Un-Addiction: A Mind-Changing Conversation on How We Think About Addiction and Risk, with Nzinga Harrison, M.D.

Hopestream for parenting kids through drug use and addiction
Hopestream for parenting kids through drug use and addiction
Un-Addiction: A Mind-Changing Conversation on How We Think About Addiction and Risk, with Nzinga Harrison, M.D.
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ABOUT THE EPISODE:
When Dr. Nzinga Harrison was recently approached by her son, a high school senior, about going to his first party, she consented. He was unsurprised by her followup question: “Do you think there will be drugs there?” As an addiction psychiatrist and M.D. specializing in addiction medicine, Dr. Harrison had been talking with him about substances since he was very young, so the question wasn’t awkward. “Yeah, probably,” he replied. As her stomach twisted, she realized that the years of preparation for this stage of his life were about to be tested – if not at the party, then sometime soon afterward.

In the two years since our favorite doctor was last on the show, Dr. Harrison has organized much of her extensive knowledge about the roots of substance use disorders into a new book: Un-addiction: 6 Mind-Changing Conversations That Could Save a Life. The framework is comprehensive and data-driven, but also plainly written and easy to understand. I tried using sticky notes to mark the best parts, but gave up when I realized I was marking almost every page.

In this conversation, Dr. Harrison lays out these six conversations, sharing with us how the conversation with her son progressed, and covering a range of other topics, including:

  • Conversational scripts for talking to kids about substances
  • The importance of asking, “What do you know?” without judgment
  • The nascent idea of “pre-addiction” and how understanding it can change the trajectory for someone struggling
  • How your ZNA (zip code at birth) predicts health outcomes better than your current zip code
  • How cultural traditions and rituals can create risk factors

EPISODE RESOURCES:

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Nzinga:
 0:01When we tend to think of addiction, we think of people dying from drug overdose. We think of people who have lost their family. People who have lost custody of their kids. People who have lost their jobs. People who have hit quote unquote low. Rock bottom, but in reality, addiction starts way before it is that severe. And so if we can identify mild substance use disorder, moderate substance use disorder, those pre addiction stages, we have the ability to intervene. I say before stage four,
Brenda:
 0:42you’re listening to hope stream. If you’re a parenting, a young person who misuses substances. It’s in a treatment program or finding their way to recovery. You’re in the right place. This is your private space to learn from experts and gain encouragement and support from me, Brenda Zane, your host and fellow mom to a child who struggled. This podcast is just one of the resources we offer for parents. So after the episode, head over to our website at hopestreamcommunity. org. I’m so glad you’re here. Take a deep breath, exhale, and know that you have found your people. And now let’s get into today’s show. I’m trying to figure out how two years have gone by since I’ve had Dr. Nzinga Harrison on the podcast. If you haven’t heard her first two episodes, be sure to rewind your podcast machine to episodes 46. Which is simply titled the marijuana episode, and then go to episode 57, which is the Xanax episode. Both are mind blowing conversations you are going to want to have in your brain. Back in 2021, we were already seeing the deleterious effects of high potency THC products. And as you know, it is only continued to get worse. So many of our kids are experiencing psychosis and really serious mental health issues as a result of these high potency products. And before I dive into more about Dr. Harrison, I want to let you know about an opportunity to be part of a study. That is being done at McLean hospital. If you have a kiddo who’s experiencing psychosis and you want to know how to help them, please be sure to get the show notes for this episode because I’m going to put a link in there to the details of this study. The purpose of the research that they’re doing at McLean is to develop and evaluate an intervention that adapts craft community reinforcement and family training for families experiencing first episode psychosis. and substance use delivered via telemedicine. And not only is it free to be part of the study, you can actually get compensated up to 200 for participating. So this is all kinds of goodness. So all the information about this research study that you could be a part of is in the show notes. Those are at brendazane. com forward slash podcast. And then you’re going to look for episode two, one, two, Dr. Nzinga Harrison. Okay. So back to our favorite addiction doctor. In addition to all the things this woman does, she recently published a book called unaddiction six mind changing conversations that could save a life. It’s available wherever you get your books. And let me tell you, It has got such relevant information about things you may have never even considered before. It’s got scripts for how to have conversations. I mean, the book is just a gold mine of material that you’re going to want to have on hand. Dr. Harrison cracked up when I showed her my copy of the book. which has so many colored sticky notes sticking out of it from all angles. I just could not stop highlighting parts of it that I wanted to be sure to cover when we spoke. In case you don’t know who I am talking about, Dr. Nzinga Harrison is a board certified physician with specialties in psychiatry and addiction medicine. She’s also the chief medical officer and co founder of Eleanor Health, which is an innovative mental health and addiction treatment company. Dr. Harrison holds an adjunct faculty appointment at the Morehouse School of Medicine and sits on the practice management and regulatory affairs committee