Dwight Hurst, CMHC: Welcome back, everyone, to a podcast to answer your questions on addiction, recovery and mental health by Waismann Method Opioid Treatment Specialists and Rapid Detox Center. I’m Dwight Hurst, joined as always by Clare Waismann and David Livingston, and we have a pretty special discussion today. Happy anniversary! First of all!
Clare Waismann, RAS/SUDCC: Thank you.
Dwight Hurst, CMHC: It’s kind of exciting.
Clare Waismann, RAS/SUDCC: This is our 23rd anniversary we started. I founded the Waismann Method in 1998. Wow. Yeah, yeah. Almost a quarter of a century we’ve been here, and
Dwight Hurst, CMHC: I don’t know traditionally what if that’s, you know, silver, gold, copper? I’m not sure. Gift-wise, but
Clare Waismann, RAS/SUDCC: It makes you feel old a little, right?
Dwight Hurst, CMHC: Yeah, I would imagine. But that’s quite an accomplishment, too. I remember back from our early episodes you talked about having seen sort of a dearth of detoxification differently than you’d seen in, say, other countries.
Clare Waismann, RAS/SUDCC: Yeah, medical opioid treatment. And my brother-in-law was actually, um, doing similar treatment in Spain. Dr. Legarda, we thought about bringing it here. And then I met, you know, the doctors that helped me found this. And in the beginning, we started with detoxification under anesthesia. So that’s all we did really fast. We understood that there could not be one treatment for all patients, so we evolved. I think I’m humble every day. I do this job because I learn more and more. I feel the need to accomplish more, provide more.
Dwight Hurst, CMHC: So how have you seen the evolution in the industry since 23 years ago?
Clare Waismann, RAS/SUDCC: You know, I think in the industry itself, I think we are moving away from, you know, the cookie-cutter approach, the stigma. Um. The idea that people that struggle with addictions were lesser then, uh, to a more scientific approach where we understand, um. The consequences of untreated mental health, we understand, um, the chemical changes that happen in somebody’s brain function after using, um, any kind of substance for, you know, a certain period of time, regardless, if they did because of pain management or social issues. So I think again,we have learned a lot more about the neurobiology of substance use. So I think because of what we have learned we have become less judgmental and more effective.
Dwight Hurst, CMHC: Yeah, it seems like that was an important thing when you opened up as well, so you feel like the rest of the industry is has caught up to those that were already looking at it that way, I should say.
Clare Waismann, RAS/SUDCC: I think, yes, in a way, yes, but again, um, as you know, we spoke before when we started this, um, the goal was to get a patient through an opioid withdrawal under anesthesia. And um, you know, very fast we understood that we needed more. We needed more available protocols to detox the patient. We could not use one protocol for all. Some patients would do better under anesthesia, where others would not. And we understood that, um, we needed to do a more comprehensive, um, pre-evaluation to make sure about, you know, patients candidacy for any of our protocols to make sure a patient’s health needs. Um, metabolism all the things that would be, you know, major factors during treatment. But um, more than anything, I think we also understood Um. That when patients are detoxed, they are left in a very, uh, hypersensitive space emotionally and physically. So we after a few years doing detoxification, we created Domus Retreat that I truly believe is our golden key because it allows patients after detoxification to gain a bit of physical strength, big, you know, emotional stability. And also with David, that is, you know, a major part of Domus Retreat, they are able to plan the next foot forward and it’s so different to every patient. What you know, what is, you know, the next step to maintain health. So I don’t even say maintain sobriety or say maintain health, what is, you know, the best option for them after that, you know, based on what is available for them? Yeah, those you know, we can make a decision what’s good for you? But if that’s not available for you and that is not a reality for you, is another failure. So it’s really important to hear the patient to understand where they’re coming from and to find the best option of, you know, how to again, maintain a healthy and somewhat happy life.
Dwight Hurst, CMHC: That’s really interesting to say when you look at that. I think people think of detox as one particular thing. And I know that when people are thinking about going to the detox process, sometimes it’s almost like they treat it like, Oh, I’ll just go do that and then something else and may not weigh out the importance of those things you just said. Because if I go to somewhere like maybe, maybe a hospital that doesn’t specialize in that, I know of a few in my area that they’ll do a chemical detox. But I’ve seen real limits when someone just goes to a general medical facility, you know that you kind of roll the dice on if the person has specific addiction training or not. Just like if you go to your general practitioner and ask for an antidepressant, some know a lot about it, and some of them would be way better off sending you to a psychiatrist, you know. Correct. Correct. Yeah. So so I can see having not a menu, that’s not the right word, “myriad” would be a better word. Probably have different options that meet the person’s needs, depending on the person, instead of depending on the program.
