The Addicted Mind Podcast

Would you have made different decisions if you’d known, early in life, that you had a genetic propensity toward addiction? Dr. Evelyn Higgins asks that question, and it opens up a bigger one: what changes when we look at the biological side of addiction? In this conversation, we talk about how understanding our biology can move us away from seeing addiction as a moral failing, and toward more understanding.

In this episode, I’m revisiting my conversation with Dr. Evelyn Higgins, which first aired as Episode 217 in January 2023. We talk about the biological side of addiction: genes, biomarkers and brain chemistry, and how they connect with stress, trauma and the environments we live in. Evelyn shares how her years in pain management and her own family’s experience with addiction led her to ask what was happening in the body, not just in behavior.

We also talk about why addiction is not a moral failing. Looking at the biology can feel uncomfortable, because it means there are some things we don’t have total control over. But it can also bring more understanding, both for the people who are struggling and for the families who love them.

In This Episode

• Evelyn’s path into this work, from pain management to her family’s experience with addiction
• What epigenetics means, and how, in Evelyn’s view, stressors in our lives can influence how our genes are expressed
• The difference between describing symptoms in our own words and looking at objective lab information
• Family history, genetic propensity and having open conversations with young people before they experiment
• How seeing addiction through a biological lens can change the way families respond to a loved one

Key Takeaways

• Addiction is not a moral flaw. Evelyn points out that no one wakes up wanting to lose their family, job or home. We don’t call someone with diabetes weak, and she argues that addiction deserves the same understanding.
• Biology and behavior work together. Evelyn notes that addiction is described as a biopsychosocial condition, yet the biological part often goes unexamined. She’s clear that behavior change remains just as important. Biology adds to the picture rather than replacing the work of recovery.
• “White-knuckling” may point to something unaddressed. Evelyn describes people who are sober but still angry and struggling every day. In her view, this can happen when a person’s physiology hasn’t been looked at.
• Understanding can bring hope. Evelyn shares that when she goes over lab results with people, some of them cry and say, “I’m not crazy.” As we talked about in the episode, there’s hope in that: we have the power to change how we respond to new knowledge about ourselves.
• Everyone’s experience is different. Many people don’t realize how anxious or depressed they’ve been until a substance or behavior suddenly takes it away. That’s part of why Evelyn and I talk about the importance of a personalized, individual approach.

About Dr. Evelyn Higgins

Dr. Evelyn Higgins is the CEO of Wired For Addiction. Her background is in clinical practice and pain management, and her work focuses on the intersection of epigenetics, neuroscience and addiction. She has also spoken about the biology of addiction in a TEDx talk.

About Our Sponsor: Wired for Addiction

This rebroadcast opens with a new introduction where I welcome our new sponsor, Wired for Addiction. Evelyn is the company’s CEO, and the conversation you’ll hear originally aired in 2023. If it speaks to you or someone you love, Evelyn and her team have put together a free guide, The Biology of Addiction: 10 Core Biomarkers. You can download it at theaddictedmind.com/wired.

Connect with Evelyn

• Website: Wired For Addiction
• TEDx Talk: The Biology of Addiction

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Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is a rebroadcast of Episode 90 with Julie L. Hall, a conversation originally released on The Addicted Mind.

Maybe you grew up in a home where your feelings didn’t seem to have a place. Everything seemed to orbit around one parent’s moods and needs, and you learned early to make yourself small. Maybe you’re only now finding words for it. That can be such a confusing, painful thing to sit with.

In this episode I’m sharing my conversation with Julie L. Hall, author of The Narcissist in Your Life: Recognizing the Patterns and Learning to Break Free. Julie grew up in a narcissistic family and describes herself as a survivor. She’s an educational writer, poet and journalist. While she was working on her memoir, she realized narcissism had been a theme running through her life, so she began writing about it directly. That writing became part of her own healing.

We talk about what narcissistic personality disorder is, as Julie understands it. To her, it isn’t simple vanity. It’s a defensive coping structure, often built early in life, that can cover deep feelings of vulnerability, shame and worthlessness. We look at what it can be like for children when a family is organized around a parent’s needs. We also talk about how addiction, depression, anger and family rifts can show up in these families, often without anyone naming what’s driving them.

It’s a heavy conversation. But there’s hope in it too, and a lot of that comes from Julie’s own story of putting words to what she lived through.