for the American Society of Addiction Medicine. She is also importantly mom to two teen boys. So she is in it with us. And in this conversation, you will hear how even as an addiction doctor, she has her own challenges to face with her family. With her kids and she gives us a window into how she talks with her boys about things like parties Substances drug testing and about making decisions around their choices about using or not using This my friend is an episode. You’re gonna want to be sure to save Also, I would encourage you to pass it along to people in your life who may not understand what you’re dealing with or who have an outdated understanding about what addiction is. I cannot thank Dr. Harrison enough for taking time out of her insanely busy schedule to chat with me about her new book, Unaddiction, six mind changing conversations that could save a life. Here we go. She is back folks. We are Back with Dr. Nzingha Harrison. It’s been two years, over two years. I went back in the time machine and we last recorded in April of 2021. I cannot
Nzinga:
 6:12believe that. Like time
Brenda:
 6:13flies. So happy to have you back. You have a new book out, which we’re going to dive deep into. I showed you my copy of the book, which. I had to stop sticking the little stickies into because every page had a sticker on it and was like, well, that’s not, that’s not
Nzinga:
 6:29helpful, but welcome back. I love it so much. Thank you. Thank you. For having me back. I love you show me the book with all the tabs in it. I’m just like cracking up. It’s literally. Exactly. What I hoped is that every page she has it down the side and she has it across the top. It’s like so good. All of these little color tabs. I just wanted every single page for people to see themselves in there, you know?
Brenda:
 6:56Yes. But also so many resources and just like, I personally love, you have all these key takeaways at the end of the chapter, which is so helpful because you, as you’re reading, you’re like, Oh, what am I going to do with all this information? Which is why I have all the tabs, but then you give us a nice, like little chunk at the end of the chapter with, with all of the key stuff. So that is fabulous. So I want to dive into it. But I’m curious. You have so much going on. The chief medical officer for Eleanor health, you have a podcast, you see, I’m assuming you probably see patients at some level. I don’t know. Maybe not. What possessed you to say, I should write a book. Cause I just don’t have enough in my life going on.
Nzinga:
 7:40I know. Isn’t it like so wild. It’s really a great story actually. So my first podcast was in recovery with Dr. Harrison available wherever you get podcasts. And there was a listener who literally just sent me a message on my website. It was like, If you don’t have a literary agent, I assume you already do, but just in case you don’t, I’d love to talk to you. And I was like, why would you assume I have a literary agent given I have zero intention to write a book? But I spoke to her and she was just this phenomenal woman, Jennifer Keene from this organization Octagon, which actually mostly represents athletes. And she you know, helps people publish books. She’s a literary agent. And I was like, I’m never going to write a book. I don’t have time to your point. Right. Brenda was like as much as I would love to. And she said, listen, You do all these speaking engagements, you co founded Eleanor Health, like, this is obviously your passion. A book is the way to reach the most number of people that you would never, ever physically come in contact with. And she convinced me to do it, and then helped me find my collaborating author, Linnea Floyd, who was just a joy to work with, and Linnea just helped me capture All of my soapboxes, all of the things I wish, you know, everybody knew and really just like in a way that empowers people to take action. So that’s how it came to
Brenda:
 9:12be. That is amazing. Yeah, I love it. When you have literary agents reaching out to you, that’s a good sign. I would say that’s a very good sign. You’re doing something right in the world if that happens. So the book, you talk about these six factors that contribute to your risk of developing a substance use disorder. And I, I think you were so right somewhere you talked about how we really tend to just think of one, like the genetics, that’s kind of. What we think about when we think about addictions, like, Oh, you know, your granddad had this thing with alcohol or whatever. And we, we sort of leave it there. And so you really pulled back the covers on so many other ones. So maybe just talk about those quick, you know, we won’t do a deep dive into each of them because I have 4, 000 more questions, but if you could just kind of give us the lay of the land of where you, where you started with all of this.
Nzinga:
 10:00Yeah, definitely. So the full title of the book is unaddiction six mind changing conversations that could save a life. And so we structured the book into six chapters. And it’s this idea that every chronic condition substance use disorders and other addictions included have three inputs biological, psychological, and mental. And environmental and those three inputs. There are a set of conditions that you’re born into. We call those inherited. So you’re inherited. Biological is your genetic risk. You’re inherited. Psychological is the childhood dynamic. You were born into your inherited. Environmental is the childhood environment you were born into. And then throughout our lives, our twenties, thirties, forties beyond. Those same three repeat. So there are biological risk factors that we acquire illnesses, prescriptions. There are psychological risk factors that we acquire relationships. There are environmental stressors that we acquire. And so the book really goes through what are. Those risk factors in each of those six buckets. How do you recognize them? So I think your tabs are probably on the like very tangible exercises that I give and then also a script for how to have a conversation about that bucket.
