Accidental Alcoholism: Gray Area Drinking

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Hi, I'm Joe Casciani, your host for the Living to 100 Club Podcast. Our conversations are all about aging well and doing what it takes mentally and physically to live longer and healthier. Our guests share insights and recommendations about successful aging, stories of perseverance, and inspiration about our future. Today's program fits the bill. Our podcast today focuses on the status of excessive alcohol use in middle-aged and older adults., and the recent factors contributing to overdrinking and some recommended solutions. Our guest is Adrian Tiki, the co-owner of The Lodge at Delray Beach and creator of Recovery Comes Home for those undergoing treatment and rehabilitation for their substance abuse. We describe how the COVID pandemic contributed to an increase in the use of alcohol and other drugs, such as the increased anxiety and stress, ease of access— meaning alcohol can now be delivered to homes in every state except for— and the isolation and boredom during the lockdown. So is escape the primary driver, or are there other contributors to this change in our drinking patterns? Before we start our interview, let me just give you a little background on Adrienne. Adrienne Tiki is a recovery advocate, certified life coach, co-owner of The Lodge at Delray Beach, and creator of an innovative signature year-long program called Recovery Comes Home. A force to be reckoned with, she is a 4-time ICU survivor with a physical redemption story to tell. Since getting thrown into this profession 14 years ago by marriage, Adrienne has worked tirelessly to mend the huge chasm that happens when family relationships are strained by substance use or abuse. Her greatest strength is her own experience with a progressive and potentially fatal illness. Starting from common ground, Adrienne seeks to break the silence, stigma, and isolation by providing a recovery program for both the client and their family members. Adrienne, welcome to our podcast.

Thank you, Joe. It's really a pleasure to be here.

Great, you're very welcome. Glad to have you with us. I always open by asking our guests to tell us a little bit about the journey that brought you to where you are today.

The, the story of, of where— what, what brought me to where I am today and, and the lodge in general is really a love story. It was in disguise for the first 3 and a half years, as I met my husband in church. And this was a man that he was 6 years sober at the time that I met him, and he was all into this thing called Alcoholics Anonymous. I had heard about AA, but I really didn't know much about it. I knew very, very little about the— anything in the recovery continuum. In fact, I was living across the street from one halfway house and a three-quarter house, and I had no idea that that's what— who was living there, that they were any kind of, uh, thing out of the ordinary.

Sure.

So we met, we were best friends, and he asked me in 2008 to draw up, uh, the website, to draw up the principles and the policies and procedures. And we did that. We kind of came up with those together and we posted. We had our first website. Now we have somebody that does that for us 14 years later. But right there in the beginning, I was, I was part of this. And then in 2009, Jim went, went home to Connecticut and we just missed each other in a different way than we had before. And so, um, we jumped into, uh, dating in January of 2010, and then we're married, um, 10 years on the St. Patrick's Day of this year.

Wow, congratulations, 10 years.

Yeah, thanks. Um, and so it really evolved as— the reason I tell this story is a love story because Everybody that comes to our house looks at us like a surrogate mother and father. And we like to say that I'm the tough— I mean, I'm the love and Jim's the tough.

Okay.

Love and tough. All right.

Yeah.

It needs both. And there is something to be said, you know, the boys, they can take direction from Jim when he's got a deep billowing voice and he means business and the guys know he means business. But you know, that same deep billowing voice won't be heard by the girls. They'll just tune them out, right? You have to have a whole nother approach. Do you have daughters, Joe?

No, no.

Yeah, see, you have to have a whole nother approach with girls.

Yeah, you have to be on different channels, right? Depending on who the Who the listener is.

Who the listener is. That's, that's the truth. So that's, that's really what, what brought us to be here today. We, um, it was a passion that Jim had because there are so few quality houses in Delray Beach at that time. Um, we really wanted to make a difference and raise the bar in recovery residences in our area. So, uh, like, you know, we have a seat on the drug task force in town. Um, we've been very active with the South County Recovery Residents Association, and of course our FAR certified, which is the Florida Association of Recovery Residents.

