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Meet Dr. Nick Colangelo, Nick has spent decades in the in the Field of Substance Use Disorder in many roles. In 1975 Dr. Colangelo began his this career as the Aftercare Coordinator at Runnell's Hospital in Berkeley Heights, New Jersey. Nick was also on the Somerset Council on Alcoholism. There he was a Crisis Counselor, and he was the Director of the Kelly House in Somerset, New Jersey that was a 12 bed detox center. In 1979, Nick became the director of the Sarah Mayo Hospital in New Orleans, Louisiana. He was also the Hospital Administrator of 200 beds and a detox center of 27 beds. In 1979, Nick worked for LifeMark Corporation, and that was Houston, Texas. There, he was the Director of the Westgate Hospital Alcohol Rehabilitation unit with 40 beds. And at this time, he was also an Acquisition Researcher, and a Speaker, Trainer and Consultant in Arkansas, Florida, Mississippi, New Jersey, Oklahoma, and Texas. In 1982, the Scranton family, the founders of the City of Scranton, donated their summer residence in Waverly, PA to a Geisinger Affiliate to become Marworth treatment center. In 1982, Nick became the president of Marworth. At at that time he designed it to build a freestanding family residence there of 20 beds. The treatment center had a 72 beds for drug and alcohol treatment. He also designed and opened up an adolescent Drug and Alcohol Treatment Center with 60 beds on Shawnee on the Delaware and Pennsylvania for more with in 1989. By 1989, Marworth was recognized as one of the top 20 rehabs in the Country to attend, that is out of about 4500 facilities that operated in the US at that time.Nick designed and developed a 60 bed treatment center, Tully Hill Treatment Center in Syracuse, New York. Moving on from Marworth. In 1989, Nick became the vice president of a 50 bed adult and 50 Bed adolescent treatment center, and Wilkes Barre pa Clearbrook. In 1997, Nick became the president and CEO of Clearbrook, Incorporated. At that time, he has designed and built a freestanding residence of 20 beds as well. In 2019, Nick became the CEO of Brookdale treatment center, Swiftwater, PA, establishing it as of a state of art campus of recovery. From 2001, to present, Nick is also the co founder of "Families helping Families", free education, support programs offered in Pennsylvania, focused in Scranton, Tunkhannock, Bloomsburg,Dallas.
Nick stops by today to catch up and have a chat. We talk about this prolific career, which will be coming up on 50 years, and all the changes that have happened in drug and alcohol treatment. Some of the changes for good, some for ehhhhh, and some driven by technology. . One specific topic we talk about is "Medication Assisted Treatments." And, for lack of a better term, maybe stigmas in Recovery Communities that existed, or fundamental definitions of recovery, that people in the last four decades had to loosen their grip on, and Nick experienced this firsthand of how these became life saving medications, and wider paths to recovery for individuals. We do a kind of a deep dive on MAT, and I learned a lot, that was the point of this podcast to "learn in real time". So I hope you enjoy the discussion.
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Dr. Nick Colangelo 0:00
gonna lead me off right with a question or something or
Unknown Speaker 0:02
Dr. Nick Colangelo 0:03
Okay, go. We're live good. We're
Joe Van Wie 0:07
we're here with Dr. Niccole, Angelou. And for full disclosure, when my friends are on here, we have a long running relationship. And that started with my father. And I wanted to thank Nick for coming here today, and maybe add a little context to his visit. I've been trying to get him on the podcast. But I met Nick when I was probably six, five years old, more worth with digger in this enchanting piece of real estate.
Dr. Nick Colangelo 0:40
40 years ago, yeah.