In This Episode

• How Julie’s memoir turned into writing about narcissism, and became part of her healing
• The difference Julie draws between the everyday self-focus most of us have and narcissistic personality disorder
• Why Julie sees narcissism as a defense against vulnerability and shame, and how that can look from the outside: avoiding self-reflection, and seeing people as either worthless or wonderful
• What it can be like for children when a family is structured around a parent’s needs
• Addiction, denial and grief in narcissistic families, and why Julie sees education as such an important step

Key Takeaways

• Julie sees narcissism as armor over shame. In her view, the superior or grandiose exterior is a persona built to cover feelings of vulnerability and worthlessness. It isn’t a picture of real confidence.
• When a parent’s needs come first, children carry the cost. Julie describes families where the children’s needs become secondary to the parent’s. She talks about the pain, confusion and complex trauma those children can carry.
• What goes unnamed is hard to heal. Julie describes addiction, depression and family rifts showing up in these families with no awareness of the core issue underneath. Denial is a big obstacle she sees for adult children, and the grief can take a long time to move through.
• Understanding can be part of healing. For Julie, learning and writing about narcissism helped her make sense of her own life. She sees education as an important step for people who grew up with a narcissistic parent.

About Julie L. Hall

Julie L. Hall is the author of The Narcissist in Your Life: Recognizing the Patterns and Learning to Break Free. She grew up in a narcissistic family and describes herself as a survivor. Julie is an educational writer, poet and journalist, and she writes the blog The Narcissist Family Files. Her articles have also appeared in Psychology Today and HuffPost.

Connect with Julie

• Website: The Narcissist Family Files

Resources Mentioned

• The Narcissist in Your Life: Recognizing the Patterns and Learning to Break Free by Julie L. Hall
• The Narcissistic Family: Diagnosis and Treatment by Robert M. Pressman and Stephanie Donaldson-Pressman

Supporting Resources

• Looking for a therapist? Novus Mindful Life offers therapy for addiction, betrayal trauma, anxiety and depression, in person in Garden Grove, CA, and by telehealth in California, Idaho, Virginia, Florida and Texas. → NovusMindfulLife.com
• Healing after betrayal? Addiction can break trust in a relationship. Shame to Resilience is a guided program for both the betrayed partner and the person who caused the harm. → ShameToResilience.com
• Stay close to the work. Get new episodes, tools you can actually use, and a little hope for the hard days in your inbox. → Subscribe at TheAddictedMind.com

Listen, Follow and Review

If this conversation helped you, or helped you understand someone you love a little better, please follow The Addicted Mind and leave a rating or review. It helps someone else who’s struggling find the show.

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• Instagram: @addictedmindpodcast
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• Leave Duane a voice message

If some of this feels close to home, please go gently. Recognizing a pattern isn’t the same as diagnosing someone you love, and you don’t have to sort it all out at once. Understanding where the pain came from can be a place to start. Wherever you are with it, you’re not alone. Find more episodes and resources at TheAddictedMind.com.

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.

Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Content note: This episode includes discussion of childhood abuse, domestic violence, and a suicidal crisis. If you’re struggling, call or text 988 (Suicide & Crisis Lifeline). It’s free, confidential, and available 24/7.

For so many of us, staying quiet was how we survived. When a childhood is shaped by violence, abuse, and chaos, silence becomes a kind of armor. And that armor often follows us into adulthood, into our marriages, our careers, and our drinking.

In this episode I sit down with Rich Dunning, a medical device executive, father, husband of 32 years, and author of Silence Was My First Language. Rich grew up in the Bronx surrounded by abuse, alcoholism, hunger, and periods of homelessness. He became, in his words, a father at 10 years old, caring for his siblings when no one else would. That survival instinct carried him a long way, into a successful 28-year career and a family he loved. But the pain underneath never left, and alcohol became the way he quieted it.

Rich talks about how outward success hid a deep sense of shame, and how losing his brother and his job cracked everything open. He also shares the morning his story nearly ended, and the moment his son’s voice called him back. That was his day one. Rich is now more than nine years sober, and in recovery he found a new language. He chose to publish his story so a child or teen might get help sooner than he did.

It’s a heavy conversation. But Rich’s story is a powerful reminder that childhood trauma and addiction don’t get the last word.

In This Episode

• Growing up in the Bronx, and how silence became Rich’s first language
• The counselor who saw right through him and suggested he write down his memories
• Two fractures: the death of his 20-year-old brother and losing the job that defined him
• Being called a “dog” as a child, and the imposter feelings that followed him into his career
• Paranoia, isolation, and the made-up backstory he used to hide where he came from
• The unraveling: blackouts, hidden bottles, failed rehabs, and trying to control everything
• Rock bottom, surrender, and day one of recovery
• Why he wrote the book like a novel, and why abuse awareness still matters
• Finding his voice during COVID and deciding to publish
• Amends, rebuilding trust, and honest conversations with his kids about their family history