Yeah, yeah, yeah. Well, quite a journey. That's quite a program, and I'd love to hear more about this. Just for our listeners, Delray Beach is in South Florida on the Atlantic side. Not far from Boca Raton, which is north of Fort Lauderdale, just to give people a perspective. I've been to Delray Beach. It's a beautiful area. I love to be there. Yeah. So tell us about your residential centers, Adrienne. What, what services do you provide and who are your participants?

So we, we get people just after they've been to treatment or, um, possibly a residential detoxification. And they come to us as a bridge between their old life and their new. And we provide that safe space for them to do, you know, begin doing the things that a regular normal life would entail, but with a bit of a safety net.

Okay.

Right. And They really walk with them through their first year. We do have a 6-month commitment, but only a handful stay 6 months. Most people stay a year to 18 months.

Wow. Okay.

So they're, they're learning and growing along the way. We get them what we call recovery jobs, things that, um, that are not— you don't have to take your work home with you. For example. You know, in fact, we've, we've had, we've had very high-level people in our, in our lodge. Some had to change their name because, uh, they would be known. But we make everybody play by the same rules. That's, that's one of the good reasons why we're so successful, is we just don't, we, we just don't entertain that. You know, they, they really have to want to be clean and sober.

Yeah. So regardless of their background or profession or maybe celebrity status, everyone is approached with the same, same program, same model. So these are residents, these are, these are people who have finished more or less their rehab treatment program. But are not ready to return to their own home, return to their usual lifestyle. And as you say, it's the bridge between—

Correct, the gap, yes.

—resuming their normal lives. That's right.

A lot of people, the first thing that they ask— excuse me— the first thing that they ask is that, or do you have someone to stay there overnight? And that really defeats the purpose. You know, they're learning how. We have people there, uh, checking, um, for bed checks up all the way up until 1 o'clock, and then someone in the house at 7:30, you know. So 6— for 6 hours, yes, they are sleeping in their beds by themselves. And, and yes, people have tried to sneak out and we have caught them.

Okay, so they make a commitment to, to being here and to really living there for X number of months or, or longer.

And follow the rules. Most, most people do not get kicked out for using. They get kicked out for just belligerent, just not wanting to follow any rules of any kind, not able to conform, not able to be a part of, you know, and we, we have to have repeated attempts, but There are too many people that need help. I mean, our phone is ringing off the hook. Yeah, well, we've— yeah, so, um, they have— they really have to be recovery ready.

Yeah, yeah. And if they're not ready, I mean, if they're not ready to make these changes, and these are huge changes, I can appreciate that these are major life changes from one lifestyle to another. So you want people that are really 100% committed.

Yeah, we, we had a, we had a guy that, you know, he owned a home around the corner in Boca. Our, our houses are on the, the line between that, that line between Delray and Boca. So literally I'm on the canal, across the canal is Boca Raton. Okay. So, um, yeah. He had a house around the corner and he could not get this thing. He was addicted to prescription medications and he had a lot of money to order these medications with a phony doctor, you know, and he was, you know, he always tells the stories like Um, when his wife— his windows were all tinted out, right, because he wanted it to be really dark in his car. And his wife knocked on the door and he rolled down the window, and before he could do anything, she had grabbed the bag in between his legs that he had in the seat. And he's running on the, you know, down after her going, not the pink ones, not the pink ones. You know, so it's that easy.

So what are they— what are the kind of common elements? I mean, what, what brings the people to these locations, these centers for you, these homes? What, what brings them there? I mean, I understand they've all been through rehab and they're ready to—

right, continue. But what they're in— what they have in common is despair and the hopelessness and just, um, the depression of what, what they've just been through. You know, it's, it's very, very traumatic. Sure. They may have lost their jobs.

They may have lost a lot of loss, maybe separation and family disruption.

Yeah, I would say, um, you know, there's, there's a lot of deaths before you get to the final one. And especially this— their world just becomes so small. And so what we try to do is open it up again. Yeah. And be the— we know that we can't be the therapist. We don't try to be. We try to connect the ones that we know that, okay, this person— if, for example, we deal with people that are primary addiction and secondary mental health, and then primary mental health, secondary addiction. Addiction, sure. And those are, um, especially with what the, what the commonality is, is that the obsession of, of the mind and the compulsion of the body.