Brenda:
 11:19Yes, which is really helpful because those words don’t naturally come out of our mouth, right? It’s not a conversation that we, we should be having it more, but it’s probably one that we don’t have. And so having those words is really, really helpful and having the exercises to be able to go through. And. identify, you know, is this, wow, is this something I should be thinking about? So that was, that was super helpful to read. And I, I loved and I don’t think I really heard this before the term pre addiction was one of those, you know, you talk about how, like, I’m going to shock you a little bit, like, I’m going to give you some things. That you might not feel comfortable with, or you might not have ever heard before. And I have to say that pre addiction was one of those for me. Could you talk about that a little bit? Yeah.
Nzinga:
 12:05So I even say this in the book, like, I love this concept of pre addiction so much. I wish I had come up with it, but all credit due to Nora Volkow over at the National Institutes of Health, NIDA, National Institutes of, it’s called drug abuse. You’ll read in the book also why we’re going to throw the word abuse out of our lingo, but it’s this idea, you know, I’ll start with diabetes. We used to just be like, you have diabetes or you don’t. And then someone super smart was like, actually, if we could identify pre diabetes, maybe we could prevent people from developing diabetes. This concept of pre diabetes came, this concept of pre hypertension came. And Dr. Bolkow has given us this concept of pre addiction, which is when we tend to think of addiction, we think of people dying from drug overdose. We think of people who have lost their family, people who have lost custody of their kids, people who have lost their jobs, people who have hit quote, unquote. Rock bottom, which is another concept we explore. In the book, but in reality, addiction starts way before it is that severe. And so if we can identify mild substance use disorder, moderate substance use disorder, those pre addiction stages, we have the ability to intervene, I say, before stage four. So we want to find that lump before it metastasizes, and this is the concept of pre addiction.
Brenda:
 13:31That is really smart. And I’m wondering, just because a lot of the parents who are listening to this podcast have either adolescents or young adults, and it seems like that might be a less like stigmatizing term to use. In, in thinking about like those, that audience, younger kids, young adults in pre addiction, how would you start that? You’re so good with like starting conversations. How would you start that conversation? Because I love this term. I think it’s so great.
Nzinga:
 14:03It’s so good. So I love talking to high schoolers specifically in the book though, literally I give you a script. How do you have a conversation about drugs starting in preschool? With your preschool or your elementary, middle, high school and adult child I’m actually going to speak at my son. He’s graduating high school this year, which is crazy. My youngest. I’m going to be an empty nester. I go each year and talk about addiction to the high school kids. And the way to start the conversation is What do you already know? Right? Like the first thing is that you have to be completely nonjudgmental. Just say no. It’s out the window. It doesn’t work. It’s dangerous because what it does is tell your child, you can’t come talk to me about this. And so what I’m hoping with this book is that literally from preschool, you’re letting your kids know you can come talk to me about this. And so the first step in the book, I think I call it ask, don’t tell, which is a play on a very unhelpful previous concept, right? Ask, don’t tell, ask, what are your thoughts about drugs? What are your friends thinking about it? Anybody using? Are you using? Anybody feel like they can talk to their parents about it? Do you feel like you can talk to me about it? Ask. And then it’s empowering them with information for them to do their best at making decisions to keep themselves safe in different situations. And so, I’ll just tell a quick anecdote. Brenda, my older son, who is a freshman in college, And doing great when he was in high school, the first party comes up, right? And he’s like, mom, can I go to this party? And I’m like, Oh my God, this is like freaking out on the inside, but like never let them see you sweat. Yeah. I’m like, cool. I was like, this is super exciting, which it is. It’s a huge developmental moment. And I was like, do you think there’ll be drugs there? Casually? We’ve been talking about drugs since they were three. So they’re there. He’s not surprised by this question because we have a lot of biological inherited risk factor. So do you think there’ll be drugs there? And he’s like, yeah, probably I like died a little on the inside, but I kept it cool on the outside. And I was like, all right, what drugs do you think will be there? And I was like, you know, what are your plans? You plan on trying anything? And he’s like, nope. And I’m like, okay, when you’re in the moment and every, it seems like everybody’s doing it. And it’s so important to be cool at this party because it is. What’s your plan? And that’s how you talk to teenagers, right? It’s like, what’s your plan? And let’s equip you with skills to keep yourself safe. And the last thing I said to him was. Even if you do in the moment, decide to use something. How are we going to know you’re in an unsafe situation? Because me and dad will be on call on demand. You’re not getting in trouble. We’ll help you get out of there. We’ll be 10 minutes away. We’ll bring you home. We’ll figure it out. It doesn’t matter what it is, but like, how are you going to know? When you’re no longer in a safe situation. This is how you have the conversation with your adolescents.