Key Takeaways

• Silence can be a survival strategy, and it can outlive its purpose. Learning to read a room, stay invisible, and stay quiet protected Rich as a child. But carrying that armor into adulthood kept him from ever dealing with what happened to him.
• External success can mask internal collapse. Rich won national awards while drinking heavily, and strong performance made it easy for others to overlook the warning signs. When an identity rests on one role, losing that role can feel like losing yourself.
• Shame often sounds like an old voice. Called a “dog” by his stepfather for years, Rich spent most of his career feeling like an imposter waiting to be exposed. Naming where that voice came from is part of loosening its grip.
• Asking for help takes courage, and it’s the turning point. Rich’s recovery began the day he stopped hiding and said, “help me, I can’t do this anymore.” No matter how hopeless things feel, help is available.
• Trust is rebuilt through actions, not words. Recovery is an ongoing “redemption tour” of amends, self-awareness, and consistent behavior over years. It’s not a single apology.
• Honesty can break the cycle for the next generation. Rich talks openly with his adult children about their family history and genetic risk. He’s become a parent they can approach without fear or shame.

“Your past doesn’t have to define you, brother. You know, what you do right now can alter your life for the rest of your life.” (Rich Dunning)

Time Stamps

00:01 Welcome and introduction to Rich Dunning

00:52 A 15-year journey and nine years of sobriety

01:19 Silence as a first language: growing up in the Bronx

02:40 A counselor’s suggestion to write down his memories

03:36 Two fractures: his brother’s death and losing his job

07:25 What his work identity was protecting him from

09:39 Imposter feelings, paranoia, and hiding his past

11:34 Writing the book like a novel, and why abuse awareness matters

16:00 The unraveling: isolation, blackouts, and control

18:17 Rock bottom and day one of recovery

25:08 Finding his voice and deciding to publish

29:32 Rebuilding trust, making amends, and honest talks with his kids

36:51 One message for anyone who feels stuck

37:34 Where to find Rich and his book

About Rich Dunning

Rich Dunning is an author and medical device industry executive with a 28-year career. Raised in the Bronx amid abuse, violence, alcoholism, hunger, and periods of homelessness, he has been sober since 2017. His book, Silence Was My First Language, follows his journey from childhood survival through alcohol addiction and into recovery. It’s available wherever books are sold, and as an audiobook on Audible.

Connect with Rich

• Website: Rich Dunning Books
• LinkedIn: Rich Dunning

Resources Mentioned

• Silence Was My First Language by Rich Dunning
• NetGalley: book overview
• Literary Titan: author interview
• BookLife: book coverage
• Domestic Violence Awareness Month (October)
• 988 Suicide & Crisis Lifeline: call or text 988, free and confidential, 24/7

Supporting Resources

• Looking for a therapist? Novus Mindful Life offers therapy for addiction, betrayal trauma, anxiety and depression, in person in Garden Grove, CA, and by telehealth in California, Idaho, Virginia, Florida and Texas. → NovusMindfulLife.com
• Healing after betrayal? Addiction can break trust in a relationship. Shame to Resilience is a guided program for both the betrayed partner and the person who caused the harm. → ShameToResilience.com
• Stay close to the work. Get new episodes, tools you can actually use, and a little hope for the hard days in your inbox. → Subscribe at TheAddictedMind.com

Listen, Follow and Review

If this conversation helped you, or helped you understand someone you love a little better, please follow The Addicted Mind and leave a rating or review. It helps someone else who’s struggling find the show.

• Apple Podcasts
• Spotify
• Instagram: @addictedmindpodcast
• Facebook: The Addicted Mind Podcast community group
• YouTube
• Leave Duane a voice message

If you’re carrying old pain in silence, or loving someone who is, keep reaching out. Help is out there, and you’re not alone. Find more episodes and resources at TheAddictedMind.com.

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.

Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Maybe someone you love is starting treatment for opioid use disorder and their doctor mentioned buprenorphine, or a monthly shot, and you're thinking, Wait... isn't that swapping one opioid for another? Or maybe you're the one struggling, and the idea of withdrawal feels so terrifying that treatment doesn't feel possible. Those fears make so much sense. And a lot of what we've been told about these medications is confusing, outdated or wrapped up in stigma.

In this episode I sit down with Nick Casale, a pharmacist who has spent the last 15 years in addiction medicine, focused on opioid use disorder. Nick started out in a Pennsylvania Medicaid health plan in the early 2010s, right as the opioid crisis was exploding, and watched firsthand how inconsistent, and sometimes punishing, treatment coverage was. Today he works in medical affairs for a pharmaceutical company, talking with clinicians, researchers, and even sheriffs and jail medical directors about what the evidence shows.

Nick breaks down how buprenorphine works in the brain (there's a great musical-chairs metaphor in here), why fentanyl has made opioid use disorder so much harder to treat, and what long-acting injections are changing, especially for people leaving jail. And we talk about the part medication can't do alone: counseling, support, peers who've been there. It's a hard topic. The numbers are heavy. But there's real hope here. Treatment works, access is better than it's ever been, and reaching out is a brave first step.

