Episode Transcript
Dr Evelyn Higgens and Alcohol Tipping Point-20230407_102852-Meeting Recording
Deb: Welcome back to the Alcohol Tipping Point Podcast today on the show I have Dr. Evelyn Higgins. She is the founder and c e O of Wired for Addiction, which is a company specializing in the biological component of mental health and addiction recovery.
Dr. Higgins is a recognized international expert in the epidemiology of addiction. She's a certified addictionologist. Diplomat of the American College of Addictionology and Compulsive Disorders and diplomat of the American Board of Disability Analysts specializing in pain management. With 35 years in clinical practice, Dr.
Higgins has designated over 16 years to research and development in the science of addiction recovery. Welcome to the show, Dr. Higgins.
Dr. Higgens: Thank you, Deb. My pleasure to be here with you. Well, how
Deb: did you get into this studying addiction and where you are now with your own company wired for
Dr. Higgens: addiction?
Sure. Great question. 35 years ago, practicing in a rural area, practicing in pain management and disability and seeing the, try this, try that approach. To pain and it not being successful, seeing some people become dependent, even back then, 20 years after that. I'm in an urban area and I'm seeing exactly the same thing.
Try this, try that. Half this, double that. Move on to this. No rhyme or reason, no protocols followed, just guesswork based on someone's subjective vocabulary. Being diagnosed and I'm seeing people go from dependency to addiction at a much faster rate. Second layer of my why is I married an alcoholic and a man who actually had several addictions, not just alcohol.
A year after we had a daughter together, a year after she was born, we found out that he was. Now I needed answers as to what was his family history, because I was seeing behavior that was problematic. I was seeing mental health problems. I was seeing addiction problems, but I had nothing to look back at.
And that started my quest for helping my patients, one and my own daughter of what do we need to. What do we need to look out for here? So had, had, what we've been doing in this field worked, I would never wind up where I am today at with our company Wired for Addiction. There wouldn't be a need for it.
But there, you know, in this area, Deb, of, of healthcare, there's kind of this, there's a real inequity because there's this kind of, this thought pattern of you got yourself. There's a moral reason you find yourself in this position so you can get yourself out of it. And we fail to use technology. We fail to use the latest in, in science, and we just kind of do a, you know, well, I think maybe we should do this, maybe we should do that.
You know, if somebody needs open heart surgery, we're not saying you don't think so, you know, there's a clear cut. Here's what we do. So that's, that's my why, both personal as well as profess. Thank you for
Deb: sharing that. So you were really like in pain management when the opioid crisis hit and saw so many more people becoming addicted.
Absolutely. So what, you know, I actually was just listening to another podcast this morning and it was talking about w. What is addiction and how there's all these different models and it's kind of controversial, like, is addiction a disease or a choice? Or where, where do you fall on what addiction is?
Dr. Higgens: Addiction is a disease and the sooner that we are willing to recognize that the sooner we're gonna get rid of the stigma associated with it, we're gonna get rid of that moral. Part of this, what we do in wired for addiction is look at biomarkers. So it's subjective information. It's not subjective.
There's, it's not, I think I that. Or conversational? Subjective. It's objective biomarkers. Just like when you go to your doctor for your yearly and you get a cbc, blood work, right? A complete blood count. Here's your red blood cells, here's your white blood cells. It's the same thing that's subjective information.
From there, we say, okay, we're all good. There's no pathology going on, or We need to take a deeper dive into this because this is what I'm seeing. So we have biomarkers, same, same exact thing that we look at to. Here's evidence objectively of what's happening within your body. Yeah. And, and I think, you
Deb: know, when we use the term disease, like it's just important to point out like that, that can be like a disorder, you know, under the disease umbrella, you know, it's just like your body or brain isn't working as it's supposed to and Right.
And, and now we call it alcohol use disorder, and it's on a. Spectrum from mild to moderate to severe. Right? Right. So I'm so interested in what, what you do at your company. So say I am someone with the drinking problem and, and I'm like, okay, I'm gonna check out this wired for addiction. I'm gonna get biomarkers.