Brenda:
 17:18I think that’s so smart and so uncomfortable, right? Even for you as a doctor who deals with this all day, every day, it’s still uncomfortable for you. Well, maybe, I don’t know. I shouldn’t put words in your mouth, but you do have that reaction of like, Oh, like this is happening. Oh, you can put those words in my mouth. I think any parent, right? It doesn’t matter what you do for a job. It’s just terrifying. And I know you talked about in the book, how you with your kids, you have like a code word or a code phrase that they can send to you to get them out of that situation. And I think some parents would say, well, isn’t that enabling? Like, aren’t I enabling my child? What? How do you wrestle with that in, in your brain?
Nzinga:
 18:08Yeah. So I say, yes, you absolutely 100 percent are enabling your child to stay alive. That’s the bottom line. And so if you can create that conduit of Honest conversation about scary things with your adolescent. This is how you keep them alive because do I want my child to try any of those drugs? No, I don’t want you to vape. I don’t want you to smoke marijuana. I do not want you to drink alcohol. Like if you can be 100 percent T Toler, absolute abstinent from absolutely everything for your entire life. That is what I would choose for you. Yes. You are an autonomous individual, and that doesn’t help me to make decisions for you. I have to equip this child to make decisions for himself. And if he’s in an unsafe situation, let him know that it is always safe to come to me. So we told him, we were like, even if you’re drunk out of your mind, even if you’re so high. Me and dad will come get you. We will figure it out. You will not be in trouble. That is not to say there will not be consequences. Big distinction. There are natural consequences. Right. You will not be in trouble. It will not change the way we love you. It will not change our main goal in life, which is for you to be healthy.
Brenda:
 19:29So important. And I think that’s something that parents really need to talk about. If you do have a co parent, right, if it’s a partner or an ex and you’re trying to do this together, you gotta be on the same page with that. You can’t have somebody, one parent saying, You know, oh, they’re going to be grounded for the next three months. And one parent saying, no, we just need to get them home safe. And then we can super hard.
Nzinga:
 19:52That’s right. That’s exactly right. So my husband and I are, we have to be on the same page about that. And we started this at three years old. Like I’m an addiction doctor. And so. I’ve been, you know, training my whole family from the time they were born, because I have a very significant substance use disorder family history. And it’s like, okay, how do we practice prevention?
Brenda:
 20:16Yes. One of the things that I learned, one of many things I learned in the book was about the ACEs study. And I knew about the ACEs study, but I didn’t know the origin of it, that it actually, it didn’t start as something around trauma and substance use.
Nzinga:
 20:33Yes. So the origin story of the ACEs is fascinating. And we actually spoke with Dr. Felitti for the book. So special shout out and thank you to him. He was actually an obesity doctor weight management. And he accidentally one day He used to always ask, you know, when did your weight gain start? And he accidentally asked one of his patients when was her first sexual experience. And I think she said some shockingly low number, like seven years old, which you automatically know this is a history of sexual trauma. And then he started asking the question and saw that there was definitely a pattern for people that were coming to his clinic. And so ultimately did this huge study with thousands of patients to look at adverse childhood experiences. So negative childhood experiences counted up 10. And since then, there has just been study on top of study on top of study on top of study, reinforcing that those inherited psychological factors. affect our health, not just in behavioral ways, but in physical ways and social, emotional ways, even into adulthood. And so to your point, ACEs was an invisible concept when I was in medical school, but now very much especially mental health specialists are getting trained in it, but pieces, positive childhood experiences, is still very invisible. And what’s incredible. So an ACE score of four is where your risk for all of these illnesses, addiction included, starts to go up. But a PISA score and PISA scores out of seven of three starts to mitigate that risk. So you may not have full control over the ACEs. Joel and my husband, We set a goal, I educated him on the ACES early, when we had the kids, and I was like our goal is for our kids ACES score to be zero, but we don’t have complete and utter control over their ACES score. We do have control over their pieces score. And so our goal is for their pieces score to be seven out of seven. So any ACEs that might happen, the pieces can offset that. And so to your comment, the ACE is like, Oh, well that happened. Pieces score works even today, no matter how old you are 15, 25, 35, myself, 47. If I can get the more of those pieces, I can get in place for myself now. Yeah. The more it will mitigate any negative impact of ACEs that I experienced as a child.