Say that again.

The obsession of the mind and the compulsion of the body, right? So Think about if you were one to look at your phone all the time, and I said, okay, I want you to turn it face down and don't use it. Right. You know, go about your day. Whatever's going to happen is going to happen, and you try not to use it, but it isn't long before it comes into your mind, right? And at some point, that obsession in the mind becomes a compulsion to go, let me just, let me just take a quick look at it. Yeah, let me just, let me just take a peek. So this is the similar thing happens, but with these drugs are very, very potent these days, so it's, it's not hard to get people hooked.

Sure, sure. Yeah, I, I can appreciate what you said about the, the emotional state of these individuals and feeling depressed and Like you say, you help them to see the whole picture. And I use that same metaphor when I present to groups talking about how depression can narrow our perspective such that all we see is what's wrong. All we see is the failure, the disappointment. We don't see the whole picture. We don't see some of the good things, some of the strengths that we still— all we see is what's wrong. It's that the effect of that, I mean, depression affects us in so many ways, but I think one way it affects us in particular is that it just narrows our perspective. And it's like this tunnel vision, all we see is what's wrong. So helping people to take off those blinkers and see the whole picture as part of their recovery, I can see that.

Right, and we have them being, feeling successful about themselves by doing these esteemable things. That's how you get self-esteem, right? Sure, sure. As you go, you put in an honest day's work, you know, you make sure you hit a meeting, you address these mental health issues that you have by, like in our case, the people that live at our house are there on medication management, where, you know, we will dose you out your medication and see you, you know, take it. Sure. Because that's one of the biggest things is people stop taking their medication and because they just feel great, everything's fine. And then, of course, and then they just start the downward spiral. That's how quickly, that's how quickly this can become a problem.

Sure. Yeah, the person thinks I'm doing fine, I don't need those meds anymore. We saw that all the time with psychiatric patients and, um, just that whole notion of, I'm, I'm better now, I don't need my meds anymore. I know when you and I talked, um, initially we talked about the effects of COVID and how this has contributed to, or at least put a spotlight on, the increased use of alcohol and maybe other drugs as well because of the lockdown and people being so stay-at-home and isolated and shut off from their usual support and friends and family. So you use the term accidental alcoholism. That's a curious term.

Tell me what you mean by that. Yeah, well, um, I— nobody— look, nobody wakes up and, and says, I want to be drinking alcoholically or using in an addictive manner today. Sure. They, um, that's not an aspiration, you know, it is a reality. But what's happened is many of us think of the addict or alcoholic as, as some user on the street, right? The guy with the, um, shopping cart. Uh-huh. The, the paper bag and as you know, the brown paper bag. But the reality is that with, especially with your audience, drinking alcohol is up during the pandemic, and particularly in adults 65 and over, because they are using it. Our society uses it as a way to cope. What people don't understand though is that, you know, older adults, the metabolism is different and 4 drinks might not be what 4 drinks was at 35. Sure, sure. So you've got that, but there's statistics to back this up that there's a rising use in alcohol for people that are over 65. And that certainly doesn't bode well for your live to, live to be 100, right? Because they, they will be facing health consequences. Yeah, liver damage, another hurdle, a big hurdle.

Sure, sure. So a lot of stress and anxiety during the pandemic, a lot of concerns about coming down with the virus and recovery and being separated from our support systems, our family and friends. And you talked about how alcohol is so easily bought now. We can actually— That's right. Home delivery, right?

A lot of people don't know that. Yeah. A lot of people didn't realize that, that not only was there home delivery, but this was actually a policy decision because if there was no access to alcohol all of a sudden, it would be pandemonium on the streets. If you just woke up tomorrow and all, every place that had liquor wouldn't, couldn't sell it to you, I think there would be pandemonium in the streets. And there also, the reason that they made that decision was because if someone was an alcoholic and was drinking alcoholically and then just didn't have access all of a sudden they would fill beds in the hospital that were needed for COVID. Interesting. So it's a, you know, that's a backdoor policy that not a lot of people were aware of. Everybody wondered why you could go to church and not, or why, I'm sorry, why you couldn't go to church and you could buy alcohol. Sure, yeah.