Like what, can you kind of walk me through what the process is and then what you do with that information, what you're looking for, like this is fascinating.
Dr. Higgens: So we look at 85 different biomarkers, starting with neurotransmitters, brain chemicals, things like serotonin, dopamine, epinephrine, nor epinephrine, phenethyl, alanine.
The list goes on and on. Hormones from stress hormones to androgen sex hormones, and then something called genetic single nucleotide polymorphisms, A snp. What that means with a SNP is that there's actually an error in genetic. That error creates what we call aberrant behavior. What's aberrant behavior?
Things like risk taking, impulse control, addiction, anxiety, depression. So we can identify all of these things and then by looking at the biochemical pathways of each one of those biomarkers, we can then, Say what needs support and to what level needs support, because we're all different. You know, there's seven and a half billion people in the world, yet we treat everybody like they're all the exact same.
Here. Take this, and then we wonder why things don't work. Right. We even look at a particular gene, like to use the example with an S SRI drug, an antidepressant, because we are bombarded with that because there's so many of them, you know? And whether it be in print ads or radio or tv, it's take this, take this, take this.
So, and I'm not antip pharmaceutical whatsoever. There's a time and a place, but I am pro. Let's get to the reason why. So we figure out where the problem lies instead of throwing bandaids on and taking time out of this person's life without having effective treatment, because we're guessing the whole time.
So in doing that, we look at the biochemical pathways and then we can identify one of the genes that we look at in particular. Would tell us that an S S R I drug isn't even gonna be effective if you have this particular biomarker. So how many times we see somebody that's been on serotonin for 15, 20 years, where first of all, it was never designed for an individual to be on that long.
It was designed for an acute situation in an individual's life, not to live on for the rest of your life. And that person has been on it for that long. Well, we see that they, they're serotonins in the tank. So first off, that never worked for them. And your, your kidneys, your liver, your bladder is still going through this process all day of taking this in and getting rid of it to no effective.
End result. Right? And then no one looked at, hey, this person was never going to effectively be able to metabolize an S S R I drug to begin with that wasn't gonna work with them. So go be even beyond that. What does that do to somebody that's been on particular med for that long of their life and it hasn't been effective emotionally?
They start to believe they're the. I just, I guess I don't wanna be better. I'm just, you know, it's all, it's all me. And what that does to somebody's psyche is, is, is harmful.
Deb: . And so if going back to like the drinking example mm-hmm. And you get your biomarkers, and your neurotransmitters are off and whatnot, then.
Dr. Higgens: So then that's when we look at, we do what we call a biomarker evaluation. We look at all of those 85 biomarkers. Here's what's going on with you. This is what all these things mean. These are the clinical correlations to each one of these, and then how do we have to support it? What's missing within those pathways?
Or what's too much or what's too little within those pathways? And then everybody has their own treatment based on their own.
. Okay. Nutraceuticals, pharmaceuticals, combination of both depending what that individual shows in their labs.
Deb: But, but like number one, removing the
Dr. Higgens: alcohol, correct?
Correct. Sure. Sure.
Deb: So interesting. So so how much of it is genetic when we're talking about
Dr. Higgens: addiction? So when we actually, there is a study that just came out in nature like a couple weeks ago that the N N I H did talking about the amount of genetics related to addiction and that it is with these SNPs and this does all exist.
And I actually did a TED Talk understanding the biomarkers of addiction. And in that I talk. To me, the sweet spot would be someone having this done when they're young and knowing here, here's, here's what I'm made up of, and here's my wiggle room. Or my lack of wiggle room. Because as we all know, when you're young, you're in school, your buddies are gonna say, Hey, got a great idea.
Here's what we're all gonna do after school today. You know, you need to go into that knowing, and we still all have free. We can still all make our choices, however we wanna play out our life. But being armed with those facts, you then have the opportunity to make different decisions. Mm-hmm. Everybody comes into this world with something.
Some families it's cancer, some families it's cardiovascular disease, some families it's mental health and addiction, and we should know. We shouldn't say, you know, like where I started out, it's like it's all on you. You got yourself here. Get yourself out. We shouldn't know this, just like any other part of our health.