In This Episode

• Nick's path from retail pharmacy to a Medicaid health plan to addiction medicine, and why he fell in love with this work
• Why insurance coverage for opioid use disorder treatment was "all over the board," and how kicking people off treatment for a failed drug screen made things worse
• What buprenorphine is, in plain language: a partial opioid agonist that holds the receptor, eases withdrawal and cravings, and blocks other opioids
• The three waves of the opioid crisis: prescription opioids, then heroin, then fentanyl and other synthetic opioids
• How fentanyl changes the brain by creating more opioid receptors, and why that makes withdrawal so brutal
• Tablets and films vs. long-acting weekly and monthly injections, and why steady levels matter now
• Medication for opioid use disorder in jails and prisons, and why the days after release are so dangerous
• How buprenorphine can be misused, and why naloxone was added to some forms
• What real-world research is showing beyond clinical trials: fewer non-fatal overdoses, fewer serious infections, people getting their lives back
• Access and cost today, and why so many people still aren't getting treatment.

Key Takeaways

• Most people who need treatment aren't getting it. Nick shares that roughly 4.8 million U.S. adults live with opioid use disorder, and only about 1 in 5 receive medication for it. He describes the overdose toll as the equivalent of a Boeing 737 crashing every day.
• Buprenorphine works differently from other opioids. Nick's metaphor: heroin plays musical chairs, jumping on and off the receptor. Buprenorphine sits down and stays. That steadiness helps keep people out of withdrawal and blocks other opioids from taking the seat.
• Fentanyl has changed the game. According to Nick, the street supply is now dominated by fentanyl and other synthetic opioids. They're so potent the brain grows more opioid receptors, which makes withdrawal harder and treatment more complex.
• There's no set timeline for treatment. ASAM (the American Society of Addiction Medicine) recommends at least three months, and longer treatment is linked to better outcomes. How long to stay on medication is a decision between you and your provider, much like blood pressure medication.
• Relapse isn't a reason to be punished. Nick and I agree that setbacks are part of many people's recovery journeys, and treatment should keep the door open.
• Medication is one piece, not the whole picture. Buprenorphine works "exponentially better," as Nick puts it, alongside counseling, behavioral support and peer mentors.

"Just be brave, seek out the treatment... just make that first step." — Nick Casale

TIME STAMPS

• 00:15 Nick introduces himself and his work in addiction medicine
• 01:40 From retail pharmacy to a Medicaid health plan in the middle of the opioid crisis
• 08:06 What "transmucosal" means and how buprenorphine treatment has evolved
• 10:47 How buprenorphine works in the brain, and the musical-chairs metaphor
• 16:05 The numbers: 4.8 million adults with opioid use disorder, and 1 in 5 treated
• 17:01 The three waves of the opioid crisis
• 20:02 How fentanyl "upregulates" opioid receptors
• 21:58 How long should treatment last?
• 25:42 Long-acting injections and steady protection
• 28:57 What the research shows, and why abstinence isn't the only measure
• 30:52 Treatment in jails and prisons, and the risk after release
• 33:40 Stigma and pushback in correctional settings
• 36:40 Can buprenorphine be misused?
• 39:36 Why medication works best with therapy and support
• 44:29 Access, insurance and cost
• 47:48 Nick's one message for anyone struggling

About Nick Casale, PharmD

Nick Casale is a pharmacist who has worked in addiction medicine for about 15 years, with a focus on opioid use disorder. He began his career in retail pharmacy before joining a Pennsylvania Medicaid health plan as a clinical pharmacist, where he led the plan's opioid overutilization program and its addiction medicine benefit during the height of the opioid crisis. He then moved into the pharmaceutical industry, first working with Medicaid programs across the country and now leading a medical affairs team. His team shares scientific information with physicians, nurse practitioners and physician assistants, works with leaders in addiction research, and helps jails and prisons understand the evidence for treating opioid use disorder.

Connect with Nick

• LinkedIn: search Nick Casale, PharmD

Resources Mentioned

• Buprenorphine and buprenorphine/naloxone (tablets and films taken under the tongue)
• Long-acting injectable buprenorphine (weekly and monthly)
• Methadone and naltrexone, other medications for opioid use disorder
• American Society of Addiction Medicine (ASAM)
• National Commission on Correctional Health Care (NCCHC)
• SAMHSA National Helpline: 1-800-662-4357, free and confidential, 24/7
• FindTreatment.gov: find treatment providers near you, including medication for opioid use disorder

Supporting Resources

• Looking for a therapist? Medication works best with support around it. Novus Mindful Life offers therapy for addiction, betrayal trauma, anxiety and depression, in person in Garden Grove, CA, and by telehealth in California, Idaho, Virginia, Florida and Texas. → NovusMindfulLife.com
• Healing after betrayal? Addiction can break trust in a relationship. Shame to Resilience is a guided program for both the betrayed partner and the person who caused the harm. → ShameToResilience.com
• Stay close to the work. Get new episodes, tools you can actually use, and a little hope for the hard days in your inbox. → Subscribe at TheAddictedMind.com

Listen, Follow and Review

If this conversation helped you, or helped you understand someone you love a little better, please follow The Addicted Mind and leave a rating or review. It helps someone else who's struggling find the show.

