Navigating Addiction and the Complexity of Change with Daryl Shorter, MD Pt. 1
In this week’s episode of Health Gig, hosts Tricia and Doro speak with Dr. Daryl Shorter, an expert in addiction psychiatry. Dr. Shorter shares his professional insights, highlighting the complexity of addiction and the challenges individuals face in their path to recovery. The episode delves into topics such as the diverse approaches to addiction treatment, the role of genetics in treatment success, and the stigma surrounding addiction. Dr. Shorter's empathetic and holistic approach to addiction medicine sheds light on the importance of understanding and supporting individuals on their unique paths to recovery, making this episode a must-listen for anyone interested in mental health and addiction.
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Website: https://www.menningerclinic.org/staff/daryl-shorter
LinkedIn: https://www.linkedin.com/in/daryl-shorter-798a276/
Quotes:
Everything in the life of a person who struggles with addiction might be telling them the substance is not doing them any good, yet they continue to engage in the source of their addiction. - Daryl Shorter, MD
The natural trajectory for some people can include a spontaneous recovery, and they may not even necessarily have identified themselves as or been identified as having an alcohol use disorder. - Daryl Shorter, MD
When we live in a manner that is consistent with our values, and we're accomplishing our goals, that's how we ultimately can create meaning in our lives. - Daryl Shorter, MD
Show Notes:
DARYL SHORTER: I'm originally from Chicago, Illinois, but I'm a Texan by choice, not by birth. Although Chicago will always have an extremely important and special place in my heart. I first came to Houston for a school. I went to college at Rice University and then stayed for medical school at Baylor College of Medicine. So I spent eight years here in Houston, becoming acclimated to the weather and the heat.
DARYL SHORTER: I thought I would become a child and adolescent psychiatrist. There's such an important emphasis on the development, the family, and how to perhaps take on a more preventive role in the mental health care of individuals. And so child psychiatry was where I thought I would land. And then I rotated on an inpatient child psychiatry unit and realized that that work didn't necessarily speak to me in the way that I thought it might.
DARYL SHORTER: I experience a lot of hope in working with folks who have addictions.
DARYL SHORTER: You want them to trust you and to trust that you have their best interest at heart.
DARYL SHORTER: After completing residency at Ohio State, I went to New York University and did an addiction psychiatry fellowship there. I was in New York for a couple of years, and that really greatly expanded my thinking and understanding. The depth of my learning really came in addiction at NYU. And then after that, I came back to Baylor, and I've been on faculty ever since and worked in the VA system. I did that for about 12 years, and now I've been at Menninger for two and a half years and doing a variety of things within the addictions field education and overseeing training programs and research and of course, clinical work.
DARYL SHORTER: There is really no one size fits all approach to the care of really any patient, certainly for folks that are struggling with mental health conditions and absolutely for folks that are dealing with addictive disorders or other types of behavioral addictions or substance use disorders.
DARYL SHORTER: Some people benefit from having medications as a cornerstone component of the overall addictions treatment. Some people need a combination of those things mindfulness, yoga, meditation, spiritual practice, going back to church for some people, maybe something maybe more faith based. There are other types of mutual help groups that are not just 12 step oriented. That can be helpful for people. Really, it's about finding the thing or things that work best for the person that I'm working with and really trying to support them in doing those things.
DARYL SHORTER: I would say probably the majority of people believe that they are responsible, personally responsible for finding recovery from addiction or sobriety or abstinence. However they think about that, and a part of that belief in self reliance can also lead on a reliance upon God.
DARYL SHORTER: We try to support people in doing the things and following through with the things that they are most interested in doing, as long as they're not posing a risk of harm. Yes, and even in a case like that, if they do, we talk about how to reduce those harms.
DARYL SHORTER: Talking to people about craving very intense desire to use as another symptom or another aspect of addiction, the other two aspects are broadly one a loss of control over the use. By that I mean someone sits down and they say, I'm only going to have one and instead they have six.
DARYL SHORTER: We need to ensure that all types of people are included in that type of research. Sometimes it can be very difficult to or a little bit more challenging to enroll women with substance use disorders and clinical trials. There's so much stigma and judgment around substance use disorders in general, and in women in particular, experience quite a bit more, and that actually serves as a barrier for them coming into care and seeking treatment. And that also extends to their involvement in research as well.
DARYL SHORTER: We attach that language of motivation to people with substance use disorders without understanding or appreciating that change is a process, that change is really hard, and it can be gradual and that it's not necessarily linear. So people might come to us in a stage of change.
DARYL SHORTER: We don't necessarily have it in the DSM five just yet about phone addiction, but we're not so different from people that are struggling with substance use disorders if we really look at our lives.
DARYL SHORTER: The DSM stands for the Diagnostic and Statistical Manual. Yes, it is the way that mental health clinicians go about diagnosing and classifying psychiatric and psychological conditions.
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