Brenda:
 23:19Hi, I’m taking a quick break to let you know some exciting news. There are now two private online communities for supporting you through this experience with your child or children, the stream community for those who identify as moms and the woods for guys who identify as dads. Of course, this includes step parents and anyone who is caring for a young person who struggles with substance use and mental health. The stream and the woods exists completely outside of all social media. So you never have to worry about confidentiality and they’re also ad free. So when you’re there, you’ll be able to focus on learning the latest evidence based approaches to helping people change their relationship with drugs and alcohol. In both communities, we have a positive focus without triggering content or conversations. And we hope you learn to be an active participant in helping your child move towards healthier choices. You’ll also experience the relief of just being able to be real, connect with other parents who know fully what you’re going through and have battle tested mentors alongside. You can check out both the stream and the woods for free before committing. So there’s no risk. Go to HopeStreamCommunity. org to get all the details and become a member. Okay, let’s get back to the show. Protective childhood experiences. Like, is there a rank order of those? Like, I’m just thinking like, how do we stack the deck?
Nzinga:
 24:51Yeah. I love this question. I do not know that there is a rank order. Although I imagine there is a rank order, so I could say like feeling protected by an adult. I don’t know. In your life seems like at the very top, just based on what I know about Children who experienced sexual assault and molestation. The bigger injury is when they tell someone and are not believed. That is actually insult that is associated with the most negative lifelong consequences, even more so than the act itself. And so I would think being protected is at the top. You also think about Maslow’s hierarchy, right? Like I would probably stack rank that at the top. This is, this right now is in Zynga’s opinions, not the medical literature. The other one I would say, Is having two non parent adults that took an interest in you. And the reason I stack ranked that at the top is because one, that’s something we can do for other children in our lives that are not even our own children. But also you think about whenever you hear someone give a thank you speech, they think that one teacher that made a difference. They think that one coach that made a difference, they think that one member of their church that made a difference. They think that mentor they’re fully grown adult professional people. They think they’re executive coach, right? Like people taking interest in us. Is a neurobiological fundamental need. And so I would stack rank that. But again, ING’s opinion.
Brenda:
 26:24Yes. Well it makes sense. I mean, I love both. I love both of those. The feeling protected. You know, I’m a huge fan of Dr. G Mate. I’m sure you are. And he talks about the trauma isn’t. What happened to you, it’s what happened to you as a result of what happened to you. And so often, like you said, a trauma goes either unnoticed or undealt with. Like we try to sweep it under the rug. Like, well, that didn’t happen. You know, we’re just going to carry on and pretend like that. None of that happened which then just starts to eat away and to lead, like you said, leading to not just addiction, but diabetes and autoimmune diseases and like all these things that we wouldn’t necessarily associate with something like an adverse childhood experience. And then you talk about, you know, the environmental factors and the neighborhood that you grow up in the zip code. Is it the zip code? Yeah, the zip code that you are born into. Like, this is so amazing.
Nzinga:
 27:25I know it’s mind blowing stuff. So I do a lot of stigma reduction I have for the last 20 years. And one of my strategies for stigma reduction for addiction and other substance use disorders is to talk about the biological component of the illness. Like it’s an illness, not a choice. This is an environmental component. So Your ZNA, which most people have not heard of, so it’s a concept which is the zip code you were born in, predicts your current health more than does the zip code you currently live in. That’s how strong the developmental influence is. And so what we talk about in the book is like knowing As children, for your children, generational prevention, knowing their Z and A, and then trying to use pieces and other strategies that we give in the book to mitigate any risk that comes from that, but then also as adults, and this is what I hope the. inherited biological, psychological, and environmental chapters do for people is just validate, validate the experiences you have had, validate the impact of those experiences on you today, even though they were when you were a child. Cause we kind of have this idea like, yeah, I mean, get over it. We were a kid and it’s like, no, physiologically, biologically, psychologically. Those things we experienced as children are with us today. And so how do we recognize them and manage them?
Brenda:
 29:01It was, that was so fast. I think I read that twice. I was like, what, this is amazing information to have. And it, like, it’s so empowering, right? To not that we say, oh, well, you know, I was born here. So therefore there’s nothing I can do. It’s not that it’s just to have that information so that you can Villain on it, you know, and to, to take that into account for yourself, for your kids. And then also the chapter on the cultural influences, my co founder of HopeStream, her, she has a big Polish family and a big part of their tradition is to take shots at like, at the holidays and she’s got two kids in recovery. And it’s like, What do you do? You not have them in the room. Do you not have them at the set? Like, it’s really tricky. Maybe talk a little bit about that because I think that’s something that we don’t, we talk about the genetics and all that, but we don’t necessarily talk about these cultural things that are maybe the biggest barrier for a lot of people to make a change.
