long word, but basically, I mean, help me out here.

[00:58:38] [SPEAKER_05]: But it's like they lack insight that they have an illness.

[00:58:41] [SPEAKER_05]: So like if you're an active psychosis and you think you're God and you really believe that, that's anasognosia.

[00:58:49] [SPEAKER_05]: Right? So...

[00:58:51] [SPEAKER_02]: Anasognosia, a $20 word word.

[00:58:52] [SPEAKER_05]: Yeah, I know. So they lack insight into their condition.

[00:58:55] [SPEAKER_05]: Right?

[00:58:55] [SPEAKER_05]: So I started to show up at conferences and going like for people who are dying from their substance use and lack insight into that,

[00:59:09] [SPEAKER_05]: psychiatrists don't say they have anasognosia because they know what day it is.

[00:59:13] [SPEAKER_05]: They know what time it is. They say they're in denial.

[00:59:17] [SPEAKER_05]: They're in denial. They've done such bad things they can't possibly look...

[00:59:21] [SPEAKER_05]: To me, that's stigma.

[00:59:24] [SPEAKER_05]: What they are is they're delusional.

[00:59:28] [SPEAKER_05]: Like tell me what the definition of delusional is because they think the solution is just a little more of this substance or that substance.

[00:59:37] [SPEAKER_05]: Everything will be fine and everybody else is a problem.

[00:59:41] [SPEAKER_04]: Totally.

[00:59:42] [SPEAKER_05]: And so why are we calling that denial?

[00:59:45] [SPEAKER_05]: That's all of a sudden, yes, that guy just hasn't got his shit together.

[00:59:49] [SPEAKER_05]: No, that's part of the illness.

[00:59:53] [SPEAKER_05]: And they don't even make the distinction when they're minors.

[00:59:57] [SPEAKER_05]: That to me is where it gets close to...

[01:00:00] [SPEAKER_05]: I just got to say it like there was a case and I don't have all the details.

[01:00:03] [SPEAKER_05]: Going to put that out there.

[01:00:06] [SPEAKER_05]: But there was a case several years ago where a 12 year old overdosed in B.C.

[01:00:11] [SPEAKER_05]: And it was her fourth overdose and she died.

[01:00:14] [SPEAKER_05]: Apparently, she refused treatment the first three times.

[01:00:18] [SPEAKER_05]: Now, I'm going to go with...

[01:00:19] [SPEAKER_05]: I don't know if she actually made it to the hospital all four times.

[01:00:22] [SPEAKER_05]: But I'm going to assume she got there once or twice before.

[01:00:25] [SPEAKER_05]: And it means some doctors said this kid's got capacity to make treatment decisions.

[01:00:30] [SPEAKER_05]: They don't want help.

[01:00:31] [SPEAKER_05]: That's what matters.

[01:00:33] [SPEAKER_05]: To me, that shot...

[01:00:36] [SPEAKER_05]: So many people are getting sacrificed on the altar of readiness.

[01:00:43] [SPEAKER_05]: We have decided that is the most important thing.

[01:00:45] [SPEAKER_05]: There's nothing...

[01:00:46] [SPEAKER_05]: It's that like the stage is a change.

[01:00:48] [SPEAKER_05]: If they aren't ready, just roll back up the carpet and wait.

[01:00:53] [SPEAKER_05]: You have to wait.

[01:00:54] [SPEAKER_05]: And when you do that with a 12 year old...

[01:00:58] [SPEAKER_05]: When I'm reading psychiatrists telling me the effect of drugs and addiction on the brain,

[01:01:05] [SPEAKER_05]: especially of an adolescent,

[01:01:07] [SPEAKER_05]: and then somehow they're not picking up that a 12 year old lacks capacity

[01:01:12] [SPEAKER_05]: when they're saying, I'm totally good.

[01:01:14] [SPEAKER_05]: I don't need help.

[01:01:15] [SPEAKER_05]: It's my fourth fentanyl overdose.

[01:01:16] [SPEAKER_05]: I've got this.

[01:01:18] [SPEAKER_05]: That to me is child abuse.