Clare Waismann, RAS/SUDCC: And be able to tailor those options, not just, you know, based on your evaluation, but based on how patients are progressing during treatment. So then I think rapidly talks about a really bad rap because of the overnight clinics. To treat the patient, you know, to detox them overnight. Number one, when you put them in the hospital, you’re really not aware of what’s A. In their system that could have, you know, severe side effects during procedure. You don’t know how their metabolism works. And, um, you don’t know about, you know, specifics about their current health. You don’t have enough time to do so. And afterwards is what we were talking about. Just to detox them and send them to a hotel room with a family member, it’s irresponsible to say the least. Yeah, because the patient first, the level of anxiety of forget, let’s say they’re doing great from the detox, just a level of anxiety of how am I going to face, you know, life, my family, the world. You have their whole metabolism trying to adjust to sleep, gastrointestinal function, endorphins, everything. Now you have a family member that is always also anxious. So the combination of both. And worst of all, you have a patient that now has been detoxed, so their tolerance level is much lower. And, you know…
Dwight Hurst, CMHC: And that’s very risky if they relapse,
Clare Waismann, RAS/SUDCC: …very risky, because if they feel too anxious and they decide to use an opioid because that’s what they are used to doing when they don’t feel well now, they’re at a much higher risk of overdosing. So to have a place where they can for a few days, stabilize emotionally and physically is crucial for a, you know, responsible medical detoxification.
Dwight Hurst, CMHC: When did Domus become a part of it? How many… Was that fairly early on, in the last 20 years?
Clare Waismann, RAS/SUDCC: Yeah, yeah. Domus, I think, is we have it for 16 years, David. Um.
David Livingston, LMFT: It sounds right.
Clare Waismann, RAS/SUDCC: Yeah, around that.
Dwight Hurst, CMHC: And having brought that in. David, what are some of the things you could say about the role that the therapy and psychological approach there comes in within a detox process and detox facility?
David Livingston, LMFT: Well, you know, first of all, it’s been a it’s really been a privilege for me to be able to be. You know, working with Claire and the Waismann Institute and the doctors for, you know a long time, you know, in some capacity for, you know, really adeptly for 16 years and, you know, even before that. Um, and this was not my, you know, getting involved in addiction was not my primary interest as a clinician, because really what I wanted to do was help people improve their lives and the thinking around addiction was not necessarily oriented as such. And so when I met Clare and I and she and I began to talk about our philosophy of what we were going to create a Domus and the type of care we were going to implement and the philosophy. And, you know, and we were in alignment with what we wanted that to be. It really began to change and I’ve enjoyed and continue to because really our orientation is exactly that. It’s, you know, we could. Once you’re off of the chemicals, once you’re your detox from the chemicals and honestly, the way we do it, you know, part of the the the the, you know, part of what’s so good about it is everybody gets it done. It’s like, you’re off it, you don’t feel good for a couple of days, but then all of a sudden everyone’s like, I can’t believe I’m done like, it’s, you know, and so you help them through that. They get through that. And then there’s this really a space to begin to work on and understand what are the drives and the addictions? What are the things that are being minimized or not dealt with, you know, in a person’s life? And you actually get to begin to do some real therapy, which is about improving the individual’s life. And you know, and deal with and not just dealing with you know, suffering from a long term, you know, process of trying to get off whatever chemicals are on, the opioids, so it’s been a privilege. And the other thing is, for the most part, people are very interested in learning and understanding, and they actually want to know, why am I doing this? And the idea that you know and really my training is towards that, not just a behavioral approach. Ok, what do you do now then that’s useful. But if you don’t understand why you’re using it, like what’s driving it, what are the problems? What is it? I’ve got to really understand. Then you’re kind of you have to understand both, as I’ve said many times. So it’s just been a privilege to be able to be part of this.