Nzinga:
 30:09Totally agree with that statement, because at the end of the day, and humans are pack animals, it is not just that we want to be in the pack. We actually need to be in the pack as a matter of survival, emotional and tangible. And so I mean, I tell this anecdote, I’m an addiction psychiatrist and literally my family is not Polish, but we also developed this Ritual of taking a shot the holidays so much to the point that we give a little shot glass of Sprite to the children and the children are like, I can’t wait until my shot glass actually has it’s fireball whiskey that we take and I’m like, I’m in the moment and I’m like, I’m an addicted psychiatrist and I am like participating in programming these children to not be able to wait until the moment they could take a shot of his whiskey. I was like, all of it is just so, but that is how strong culture is. And belonging is and substances and alcohol, cigarettes, vaping, marijuana. Now, some of these are so central to our culture that we have to make it safe. You can’t even say, I don’t drink. People were like, you don’t drink. And so the way we have made it safe for people to say, I stopped smoking. It did not used to be you did not used to be able to say that either because smoking was what cool and sexy people did and if you stop smoking, then it sucks to be you because not cool and not sexy. But now it’s like I stopped smoking and we’re like, yeah, you didn’t used to be able to tell people you were a cancer survivor. Because it was like, people were kind of scared of you. Now you’re like, I’m a cancer survivor. I was like, yeah. And so we have to get to the point for your friend who has two kids in recovery. How do we talk to the family and say, like, you’re either we’ll stop doing the tradition. We’ll change the tradition to something else. We know you won’t be there for the tradition and we know why you’re not there and we support you. Like what proactive action can we take to make that ritual safe for people who are in recovery? First, we have to have the conversation about it.
Brenda:
 32:35It’s not even just with substances, right? But especially with substances, it seems to be a very delicate and protected thing like, Oh, don’t mess with this. It’s like food, right? Like don’t mess with our food. Our cultural food, say you can’t have that anymore because it’s not healthy or whatever. Those are fighting words. Like that’s dangerous, dangerous territory.
Nzinga:
 32:59You will actually get in a fight. Yeah. And you’re like, I’m fighting for my health. But at the same time, these cultural things they get inside of us. I mean, I agree with your statement upfront when you said possibly the most important. I think, yeah, because culture can increase our biological risk or it can decrease our biological risk and our culture as we have it today increases our risk.
Brenda:
 33:29Yes, for sure. I mean, if you don’t have somebody that’s close to you, who’s going to support you. And, you know, you talk in the book about be your ally, like you need somebody that’s going to be by your side to say, Oh no, she’s not doing that anymore. Or, Hey, let’s step outside while the, you know, everybody’s doing their shots. So, so important. And I, and I would love to touch on the, the current, cause it’s been two years, which I can’t believe since we talked about marijuana and addiction and. Xanax in an addiction in young people. And what we’re seeing in our community, our parents get on our calls and they say, my kids started smoking weed six months ago, and I don’t recognize them anymore. And they’re having psychotic breaks. And I’m wondering, has, have you seen this change since? We last talked in 2021 because I feel like I’m hearing a lot more. I’m not a doctor. Like I’m just, I’m hosting these calls with parents, but what are you seeing around that? Because I feel like the youth culture and marijuana is just like tight and it’s gotta be really hard. For our kids, but also there’s the physical impact that’s happening to them.
Nzinga:
 34:47Yes, this is a thing. Definitively. The medical literature is showing it to us. So it’s really pinned in the marijuana products of today are not the marijuana products that we grew up. So if you look at the THC potency, you know, the main two big compounds in marijuana are going to be THC and then CBD cannabidiol. Yeah. CBD is actually therapeutic in a myriad of ways. I try to get everybody to take CBD. not psychoactive, doesn’t have addictive potential, doesn’t drive the negative consequences. THC, on the other hand, is what’s giving you that intoxication feeling, giving us the negative cognitive impacts driving that risk for psychosis and lethargy and apathy. And unfortunately the marijuana products of today are just so much more THC potent. So if you look back I’ll say back in our day, assuming like we were around this hour, our day is the same day. It’s like 4%. It’s like 4 percent THC. These days, kids are vaping almost pure THC products. The marijuana on the street is as high as 20%. Edibles can be even more. And so we are seeing more psychosis. More addiction, more psychosocial consequences, more injuries, and as more people use marijuana, that will continue to be the case as marijuana THC concentration continues to get higher. That will continue to be the case. And so it is extremely important to equip our kids. With the information about this. So like I told Zaire when he was going to that first party, I was like, just to be clear, the brownies might not just be brownies, probably
Brenda:
 36:34aren’t
Nzinga:
 36:35right. I was like, if it doesn’t come straight off a package, like if they have a table full of foods and drinks, Just be clear. You have no idea what’s in those food or drinks. And I told him, I was like, we’ll drug screen you when you get home. It’s not for you to get in trouble. It’s for you to tell me whatever you took. So like, tell me before we see the drug screen, or if something pops up in there that you didn’t know you took. We also need to know that. And so it’s just being able to have those conversations, but yeah, higher psychosis, higher addiction, higher injuries, higher. social consequences. What’s where kids is like school trouble and family trouble. It is, it is real.