So that's interesting. The states changed their laws probably before this, they said no home delivery, had to purchase it on your own, it was retail store or a bar or whatever. And after the change, people could then have it delivered to home. Yeah, that's interesting. That's kind of a—

Also in Florida, you could go to the drive-through in Pollo Tropical, which is a Cuban-American restaurant here in South Florida. Uh-huh. And you could get a mojito through the drive-through. Oh wow, yeah, you're right. Things were taken to the extreme, right, that people were using the letter of the law as liberally as they could. And, you know, something else curious happened when people could start going out again. They were complaining to their bartenders that the drink didn't have enough alcohol in it. Oh. And the bartenders are saying, no, that's not No, it's not the problem with the drink.

It's different from what I was serving myself at home.

And how big, you know, I only had one glass, right? But one glass was, wow, you know, a pretty liberal pour. Yeah. And look, it's our, like I said, our society just, we've got commercials that glamorize Nobody was wearing a mask in those commercials. Hmm, sure. During the pandemic. Sure. You know, you could— and, and attributes to the escapism that that kind of alcoholism can lead to, or, or the vice versa, that the escapism— they choose the alcohol, or they'll choose something else like going to sleep and hoping when they wake up it'll be magically fixed. But the point is that everybody has to take the same actions once they do have a problem. It's if you can't stop on your own.

Yeah, and we'll talk about that in a few minutes. This is just such an interesting perspective that COVID— I mean, this kind of isolation and boredom and whatever plus the stress, plus the ease of access, all contributed to this increase in alcohol use. And as you say, we couldn't go to church, we couldn't go to gyms, or, you know, our senior centers, or wherever, but we, we could have these escapes at home.

And a lot of people, when they talk about alcohol, they talk about it like it's a relationship. You know, they have a vested interest in this relationship that they have with alcohol. It doesn't talk back to them. It doesn't lie to them. It always is comforting, you know? And it can be really easy to say, "I don't have a problem. Yeah, I drink every day, but I could stop anytime I want to. I just don't want to." Well, that might be that you might be on the, in the gray area of drinking.

Yeah. And as you say, if we can't go a day without a drink, that's a concern. I think so. Yeah, sure, sure.

Yeah, at least something to consider to go, do I know, do I know someone that, that is drinking like that now? Or am I drinking like that now myself? But truth be told, I mean, since I've started this going, we've— we're trying to switch to virtual and I'm learning all these things online. It's— it is amazing to see the, the number of people that have come out of the woodwork to just talk to us about this slippery slope of this accidental alcoholism, not realizing that it was going to be a big deal. And then it turned into taking the drinks to their office, which turned into someone smelling it. And that turned into a 2-week detox that everybody else thought, you know, the boss was on vacation and we got him.

Interesting. Sure. Yeah. Yeah, fascinating conversation, Adrienne. I really appreciate your knowledge and your insights about this. I'd like to just pause for a second and shift into another drug which is becoming very prevalent in high risk, which is fentanyl, which is the opioid pain reliever. It's a huge problem. Contributing to many addictions, unintended deaths. And as we've heard in the news, there are a lot of class action lawsuits against some of these drug manufacturers. How has it escalated so quickly? Why, why is it so prevalent today?