Joe Van Wie 0:42
So dig. The reason I wanted to put this as a background was because about six months ago, I called you, I needed some guidance, I thought you would be helpful. And I'm calling you. You say I'm in town, I run up to Starbucks, we meet, talk for an hour. You drove away, and I'm driving away and I had the weirdest feeling I've ever had. I was first time I had this feeling after talking with you was that I was 44 years old. It's the first time I felt like an adult. I'm saying this because I'm like, wow, Nick. Nick was talking to me like I was his friend. And I've never, ever had that connection. Until you know this last time I got sober the roulette wheel, my relapse was so brutal. I always felt like I was 16 around you, like you were an extension of authority. And I couldn't let that guard down and connect with you, you were always an extension of someone that was going to make sure I was gonna do the right thing, whatever in my head. And when I drove away, and I've just spent a year in the drug and alcohol field, I was just washed with how like a veil dropped of what you did for not only myself, my father and my family, and a time when recovery wasn't too common, it was emerging locally, in the 80s. I had a full new appreciation of who you are. In the lens of my 44 year old self looking back at a 16 year old mind, I was like, Oh my God, you You did things that saved not only my life, and my father wanted to start the podcast to thank you on that. So I never got to thank you directly for those things. Thank you. So now that we're two adults talking, you
Dr. Nick Colangelo 2:29
know, I'm way past adult I'm 78. Now, whether with a 16 year old mind,
Joe Van Wie 2:38
you've been in this field for a long time and in Scranton, our first footprint of immediate help was Maher worth, what how would you summarize? How did you end up in those doors and working at more worth?
Dr. Nick Colangelo 2:52
Well, there's some kind of grace and other influences that there's no way we will be able to describe that. Matter of fact, there's a short story that goes with this i i visited Scranton when I was in my 20s. And of course, I wound up in Carbondale and hit every bar there was and I'd love Scranton. And I remember going home and telling my parents that I was in Scranton, and what a great place and my father just shook his head. Now fast forwarded, married working in Texas, and having a pretty nice career. And having seen the brochure of Mr. Worth at a table in California to conference, I said God help the person that's going to have to open that I mean that there was an explosion of treatment centers taking place in the early 80s. And lo and behold them, I'm home for a holiday and a headhunter calls me and says, I have a project and I'm interested in talking to you and I said, I'm not really interested. I'm happy where I am. And he said more worth really. And I said I've read the brochure, I said what is that about? I said, I'm home for Christmas, I'll give you a call. Well, long story short 1982 I wind up opening up more work. So there is some conversation we have, are we planning are we chosen? How does it all happen? And, you know, for seven or eight years are worth I think changing the landscape and recovery of what occurred in Scranton, there were like seven meetings between Hazleton and Carbondale and 82. There wasn't any real inpatient treatment and like a combination of that being the Scranton home. geislinger. Yeah. And really, a group of talented people that were assembled it was almost magical and mystical would happen and recovery exploded which is still foundation General, in our area, yeah. And so I was an instrument in that in the country. And the countries matter of fact, four or five years afterwards, we're in the top 20 in the country of 1000 treatment centers.
Joe Van Wie 5:14
So you were sober into read a pamphlet, the names in your head, there's an intention set you whatever way you were thinking about it. It's just strange. I don't acknowledge those things when I'm drinking. But to have that word more worth in your head, then get a call. It just creates an more interesting life that you're more tuned. Like, do you do have more of those moments that?
Dr. Nick Colangelo 5:36
Yeah, my whole career has been. I applied for a couple of positions before Mr. Worth and and a couple after, I have never received a job that I applied for. Someone always calls me on the phone and says, are you interested, or we have this, or we've heard this, you talk to us. And that is still occurring? That's why I mean, I really the carp situation in West Palm Beach, or the indigene, that I was part of when their treatment center close at large enough for profit to take care of people for nothing for 90 days. A high school student that I taught, and up on the board had become sober from my hometown, and he called me said, Will you come down and talk to us? So there's another side conversation to when do we make our path? Where are and you know, you were very kind with your words. And what I want to say is that I've been fortunate to be an instrument of change and goodness and a lot of people's lives. And, you know, my first thought getting sober was I'm going back to law school.
Joe Van Wie 6:54
Any more lawyers,
Dr. Nick Colangelo 6:56
and you know that that story is fascinating in itself. I was being admitted to Seton Hall Law School when I was walking out of the out of the building that night. And I stopped and I listened. And here's what I heard is, is your dream. Yeah. Or is it somebody else's. And I heard it's your father. I said, we're not going to do this again. And when I walked out of that little school, I knew I was never coming back. And I went, and I talked to somebody and pointed me in another direction. And the rest is history. Yeah, it's so I think getting sober sometimes has some of the same possibilities that my life has had on the sober and we're very compelled to be pushing in a direction, doing the things to win that we want to win. And there are other forces operating around us. And then one day, it all comes together and we go in a different direction.