• Apple Podcasts
• Spotify
• Instagram: @addictedmindpodcast
• Facebook: The Addicted Mind Podcast community group
• YouTube
• Leave Duane a voice message

If you're struggling with opioids, or loving someone who is, keep reaching out. Help is out there, and you're not alone.

Find more episodes and resources at TheAddictedMind.com.

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.

Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Maybe you've watched someone you love do something that makes no sense, something that's clearly hurting them and everyone around them, and you've asked, "Why would anyone choose this?" Or maybe you've asked that question about yourself. It's such a human question. And the answers we come up with, the stories we tell about addiction, end up shaping how we treat people who are struggling... including ourselves.

In this episode I sit down with Dr. Maria Cichosz, a writer, critical drug studies scholar and professor of literature and creative writing at Victoria College, University of Toronto. Maria isn't coming from a medical or therapy background. She has a PhD in literary and cultural studies, and she brings her own story: growing up as the child of Polish immigrant parents in a home marked by generational trauma and addiction, and her own relationship with substances over the years. Together we look at how our ideas about addiction have changed over time, from a choice, to a weakness of the will, to a disease of the brain, and what each of those stories gets right and what it misses.

It's a big conversation, and Maria doesn't pretend there are easy answers. But there's a lot of hope in it. When you can see that our ideas about addiction haven't always been this way, you can start to imagine they could be different. More compassionate. More human.

Key Takeaways

• Our ideas about addiction have a history. The idea that addiction is a disease of the brain is only a few decades old. Before that it was seen as a weakness of the will or the soul, and before that, a behavior some people chose. Those stories affect how people get treated today.
• The brain disease model helps, and it's still only part of the picture. It takes blame out of the equation. But a brain scan is "a brain in a vat," as Maria puts it. It doesn't show poverty, trauma, isolation, overprescribing or punitive drug policy.
• Environment matters, a lot. In Rat Park, rats who had community, play and stimulation mostly chose not to take the drug. Rats aren't people, but we're social creatures too.
• Compassion and responsibility can live together. Duane and Maria sit with the hard question of how we hold people accountable for the harm they cause while also understanding the forces that brought them there. Neither of them has a clean answer, and that's okay.
• Stories can build empathy. Fiction lets us step inside someone else's head and see that they think, feel and struggle much like we do.

"I wish I could tell you it gets better… We can't always see among the murkiness of where we are in the moment, but there is certainly something on the other side, even if it's a twisting path to get there." — Dr. Maria Cichosz

Timestamps"

• 00:36 Maria introduces herself and how she became "the drug person" in her academic work
• 06:18 Growing up in a home shaped by generational trauma and addiction
• 12:48 Addiction has a history: why the brain disease model isn't the whole story
• 13:54 From Roman law to "a disease of the will": how our ideas about addiction changed
• 24:01 What the brain disease model gets right, and what it can miss
• 30:37 The Rat Park study and the power of environment
• 33:42 The other side: psychedelics, harm reduction and moving past "good vs. bad"
• 38:54 Set and setting
• 41:30 Maria's novel Middlemen
• 45:35 One thing Maria wants you to know

About Dr. Maria Cichosz

Maria Cichosz is a writer, critical drug studies scholar and professor of literature and creative writing at Victoria College in the University of Toronto, where she also directs the Victoria College Writing Centre. She holds a PhD in Modern Thought & Literature from Stanford University, and her research focuses on post-1945 literature, art and theory, with a particular interest in drug histories and cultures. Her writing has appeared in Critique, the Los Angeles Review of Books, the Literary Review of Canada and American Literature. She's the author of the novels Cam & Beau (2020) and Middlemen (NoN Publishing, fall 2026). On Drugs, part of Biblioasis's Field Notes series, is forthcoming.