Dwight Hurst, CMHC: I’ve had some experience just like what you said, which is, I didn’t think when doing psychological training and going to school, you know, I didn’t think about addiction, particularly as an area to focus. But I think the really interesting thing with it when I started doing that is that you’re really working with everything as far as clinically. And that’s something that I mean, I guess we could say that to anybody out there who is training or thinking of being a clinician is think about it this way because addiction doesn’t discriminate, right? And you get you may get some things that are similar with patients that come through, but you’re dealing with people from all walks of life and you’re dealing with people often who have all kinds of different issues that the drugs are masking, right? And so when you’re dealing with addiction clinically, you really are working with with a little bit of everything I should say as far as presenting problems, right?
Clare Waismann, RAS/SUDCC: Yeah, I think you’re dealing with human beings first, primarily, um, and human beings suffering from, you know, several different conditions, including addiction.
Dwight Hurst, CMHC: Yeah. Yeah, I mean, if you open an anxiety and OCD clinic, you’re basically working with that. If you are working with addiction, though, you’re going to work with that, you’re going to work with depression, you’re going to work with trauma a lot of times and abuse and just a lot of different things, you know, and so. And it’s funny how much that makes sense because of what you just said, Clare. You know, it’s a human being’s going through this particular problem, this medical problem. So it shouldn’t be a surprise, but sometimes, unfortunately, when we don’t have and I lacked that experience to know that, oh, this is just I think people go through it. It’s not like its own little special thing in a way.
Clare Waismann, RAS/SUDCC: Yeah, right. And can truly, truly affect everyone. I mean, we see patients, you know, 20 years of age that, uh, started using, um, you know, opiates one way or the other socially, and we treat, you know, eighty-year-old ladies that had five hip surgeries. And um, but I think, more importantly, to know if we have to celebrate, you know, 23 years of accomplishment. I think as David was saying, Um. How we view and how we treat people, regardless, if it’s detoxification under sedation, medically assisted detox, you know, therapy through Domus Retreat, it’s truly is how we treat the person. I think there is a healing that starts immediately because they come in as they came in to, you know, treat any other condition. They are respected and they are heard. And you know, they. They are able to express themselves. Um, they’re able to, um, behave within, you know, their own, um, feelings. I mean, obviously being respectful to others. But I think the sense that they’re being treated as a person and not as an addict or you know what I’m saying, I think the healing starts there, the trust starts there and understanding what has happened to their brains and what how we are helping reverse that condition and how they can help themselves reverse that condition. I think the understanding, respect, I think the whole package together is incredible of how fast that healing starts. One of our biggest accomplishments is even those that have relapsed, they know it is possible and they can feel well, I think something there changes and we have been able to do that for thousands of people. I think that’s truly our biggest accomplishment.
Dwight Hurst, CMHC: It’s an interesting thing to be able you’re really talking about hope. Hopelessness plays a large role. I mean, do you see that a lot of times when people are first coming in that they’re feeling unsure or lack of hope that they can get better?
Clare Waismann, RAS/SUDCC: Yes, because a lot of the patients we see there have been through five rehabs, 10 rehabs, you know, um, people have said they’re always going to have an addiction issue. You know, there’s nothing you can do. You’re always going to be taking some kind of MAT drug. Or so it’s um, when they see that there is a solution in solution, it does not have to be painful or based on punishment. It can be something that is actually a good experience. Everything changes.
Dwight Hurst, CMHC: Yeah, there’s a real feeling of not giving up on people, and I think, unfortunately, the old school kind of, oh, you could say just the the the hard case approach would be to say I’ve met people who have maybe relapsed or had to go through treatments multiple times and they have to put up with people sometimes who will tell them, Oh, you’re just not serious about it. Oh, you just aren’t, you know, are you? And I think people think it’s a tough love sometimes, but talk about a recipe for hopelessness. If you tell people, Oh, you’re not serious about this. And one thing I noticed that when we talk about this, I mean with you, Claire and with David as well. You talk a lot about the idea of just believing people when they come in and say, I want to stop, it’s like, Yep, you do want to stop. I believe you.
Clare Waismann, RAS/SUDCC: But I don’t think anybody wants to suffer, I don’t think anybody wants to be a slave to anything, uh, regardless. You know how long they’ve been doing it. I truly believe that everybody, you know, deep, deep in their heart, they want to be, um, happy. You see, David, that fast transition correct that emotional transition of the patients?