Joe Van Wie 7:55
I, I relate to that profoundly, because it's subtle. And I think a lot of people have those moments. It's intuition. And if I skip too many of them, I get a lot of pain. I'm not living an authentic, my authentic life. Correct. I created a life 16 year old Joe wanted. It wasn't any consideration with adult Joe because I didn't let him run my life too much like it was like to run from fears. And I skipped too many of those moments, and the pain was overwhelming. But I think being sober, practicing some model, be at the 12 steps. It compels you to take the adventure. It's not boring, like sobriety is not boring. It's not just being sober. You're compelled to live an adventurous life. That's more profound than being selfish,
Dr. Nick Colangelo 8:43
but a great word. There's a philosopher Tillich wrote a book that I read 40 some odd years ago, Life is an adventure that suddenly six pages, and I read it, and I realized that I was on it was early in recovery. And I was on the brink of an adventure. Yeah. Not a punishment, not a surrendering of an idealized make believe life. That's something new and exciting. And and I told you what my age is. I'm still on an adventure. Yeah. And that just propels you into a lot of goodness. I think joy and excitement in your life. You don't you want to get up in the morning. You want to get going. You want to go do thing. Yeah. And it's the connection of people that augment all that. Yeah, I'm not sure you can do that in a vacuum and experience the same thing. I know people try to do it and it appears that they do it. But when I really look at successful people, there's combinations of connections that allow them and that whatever they have used to get themself in a position to reprogram and go in a different direction, which are a variety We have different things in the world today and the world of recovery. It sets you free. Yeah. Because I was a prisoner of war, I believe you were the Yeah, part of the life that I know about yours
Joe Van Wie 10:12
was tormented. It's so self consuming. And then when I would stop at a Clearbrook, or more worth, I would forget how, how far the answer demands you to go. I'm like, I just wanted to stop drinking. Like I thought I knew that
Dr. Nick Colangelo 10:27
very important beginning by the way, yes, it
Joe Van Wie 10:29
is. But it was scary. Because I couldn't make the leap of faith again, I understood it when I was a young guy. But that doesn't take hold in your brain. Sometimes if you don't practice the principles, let's just say of adventure for the sake of us or dialogue, of the steps of taking a risk that integrity is more important than achievement or opportunity. I thought they could have a little wiggle room, and I was getting lost in there. Where I was going with this, it's humbling when you connect with people and the way you have, and for four decades of this treatment, it's what can you take credit for, in the sense like you're an agent of change, you chose a life that connects to people. And that's how people get better from the way we understand it. Like, well, how many variables are involved? How can I take credit for things like all these things, were in motion? I'm just open to be in the flow of it.
Dr. Nick Colangelo 11:29
You really should not take credit for it. It is you had been cast. You know, when I look at look, somehow by whatever makeup allowed me to find great comfort in the work that I do. I have never since 1975 worked a day in my life. Now, that doesn't mean there haven't been some disappointments and difficulties. But I said I was going to do this. Because I had choices. I could have gone and done other things. Yeah. I was chosen or chose and circumstances moved me over here. And I said, I'm gonna do this. To the first day, I don't love doing it. Wow. And I still love doing it. And it's you know, it's funny, you know, the things you remember being small. I came home one day, I don't know how old I was. And I told my father, I want to be Johnny Appleseed. And again, he just shook his head. Well, guess what? I wound up Johnny Appleseed. You play above just a different sort. Yeah. It's hard for me to articulate the joy that I have, you know, a year ago, January, Christmas Eve. I contracted COVID. Yeah. And scary. Then 14 days later, I deoxygenated and took my first ambulance ride. Wow. And I wound up in geissinger for six days. And I don't remember most of the ride. I don't remember the head of the hospital who met me there. I vaguely remember the people in the spacesuits, you know, in the isolation. And the conversation the next day they came in and they told me I was going to get the Trump medications, the two days and cetera, et cetera. I couldn't brush my teeth. And I remember saying, Well, I've been there once before. And I said, Well, this is that let me do it. Right. And if not, can we please get me out of here? Yeah. And as soon as the medication started, the nose of the plane started up. Which was great that itself, I think. But then I had my phone with me. I can't tell you how many. Nick, we're praying for you. And you know what? It's all the flowers. Well, the connections. Yeah, all of that. And I was never alone for one moment in their home. And I was always and I think that is what's hard to sell to a disconnected person about what the reward of connections are. And, you know, I remember a person by the name of Connie F. Was died of a pretty bad cancer when I first came that SCRAN Yeah. And he said, the quote I have around me, he said, it's over and I'm ready. I never forgot that. No, it's really mean that I have certain things. So there is it's almost romantic. It's almost a little bit of faux faux stuff when I talk when I talk like this. But when you're laboring with people and you're genuinely giving and trying to help them and they get hurt All you have to do is remember, don't take credit for it. Yeah. Or else, I think you can get into a lot of difficulty. And I'm an instrument, I'm a ditch digger. I just go around doing the seed work. And then that remarkable. No one can help anybody with anything, unless there is this germination of a willingness. Yeah, I mean, I've been told what I could do to myself more times than I can remember a count. And that's just not willing. And then I see the transitions along the way, on various ways that they go through their pain and their moment of truth. And then what happens is they become willing to go follow some instruction, and their whole life changes. You're an example of that. I'm an example. And there's countless millions of people around wherever I go on the global bomb generally around recovering people. Yeah. So yell the jail.