Deb: . Interesting. I, with addiction and with alcohol, the message that , I say, that I have heard is like, anyone can become addicted. To anything. It's just a matter of time. And when will you hit that ceiling? And so some people, and, and correct me if I'm wrong, I just wanna explain it how it was explained to me by a counselor and so for some people it's lower than others. So first, Someone who has the genetic component, maybe they're, they grew up in a, a drinking environment.
They started at a young age. They have more stress, like they're gonna hit that ceiling sooner than someone who doesn't have the genetics. They don't start drinking till later in life, they, or whatnot. But everyone at some point has the potential to become addicted. To whatever substance at, at some time that you just, you may never hit that ceiling.
Dr. Higgens: Correct. A absolutely correct. You have the perfect storm for becoming dependent versus someone that says, yeah, you know, I enjoy this. I become addictive. You know, you start to see yourself become a dependent. You say, whoa, I better slow down the whole sober curious movement, right? You know, who, who are you without alcohol and can you remove that alcohol from your life?
And. Play it out without it. Some people they can't do that. You know, other people say, all right, I'm gonna try it and are successful at it. Yeah.
Deb: Why do you think some people become like alcohol's their thing like alcohol was my thing. Totally. I wouldn't say I have like an addictive personality, like I could take it or leave it.
When it came to smoking marijuana, just other kind of traditionally addictive substances, like what makes one substance more addictive than another? How does that all come into play?
Dr. Higgens: So, good question. So typically someone. Winds up addicted to whatever substance in this case, alcohol. Alcohol from a diagnosed condition being treated incorrectly, an undiagnosed condition or a trauma.
So the earlier in your life that you start, that you find that go-to, let's say it becomes alcohol in this case, and that is a self-medicating situation for you. People that you know use the, I was four years old. I was at the beach with my dad. My dad said, hold on to this beer. I'm going in the water.
People can still tell me what that was like. And at four years old say, it was the most incredible feeling that I had. And everybody uses that same thing. It was that feeling that was like, whoa, this is good. I am not anxious. And, and you know, a four year old doesn't understand what that is, but they understand that I feel better, and that self-medicating works until it doesn't work, and then it becomes the next problem.
Deb: What, what do you think about like our phone addictions? Would you call that an addiction?
Dr. Higgens: Absolutely. Absolutely. Why? Because when that phone goes off, I mean, I put mine on silent for this interview, but you know, if I had it on and there was a ding, you all look at that ding. Why? Because you have a dopamine spike.
When you hear that ding, what does that mean to you emotionally? Someone wants me very addict. The amount of people, like when you look at your end of week and you see your screen time, you say, you've gotta be kidding me. I could have had a part-time job and made a fortune the time I spent scrolling through a phone.
Really? What did you get out of that? It's looking for that pleasure. It's looking for that dopamine spike. .
Deb: Yeah. And then, and I don't know, maybe I didn't get the answer I wanted, I was looking for, but what was it that made it more likely to become addicted to drinking rather than dr?
Like what makes something,
Dr. Higgens: your thing, so you're looking to self-medicate whether you realize that or don't realize that. And whatever comes along to you first and works becomes your go-to. And then there's people that have multiple addictions, but whatever it is that's your go-to. And for a lot of people it is alcohol because it's prevalent in school.
You know, way before the drinking, the legal drinking age. And it's accessible and it's easy.
Deb: , that makes sense. That's so interesting. , you've been in this field for a long time and so much has changed. What have you seen that has changed in the last 30 years or not?
Dr. Higgens: Yeah, tell me more. And that goes back to that stigma, that shame, that moral failing, that we're still practicing in this area of addiction as if it's 19 50, 19 70, 19 90 2000. It's 2023. And we have failed to incorporate technology into what we do. It, it's, it doesn't make sense. But it's that, it's still that stigma that's attached and it's these open conversations like you and I are having.
And thank you for doing this constantly of having conversations with people because that's what brings that stigma down. That's what says, you know what this is, there's part of, this is how I'm made up. So we're all made up of something. So figure out where your weaknesses lie. We all have weaknesses in life.