[01:01:20] [SPEAKER_05]: I'm just going out there.

[01:01:23] [SPEAKER_05]: If there's treatment available for a terminal illness and a parent doesn't provide it,

[01:01:30] [SPEAKER_05]: that's child abuse, child neglect.

[01:01:32] [SPEAKER_05]: They're going to take our kid.

[01:01:33] [SPEAKER_05]: How is it okay if the medical profession does it?

[01:01:36] [SPEAKER_05]: How is it okay if the government could provide that treatment?

[01:01:40] [SPEAKER_05]: They're just not providing the resources to provide that treatment.

[01:01:44] [SPEAKER_02]: Shops fired.

[01:01:46] [SPEAKER_02]: And I mean, we are getting to the top of the hour.

[01:01:49] [SPEAKER_02]: I do...

[01:01:49] [SPEAKER_02]: I feel compelled to mention the episodes and specifically the last episode

[01:01:54] [SPEAKER_02]: that we recorded with our class weekend.

[01:01:56] [SPEAKER_02]: I guess by the time this airs two weekends ago, check it out.

[01:02:00] [SPEAKER_02]: So their head clinician, Donnie Sering came on and discussed the mandated treatment components.

[01:02:10] [SPEAKER_02]: I saw it.

[01:02:10] [SPEAKER_02]: They got going on the art.

[01:02:11] [SPEAKER_05]: I saw it. It was great.

[01:02:13] [SPEAKER_05]: You did watch that?

[01:02:13] [SPEAKER_05]: I did. Whenever an art comes on, I watch.

[01:02:15] [SPEAKER_02]: What an amazing episode, right?

[01:02:17] [SPEAKER_02]: Oh, absolutely amazing.

[01:02:19] [SPEAKER_02]: Yeah, it was.

[01:02:19] [SPEAKER_02]: So much of what we've discussed in this episode is covered in that, right?

[01:02:25] [SPEAKER_02]: As far as the youth goes.

[01:02:27] [SPEAKER_02]: I mean, I think...

[01:02:29] [SPEAKER_02]: I wish that we could apply these existing laws, as you both very clearly said,

[01:02:36] [SPEAKER_02]: multiple times and multiple episodes to people that need it now.

[01:02:41] [SPEAKER_02]: But I think the best place to start is with the youth.

[01:02:45] [SPEAKER_04]: Yeah, of course.

[01:02:46] [SPEAKER_02]: For so many reasons, because of all the suffering that can be avoided

[01:02:49] [SPEAKER_02]: for the years to come for the next generation, for all of those things.

[01:02:54] [SPEAKER_02]: It seems absurd that one would even have to state the benefits

[01:02:59] [SPEAKER_02]: of mandating a youth into treatment.

[01:03:01] [SPEAKER_05]: I think it's the low-hanging fruit because it's pretty clear at law,

[01:03:08] [SPEAKER_05]: we have a duty to protect minors.

[01:03:09] [SPEAKER_05]: It's why we've got...

[01:03:11] [SPEAKER_05]: I mean, the hypocrisy of saying it is illegal to sell them a joint.

[01:03:17] [SPEAKER_05]: It is illegal to sell them a light beer.

[01:03:21] [SPEAKER_05]: But hey, if they're addicted to fentanyl...

[01:03:23] [SPEAKER_02]: You can't sell them a lighter. Literally.

[01:03:25] [SPEAKER_05]: If they're addicted to fentanyl and they want to be,

[01:03:29] [SPEAKER_05]: well, it's their right.

[01:03:31] [SPEAKER_05]: The most important thing is not intervening until they're ready,

[01:03:34] [SPEAKER_05]: even if they die, even if they're criminalized.

[01:03:40] [SPEAKER_04]: Hypocrisy.

[01:03:41] [SPEAKER_02]: 100% it is.

[01:03:46] [SPEAKER_03]: I feel like I'm watching...

[01:03:49] [SPEAKER_03]: Like when Angie, when you speak,

[01:03:50] [SPEAKER_03]: I just feel like I'm sitting there jaw on the floor.

[01:03:54] [SPEAKER_03]: I just like...

