Aug 14
  • Written By Scott Drochelman

  • #197 – Dr. Alexander Elswick

    #197 - Dr. Alexander Elswick

    Recovering Professor On His Journey From Homeless to PhD

    Dr. Alexander Elswick grew up with privilege and seemingly all the protective factors that might keep him out of the way of addiction. It was then that anxiety disorders began showing up for him. He began getting in trouble in college. He was prescribed opiates and quickly became addicted.

    He went to jail on drug trafficking charges and was kicked off his college baseball team. What followed was a cycle of arrests, homelessness and treatments. He was shocked the way he was treated in homelessness. Nothing had prepared him for that painful experience, but it was eventually a part of his finally getting sober.

    Today, Dr. Elswick serves the University of Kentucky as an Assistant Professor and Extension Specialist for Substance Use Prevention and Recovery. He is a trained researcher, recovery coach, and mental health therapist, as well as the co-founder of Voices of Hope, a peer-driven recovery community organization, and the co-founder of the University of Kentucky Collegiate Recovery Community, a supportive infrastructure for students in recovery.

    Tune in to Learn About:

    From Privilege to Addiction: A Journey of Unexpected Struggles

    • Explore how Dr. Alexander Elswick’s privileged upbringing didn’t shield him from the challenges of addiction and anxiety disorders.
    • Discover the surprising turn of events that led him from a seemingly stable life to grappling with addiction and legal troubles.

    Navigating Rock Bottom: Homelessness, Arrests, and Recovery

    • Dive into the cycle of arrests, homelessness, and treatment that Dr. Elswick found himself trapped in.
    • Gain insights into the shocking realities of homelessness and how it served as a turning point in his path to recovery.

    Transforming Pain into Purpose: From Addict to Advocate

    • Learn how Dr. Elswick’s personal struggles fueled his transformation into a trained researcher, recovery coach, and mental health therapist.

    Building Resilience and Support: A New Life of Service

    • Explore how his journey from addiction to recovery shaped his dedication to creating supportive infrastructures for others struggling with addiction, and gain insights into his unique approach to substance use prevention.

    To find other similar episodes by topic, click here.

    Connect with Dr. Elswick

    Website | voicesofhopelex.org

    Instagram | @voicesofhopelex

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    Episode Transcript

    Speaker 1:

    Coming up on this episode of The Courage to Change, sponsored by Lionrock.life.

    Dr. Alexander Elswick:

    You know how the story goes. I got prescribed opioids. I took them as prescribed, but I got addicted and it seems like I woke up two years later and I had $150 a day addiction. I was really starting to bend my own morals really quickly. I had some really hard lines that I wouldn’t cross, and as soon as I crossed them, it’s like, “Wow, I’m willing to do some wild things.”

    Ashley Loeb Blassingame:

    Hello, beautiful people. Welcome to The Courage to Change: A Recovery Podcast. My name is Ashley Loeb Blassingame, and I am your host. Today, we have Dr. Alex Elswick. Dr. Elswick grew up with privilege and seemingly all the protective factors that might keep him out of the way of addiction. It was then the anxiety disorders began showing up for him. He was later prescribed opiates and quickly became addicted. He went to jail on drug trafficking charges and was kicked off his college baseball team. What followed was a cycle of arrests, homelessness, and treatments. Nothing had prepared him for that painful experience, but it was eventually a part of his finally getting sober.

    Today, Dr. Elswick serves the University of Kentucky as an assistant professor and extension specialist for substance use prevention and recovery. He’s a trained researcher, recovery coach, and mental health therapist, as well as the co-founder of Voices of Hope, a peer-driven recovery community organization, and the co-founder of the University of Kentucky Collegiate Recovery Community, a supportive infrastructure for students in recovery. Well, I feel like we had the Huberman of Kentucky on because Dr. Alex Elswick reminds me so much of Dr. Huberman, both incredibly knowledgeable and they even look alike. I loved how Dr. Elswick was able to frame some old concepts in new ways for me.