Joe Van Wie 16:01
Yeah, it's liberating. I want to go back because the hospital that's the first time I've heard you having a health crisis that, you know, we're all aware of as community. I called you and I was talking to you. And to be candid with you that something was different. Like there was a I'm not saying he gots off. But there was a gentleness and a calmness that was kind of frightening to be on the phone, but yet to have someone calm. It wasn't nonchalant. Like, I'll be fine. I'll be okay. You work on. I want to explore that with you. Because was there a consideration when you were that sick? You've been sober for so many decades that you might not leave the hospital? Did you have that thought?
Dr. Nick Colangelo 16:43
I had no idea whether I was leaving. I was not. Yeah, I had. It was like there were people at that time, that were on respirators, and they were passing away. And like, I've worked around hospitals, and in our, for my whole career, and I knew that I was a candidate for a couple of reasons to wind up on event. Yeah, I didn't. So, but I was between a belief that I have not to be confused with religion, who teaches you to believe in showing, I believe me personally, and I wasn't alone. And I wasn't alone from the connected people. Yeah, family and friends and associations. Not necessarily friends. So if you can be in a jam like that, there's not be alone. There is something extraordinarily comfortable. Yeah. And safe. Yeah. And then when the medicine started to kicked in, I thought, Okay, I'm gonna go, I could get here. I mean, I wasn't in great shape. When I got out and I was still on oxygen. I had lost 30 pounds almost overnight. And I wasn't a long haul er, but that took me some time to get back into shape. Yeah. And I'm grateful. No,
Joe Van Wie 18:05
I loved hearing that. Because I used to be cantankerous, and, you know, just broody and thorny talking to you about submitting my will to a power greater than ourselves, this context of a 12. And what you described is implying the scar to me like that spiritual to me, connection Association. There's something shared that's intangible when I'm experiencing it, and it's not fake. It's, it's beyond almost belief, because you experience it, you're experiencing power. That's what I was missing. When I had a stent in the hospital on a respirator. The year prior to that I woke up to the cellular level of my body was anxiety, because I knew how alone I made myself because all I think about is myself. And people started showing up at the hospital and from loneliness and went to regret. I wish I had more time I wish I connected more to while I haven't made, get the hell out of here. But to hear that that's that's spiritual. That's not spiritual nonsense or spookiness to me. That's an axiom. There's a power in community connection that I can't, I can't describe. It's not me independently. I wouldn't be if I didn't tap into that in time, I was in trouble.
Dr. Nick Colangelo 19:26
There is a lux, I was I've been around religion my whole life, though. And I'm not against religion. I don't get into the theology, theological debate. I remember when you wanted to debate because because of the confusion between religion teaches spirituality, it is not spirituality. And it is up to the human being to interject into themselves. Yeah, their own sensing and meaning. You know, it kind of goes to Victor Frankel's man's search for meaning. Yeah. And once you have that, and your imaginary friend, so to speak, is your or however you want to elevate that, and your system of belief, which we call faith, but believe, you know, you're kind of okay in almost any and all circumstances, and I've been blessed to be with people who are taking their last breath. And they're fine. Yeah, there's are okay, so there is a way. Yeah. But you cannot be chasing the material. And think that that's going to give you the inner spiritual. You've got to serve a couple of Masters on that. Yeah, not that the outside is wrong. No, but the inner is where all the strength comes. And that's not what we learn in our society. And that's not
Joe Van Wie 20:52
what we know, we don't we get taught there's a separation between man and the material world as if they're happening. It's, you know, it's hard to unpack this. But this material world seems to have existed prior to consciousness arriving. That's how we tell our story. A lot of Eastern people don't do that we emerged, we're part of the story the whole time, we just now emerging as intelligent. And as a product of it, we feel Westerners, I'm sure you have a Catholic background, I'm some soul that got deposited into this world. And that's hard to parse for me because it feels like an alien. It adds to my loneliness, these ideas, but I had to get over that with I was suffering because of my cognitive thoughts. And it's called Addiction Disorder. When I was sober. I wasn't getting relief at drunk I was going into a later stage. There was a spirituality I can't fully define, but I was I let go of my resentment in the first three months of where I wanted to make arguments, religion, this is a disappointment. This doesn't make sense. I was gonna run out of time, put my looking and talking that way, I was gonna die because of something that that happened for 10,000 years before I got here. Like, this is my beef, no. Joke. Cut the shit get over it. Your friends are waiting for you to wake up your family. This is I wasn't looking at that as the scenario I was looking at. But what if we're all wrong? Should I stay drunk?