[01:03:56] [SPEAKER_03]: Like I don't even need to speak.

[01:03:57] [SPEAKER_03]: I'm happy to just listen.

[01:03:59] [SPEAKER_03]: You say things so well and so eloquently and yeah, it's just awesome.

[01:04:06] [SPEAKER_05]: Sometimes I think it's mental illness on my part.

[01:04:10] [SPEAKER_05]: I just like so...

[01:04:12] [SPEAKER_05]: I am obsessed with it because of our family's experience

[01:04:18] [SPEAKER_05]: and the experience of the parents I am continuing to provide.

[01:04:23] [SPEAKER_05]: Peer support to all of whom I think are awesome parents.

[01:04:29] [SPEAKER_05]: They all have regrets and guilt and shame of things they could have done better.

[01:04:34] [SPEAKER_05]: What parent doesn't?

[01:04:36] [SPEAKER_05]: But they tend to think everything's their fault

[01:04:39] [SPEAKER_05]: and if they just, just, just...

[01:04:41] [SPEAKER_05]: And it's like there's two things you can't control.

[01:04:46] [SPEAKER_05]: You can't control your loved one and you can't control the outcome.

[01:04:50] [SPEAKER_05]: And like your work is learning how to accept that

[01:04:53] [SPEAKER_05]: because peace comes with that in the sense that

[01:04:57] [SPEAKER_05]: anxiety's trying to control what you can't control.

[01:05:00] [SPEAKER_05]: And so many of them have these stories

[01:05:03] [SPEAKER_05]: where they really are just waiting for their kids to die,

[01:05:07] [SPEAKER_05]: whether they're minors or adults.

[01:05:09] [SPEAKER_05]: They're usually adults, right?

[01:05:11] [SPEAKER_05]: And they can be...

[01:05:12] [SPEAKER_05]: Their adults can be in their 30s.

[01:05:14] [SPEAKER_05]: So the parents are getting to be senior citizens.

[01:05:18] [SPEAKER_05]: They have had...

[01:05:20] [SPEAKER_05]: They've done their best their entire lives.

[01:05:23] [SPEAKER_05]: They have never received the support they need from our society.

[01:05:28] [SPEAKER_05]: And like I said before,

[01:05:30] [SPEAKER_05]: now we've got librarians suffering abuse

[01:05:33] [SPEAKER_05]: because the homeless are in there

[01:05:35] [SPEAKER_05]: and we've got long-term care workers suffering abuse

[01:05:39] [SPEAKER_05]: because they've opened up some spaces to people

[01:05:42] [SPEAKER_05]: who aren't being treated and have serious addiction,

[01:05:45] [SPEAKER_05]: mental health issues.

[01:05:46] [SPEAKER_05]: And so many families have gone before them

[01:05:50] [SPEAKER_05]: and asked for help and were told,

[01:05:54] [SPEAKER_05]: no, you have two options.

[01:05:57] [SPEAKER_05]: You kick them out of the house and they're homeless.

[01:06:00] [SPEAKER_05]: And the parents going, but I know housing first,

[01:06:02] [SPEAKER_05]: they're not gonna get better if they're on the street.

[01:06:04] [SPEAKER_05]: Housing first.

[01:06:05] [SPEAKER_05]: You get to kick them out or you keep them in your home.

[01:06:10] [SPEAKER_05]: Or if you're lucky, if you have money,

[01:06:12] [SPEAKER_05]: you could maybe provide them a home.

[01:06:14] [SPEAKER_05]: But if they're at serious risk to harm themselves or others,

[01:06:17] [SPEAKER_05]: they usually can't keep them in their home.

[01:06:20] [SPEAKER_05]: And if they have money to provide them apartment,

[01:06:22] [SPEAKER_05]: they get kicked out of there.

[01:06:25] [SPEAKER_05]: So basically we...

[01:06:27] [SPEAKER_05]: They have the option of kicking them out of the home

[01:06:30] [SPEAKER_05]: or suffering abuse in the home.