    I also felt he brought an incredibly important perspective on homelessness and that experience and on what makes a person reachable. Do they need to hit a bottom? Ultimately, I think this episode is a phenomenal masterclass in substance use disorder and the many options that are out there for people in terms of getting help and recovery from a person who is both academically trained but also has that lived experience component, which makes such a huge difference. So, I hope this episode helps you tremendously. I absolutely loved my time with Dr. Elswick and I hope you do too. Without further ado, I give you Dr. Alexander Elswick. Let’s do this.

    You are listening to the Courage to Change: A Recovery Podcast. We are a community of recovering people who have overcome the odds and found the courage to change. Each week, we share stories of recovery from substance abuse, eating disorders, grief and loss, childhood trauma, and other life-changing experiences. Come join us no matter where you are on your recovery journey. Hello, hello.

    Dr. Alexander Elswick:

    How are you, Ashley?

    Ashley Loeb Blassingame:

    I’m doing okay. A little frazzled. I apologize that I showed up and I got a new car yesterday. The keychain, I took the keys off to the office, so I had to go back and get them.

    Dr. Alexander Elswick:

    I understand.

    Ashley Loeb Blassingame:

    So one of those things where you’re like, “I’m doing great. I’m on time. Time to stop to get a coffee,” and then you’re, “Fuck.”

    Dr. Alexander Elswick:

    I mailed a letter today for the first time in I don’t know how many years, and I screwed up the address. Had to get a second envelope, then mailed it, forgot to put a stamp on it, had to go mail it. So, yeah, one of those.

    Ashley Loeb Blassingame:

    Yeah, one of those, where you think you’re really adulting and then the universe is like, “By the way, you still suck at this.”

    Dr. Alexander Elswick:

    That’s true.

    Ashley Loeb Blassingame:

    Tell me a little bit about what it was like growing up, where you grew up, and what your genetic risk factors were.

    Dr. Alexander Elswick:

    Yeah, so I grew up really privileged, just to be quite honest with you. My dad’s a doctor. My mom’s an accountant. I have two sisters, one biological, Lindy, is an older sister. My younger sister, Katie, is adopted from South Korea, and we’re like the idyllic suburban family. Nothing bad happened to me as a kid. No neglect or abuse or anything like that. My parents are wonderful people. They are people who choose not to use drugs. They drink alcohol very rarely. My dad probably hasn’t had a drink of alcohol this year. Not because he’s trying to abstain. He just doesn’t like it. But despite all that, yeah, there’s so much addiction in my extended family and I had no idea because in my immediate family, there isn’t any. Also, my dad’s adopted, so I don’t know about all of his genetic risk.

    Ashley Loeb Blassingame:

    Interesting, interesting. Okay. When did you find out about the extended family?

    Dr. Alexander Elswick:

    Probably at the age of 22 in a third rehab, something like that.

    Ashley Loeb Blassingame:

    Yeah, love that for you. Yeah, family. Oh, really? Great. I thought I was the only piece of shit in our family. You didn’t think to mention that at, I don’t know, 12?

    Dr. Alexander Elswick:

    Yeah, I could have used that. Yeah, I think so.

    Ashley Loeb Blassingame:

    Could have used that. Yeah. Thanks, guys. So, you had some co-occurring disorders come up when you were 12, 13. What started to happen for you?

    Dr. Alexander Elswick:

    Up until the age of 12, I was as happy as a kid could be and as carefree and easygoing and had no problem. Starting with adolescence and puberty, I started to develop anxiety disorders and just got symptoms of anxiety out of the blue. It really wasn’t something I’d struggled with prior to that, so I didn’t understand it. I ended up being diagnosed with generalized anxiety disorder, social anxiety disorder, and trichotillomania. Are you familiar with trichotillomania?

    Ashley Loeb Blassingame:

    I’m aware. Did you have a spot or did you eat the hair or what was your hair of choice?