We all have strengths in life. We have to recognize our weaknesses just as much as our strengths and say, what do I need to know with my weaknesses? You know, when you go for a job, it's like, what am I really good at? Right? You, you're graduating from high school, you're gonna go to college. What am I really good at?
That's your strength. Well, to be really. Balanced and have a wonderful life. We also have to look at where our weaknesses are and say, okay, here's what I'm gonna do with. Yeah. And
Deb: then so we still have a lot of change to do, like breaking the stigma and whatnot. What about just like all the new science?
Because I had heard this and it makes sense when I think about it. Like in the last 25 years, we've learned more about the brain mm-hmm. Than all the years. Because of like all the new imagery and testing capabilities and whatnot. Can you kind of speak to like all the new science?
Dr. Higgens: Sure. And there's a lot of science we now have to employ that science, right?
Mm-hmm. The NIH spends billions a year. The C, c, the same thing, you know, with all money that we all pay in taxes to learn these things, and then studies happen. That study gets published and then we sit on that information. It's useless unless we put it into play and use it to help people. Right. So we're gonna start seeing more and more of that coming out now.
But it's like anything, it takes time. It takes time for people to learn to think a new way. You know, even if we're a physician, if they graduated 30 years ago, they're like, I practiced this. This is how I do it. I am not gonna u upset the apple cart. This is, I'm not learning anything new. Boom, here we go.
And teaching people to, to think a new way, always takes time.
Deb: , it's a big cultural shift. Absolutely. I, I'm hoping that we're seeing a cultural shift in like how we treat drinking and, you know, having this sober curious movement. And I feel like that the, the opioid epidemic, it's so interesting cuz when I, I went to nursing.
20 plus years ago. And pain, pain was what? The fifth vital sign. Mm-hmm. And it was all about treating pain and pain management. And it's, it's okay, we have this new drug now we're gonna keep giving people these opioids and whatnot. And then it, and it just happened so fast that then they started seeing all these people becoming addicted to these highly addictive substances.
Because of what the, just that dramatic artificial dopamine, serotonin increase, whatnot. And, and now the culture has shifted to where pain management is starting to be treated differently and, and doctors in are being more careful about prescribing opioids. Like would you agree, like with that timeline, I mean, you've been in it.
Dr. Higgens: Sure, sure. Sure. Really the, when the Sackler family created Oxycontin, they created that pain scale where happy face, sad face, the one through a 10, tell me what your pain level is. They created that, and that was to go along with making it really easy for doctors for, to prescribe, because again, they knew that there was gonna be, you know, if you're asking somebody to change the way they do something, at best, you better make it really.
So they created that pain scale and somebody just got to identify which, which face do you feel like, boom, here. Okay, so take this. And then that became abused, abused, abused, abused. And now physicians are extremely cautious about how they prescribe. And, and there's a lot of people that actually are in need of some type of pain management and having a hard time of getting it because they're so, To prescribe.
So we abused it. So now we're on the other side of that, you know, and there's people that get caught in the middle that are at a loss because of that. What happened on that rollercoaster there? And, and that's, that's shameful.
Deb: , and just relating it back to alcohol, what I'm seeing more and more come out about alcohol and, and related to all this new science is more and more studies are getting examined more and more, government agencies are coming out and just saying , he, we didn't study this correctly.
Right. And no amount of alcohol is safe for your. And so now we're starting to show slowly, like turn the ship in, in that direction too. Right? Right.
Dr. Higgens: I mean, at the end of the day, it's a toxin. So there is no amount of a toxin that you put into you that you say, Hey, great idea. Right. You know, when we have to be honest and boil it all down.
But you know, there's so much lobbying that goes into make this okay, make this okay. But people. I, I think with the advent of people having information that they can get easier, they're being more vocal. I mean, if you just look at the alcohol situation, the amount of alcohol, non alcohol beers that are now available, right?
Back in the day, it was just go duals. That didn't really taste good. And now there's Heineken Zero and there's Becks has one just as good. They're really tasteful, but that means that the market wants it, which is great. These mocktails that are coming outta really delicious drinks because the market wants it.