[01:06:32] [SPEAKER_05]: And so those homeless people

[01:06:34] [SPEAKER_05]: who end up being problematic to society

[01:06:37] [SPEAKER_05]: were often first problematic to their families who said,

[01:06:43] [SPEAKER_05]: we have to help them now

[01:06:44] [SPEAKER_05]: because bad things are gonna happen

[01:06:46] [SPEAKER_05]: and they've been ignored.

[01:06:48] [SPEAKER_02]: Ladies, we could do this for a long time.

[01:06:52] [SPEAKER_02]: If we've already gone over the hour mark,

[01:06:54] [SPEAKER_02]: which I mean, I wouldn't change that for the world,

[01:06:56] [SPEAKER_02]: but we do have to cap it.

[01:07:00] [SPEAKER_02]: I'm always looking forward

[01:07:01] [SPEAKER_02]: to your next appearance on the show.

[01:07:03] [SPEAKER_02]: Yourself, Andra Sidney, of course.

[01:07:06] [SPEAKER_02]: It's been a while since we've had this Sidney Arntz.

[01:07:08] [SPEAKER_02]: We're gonna have to get her back on as well.

[01:07:10] [SPEAKER_02]: And before we get into Daily Gratitudes,

[01:07:11] [SPEAKER_02]: I have to say,

[01:07:13] [SPEAKER_02]: I think both Lisa and I have said this to each other

[01:07:15] [SPEAKER_02]: and maybe yourself as well in the past,

[01:07:17] [SPEAKER_02]: but I'll do it again.

[01:07:19] [SPEAKER_02]: You have a gift for taking these amazing ideas

[01:07:24] [SPEAKER_02]: and simplifying them down to a sentence or two or three.

[01:07:27] [SPEAKER_02]: And thank you for that.

[01:07:29] [SPEAKER_04]: Thank you.

[01:07:29] [SPEAKER_02]: Like I think it's a wonderful thing that you do

[01:07:33] [SPEAKER_02]: and it might be even outside of your awareness

[01:07:35] [SPEAKER_02]: because it's so natural to you,

[01:07:37] [SPEAKER_02]: but it's an amazing thing that you do.

[01:07:39] [SPEAKER_02]: So I have to say thank you for being you

[01:07:42] [SPEAKER_02]: and for articulating things the way that you do.

[01:07:45] [SPEAKER_02]: With that said,

[01:07:47] [SPEAKER_02]: that does bring us to my favorite part of the show

[01:07:49] [SPEAKER_02]: and that is the Daily Gratitudes.

[01:07:51] [SPEAKER_02]: And oh, hey, I'll save myself some post-production work here

[01:07:55] [SPEAKER_02]: and say that today's Daily Gratitudes

[01:07:57] [SPEAKER_02]: are brought to you by Yatra,

[01:08:00] [SPEAKER_02]: the Yatra Center here in Karmic, Thailand,

[01:08:02] [SPEAKER_02]: where I reside.

[01:08:03] [SPEAKER_02]: For anybody that hasn't paid attention to my journey so far,

[01:08:06] [SPEAKER_02]: I came to Thailand and started my healing journey at Yatra.

[01:08:08] [SPEAKER_02]: They treat addiction through the lens of trauma

[01:08:10] [SPEAKER_02]: and they do it very, very well.

[01:08:12] [SPEAKER_02]: Completely changed my life.

[01:08:13] [SPEAKER_02]: There's a day goes by

[01:08:14] [SPEAKER_02]: where I don't feel some gratitude for my experience

[01:08:17] [SPEAKER_02]: in its entirety there.

[01:08:19] [SPEAKER_02]: So check them out.

[01:08:19] [SPEAKER_02]: You can learn more

[01:08:20] [SPEAKER_02]: and see some episodes that Mike has starred in,

[01:08:22] [SPEAKER_02]: their head clinician,

[01:08:23] [SPEAKER_02]: at www.808podcast.com slash trauma.

[01:08:26] [SPEAKER_02]: And let's get into some Daily Gratitudes.

[01:08:28] [SPEAKER_02]: Let's start with you and what you got for some gratitude today.