    Dr. Alexander Elswick:

    Whenever people recognize it, I always assume it’s either one, you’re a clinician, two, you have trichotillomania, or three, you’re really good with your Latin prefixes and suffixes because you could just figure it out. I don’t know. But regardless, yeah, no, that’s right. Hair pulling, for me, it was my eyebrows. When I was in seventh grade, I pulled my eyebrows clean out of my face and I always joke and tell people that I’ve recovered, but it’s really not entirely honest, because I started growing facial hair when I was probably 18, but not meaningful facial hair.

    I didn’t actually start to grow facial hair until I was probably 24. When I started to grow a beard, it came back with a vengeance and I all of a sudden found that I’d migrated to beard plucking. It’s a strange distressing disorder because it’s so much like any other process addiction or any other addiction. I would say to myself out loud, audibly, “Alex, stop.” I would try to sit on my hands, and 30 seconds later, you’re just like, “Here it comes.” It’s a wild thing.

    Ashley Loeb Blassingame:

    The first time I ever encountered it, I was in my second something rehab and you couldn’t have picked someone with nicer hair. To this day, some of the most beautiful hair I’ve ever seen, which I just thought was the funniest juxtaposition. She would pull it out, and eventually while we were there, she just shaved her head. She’s a clinician now and doing well. I remember thinking, “What is this thing?”

    Then one of my best friends struggles with it and same deal. She’d sit on her hands. She’d put her hair up and you’d catch her going for it. She had a little ritual with it and then would bite it. I suspect that a lot of people struggle with some form of this, even maybe mild and just think it’s just a weird habit or whatever, but it is a thing where you’re trying to stop and you cannot stop doing it and people will pluck bald spots in their head.

    Dr. Alexander Elswick:

    I think you’re absolutely right. That’s my experience. I get the opportunity to share my story in lots of different contexts and frequently people ignore the 90 minutes about addiction-

    Ashley Loeb Blassingame:

    Totally.

    Dr. Alexander Elswick:

    … but they want to come up and say, “I pull out my head hair and I didn’t know that was actually a condition.” I think it’s probably way underdiagnosed because that happens to me pretty frequently.

    Ashley Loeb Blassingame:

    Did you feel like your parents were really supportive? Where did you grow up?

    Dr. Alexander Elswick:

    Yeah, I’m born and raised in Lexington, Kentucky. It’s where I am right now. It’s where my home is, and yeah, I have wonderful, attuned, responsive parents. I think that they did the best they could with what they had. I think they don’t come from a world where they had much understanding of mental health, and so I think it was hard for them to navigate. It’s an interesting question because early on, the way that we would frame the narrative my family had about my addiction early on was not about addiction and it was not about mental health. We always talked about choices and everybody always said, “Well, Alex is a good kid. He’s just making bad decisions.” I wish that mental health had entered the conversation much, much earlier.

    Ashley Loeb Blassingame:

    Yeah, I have a hard time with that as well when we’re talking about that because there’s a lot of conversation about making choices and I think there is a period of time where I talk about alcoholism and addiction as it relates to the stages of cancer. You’re stage four alcoholism, you’re under a bridge, you’re affecting society now, but stage one and two, alcoholism, there’s some amount of choice, but there’s an invisible line where that choice gets taken away. None of us are really clear on where that is, but you know it when you see it and when you feel it. So, something that was once a choice, the choice diminishes slowly or quickly over time.

    How do we talk about something where there’s choice in the beginning and it fades away? How do we talk about something, especially for people who don’t understand? I have a friend who says, “This is my drug of no choice.” What was your substance of choice? What was your drug of choice? He is like, “It’s not my drug of choice. This is my drug of no choice.” Did you find that growing up in Kentucky had any bearing on your experience in terms of the acceptance and the culture around some of these topics?