Brenda:
 37:14It’s so disheartening. And, you know, you just feel like a broken record talking to your kids about, Oh, it’s dangerous. Like it’s so, it’s so hard to get that across, but then What we’re also seeing is the kids are starting to ask for help. Like, you know, having a psychotic break I think is different than, Oh, I got kicked off the football team. Right. If you, if, and so they’re starting to say, I need help. I need help. Like I’m, I’m losing my mind, literally losing my mind. It’s just heartbreaking.
Nzinga:
 37:47Huh. Yeah, it’s heartbreaking and it’s scary. And so back to this idea, we talked about pre addiction, if we can equip our kids. And so like, I’ve already mentioned my, my genetic loading for not just substance use disorders, but also serious, persistent mental illnesses, schizophrenia and bipolar disorder specifically. And so my kids know this risk for them. Right. And I tell them like, listen, you’re going to go to a party and somebody might be able to do a line of cocaine. There’s going to do a line of cocaine. It’s fun. You do a line of cocaine because of your genetics. It has different implications. So I hope you will just say no, but if you do a line of cocaine, let’s talk about red flags. So like marijuana, I hope you just will not do edibles, vape, smoke, whatever hit the ball. I don’t want you to do any of it. But if you do, how do you start recognizing the red flags before it is a psychotic break? So let’s talk about those signs of pre addiction and for adolescents, the scale I would use is the craft. So in the book, I talk really about adults and I get the cage. But for, for adolescents, it’s the craft and it’s just, it’s just a five question questionnaire that just asks like, have you ever used in a car? Have you ever used alone? Have you ever had trouble with your friends and family at CRA FFT? And so when I go to high school next week and teach about this, what I actually do. Is say, I want you to think of one person you might be worried about. You’re not sure if you should be worried about them. It’s either yourself or it’s a friend. I know you have one. I know you either have yourself or you have a friend or a family member that you are not sure if you should be worried about. And let’s go through the craft questions. And I want you to answer the craft questions thinking about that person. And then I say, if their score is two or three or four, here’s how you start the conversation. I’m worried about you. I did this craft score. It was high. Dr. Harrison told me I should speak up.
Brenda:
 39:54It’s always better when a doctor tells you to do something.
Nzinga:
 39:57Yeah. Blame it on Dr. Harrison.
Brenda:
 40:01That’s great because it, I like how you say, you know, you or a friend, because then it takes the pressure off of maybe I am worried about me, but I can project it onto a friend or a family member. So that’s really smart. You know, a lot of us weren’t raised having these conversations, so they do feel very uncomfortable. It almost feels like, well, if I start this conversation, then I’m giving them permission to use something. And I guess I should say they’re going to do it. If they’re going to do it, they’re going to do it.
Nzinga:
 40:34We used to think the same way about suicide. We used to be afraid to ask the question. And what we know unequivocally is that not asking the question increases the number of our kids that we lose. And it is exactly the same here.
Brenda:
 40:50Yeah. Yes. And ask, and just saying, like you said about, you know, I hope that you don’t do this, but if you do, let’s talk about what those red flags are. I think this is a, I just want to touch on it again because I think it’s a conversation that feels doable. Like it doesn’t feel super, super scary, but just to say, what would, what would make you concerned? And here’s some things that would make me concerned, you know, cause our kids might have a different lens on it. They may say, well, you know, if I got kicked off the team or if my girlfriend broke up with me. And so then you could have that conversation together and say, okay, so here’s your red flag list. Here’s my red flag list. Let’s just make sure that we’re looking at this list. So that if one of them starts to pop up, that now we can have a different conversation. And would that conversation then be about getting some help or getting some treatment or what would you recommend then?
Nzinga:
 41:52Yeah, it would be about trying to change the use pattern and if you can’t change the use pattern, getting some help. Right. So either getting some help to do that. But I love what you said, like, what would some of your red flags be here? What some of my red flags be. And if we see the red flags, you said, then we can have the conversation. I would even say like in that conversation, say we promise to each other that if I see any of your red flags or any of my red flags, that I’m going to, that our relationship is safe enough. For me to bring it up. If you see any of your red flags or any of my red flags, our relationship is safe enough. For you to come to me. That’s our commitment to each other and this conversation. And when you come to me, we’re going to figure it out and figure it out means getting some help, whether that’s primary care doctor, pediatrician, therapist, internet, family groups, like there are a lot of options, but. Figuring it out means me and you together.