[01:08:31] [SPEAKER_05]: I knew you were going to ask

[01:08:32] [SPEAKER_05]: and I hope you can see this

[01:08:35] [SPEAKER_05]: because I have my first grandbaby, Marlee.

[01:08:42] [SPEAKER_05]: And when I am having a bad day

[01:08:47] [SPEAKER_05]: and let's just say last week was a bad week,

[01:08:51] [SPEAKER_05]: can you see this?

[01:08:53] [SPEAKER_05]: You can't, can you?

[01:08:54] [SPEAKER_05]: How do I?

[01:08:55] [SPEAKER_02]: Come up a little bit closer to center there.

[01:08:57] [SPEAKER_05]: Wait, wait, wait.

[01:08:57] [SPEAKER_05]: The phone went off.

[01:08:59] [SPEAKER_02]: Can you see that?

[01:09:01] [SPEAKER_05]: Oh shoot.

[01:09:02] [SPEAKER_05]: Wait, wait.

[01:09:03] [SPEAKER_05]: I just lost again.

[01:09:05] [SPEAKER_05]: Oh my God.

[01:09:06] [SPEAKER_05]: It's that face.

[01:09:06] [SPEAKER_05]: It was a great picture.

[01:09:07] [SPEAKER_02]: I'll tell you what, Anne.

[01:09:08] [SPEAKER_02]: Send it to me.

[01:09:09] [SPEAKER_02]: Send me that picture

[01:09:10] [SPEAKER_02]: and I'm going to put it up right then in this.

[01:09:13] [SPEAKER_02]: All right.

[01:09:14] [SPEAKER_02]: Please do that.

[01:09:14] [SPEAKER_05]: I'll have to get mom's permission, I guess.

[01:09:16] [SPEAKER_05]: I didn't ask for it.

[01:09:17] [SPEAKER_05]: But anyway, Marlee.

[01:09:18] [SPEAKER_05]: I am so grateful for Marlee.

[01:09:20] [SPEAKER_05]: She makes me happy.

[01:09:22] [SPEAKER_02]: What a beautiful name too.

[01:09:23] [SPEAKER_02]: Yeah, I love it.

[01:09:24] [SPEAKER_02]: Thanks.

[01:09:25] [SPEAKER_02]: That's awesome.

[01:09:26] [SPEAKER_02]: That's awesome.

[01:09:28] [SPEAKER_02]: I can't think of a better gratitude.

[01:09:30] [SPEAKER_02]: Lisa, that's a hard act to follow, but what you got for some gratitude?

[01:09:32] [SPEAKER_03]: I know.

[01:09:34] [SPEAKER_03]: So similar.

[01:09:35] [SPEAKER_03]: So my daughter turned seven 10 days ago and tomorrow is her birthday party.

[01:09:41] [SPEAKER_03]: And so we have a lot of people coming to our house tomorrow for her party.

[01:09:47] [SPEAKER_03]: But you know, I feel like when we-

[01:09:48] [SPEAKER_02]: Did we run into circus this time or what do you got going on?

[01:09:50] [SPEAKER_03]: This time it's butterflies.

[01:09:52] [SPEAKER_03]: It's butterflies.

[01:09:53] [SPEAKER_03]: And we're actually doing a butterfly release, which I'm excited about.

[01:09:56] [SPEAKER_03]: Oh wow.

[01:09:58] [SPEAKER_03]: Yeah.

[01:09:59] [SPEAKER_03]: That's cool.

[01:10:01] [SPEAKER_03]: But I think like, you know, doing episodes like this and hearing, you know,

[01:10:04] [SPEAKER_03]: like it's part of what we do.

[01:10:07] [SPEAKER_03]: It's part of my own journey, my own life.

[01:10:13] [SPEAKER_03]: But just like being able to pause and appreciate.

[01:10:18] [SPEAKER_03]: And she's little and obviously when she's 16, you know,

[01:10:22] [SPEAKER_03]: I won't have that same level of control over her life.

[01:10:26] [SPEAKER_03]: But I feel very lucky right now that she's seven and all she wants is to

[01:10:33] [SPEAKER_03]: be with me all the time.