    Dr. Alexander Elswick:

    Fortunately, just for folks who may not be as familiar with Kentucky, Lexington and Louisville are the urban centers in Kentucky, so they’re two blue dots in a sea of red socially, politically, in every sense. I was fortunate in some sense that I think there’s less stigma in Lexington than there is in rural communities surrounding, but my family comes from Eastern Kentucky where there’s a tremendous stigma surrounding mental health and there’s a real belief that we don’t air our dirty laundry. We keep our problems to ourselves and it’s not the social norm to say out loud, “I have this problem” and to identify.

    So, yeah, I think that’s part of the reason so much of it was around choice and the conversation’s always presented as this false dichotomy. Either it’s a choice or it’s a disease, and I like it so much better when you think of it like if my brain is my choice organ and my brain is the organ that’s diseased in addiction, then my ability to choose is disease. So, you can use the word choice, but it doesn’t mean the same thing as when you say, “Am I going to choose to put on a blue shirt or a red shirt today?” It’s not a willful volitional intentional thing you have this control over. So, I think that’s a fascinating question about how does choice change over time?

    Ashley Loeb Blassingame:

    Well, I mean, not to get too neuroscience-y, but I mean the reality is it starts off as front brain decision. These people are rad. I’m going to get in there. We’re going to drink. This is cool. Then it migrates down to the brainstem, and now it’s the decisions that were once I want to be cool or whatever it is are now migrating down to the brainstem. They’re being made in the same place as our autonomic function, so where our breathing and our sleeping and our heart. So, to me, it is literally that migration down into the brainstem.

    Then at that point, all of us who’ve experienced any kind of real addiction where you literally are using against your will, it’s the most obscene feeling of just I am using against my will. I truly thought that I was going to end up in a psych… Who am I kidding? I ended up in a psych hospital, but I thought that that was where I was going to stay because it felt so truly insane. If you read back on the history of Alcoholics Anonymous and stuff, that’s where we ended up in sanitariums.

    Dr. Alexander Elswick:

    I would just layer onto that, that if people are in the beginning making the decisions with the front brain with prefrontal cortex, most often they’re people who are young people. We’re talking about 13, 14, 15-year-olds who actually don’t have well-developed prefrontal cortexes. So, you know what I mean?

    Ashley Loeb Blassingame:

    That’s a great point.

    Dr. Alexander Elswick:

    Even then saying it’s a choice, I had a counselor say early on and I’ve always believed this to be somewhat true, that he said, “If you really want to assume responsibility for your drug use, you need to hold yourself accountable for being a 15-year-old kid experimenting with cannabis.” He’s like, “That’s where you’re going to have to go, because that’s probably the closest thing to a choice that you’ve ever made related to drugs.” For what it’s worth, for me, the first 2,000 times that I used a substance, it was an overwhelmingly positive experience. I never say that to condone drug use, but to say it gave me a real tangible benefit. You couldn’t tell me that drugs were bad because I knew that they were good. I experienced it every day. I knew that they were good.

    I didn’t, of course, understand the consequences of my long-term drug use and all those things, but for a person with anxiety that wasn’t being treated, drugs did a lot of good for me.

    Ashley Loeb Blassingame:

    Oh, yeah. I would say I hired them for a job and they did a great job and then I was stuck with this shitty employee after a while, but they did a great job in the beginning. You have this bond and then it escalates that you need different things. So, now that’s where the drugs change and all of that. So, you started with cannabis, and then how did you move into any other substances?

    Dr. Alexander Elswick:

    Well, truth be told, maybe this sounds cheesy, but I mean it sincerely, the first drug that I ever found was sports and exercise because it was like a form of genuine escape where your parents could be getting divorced or friends are overdosing all around us, there’s all this tragedy. But when I play basketball, I mean it when I tell you that for two hours, I don’t think about any of that. Not once. All I think about is leather ball on an iron hoop over and over again, and it’s like a form of escape. I think it gave me a little taste of what it’s like to be present, to be in flow, to be in touch, all that stuff. Then I played sports in high school. I played golf and basketball and baseball, and the older guys in the baseball team dipped tobacco.