Well, I'd say the first reason, 100%, is that, that fentanyl has, um, this is the synthetic fentanyl that we're talking about now, has been crawling over the southern border. And even the, the people that are, that are stationed at the border are beginning to see that this is really a problem. I think the, the last one that was on the news was about a week and a half ago that they had made a bust of this synthetic fentanyl. So fentanyl is a, is a narcotic drug It is the highest class of narcotic that, that you can get. That means that there is a risk of addiction, but that the medical community has deemed in certain circumstances, mainly before the pandemic in surgeries, and just barely, you know, for a few days post-surgery. But they are This is a synthetic version of this kind of drug. Okay. That is being made in people's kitchens. And we, so far as what we, the, what we think now is the line is the, the product itself is actually coming from China, but it's being funneled into the United States through the Mexican border. Okay. Okay. And that's— that is really— Florida is not really that far for them. You know, we— but we are not the only state with the problem. You know, this— what really happened is there was a perfect storm in Florida of people driving down to get, um, go to doctors. They would have a strip, a strip mall. There would be the doctor's office and then they would go to the MRI or the CT scan to back up their diagnosis for, um, and then they would write, go write them the prescription based on what the MRI said and the pharmacy was next door to that. So you would have people driving down from Kentucky to get these drugs, and they would buy them in such huge quantities. And so when those pill mills started getting shut down, then people turned to heroin on the street. And right now there is no more heroin. All heroin is now fentanyl. Oh well. So this has been a downward spiral Like I said, Florida unfortunately is in the perfect storm of— look, we have beaches on 3 of our— we're a peninsula. Yes. And so people want to recover in the sand, especially people with money. And let's face it, that's part of the issue is people with money is that it goes hand in hand with drinking, especially fine wine collections. Maybe it's your, you know, you've got a collection of bourbons, just like your fine art, right? Sure, sure. Yeah, easier access. And yeah, a lot of money, a lot of boredom, a lot of access.

Um, so the, the synthetic fentanyl is not, is not the subject of these lawsuits against Purdue and these other companies. It's the, uh, it's really coming in illegally, of course, from other countries. And now, as you said, it's being laced with other drugs, or it's being mixed in with other drugs.

That's correct. So boost— yes, for, um, actually not for an increased boost. They know it's addictive. It is increasing. They're putting it in marijuana, they're putting it in cocaine. They're putting it in meth and they're putting it in crack. They're also putting it in Xanax. So if you buy Xanax, it's not Xanax anymore, it's fentanyl. It's just crazy what they're doing with these drugs and they're killing people. We've had 3 people die in the last 2 weeks. Not people that were in our houses currently, but people who had gone through our houses at one point in the past.

Well, it's a very toxic, very dangerous situation.

Yeah. So it, they're not, it's this, this fentanyl that we're talking about. No, it's, it's not connected to the lawsuits in that, in that regard. Mm-hmm. Um, that they're, no, they're not being sued as it is right now. But the, the point of the matter is the, this, the situation with Purdue Pharma, who was owned by the Sackler family. Mm-hmm. They knew that the stuff was addictive. And that when people came and said, "Look, I think I'm getting addicted to this," they said, "Yes, oh, you have referred pain. You need actually more drugs." Hmm, wow. And so they, you know, they were— it was like a bamboozle campaign. They were— they targeted the people, they targeted the doctors, and they targeted the pharmacists, that this was a way to treat back pain, non-surgical pain and open it up, when that shut down, that made the room for the illegal market. I see, sure. Drugs aren't ever going away.

Fascinating, yeah. So let's shift into, um, uh, how do we intervene? What if we suspect we're having, um, maybe a little bit increased vulnerability to alcohol or we see a family member or friend, close friend, where do we start? What do we— what are the questions we should ask ourselves, and what steps do we take?

Well, um, I think the most obvious are the people that, um, that clearly have too much to drink. They're the lush at the party. And in that case, um, what we would probably say first is that the person who is the loved one might want to get some kind of support group for themselves first. Okay. Because anyone who's dealing with an alcoholic is having a rough time in life, and most often they don't have anyone to share it with. So I would say that would be first, is to get yourself some, some support. And then I would just start just planting the seeds, you know, of— you would ask them, maybe challenge them to a 21-day sober reset. Mm-hmm. You know, there, there are people that, you know, can drink for 6 months and stop for 1. And think that that's not an issue. So, I mean, I think the best place to start is with yourself, but the, um, the best place to go if you want to find out about addiction or substance use disorders is what they actually call them in the industry. It's called substance use disorders, and that's at SAMHSA.

So you mentioned, um, programs that offer education and support services.

SAMHSA is one of them. Yeah, SAMHSA. It's called the Substance Abuse and Mental Health Service Administration, and that's at www.samhsa.gov. And they have a national helpline. They have a They have suicide and crisis hotline. I think that's just a really good place to start. They also have the National Association of Recovery Residences, which also has its Florida counterpart and the Florida Association of Recovery Residences. We call that FAR, and that is faronline.org, F-A-R-R.