Dr. Nick Colangelo 22:24
I have a I have these little deals. And we all talk you know, but I had a friend that used to say there's a better way. Yeah. That challenges people. So I have said there is a different way. Try it a different way. And if have we all have to solve our own argument? Yeah. You know, arguing with somebody else is just a distraction.
Joe Van Wie 22:47
No, I'm still arguing with myself. I already know what I'm doing
Dr. Nick Colangelo 22:50
it and so what is the real goal? Well, let's use addiction as a model. Yeah. If I'll go to the with another story. So I had some hand surgery. About five, six years ago. Okay. Simple surgery. But when it came time for me to come back, I was not in the room. I was in heaven. I was in some place that I had never, ever, ever been. I said Holy Jesus. And who doesn't want to do is stay there and bathe in it? Yes. Perfection.
Joe Van Wie 23:35
Nick, is this under the anesthesia? Yeah. Okay. Yeah. No, it's
Dr. Nick Colangelo 23:39
not the anesthesia. That was something else that it can't be it's consciousness or something. And well, it's, uh, what happened was then there was an intruder into this perfection. And I heard this very distant voice. It's time to wake them up. What else I could do is say, I gotta get her out of my life. Yeah. And then she grabbed my toe. And I really got upset. And then she wiggled it. And I had to leave where I was swaying it. And I wanted to come back and tell her the hell out of here. And my eyes just shuttered and she said, Okay, he's coming back. We're okay. Then I turned around and tried to go back. Gone. Yeah, it's gone. It's gotten close. It's there, but it's less, and then it's less. And then what happens is, I wake up, and then my consciousness and my fight, and then I say, okay, he goes back, and I says, sense of self self. And I say, what was that I was on proper thought. Oh, my God. I understood. Michael Jackson completely. Yeah. I want to talk about this. This is crazy. So So what's happening now is that I was my mentor said that it's Certain people are susceptible we'll figure it out and 100 years. Yeah, or we won't. But what happens with all mood altering substance it hits our brain in a certain place. It brands it as perfection. Wow. And it is stronger and better than the best orgasm you've ever had your and it is perfection and it's not allowed for mankind. Well, why wouldn't we go there and why wouldn't we go to the gates of hell and death pursuing it?
