when people have a deep deep addiction
sometimes they don't have insight and
they're very guarded and it's hard for
them they may still be in denial
and because of that guarded nature
they're trying to hide it as best as
they can and they don't want you to know
they understand believe it or not that
there's judgment and criticism and shame
behind what they're doing so they will
do the best that they can do to hide
this so these are things i want people
to be on the lookout for because these
should all peak your
radar
to say wait a second here i think we
need to
take that next step in seeking some help
or at least confronting the person
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it's really important to understand what
happens behaviorally and physiologically
physically so you might be able to
intervene sooner but let's talk about
how it presents outwardly right
so if i were to take an opiate i'm going
to be very relaxed
i'm going to be lethargic somnolent and
likely probably pretty tired
so physically you're going to see things
what we call psychomotor retardation
which means that
your motor skills are slowed
so it's almost like they're moving in
slow motion right so if you're sitting
there and you're observing somebody that
you think might have an opiate issue and
they're trying to play it off like
they're not high
and they're going to grab a glass of
water
you know it'd be like
right now did that look normal to you no
right it didn't look normal right but to
that person it's normal speed right so
as an observer you're going to see okay
psychomotor retardation they're sort of
in slow motion
right so those are that's something
you're going to see
there's something we call the opiate nod
or the heroin nod
is that
heroin addicts or opiate addicts they
they can't perceive to themselves that
they're not acting normal but because of
that lethargy and somnolence they will
actually have these like little attacks
of sleep almost like narcolepsy so if i
was sitting here talking to you
and it seemed like we were having a
normal conversation and while you were
talking and i wasn't stimulated
i did that
right it would either look like wow this
guy hasn't slept in like five days right
or i'm a terrible host or you're really
boring me right but so you may see that
so you may see people nodding off okay
so you have that that motor presentation
or slow motion nodding off
there are also things that opiates do to
the body that are very recognizable one
thing that's very recognizable in people
with light eyes
is their pupils constrict did you say
light eyes light right what's a light
eye so your eyes are brown my eyes are
brown right so my pupil is the center of
the eye which is black
now if you have dark eyes it's kind of
hard to see that pupil
if you had bright blue eyes or if i had
bright i wish i did have bright blue
eyes right if i had bright blue eyes
you'd be able to see that black pupil
very clearly
so if you see the person that you care
about or live with and you're looking at
them and they're acting a little strange
and you also see their pupils pinpoint
tiny tiny tiny tiny okay that's a sign
of acute opiate intoxication that likely
means that they they took a dose of an
opiate got it right now you can see it
in dark eyes you just have to look a
little closer it's not as easy so you'll
see pinpoint pupils that's something
important the other thing that opiates
do to people is it makes their mouth
very dry
so you might see them kind of like
licking their lips or kind of having a
dry mouth or dry lips or having
difficulty speaking because of the dry
mouth
so these are all things that you're
going to see from a physical standpoint
very very important to see
opiate addiction is so strong kyle that
people will start to crave and pursue
these drugs
more than they would even food and
nutrition
so they tend to eat less
and you might see them start to lose
weight
so you start to see somebody and that
you know honestly that can be a sign of
other drugs as well like stimulants
but you might notice that they're start
like malnutrition right they just don't
look well they look thinner they look
gaunt they don't look hydrated because
they're putting the drugs ahead of
getting their next meal
so weight loss dry mouth pinpoint pupils
lethargy somnolence tiredness
slowed down motor reflexes that's the
physical stuff
now behaviorally
you're probably going to see some really
tell-tale behaviors
when people start developing an
addiction to the point that it's taking
over their lives in a negative way
they tend to become more isolative
especially with opiates more isolative
and more secretive
they're not as open and
talkative and and you know they're just
much more quiet and reserved and
secretive so you might see that behavior
on the flip side
because opiates don't have a very long
half-life meaning they're not active in
the body very long four six eight hours
when a person needs that next opiate
they may show signs of withdrawal and
you're going to see this because it's
incredibly uncomfortable for the person
that's experiencing it
so behaviorally they are going to be
irritable
nasty snappy it's almost like having the
worst hangover in the world or if
someone has a bad flu they're not very
pleasant right they're like leave me
alone turn off the lights right
you might start to see those early signs
of withdrawal
you might start to see them running to
the bathroom because they have abdominal
cramps and diarrhea they could vomit
they can have stomach upset from that
withdrawal they start to get a runny
nose it's called rhinorrhea a runny nose
they may be sniffling a lot
and get this yawning
a side effect of withdrawal from opiates
and i'm not sure why this happens but
they yawn a lot so they yawn a lot
minimal appetite because their stomach
is upset running to the bathroom
irritable
snappy
desperate they seem desperate and
usually it's desperation for money
like hey i need 20 bucks you got to give
me 20 bucks i just just i gotta i got to
do something and i you know you got 20
bucks on you
the desperation you start to see this