Faronline.org. And that's the Florida division of the—

that's correct. And you can go if— so if you, um, if you are in— I'm more really adept at saying if you are having a loved one who's going into a sober facility, then it would be great to look up the National Association of Recovery Residences. And then just find your state. The Florida Association is the farronline.gov. Okay. Okay. Um, but, but that'll tell you, they're the regulatory bodies. So, um, we have to, to go through an inspection, a home inspection with them. So they have gone in each of our 7 homes and inspected you know, them for what we do. We, they also go through our paperwork, our marketing materials, um, that type of thing. That's good.

So it really certifies you as a legitimate entity offering this, uh, kind of community service.

Yeah. Yeah. And I would say, um, you know, you need to— drinking even a small amount of alcohol can lead to huge problems. Later on. Health problems. I think something like alcohol is a factor in like 30% of suicides and like 50% of homicides. You know, I mean, it can be really, really dangerous. And especially, I think, for your audience, you can also call Al-Anon. Go to www.aa.org.

Al-Anon is for the family or friends or people who are part of this problem. Okay. You also mentioned, um, Recovery Dharma.

What is that? Recovery Dharma is, um, the Buddhist slant, right? Uh, see the— that's recoverydharma.org, and that uses Buddhist principles and practices to recover from addiction. Sure. They don't have a lot of meetings, but they do have— they're having a summit in Salt Lake City. And I think, you know, when I click on find a meeting, the in-person meetings, it's getting off the ground is what I'm trying to say. So, okay, there's— but there's meetings in all over the— in Canada, there's some in the Netherlands, in the UK, and then in, in most every state in the U.S.

Kind of the Eastern influence of recovery. What about Moderation Management? I know that's another, that's kind of a different school of thought. Is that an online program as well?

Moderation Management meetings were, let's see, they were, they have face-to-face, they have toll-free, and they have video meetings. And their whole goal is their moderation management is not to stop drinking altogether, but to do it on their own terms. Okay. Doing it what they can do every day. They do multiple support options, face-to-face meetings, like I said, the phone meetings, the chats, and then the private online support community. And as far as the forum goes, They also have a private Facebook group, and they do have what they call MM Absters. So they're, they're the ones that do abstain, and they have their own listserv, and they have their own private Facebook group. I've got that too on the list. Recovery— Celebrate Recovery, where they are an organization that, that their higher power is Jesus.. And so they have a safe place in which to say that because it's really not appropriate in the meetings.

Okay, so a lot of different pathways to recovery, vehicles, and one might suit somebody and not another. So there are different ways, but this is a good, this is a good kind of overview of what's available. You know, this has been great conversation, Adrienne. Again, so much information, so much insight to share. And I always like to close by asking, what would you like our listeners to take away from this conversation? What's the one takeaway?

I think, I think for people to understand that, that people with substance use disorder are just like everybody else. They slipped into this and they deserve a second chance. And we, you know, we can help offer that second chance, but we want more than anything to get somebody the help that they need. It doesn't have to be with us, you know. We know a lot, a lot of people in this industry, and we can get people— if they need help, they can contact us and we can get them the help they need.

Give people another chance. We open some doors and we get— make some wrong turns, but we can always find new doors to open for some recovery. That's great. Absolutely. Yeah. Well, it looks like we're out of time though. Um, before we wrap up, I just wanna remind our listeners to visit our website, livingto100.club, sign up for our email list and download a free copy of my 9 Tips to Make Living Longer Enjoyable. While you're on the website, be sure to peruse our library of blogs and podcasts. And finally, if you're interested, reach out to me to schedule a presentation for your group. In person or online. I think there's value in helping older adults feel inspired about their future. Adrienne, thanks so much for being a guest on our show today. For anyone that might want to contact you, what's the best way to do that?

Um, we've got all of our contact information on our website, which is www.thelodgedelray.org.

Thelodgedelray.com.

That's correct.

Yeah, I'll be sure to put that in our program notes. So thanks again, and thanks to everyone for tuning in to this episode. Hope to see you next time.

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