[01:10:36] [SPEAKER_03]: You know, she's a handful, but she's a happy kid.

[01:10:40] [SPEAKER_03]: And I just am like, you know,

[01:10:42] [SPEAKER_03]: I know there's a lot of parents out there who, you know,

[01:10:45] [SPEAKER_03]: think about their kids and they feel a lot of hurt and sadness and fear

[01:10:49] [SPEAKER_03]: and worry. And so just being grateful that today, like I get to just,

[01:10:54] [SPEAKER_03]: enjoy a happy, healthy little seven year old who just wants to be with

[01:10:59] [SPEAKER_03]: mom as much as humanly possible.

[01:11:03] [SPEAKER_02]: Amazing. That's awesome.

[01:11:06] [SPEAKER_02]: I'm now grateful for the thought of Alexis being 16 years old.

[01:11:18] [SPEAKER_01]: She's going to be a fool.

[01:11:23] [SPEAKER_03]: She is, she is a firecracker.

[01:11:26] [SPEAKER_02]: It's just like potential suffering here,

[01:11:27] [SPEAKER_02]: but it's kind of a funny thought. I'm sorry, but.

[01:11:32] [SPEAKER_03]: Lord help me.

[01:11:33] [SPEAKER_02]: I'm also most grateful.

[01:11:37] [SPEAKER_02]: Yesterday I got to experience.

[01:11:40] [SPEAKER_02]: Went out for supper or Wednesday.

[01:11:41] [SPEAKER_02]: I went out for supper.

[01:11:43] [SPEAKER_02]: At some friends from Australia actually that I met at the,

[01:11:46] [SPEAKER_02]: at the Thai language course I've been, and it was just this wonderful.

[01:11:50] [SPEAKER_02]: Like I haven't had a home cooked meal, like an actual home cooked meal.

[01:11:54] [SPEAKER_02]: Since I've been here.

[01:11:55] [SPEAKER_02]: Well since, since I left Yatra anyway, so it's been,

[01:11:58] [SPEAKER_02]: it's been eight, nine months since it,

[01:12:00] [SPEAKER_02]: since I've only enjoyed a home cooked meal. So it was,

[01:12:02] [SPEAKER_02]: it was a wonderful experience with a couple of lovely people.

[01:12:05] [SPEAKER_02]: And yeah, it was, it was, it was really great.

[01:12:07] [SPEAKER_02]: So I'm thankful for that.

[01:12:09] [SPEAKER_02]: I'm also thankful to every single person who continues to like,

[01:12:12] [SPEAKER_02]: watch, listen, talk about, comment, interact, subscribe, follow.

[01:12:16] [SPEAKER_02]: All those buttons down at the bottom is every time you do those things,

[01:12:19] [SPEAKER_02]: you're getting me a little bit closer to living my best life.

[01:12:22] [SPEAKER_02]: My best life is to continue making humble living,

[01:12:24] [SPEAKER_02]: spreading the message of the message.

[01:12:25] [SPEAKER_02]: If you're an active addiction right now today could be that day.

[01:12:28] [SPEAKER_02]: Today could be the day that you start a lifelong journey.

[01:12:31] [SPEAKER_02]: Reach out to a friend,

[01:12:32] [SPEAKER_02]: reach out to a family member calling the detox go to a meeting,

[01:12:34] [SPEAKER_02]: pray, go to church. I don't care.

[01:12:35] [SPEAKER_02]: Do whatever it is you've got to do to get that journey started.

[01:12:38] [SPEAKER_02]: Cause it is so much better than the alternative.

[01:12:41] [SPEAKER_02]: If you have a loved one who's suffering an addiction right now,

[01:12:43] [SPEAKER_02]: just taking the time to listen to this just great conversation.

[01:12:47] [SPEAKER_02]: If you just take one more minute out of your day and text that person,

[01:12:49] [SPEAKER_02]: let them know they are loved.

[01:12:51] [SPEAKER_02]: Use the words.

[01:12:53] [SPEAKER_04]: You are love.

[01:12:56] [SPEAKER_02]: A little glimmer of hope just might be the thing that brings them back.