So that's a really good thing and it's because these conversations are going on and on and on. This sober curious movement has been really big and, and has kind of suggested to people just see who you are without. You know, so many people drink before an event because they feel like they're not enough.
Right. Social anxiety, I'm not enough. I'm gonna go into this party situation or into this concert or this sporting event, or whatever it is. And I feel like I'm not enough. So let me do this and then, you know, I'll bet are off. And I'll have a say this in air quotes, right? Cause we're in a podcast. I'll have a good time.
Well, who are you? Without doing that to have a good time. You know, and that's taking a deep dive into yourself mm-hmm. And exploring that. And I challenge anybody if you do that, you're gonna come out on a way better end of who you are. Trust me.
Deb: . I wanna get your thoughts on Naltrexone. Mm-hmm.
What do you think about that medication and, and,
Dr. Higgens: Okay. Part of medically, part of medically assisted treatment you know, just for the immediate kind of triage of someone. But that's, that's not looking into why did this happen, to begin with, what's going on with the, within that individual's body of why they even got to the point that they did there.
Right? So we still have to explore the why if we're looking for long-term. But that's part of what we call me, m a t, medically assisted treatment. That's the, the norm there, but it still doesn't go into the wine. Mm-hmm. You know, we're still still trying to throw bandaids. We haven't figured out.
Bandaids always come off. So what would be some
Deb: examples of, of like the supplements or whatever you offer people once they get their, their panel done and their testing done? What,
Dr. Higgens: what right. To, to say a supplement, I really can't, but to say like if someone has a deficiency in their sero. We would be supporting that if they have a deficiency too much or too little, you know, it's not, it's, we've gotta be in that, that sweet spot too much or too little.
Both creates problems. Whether it be dopamine, you know, and you even think about someone that doesn't have adequate, optimized amounts of serotonin. The last step of that pathway is melatonin. Well, how often do you hear from people? If I'm not sleeping and I'm on an SSRI, or whatever the case may be.
That's how these things work. There are all steps and everything along each step to get to that last has to be working efficiently and correctly. So it's never any guesswork. You know, it's you, you see, because you have data of how come we're not getting there, here's why. Right. So it would just depend on what's happening with someone.
If, if they're you. One of the things that we look at is in autophagy. So autophagy we've known about since the 18 hundreds, but it was only in 2017 that a Japanese physician won the Nobel Prize for understanding how autophagy works within the cellular level and how that creates either a balance or an imbalance within those cells.
Autophagy is essentially the garbage man of your. If we're not able to get rid of the garbage every day, we're gonna have a really toxic body. What does that do to us on a day-to-day in our behavior, if we're always toxic or gonna, we reach for something else, right? So there's in, in these 85 biomarkers, there's a lot that we look at that's, that's the point.
But just to say here, you know, you would take this and this and this. It depends on what your labs. Everybody's different.
Deb: Yeah, yeah. Definitely. With this might be your same answer to my next question, but , once you give up drinking, let's say you go 30 days, 90 days, like how long until you return to baseline?
Dr. Higgens: Sure. So really depends on the individual how much damage they've done to their body, their brain, their organs but typically, From the whole package, be it the physical part, the emotional part. A good couple years is when someone's like, initially I felt. My life was over. How was I gonna have fun?
How was I going to, and they're white knuckling it through sobriety of, I'm like, I'm just gonna stick it out. I got 30 days, I've got 60 days, I've got 90 days. And then as that time goes on and you are brain actually becomes clearer, you're realizing that your body is actually working better, that your sleep is incredibly different.
So, you know, it, it can be from months to, to a couple, few years. But it just continues to get better and better and better and better for an individual. And you are learning on several levels. Your body's learning physically how to operate better. Your mind is working clearer. So what does that mean to the choices that you make every day?
You probably start to realize you're making very different choices. One from the people that you thought were your friends. They were really what? Your drinking buddies, they weren't your friends. Because when the friend, when real friends see messing, They tell you, they will rather see you get on the right path than worry about losing you as a friend.