Connect with Maria

• Website: mariacichosz.com
• University of Toronto faculty page: vic.utoronto.ca/cichosz
• Academia.edu: utoronto.academia.edu/MariaCichosz
• Middlemen from NoN Publishing: nonpublishing.com/middlemen
• Toronto launch of Middlemen: Thursday, October 22, 2026, 6:30 PM at Queen Books, 914 Queen Street East

Resources Mentioned

• Middlemen by Maria Cichosz
• Cam & Beau by Maria Cichosz (2020)
• Dr. Bruce Alexander's Rat Park study
• Eve Kosofsky Sedgwick, "Epidemics of the Will"
• Jacques Derrida, "The Rhetoric of Drugs"

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.

Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

Novus Mindful Life offers therapy for addiction, betrayal trauma, anxiety and depression, in person in Garden Grove, CA, and by telehealth in California, Idaho, Virginia, Florida and Texas. → NovusMindfulLife.com

• Healing after betrayal? Shame to Resilience is a guided program for both the betrayed partner and the person who caused the harm. → ShameToResilience.com
• Stay close to the work. Get new episodes, tools you can actually use, and a little hope for the hard days in your inbox. → Subscribe at TheAddictedMind.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode of The Addicted Mind, host Duane Osterlind is joined by Joanna Conti, founder of Conquer Addiction and the Vista Research Group. Driven by her personal journey navigating her daughter’s severe alcohol addiction, Joanna set out to solve a major gap in the addiction treatment industry: the lack of hard, verifiable outcome data.

Joanna shares how her background in software and engineering led her to launch Vista Research Group to track patient progress during and after rehab, as well as Conquer Addiction, a non-profit helping families find evidence-based care. They discuss what the data reveals about long-term recovery, why the 90-day care benchmark is critical, and how real-time patient monitoring can save lives.

Key Topics Covered

• A Personal Catalyst: Joanna’s harrowing experience with her daughter’s severe alcohol addiction, six years of navigating rehabs, and her daughter's eventual 13-year recovery.
• Marketing vs. Hard Data: The frustration of encountering unverified success claims (such as "98% success rates") and discovering in 2015 that only five treatment centers nationwide were scientifically tracking and publicly sharing post-treatment outcomes.
• Launching Vista Research Group: How tracking patient progress during treatment—including cravings, depression, and therapeutic alliance—improves patient outcomes in real time.
• What the Data Reveals: Insights gathered from monitoring over 100,000 patients in treatment and following up with over 50,000 post-treatment.
• Factors Influencing Success: How primary substance choice (alcohol vs. fentanyl or meth), age, peer culture, and ongoing support impact recovery rates.
• Why Industry Data Has Stagnated: Why nationwide 1-year recovery rates have remained around 36% to 37% since 1993, and how systematic measurement can drive outcome leaps similar to those in cancer research.

Key Takeaways & Data Insights

• The 90-Day Benchmark: Patients who stay engaged in care across various levels (residential, IOP, outpatient) for at least 90 days are twice as likely to be in recovery one year later compared to those who leave in 20 days or less.
• Support Networks: Active involvement in recovery communities (such as AA or SMART Recovery) or living in sober housing doubles the likelihood of maintaining long-term recovery.
• Real-Time Feedback: Self-reported patient surveys often surface critical mental health warning signs—such as hidden suicidal ideation or rising cravings—that patients might hesitate to share face-to-face with clinicians.
• Hope for Chronic Relapse: Data confirms that individuals with 10 to 15 prior treatment episodes for severe substance use disorders are still fully capable of achieving lasting recovery.

Guest Message

"Love them and help them find effective treatment. Don't give up." — Joanna Conti

Resources & Links

• Conquer Addiction: conquer-addiction.org — Treatment centers with verified, above-average outcome data.
• Vista Research Group: Data-driven patient progress monitoring and outcome tracking for addiction treatment providers.

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Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

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In this episode of The Addicted Mind Podcast, host Duane Osterlind speaks with actor, playwright, and recovery advocate Ned Van Zandt. Ned shares his life story—from an exotic childhood traveling the world to studying under Olympia Dukakis and working alongside high-profile actors and musicians in the 1970s. He candidly details his descent into hard drugs while living at New York's iconic Chelsea Hotel, his first 13-year stretch of surface-level sobriety, a sudden relapse that led to an arrest in Texas, and his eventual surrender to deep, service-driven recovery. Today, Ned is the managing director of a NYC sober living facility and the creator of the one-man show Lost in Del Valle.