    When I was 13, it was the coolest thing I’d ever seen. I can’t explain that to you now, but for some reason, I was desperate for a fat lip. So, I dipped tobacco and I liked the way it felt. I got curious about alcohol. To be honest with you and this surprises lots of people, but I’ve never been a person who really enjoys alcohol. It upsets my stomach, which makes it really easy for me to just choose not to drink alcohol. Having said that, I’ve definitely had my fair share of forays with alcohol. But yeah, when I was 15, I found cannabis and just fell in love and just like, “Oh, my gosh. This is the medicine that I’ve been seeking.”

    I think certainly if I had sought clinical care for my anxiety disorder, had I known that I had anxiety disorders and then sought clinical care, I probably could have gotten maybe a more effective medication. But in the interim, it’s what worked. Then I went to college and started smoking more and more and started running out of money. So, somewhere along the line, I said, “Hey, I’m going to start…” I really thought of it like this. Man, I’m spending so much money with these dealers. It seems like I could just do the same thing. So, I just started selling as innocently as it could start just to my friends, and then it grew and it grew.

    Valentine’s Day 2010, I got pulled over, 2:00 AM, on a bunch of felony drug trafficking charges and went to jail, got kicked off the college baseball team, got kicked out of college. All that to say two months later, my mom comes to me. This sounds like I’m blaming my sweet mother and I promise I’m not, but my mom comes to me and she said, “Alex, since you’re not in school, since you’ve been kicked out of school, proud of you for that, it seems like a good time to go ahead and have your wisdom teeth removed so you won’t have to miss class and deal with later on.”

    Ashley Loeb Blassingame:

    God, that’s such a mom thing. That’s so relatable.

    Dr. Alexander Elswick:

    I know.

    Ashley Loeb Blassingame:

    I can’t tell you. Well, fuck, I guess we better do the orthodontics now.

    Dr. Alexander Elswick:

    Yeah, I can imagine her needless, inappropriate guilt now looking back. She thinks she’s somehow responsible. Of course, she’s not, right? Yeah. You know how the story goes. I got prescribed opioids. I took them as prescribed, but I got addicted. It seems like I woke up two years later and I had $150 a day addiction. I was really starting to bend my own morals really quickly. I had some really hard lines that I wouldn’t cross, and as soon as I crossed them, it’s like, “Wow, I’m willing to do some wild things.”

    Ashley Loeb Blassingame:

    Are you willing to share what some of your hard lines were?

    Dr. Alexander Elswick:

    One obvious one for me was injection drug use. My best friend since I was wee young, his name’s Bobby and I share all this with permission always. Bobby started injecting drugs about the time or shortly after I started snorting oxycontin. I would see him inject it, and I always thought, it’s such a dirty, nasty… I looked down my nose at him. I really very genuinely believed myself to be better than him because I snorted my drugs. I said, “I’ll never do that.”

    One day, I had a $200 a day habit and I only had $15. I didn’t know how I was going to stretch it. I knew that if I injected it, that it would go a lot farther. So, I begged him to shoot me up, which is graphic and dark, but that’s just an example. Then as soon as I did that, injection drug use was not just on the table. It was the only thing for me.

    Ashley Loeb Blassingame:

    That’s the other thing is you have a $200 a day habit, you’re totally addicted. It’s not a choice. Then what? So you’re not supposed to use. Yeah, I could bike to work, but also, I have a car. Why would I do that? I don’t need the exercise. Let’s get this show on the road. That’s what happens. That’s how you get there. That’s how you make that leap.

    Dr. Alexander Elswick:

    Then that’s why you have to make the leap to heroin too, because the oxycontin’s way too expensive. So, injecting heroin was like, “Well, I can make this work.” I couldn’t ultimately, but it is easier to hustle $20 a day than it is $200 a day. I mean, I think especially when you’re doing things that you’re ashamed of.