Brenda:
 42:52Yes. Figuring it out is, is a phrase that I think is less scary to our kids than you’re going to stop. Get treatment. Or you’re going to get treatment. Yeah. I think that treatment word to a teenager or a young adult is terrifying. Yeah.
Nzinga:
 43:11Cause it has lifelong implications. Yes. Right? Like you have now, if you think about how much, and we should change this and we’re working on change of this, but if you think of how much stigma comes with being branded as a person with addiction, then you’re asking an adolescent to take on that stigma for the rest of their lives. Yeah. We have to know how heavy that is and we have to let them know you won’t get that stigma from me. I’m your safe person. And I saw this post on social media the other day, and it said, if I have to burn bridges to protect, to protect my child, I have all the matches we ride at dawn, like your kid needs to know you will burn it down for them, right? Like, my kids know, my mama will burn this thing down.
Brenda:
 44:06Yes, yes.
Nzinga:
 44:08That’s what they need to know all the stigma is going to come. The struggle is going to come. Even if we’re going to treatment. You need to know I have the matches, like we will burn all of it down for you.
Brenda:
 44:20I love that. We have the matches and that’s, that’s probably not a relationship that a lot of parents and kids have together. Right. It’s a you against me. It’s the parents coming down hard and you know, if I find out you smoked weed at that party, I’m taking away the car, I’m taking away your phone. You’re on restriction, like all of that, which from what I’ve seen, is that just. It makes them sneakier and drives it underground even more. And what you’re saying is it’s almost, it’s the opposite approach of being more open about it then gives them that place to talk about it and they don’t have to get sneakier and hide it and go around your back.
Nzinga:
 45:02Yeah, that’s exactly right. And listen, if, if my kid is smoking marijuana regularly or doing edibles or vaping or whatever, I may not let you drive the car, but I’m going to say, listen, I do not want to take this car from you because that also has consequences for me because now I have to either pay lift or drive you around places. But more than that, I don’t want you to die. And I know that you behind the wheel impaired puts you at risk for dying. And I’m not willing to be part of that. So no, I’m not giving you the keys to this car. It’s the same consequence, but delivered. With me and you on the same side as opposed to me and you at odds.
Brenda:
 45:48Big difference. Really big difference. It’s work. I mean, it’s just work we have to do and I think we have to get comfortable with ourselves and confident in ourselves to be able to do this and also have support, you know, find a community and, and one thing that I think stood out kind of as a whole after reading on addiction, was that we should be partnered with a healthcare provider just in general. And I think that that’s really hard to do a lot of times today, because, you know, you go to the doctor and they’re literally like, okay, I have seven minutes for you. Like, what’s wrong. And, and here’s the pill to fix it. Or here’s whatever. And so I think if, if this is, It’s something that you’re struggling with in your family, or if you see this kind of some of these pre addiction behaviors, find a doctor who is going to take the time with you to sit down. Because you mentioned over and over in the book, like this should be on your healthcare, you know, treatment plan with your provider or whatever. And I’m like, wait, who has that? Like who’s, you know, it’s not the, it’s not our, how our healthcare system is set up. to, to have that relationship. So I would say fight for your kids and fight for your own medical care so that you can, you can do this. So thank you so much. I love it. Everybody get the book on addiction, six mind changing conversations that could save a life. It is you’re, you’re going to run out of sticky tabs. So don’t, I don’t know. I just wouldn’t even start with them. Thank you so much. We appreciate you. You’re our favorite, favorite podcast doctor for hope stream. So hopefully we’ll have you back again and maybe we won’t wait two years this time.
Nzinga:
 47:37Let’s not wait two years. I absolutely love being here and I’m going to like make a picture of myself, this is podcast doctor.
Brenda:
 47:45Yes. I mean, you’re a. Full on full on doctor. But for us, for our podcast, you are our doctor. I love it. All right. Thank you so much. Have a great rest of your day. Thank you. Okay, my friend, that’s a wrap for today. Don’t forget to download the new ebook, Worried Sick. It’s totally free and will shed so much light on positive tools and strategies you can use right now to start creating conditions for change in your home. And in your relationships. It’s at hopestreamcommunity. org forward slash worried. And as always, you can find any resources mentioned during today’s show at brendazain. com forward slash podcast. That is where every episode is listed and you can search by keywords, episode number or the guest name. Plus we’ve created lay lists for you, which make it easier to find episodes grouped by topic. And those are at brendazain. com forward slash playlists. Please be extraordinarily good to yourself today. Take a deep breath. You have got this. You are not doing it alone. And I will meet you right back here next week.

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