They'll have the strength to say, you're really doing this a lot more, and I'm starting to see it affect your work, your family, everything. That's a real friend. Those other people are drinking. Right. And you, you know, you become sober and you're sitting around with these people and after a while you start to say, how many hours a day or a week?
Just like what we talked about with your phone, right? How many hours a day or a week did I spend listening to nonsense all day? That didn't even make sense by the end of the evening. And then you start to challenge yourself of, is this where I really wanna be? Is this the best that I can be? And only.
Each one of your listeners can answer that for themselves, but that's the question. Are you really being the best you can be? And that's truth to yourself. You don't have to prove that to anybody else. You could lie all day and say, yeah, I, you know, I'm not drinking anymore. It's not about that.
Deb: , I always just, you know, recommend people and, and also just going back to like, as I was preparing for this podcast, I'm like, well, at the end of the day, does it matter if you have.
An addictive gene. Does it matter, you know, how you got here? Like, just, just recognizing that you are here, you are at a point where alcohol's taking more than it's giving, and now you are looking for a solution and figuring out like, okay, how do you wanna change your drinking? What does that look like?
And maybe you're taking a, a 30 day break and just seeing how you feel. Maybe you go through your process at. For addiction and check out your biomarkers and get some additional help and support. Like just being open to just recognizing like, okay, maybe, maybe I have a problem. And then focusing on the solution.
Dr. Higgens: Right. Exactly. And, and you're right. At the end of the day, it's still, how are you gonna play it out? So if it's that, you know, you're a white knuckling and it, and it's not working and you. Sober X amount of days or years and you, you know, you fall back again and you, this is happening. You've been to rehab several times and what else?
What are we missing? What part? Right, so addiction is a bio, psychosocial, like a triangle, psychosocial bio. But the bio piece, we're just telling people, you know, make sure you're sleeping at least eight hours a day. You have a good diet, you're drinking plenty of water, you exercise, but what's your physiology?
We haven't touched. And the psychosocial has to go on. We have to talk about the get it out of you, of why you got here, but then we also have to embrace your individual physiology and say, what parts are we missing here? Just like if you didn't do talk therapy, it would be what parts are we missing because we didn't do talk therapy.
It's the same thing. Mm-hmm.
Deb: Well, what would you add to, you know, we've talked a lot about genetics, addiction, alternative ways, is there anything we didn't cover that you wanna share with the listeners?
Dr. Higgens: No, I, I, I think I think we really covered it from a standpoint of are you sober, curious and, and trying that out and see if you can do that on your own and then, People that fail multiple times.
Okay, let's look at that other piece. What's happening here? And especially if you, you know, you know a family history and you can identify, hey, there's a lot here in the apple cart. We probably should take a look at that, that you do that, it's just as important as that c, b, C every year that you do, if not more important because we already have a, a, a glimmer of what's going on.
Let's, let's not be naive and keep our heads buried in the sand. This is, this is your health. It is factual, it's science, it's data driven, and if it's a problem, let's address it.
Deb: Perfect. Yeah. And, and like I shared at the beginning, I want people who are listening to know that there are so many different ways to change your drinking to treat addiction.
You're not stuck. So just really focus on different tools and, and see what works for you. Be open-minded and curious and, and willing to give things a try. Right?
Dr. Higgens: So how. Yeah. Open-minded is a big, A big part of it.
Deb: Yes, definitely. . Well, how can someone find you in your company?
Dr. Higgens: Sure. So our website is wired for addiction all spelled out.
You can go on there. We work with individuals that come to us directly. We work with treatment centers, we work with therapists, clinicians, coaches. Physicians, we even work within the criminal justice system. We have patients that are actually incarcerated. So everything is on the website. Take a look have a conversation with us.
Tell us what you've done so far, where you're at, what kind of results you've got, and, you know, try to point you
Deb: in a. Well, I appreciate it. I appreciate, appreciate you, appreciate having you on the show and just having this conversation.
Dr. Higgens: Well, thank you. I appreciate you, Deb, and the work that you're doing and keep it up because having these kind of open conversations is what's gonna get the momentum and get us where we need to be.
Deb: Absolutely. Well, thank you. You're welcome. Thank you.