Key Topics Covered

• Roots and Early Career: Growing up in a prominent Fort Worth family, child acting in The Music Man and Oliver!, and studying acting at NYU under Olympia Dukakis.
• The Chelsea Hotel Era (1978): Moving into the legendary hotel the same week as Sid Vicious and Nancy Spungen, accelerating a lifestyle of heavy drug use and rock-and-roll partying.
• First Sobriety Attempt & Relapse: Getting sober in 1987 following legal pressure, putting together 13 years of continuous recovery, and landing roles on Broadway and Law & Order. Ned reflects on how skipping the deeper step work left him vulnerable to a sudden relapse on New Year's Eve 1999.
• The Downward Spiral: Overdosing on cocaine, leaving New York to hide out in Texas, losing his life savings, and being arrested on a dirt road outside Austin for possession with intent to distribute.
• Jail at Del Valle: Navigating time in jail, where the head of the local Texas Aryan Brotherhood gang recognized him from his role on the soap opera One Life to Live.
• True Recovery in Hawaii: Entering treatment in Hawaii in 2007, embracing sponsorship and service work, and rebuilding his acting career with roles on Lost and film projects.
• Creating Lost in Del Valle: Developing a raw, humorous one-man play directed by Amir Arrison (The Blacklist) recounting his wild history, rock-and-roll encounters, time in jail, and path to redemption.
• Service as a Pillar of Sobriety: Working as managing director and partner at Transcend NYC, helping young men find direction and recovery.

Words of Wisdom for Anyone Struggling

• Focus on the Single Frame: View life like a long roll of film. Instead of obsessing over the outcome or the end of the reel, focus exclusively on the single frame in front of you right now.
• Move a Muscle, Change a Thought: Physical action shifts mental state. Go for a walk or change your environment to break negative thought patterns.
• Get Out of Your Own Head: Engaging in service and helping others brings back the purpose and vitality that addiction strips away.

Mentioned in This Episode

Resources & Links for Ned:

Ned's Play Lost in Del Valley at the Soho Playhouse

Play Official Website: lostindelvalle.com

Sober Living Facility Transcend NYC (Upper West Side, Manhattan)

Podcast Websitetheaddictedmind.com

Supporting Resources: Duane Osterlind LMFT CSAT

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

Shame to Resilience

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

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In this episode of The Addicted Mind, host Duane Osterlind speaks with orthopedic spine surgeon Dr. David Hanscom about his book, Calm Your Body, Heal Your Mind. They explore the deep physiological connection between chronic pain, anxiety, and addiction, outlining how regulating the nervous system can lead to genuine, lasting healing.

Key Takeaways

• The Problem with Chronic Surgery: A vast majority of spine surgeries for non-structural chronic pain fail because they treat a symptom rather than the root cause. Chronic physical pain is frequently driven by an oversensitized nervous system rather than structural spinal flaws.
• Threat Physiology vs. Psychology: Anxiety and anger are physical, chemical reactions—a "fight-or-flight" survival mechanism—rather than purely psychological issues. Because the unconscious brain processes roughly 1 billion bits of information per second compared to the conscious brain’s 20–30 bits, you cannot simply talk or willpower your way out of deep physiological threat states.
• The Bridge to Addiction: When the body remains trapped in sustained threat physiology, mental and physical pain become unbearable. Without tools to down-regulate the nervous system, individuals often turn to substances or compulsive behaviors as a last-ditch effort to soothe the body's alarm system.
• Reframing Trauma Work: Continuously discussing and re-analyzing past trauma can sometimes act as a "trauma anchor," reinforcing pain circuits in the brain. Long-term recovery requires shifting focus toward present-moment awareness and neuroplasticity.

The 4-Part Framework for Healing

• Thought Separation: Using expressive writing and mindfulness to separate your identity from repetitive, negative thought patterns.
• Calming the Physiology: Directly toning down fight-or-flight chemistry by engaging the vagus nerve and creating a felt sense of physical safety.
• Softening the Ego: Cultivating self-awareness to spot cognitive distortions without needing to defend a rigid identity.
• Neuroplasticity: Constructing new brain pathways by intentionally practicing gratitude, engaging with community, and pursuing purpose.

Resources & Links

• Book: Calm Your Body, Heal Your Mind by Dr. David Hanscom
• Website: Back in Control
• Guided Healing Program: The DOC Journey

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Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode, host Duane Osterlind welcomes physician, trauma-informed coach, and author Dr. Frank Spinelli for an honest conversation about trauma, addiction, and the root causes of shame. Dr. Spinelli shares his personal story—from surviving childhood abuse in the Boy Scouts and helping law enforcement bring his abuser to justice, to experiencing a profound breakdown during the isolation of the COVID-19 pandemic.

Together, Duane and Frank explore why addiction and shame stem from the same underlying wound, how to separate healthy guilt from toxic shame, and how reframing shame as a tool rather than a sentence can guide us back toward self-acceptance and alignment with our core values.