desperation um so unfortunately because
of that desperation
if you live with someone that has an
addiction you might see things go
missing
because in order to support their habit
it becomes we talked about
how expensive this can be right at 10 to
25 dollars per bag if you're using
multiple bags per day i mean you can
easily get into the hundreds of dollars
per day of use
so things will start disappearing and
it's usually things that are worth money
jewelry stuff that's easy to pawn off
jewelry electronics it's a big one
where'd my laptop go where'd my phone go
where'd my thumb drive where all these
things go or hey have you seen my watch
have you seen you know things start
disappearing so these are things i want
people to be on the lookout for because
these should all peak your
radar to say wait a second here i think
we need to
take that next step in seeking some help
or at least confronting the person
well that was my next question about
confronting them yeah because if i see
all these signs or some of these signs
my instinct as a human being is to say
are you using do you need help what can
i do for you yep um is that
the right way to approach somebody yeah
this is this topic is so challenging
for so many reasons
when people have a deep deep addiction
sometimes they don't have insight and
they're very guarded
and it's hard for them they may still be
in denial
and because of that guarded nature
they're trying to hide it as best as
they can and they don't want you to know
they understand believe it or not that
there's judgment and criticism and shame
behind what they're doing so they will
do the best that they can do to hide
this
that primitive brain is driving i just
need that drug so i will lie to you i
will steal from you
i will manipulate you i will do whatever
it takes to get that drug that's not
what i want
it doesn't mean i don't love you
it's not what i want and this is
actually pretty miserable but they're
desperate all right right
so sometimes confronting someone with an
addiction is incredibly difficult but i
do have some pointers for that
you need to make sure
that you're not placing blame on them
because that's going to cut it short yep
if you place any blame on them like what
are you doing are you using drugs
you're not going anywhere with that
conversation nowhere okay
when you look at this psychologically
the best time to approach somebody is
when they're feeling remorseful
after doing something or getting
involved with the drug so
a night after a big use or after they
did something that they feel remorseful
about is usually a target time to
address it
but when you address someone with a
substance abuse issue i want you to use
the words i more than you use the words
you
i want you to say hey listen i've been
noticing
that this has been going on right what
that does is it just simply takes the
blame off of them right it's like i've
been noticing these things it's not you
i mean i just i just noticed and i'm
concerned
you know um is everything okay i noticed
this i noticed that right so use i
more than you use you
the other thing is
don't lecture
right
listen at least as much as you talk
that's really important
because drug addicts will turn off the
second they start getting a lecture
because they know it's wrong they don't
want this yeah right oh i oh this is
wrong let me just change yeah
thank you yeah thank you so much right
yeah
so listen
make sure that they know that you are
supportive of their recovery that's
important
to say look i'm noticing some things
here and you know kind of it seems like
there might be some issues with maybe a
substance i need you to know
that i am supportive of this
right and i will i will be with you no
matter what that doesn't mean that
you're not going to have limitations
right it's not a free it's not a get out
of jail free call sure right you can't
just do whatever you want when you're an
addict you have to have limitations but
i support you if you want recovery we're
going to find it and i'm going to be
with you every step of the way
so be supportive there's little tidbits
on how to approach that person when you
see those warning signs yeah
i shot a series with dr yip on hoarding
and part of that discussion revolved
around this idea of motivational
interviewing
where
she really encouraged people to ask
questions to their loved one using the
style of motivational
interviewing which we can talk about
another episode
but
when she was explaining it i said so
this will just work you think this will
just work you just sit someone down and
implement this technique of motivational
interviewing and they're gonna see the
light she goes oh no no no no over many
many conversations and discussions would
this finally start to have some sort of
uh
effect and so i think that's important
for
people in this series to hear too
don't think all right watch this episode
on med circle i'm going to sit down
they're vulnerable i'm going to use a
lot of i statements and then tomorrow
they'll be in treatment right this is a
a a line of supporting someone without
enabling them and having the patience to
see them all the way through their
recovery exactly it's very well said and
motivational interviewing is just that
it's not
you know and you've been through it
right you've talked about it with with
other docs it's it's it's not
argumentative it's not telling anyone
what to do it's really getting them to
kind of come to their own conclusions
and just kind of being there and just
really guiding them sort of bumper
bowling them through if that makes any
sense yes it does it's just kind of
bowling them down the lane to just know
that you're supportive and to get them
to sort of come to some conclusions that
yeah i might want to change yeah or this
may be an issue yeah right well they say
that addicts finally will change once
they've hit rock bottom and for many
that includes overdosing in our next
episode dr sportelli is going to give
you some tips and advice and an insight
on hand how to handle that event of an
overdose
thanks for watching check out the links
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