David Livingston, LMFT: What I see is that most of the time people come in and don’t really have a clear understanding of why they’re using and that we get we bear down on that. Some would say, Well, I’ve got a great life. I’ve got a, you know, I love my family. I, you know, I’ve got a good business. I’ve got, you know, my life’s working and I don’t know why I’m doing this and so forth. And then you bear down on it with them and they’re like, OK, well, how do you feel while you’re doing all this? Well, I’m tired all the time. I have, you know, I feel responsible for everybody. Ok, so the need, the need to check out. Is becomes the primary need, and that’s the human need, so imagine if you say God, well, of course you got to, you’ve got to check out, but this isn’t the best way to check out. Let’s figure out other ways to check out when’s the last time you had a vacation? Well, I haven’t had one in seven years. Well, you’re doing so. Well, why not? Well, I, you know, because nobody else and you start to bear into some of these ideas and, you know, limitations they have and the ways they’ve sort of boxed themselves in their life and what their needs are. And you humanize it because we all have a need to check out, OK? Part of the reason that addiction exists is because everybody has a need to check out. But chemicals aren’t a good way to check out because they just create a whole bunch of problems and dangers.
David Livingston, LMFT: So but the need is real. So the minute you humanize that need and they’re like, Wow, you’re right, I never thought of it that way, but that’s true. And so all of a sudden there’s hope, right? So there’s hope, not just because you’re interested in them, but because actually there’s an understanding and there’s a and there’s an excitement that you can share with them about a different way forward. So there’s got to be a different way forward that they can feel and you can feel and actually make sense, you know, and then and then you have to deal with the resistances around it because there’s always some resistance around it. But, you know, while I can’t let everybody down or I don’t think anybody can run the company the same way I could or whatever it is, there’s a million things. And so we try to set those things up and deal with that. But then there’s hope that is foundational. And so, you know, I would say so. So imagine all of a sudden you’re off of these chemicals that have kept you bound and then you’ve got a real understanding of how and why and what it’s going to take to move forward in a different way in which the needs that are driving the need for the addiction is there’s actually creative solutions to it that that actually you can look forward to. Ok, now you have real hope on multiple levels, and I would say that’s the strength of our treatment.
Dwight Hurst, CMHC: Yeah, I like how you say that the underlying need is generally something that is good, as you put it, like whether to check out or to be able to cope, right, with life. That’s a good thing. We do want to be not only does everyone need to, but everybody deserves that right. The chance to live a happy life and to and to be able to do that. And it’s a question of how I like that a lot.
Clare Waismann, RAS/SUDCC: I think there is also David, forgiveness, um, a self-forgiveness, and um, you know, because now I understand that, um, you know what led me to get here? I understand that. You know, I don’t have I’m not a bad person. I don’t have a bad personality. It’s, you know, so I think the understanding of the condition also creates forgiveness, not just with loved ones, but especially self-forgiveness that I think is incredibly important.
David Livingston, LMFT: The fact that I think that’s right, because, you know, part of what drives addiction is, there’s tremendous guilt and shame. And so when you treat people well and you’re helping them understand and deal with some of the difficulties of that, everybody deals with just being alive and being human and having competing needs. And you know, and and and the dynamic of what it means to be a human being. And you know, and then you begin to sort of deal and parse, you know, you look at the things that they really should, that they, you know, are there things that you want to be? You know, the fact that you’re getting detoxed, it usually means that you’ve already dealt with part of the guilt. Yeah, I shouldn’t have been on this. It wasn’t good for me. It wasn’t good for. Ok, well, you’ve just dealt with it. You don’t need the guilt anymore. The guilt got you here. So, so that’s you. You listen to it. So the function of the guilt that was healthy got you to that. Got you to detox. Ok, so now let’s look at what else, right? And so you go and you can parse these things step by step by step and begin to sort of pull them apart. And like you’re saying, the hope starts to materialize from this, this understanding of themselves in which they begin to see themselves, they can feel themselves in a more human way like that.
Dwight Hurst, CMHC: Thank you for joining us as we talk about the evolution and the development of the Waismann Method Treatment Center. Waismann Method treatment center in rapid detox can be reached at [email protected]. That’s another great way for you to send your questions that you would like us to feature on the show. You can also follow us on Twitter @opiates. Yep, that’s right. We got that one. Or go to opiates.com. Clare Waismann is the founder of the Waismann Method Treatment Center and David Livingston is the clinical director. Glad to have them as always here hosting this show to answer your questions. Keep those questions coming and keep asking questions. Because whenever you ask questions, you can find answers. And if you can find answers, you can find hope. We’ll be with you again soon. Thanks again for listening. Bye-bye.