Key Topics Discussed

• Trauma and the Hidden Roots of Addiction: How unaddressed childhood trauma often manifests as compulsive behaviors—whether involving alcohol, food, work, or sex.
• Shame vs. Guilt: Why guilt focuses on behavior ("I did something bad") while shame attacks identity ("I am bad"), and how the inner voice of shame is often an installed narrative from past abuse or upbringing.
• The Isolation Trigger: How the removal of external coping routines during the COVID-19 pandemic caused dormant trauma and shame to resurface for millions of people.
• Shame as Information, Not Indictment: How leaning into shame—rather than running from or numbing it—can reveal where you are out of alignment with your core values.
• Naming the "Unreliable Narrator": Why personifying and giving a distinct name to your inner critic helps separate your core self from intrusive, shame-based thoughts.

Key Frameworks & Tools

The 4 P’s of Emotional Regulation

A practical exercise to build "shame literacy" when triggered:

1. Pause: Stop before reacting or speaking.
2. Be Present: Bring awareness to the immediate moment and physical surroundings.
3. Ponder: Evaluate if your emotional response belongs to the present situation or an old memory.
4. Possibilities: Select an intentional, grounded adult response rather than an automatic reaction.

The 3 Bodies of Processing Shame

• Somatic (Physical) Body: Noticing physical sensations (chest tightness, sweating, tension) in the nervous system without judgment.
• Story Body: Recognizing the internal narrative, challenging the "unreliable narrator," and separating objective facts from emotional thoughts.
• Relational Body: Understanding how shame builds isolation walls instead of healthy, protective boundaries in relationships.

Key Quotes

"What if shame is not something we need to move away from? What if we leaned into it and used it not as an indictment, but as information?" — Dr. Frank Spinelli

"Guilt is 'I did something bad.' Shame is 'I’m bad.' The voice telling you that you're bad is probably not your own voice—it was installed by someone else." — Dr. Frank Spinelli

"Addiction and shame are not separate problems. They're the same wound—they're just expressed differently." — Dr. Frank Spinelli

Guest Resources & Links

• Book: The Shame Compass: A Radical Framework for Trauma Healing and Self-Acceptance by Dr. Frank Spinelli
• Memoir: P-Shy by Dr. Frank Spinelli
• Website: FrankSpinelli.com
• Social Media: Follow Dr. Frank Spinelli on Instagram, Facebook, and YouTube for daily short-form content on overcoming shame.

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The more we learn about the addicted mind, the more we uncover the deep connections between trauma, mental health disorders, and addiction. Today, we’re taking this exploration personal, guided by the experiences of Janet Whitney—a Licensed Family and Marriage Therapist, a mother, and a woman who has walked a challenging path alongside her daughter.

Meet Janet Whitney!

Janet Whitney is a Licensed Family and Marriage Therapist, but her journey extends far beyond her professional title. As a devoted mother, she has stood by her daughter, Hannah, through an unimaginably difficult battle with anorexia and eating disorders—a fight that has spanned years and tested the limits of resilience, love, and perseverance.

No parent ever wants to watch their child endure a life-threatening illness, especially one as complex and elusive as an eating disorder. Yet, Janet’s unwavering support for Hannah has not only shaped their relationship but also transformed her professional approach to therapy and recovery.

From Theory to Personal Insight

Recovery from eating disorders and addiction share striking similarities—so much so that Janet has woven her own life experiences into her therapeutic practice. Today, we move beyond theory and dive into the raw, unfiltered reality of healing.

The insights Janet brings to the table are profound, born from years of navigating the highs and lows of her daughter’s recovery. Her story is a testament to the power of love, patience, and the courage to challenge conventional narratives around mental health.

Key Topics Explored

• The Intersection of Eating Disorders and Addiction: How these struggles intertwine and what it means for recovery.
• Hannah’s Story: A mother’s account of the struggles, setbacks, and small victories in her daughter’s battle with an eating disorder.
• Changing the Narrative: Breaking down stigma and misconceptions surrounding eating disorders.
• The Long Road to Recovery: Understanding the time, effort, and emotional toll required to overcome such a complex disease.
• Trauma’s Role in Addiction: How past experiences shape the path to healing.
• The Conscientious Dissenter Study: A deep dive into the physical and psychological effects of starvation on the body.
• Self-Care for Caregivers: Navigating your own anxiety while creating a safe space for loved ones.
• The Path to Hannah’s Recovery: The critical factors that played a role in her journey toward healing.
• A Call to Parents: The importance of tough love in saving a child’s life—when and how to step in with strength and compassion.

Final Thought:

Janet’s story is a reminder that recovery is not linear, but with the right support, resilience, and love, healing is possible. This conversation is a must-listen for anyone touched by addiction, trauma, or the journey of supporting a loved one through their darkest days.

Resources:

https://www.janetwhitneymft.com/

Want to explore more? Let’s dive deeper into the science of addiction, the role of trauma, or share your own story. Reach out and join the conversation!

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.

Supporting Resources:

If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center

NovusMindfulLife.com

We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind

Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.