Joe Van Wie 25:33
I think that's why you always understood addicts. You wasn't authoritarian, and I've always made that connection with you. You know what ecstasy is? And that's hard to peel. So
Dr. Nick Colangelo 25:43
invested that for me. Yeah, like,
Joe Van Wie 25:46
I don't want to get on everything. Metaverse is scaring me people are gonna have better lives there. Forget the two dimensional Facebook like screen. What if I created a life that's far more interesting from a trailer with an addiction that can help complement a fake reality? It's frightening. I want to go back I was unprofitable for 19 days in a coma. Yeah, well, when you wake up it's horrifying. Yeah, I was hallucinating for a day or so. I don't know if it's from that or the brain or my oxygen. I don't know what caused it. But I all digital moths in there. Russell Prinos. Sitting in the room, Chris Hinton sitting on my lap eaten my sandwich from my coma. Hey, what the hell happened, pal? I'm like, why am I strapped to this bed. He goes, take it easy. We're gonna we got to try to get out of here. I'm seeing things that haunt me. He's like, take it easy with the birds. You know, I was telling him the birds in the room, because we kind of get out of here stop talking about birds. But I was starting. I was dreaming that whole time. In that 19 Day coma and it was a nightmare. A total and utter nightmare of physical torture. Which was like a hyper reality. People were wearing masks. It almost was cinematic it escaped from one room. It was like a twilight zone or Black Mirror episode to escape into another tormentors room. Nick, it was awful. And after a while suspended in that state of consciousness for that long I lost track of where the sense of self was because I haven't been in my mind in a while. There's a sense of self I can't see myself. It's like a POV of a human. But people in cloud mass is torturing me. I finally was getting killed in one of those scenarios. I'm getting tortured. And I'm looking up at a streetlamp. It was almost like a film. That's just my man. And it was like a penlight from, like waking me up, like he's coming back. And I was like, oh my god, I was terrified to go to sleep for three months, afraid that I would fall back into that realm of consciousness. And I was really disassociated with Where is reality? Because does this one matter if that one was that I experienced unsuspended from time? That was real. Like, I'm not saying it's a I went to traveled to a material world. But what what the brain doesn't know the difference? It's experiencing this. I was experiencing it the same way. If to hear you go to heaven. This Irish got sent and I was tormented.
Dr. Nick Colangelo 28:29
I went to heaven. You went to hell. Thank you. Thank you pro football. And so let's say call it a dream or a drug into a state. Yeah. So even dream state interpretation is pretty easy. You can come up with two conclusions. Yeah, your dream state is either going to represent your best wishes, or your worst fears. Oh, man, and I think drug induced states based on everything that's going on with a person. You got the same choices. There isn't a neutral. Yeah, I went to a pleasurable you did not know. Both imprint the brain. Yeah. And the brain forgets nothing that imprints Now I will tell you that I cannot recreate that pleasure state. No, unless you had time. Oh, well, my belief would be tools. If I had the tools or the doc to do it. He might be but my other belief about what I know about addiction was I was only perfectly high once Yeah. Now I can say twice. Once was with alcohol use other substance. And one with proposal. Yeah, but every time I went to try and recreate it, yeah, it was less. Yeah. Never hit the Perfect Note again. Now use music so I have hit the perfect one under one and a semi conscious unconscious state of Pathol the other one and injustice With alcohol, yeah. However, the substitute for that is the pleasure and joy of redirecting how I live in my life today. And which brings us into the world today of everybody's trying to manage the states and a different way than the way I got sober and clean. Yeah, it's much more complicated.
Joe Van Wie 30:20
It is, it is. And we we discussed this before. I don't know, it's, I always put this two in two lanes if medically assisted treatment. And the two lanes I unpack it, it is in what I would call the social workers realm, the ethical obligation of I am just meeting people where they're at and I'm keeping them alive. I don't care what their idea of recovery is. Can I do harm reduction in a method that will help save a life? The second realm would be as you and I have experienced and want to experience sobriety, is this clarity of mind a state? I don't think they I think they're gonna converge into a dignified lane together. Because one keeps you can't get them people sober. We know that. So if the government had a role to play in making sure scripts are more accessible to life saving MIT drugs, like first a city like Kensington, I'm all for this like this. This produces some really good benefits. We were talking about Canada, Gabor Mateus kind of caveat of Twin Cities, injection sites. I never looked at that before I look at the data it's it makes you look at and say, What is this? What am I missing? People are staying alive. That's the point. Do I want to stay alive? No, I want more than life. I want I want I want to clarity of mind. I want to feel alert. I don't want to be afraid of pain, and constantly be in a state of seeking pleasure. That's Recovery to me. It's almost Zen. And I know that is for you. It's gonna be hard because there's a big business is going to be involved. They're going to be marketing ideas, changing words for solutions. I think there's a fight that's gonna be unfolding.
Dr. Nick Colangelo 32:20
There is. You know, it was easier when I got sober. If you looked at the circle of addiction. We had Vietnam and people coming back on heroin. Yeah. We had some marijuana and we had the pills of, you know, the 70s and beauties. Valium. You know, Valium was a if you were a value thematic. They use it. They thought alcoholism was a valium deficiency. Once upon a time we use so much of it to treat and then we created another addiction. Wow. And to have this conversation first, I think you have to realize they're cylinders in addiction now. So let's say there's the opiate Okay. Let's say there's co occurring disorder, there's shrinking, but alcoholism, there's cocaine. There's pills, there's uppers, there's downers, the formula for addiction has not changed. Yell summer school, I went to David Smith. It is dose plus frequency plus physiological plus psychological makeup equals addiction. There's your math. Okay. Yeah. But that varies from person to person. And then you got subgroups that come off of that. Yeah. But now we have everybody being specialized, because that's what happens in our world. So if I'm a drug addict, I'm a young Well, I'm an opiate addict. I'm this I'm that. Well, first of all fentanyl change the game. Yeah, that no, I call instant death. Yeah, I'm not for everybody. But if you catch the wrong one, you're dead. Yeah. And so what is our responsibility and addiction and the recovery community and the treatment community? Well, I would say the same thing it was when alcoholics went into the hospital with you save a life? Yeah. So you use all the medicines that you have. Now, in that, you're still going to have mental disturbance, you're going to have mental illness, you're going to have sub and acute, you're going to have a variety of things. And my observation, and I want it to be a criticism is we don't triage and identify appropriately. Okay, what we're doing, we're generalizing. And there's an overlay on this of the usual corruptions of money and power. So you've got the pharmaceutical companies that can't make money if they're selling less of something they have to do the most. And then you've got the addiction community and the treatment centers, and the docs how they are and how everybody earns their money and we haven't had this conversation or ferreted out yet. And then has to come. And then there is a third one that is like a third rail. I was at a meeting once a guy singer, I don't know 35 years ago. And the conversation come up as suggest suggesting the discussion of legalized drugs. just legalize it all. Yeah, take all this conflict out of it, decriminalize it, stop the billions and billions that we're wasting trying to combat something that's a runaway train. And I won't use the name, but he was a senator. And he said, We'll bomb the known world before that happens. That was the answer. And, you know, when you go to Europe, which is in America, and you sit in on conferences, and you talk to people, they're more open to at least having the conversation. Yeah. You know, economically life saving. I could probably come up with If we legalize all the drugs, needles and everything, and then committed all the money saved, to treating what wound up the illness. Yeah. I mean, I'm pretty sure. Somewhere like 75% of America is taking some kind of pharmaceutical now to begin with. Yeah. I will tell you when I got sober. That was about 10 12%. I'll have to double that marketing. So everybody, we go back to the spiritual part of our conversation. Yep. Nobody's working on that. Because we keep saying if you take this, your headache goes away. If you do this, this goes away. And then the addiction gets caught up in it. And then there is the great economics of drug addiction, both in the poverty and how they're earning a living, how the undereducated are and and how law enforcement. I mean, it's very complicated conversation. I don't think we can handle that.
Joe Van Wie 37:01
Well, the conversations happening, and you've been a part of them and us territorial, like where are wherever you are, geographically, it's a different conversation. It could be, you know, more open to these ideas. I live in a country, I spent the first 30 years of my life 90% of the villains in movies were drug dealers, cartels, and it was, you know, you could spend two hours waiting for this guy to be butchered and killed in the most glorious way. And that's how the filament victory is. And without that kind of stuff here, I mean, it's an unbridled emotion charged with the idea of legalizing drugs that are intravenous. But data is data. And I think this discussion needs to get a little longer, more intelligent, because we just lost 100,000 people, we're not going to solve it the same way if saving lives and collapsing cities from here through the Rust Belt is not going to work by what was being used. I think we know that. But to have the discussion, do you see where do you see it happening? The most intelligent here? I pushed it, who are the most intelligent voices?
Dr. Nick Colangelo 38:13
I think? I think I was at least part of the group. Yeah, that did that. In the UN. What we were doing is we were treating people with questionable ma T. Yeah. And detox. And by the way, some of them were coming from Kensington. Yeah. And they told us, what we were doing was different. And we were using drugs to stop the pain, moving them on to mA T, with the 12 steps and 12 traditions hanging on the wall being part of the lectures, not an either or, and having them participate in based on calves testing. Yeah. And very, very thorough histories. And some of them that I've been at this for 15 years, I want to come off everything. Yeah, they were the lesser of that. I will show you Sure. And we did that. And we supported them. And then we sent them on to other treatment facilities. And then there were those who would go so far. And say that's it. Now, because of the fentanyl dragon at your hair. Yeah, what the patient now says should be respected. And if they say, I'm down the 20 milligrams, that's where I want to stay. While I think that person should also be able to go to an outpatient clinic or somewhere and not be rebooted up. Beyond or they're down to 15 or 10 and a half. Somebody said, Oh, no, you have to be on this. Because the brain science doesn't have the willingness quotient. So you're assessing the willingness of the end of it. tool of where they want to be. We didn't do that with alcoholism, alcoholism was here's where you're gonna go, here's what you're gonna do, and cetera cetera. But we did not have a de imminent death camp white powder, stronger drugs, heroin speed to a certain degree but absolutely fentanyl has changed the game and should change the conversation. So medicine has to be the first front of stabilization. Let's not even call it data. Yeah, it's the emergency room for the addict. And then there is a negotiation going on, which now has corrupted a little bit of the straight alcoholic, because now they want to say, so we will work out that. But I think the responsibility of everyone in treatment from the doctors, to the medicine people to the outpatient to the pharmaceutical companies, is this the right to be in that paradigm. You can possibly get here to a reasonably comfortable life if you're willing to try and we're going to help you. And that's exactly what I got out of the moment is the book of realms of our ghosts. Yeah, you're treating individuals see we're used to group process, and the treatment centers group and it's harder work. You need more data, you need more data processing. And you need to individualize the person in a simulcast of a circle of assistance. And I am hopeful we're going to there's new research coming out about actually using fentanyl. As a detox drug, so you don't know when to you know, a day or two and then a proper dose. Why should a person go into an emergency room and suffer? Yeah. Why? Because we think it's good for an addict to suffer. Yeah, if we have medicines, you stop that. And you bring them down, then they say, Well, some people will come in and abuse it. Yeah, okay. Yeah. I don't think people abuse our emergency rooms. Yeah. Where's the dignity in life? respect and dignity, if you're going to call it a disease, treat it like a disease? And every person has a say in their treatment? Yeah. And it's hard work. So it's harder work. So I am encouraging people to get out of this. And by the way, once upon a time, when pharmaceutical companies first came out with suboxone and the way they were using I was opposed to it. Yeah, sure. It's because of
just because it looked like it was an assault on people. And it was yeah, it actually was. Now I think, we will refine how it is used, what dosing is used, involve the patient and the participation. First, save the life, then give them the opportunity to experience what you want I talk about if they so choose, if they choose. Now, here's the other thing, if they do not choose that, and they choose to be maintained in some way, should they not be treated with dignity and upcycled things? And should there not be a unanimous treatment industry that respects?
Joe Van Wie 43:23
Nick, that's a great place to jump off because there's a conclusion to that listening to you say that is guarded me. I read that book two years ago, and it was enlightening to me, I was the first time I really considered this, I thought I knew there's one brand, one road to this little fanatical. And I didn't know I was thinking that way. And I wasn't an opiate addict to hear you discuss that after for decades and treatment, to not only admit that this is gonna take a lot more work. It's not a simple answer. It's but there is a modality you just described, that can start to be created, that gives people dignity, a couple options on their way to a form of recovery. We need more people talking like that. And I would love to talk again, about this because it's complex. And I think we still have great allies that don't understand yet that we need to kind of hear that, like, Oh, this is this complex. And that's people in the community, peer to peer to support this publicly, for politicians to understand they're not, you know, doing something reckless by understanding this is where the money and regulation should go to protect people in this clinical settings. That's individual wise treatment. I can listen to someone on heroin, talk about not only what they might need, what could be helpful to them. That wasn't the case 40 years ago, with just alcohol. So like you said,
Dr. Nick Colangelo 44:55
I want to make one statement two, harm reduction is misused. Yeah, and it's a shield to over medicate. In my opinion, harm we die Who, by WHO, though by easily by the system by pharmacies by anybody pushing the metal, just like they did with valium or anything for profit. But I go there lightly because that's where people go, that's our the world we live in harm reduction is that there will be a group of people. Unfortunately, that will never get the opportunity you and I have because of the formula of physiologic and psychological makeup. So here's my question, what is the treatment world between mental health and addictions responsibility to provide comfort to that group? That's what comes out of realms of our ghost. Yeah, we do not do that in this country. When our systems don't work. We just drop people to the street. Yeah. And all you have to do is walk around the streets. It's cool. Yeah. Very cool. So challenge.
Joe Van Wie 46:03
Nick, I want to thank you for coming on again. And I'll talk soon. I think we have to go get lunch now. Leo and Deke, we
Dr. Nick Colangelo 46:11
Transcribed by https://otter.ai