    Ashley Loeb Blassingame:

    Yeah. So, you get to this place where now you’re crossing those lines that you said you wouldn’t cross. What are some of the thoughts that are going through your mind as this is happening? For color, my experience was from the moment you wake up to the time you pass out, I was focused on getting the drugs, doing the drugs, getting the drugs, doing the drugs, getting the drugs, doing the drugs or getting the money. There were these other moments where my reality of who I was and what I was doing would come in and I would almost have to use more to push that out.

    It was particularly things around as you start to get into that desperation, my behaviors around theft and violence and things I was seeing. You’d have pictures of your parents or your siblings or whatever creep in, and you have to use more to push that away because the option to stop isn’t there. So, the only other option is to push out those feelings. Did you experience some of that, this privilege, and also this horrible situation clashing for you at all?

    Dr. Alexander Elswick:

    Yeah, I don’t know if it makes hitting my own kind of bottom different because I started from a place of privilege. So, addiction took me to jail, to treatment centers, and ultimately on and off the street. I think in treatment centers, I went in and had a treatment and I was always conflicted because they was genuinely part of me that wanted to stop, that just wanted it all to stop. There was a part of me that just didn’t believe that I could. So, it’s not that I didn’t want to. It’s just that I couldn’t marshal that much energy or effort into it because I didn’t really have the hope that it was actually possible for me.

    Then once I ended up homeless, it’s so awful. It was September of 2013, I’ve been homeless in a few different cities, but I ended up in Dayton and it was September in Dayton. It was the hottest September on record. I had on this pair of jeans that I’d gotten out of the Salvation Army donations and they’re way too big for me. So, I’m clenching my butt cheeks in order to keep my pants up, but because I’m doing that, it’s causing my thighs to rub. So, I developed this rash. So, I’m homeless in Dayton. I’m wearing these clothes that don’t fit. I’ve got a rash between my thighs and I’m waddling down the street with my bags. It would almost be really funny if it weren’t so awful. It’s just the fact that the realization that you’re that uncomfortable because you don’t have anywhere to go to clean yourself.

    It’s not necessarily a direct line always in your mind to this is a consequence of my drug use. I guess, long story short, I would say this, I’m not a big believer always in rock bottom. That rock bottom is necessarily the only place that people… I guess we can say more about that in a little bit. I think it can be a dangerous concept, but definitely, I believe that the consequences I experienced had everything to do with finally making me realize what I was doing wasn’t working and that the only way I was going to get out for me was to go back to treatment and try again.

    Ashley Loeb Blassingame:

    So your parents obviously funded originally and I also come from background of privilege, so familiar with the sentiment like I know, poor me, but how did you get from going to the treatment centers, having the support of your family? What was the transition for them where they were no longer willing to help, which caused you to end up on the streets?

    Dr. Alexander Elswick:

    Yeah, it’s a great question because my parents never took a tact of we’re just going to cut you off, and I appreciate that. They always said, “We’re willing to support you as long as you’re trying to be part of the same process that we are.” There was a time when I’d been five or six treatment centers and I’d relapse after every one. Every time I go to treatment, I was really miserable. Some people in there were miserable with me, and some of the guys in there were having a good time, getting their jollies off. I never understood that. I don’t know what to make of that. I just know I was miserable, and I would get out after 30 days of misery. I would relapse, and I would just disappoint everybody.

    It felt like, “Why would I go do that again? Why would I go back to treatment? I’m just going to suffer and then I’m just going to screw it up on the other side.” So there was a time when my mom was holding a bed at a treatment center, and I just finally refused to go. I said, “I’m not going. I’m not doing it.” That was the moment when they said, “If you’re not willing to try…” They were willing to work with me through relapses. I mean, I think they well understood that was part of the process for me, but at the point that I wasn’t willing to be part of the process, I think they were keen to say, “We can’t support you anymore.”

    So they stopped paying for anything that they were paying for. I didn’t have a phone. I was communicating through Facebook Messenger. I think it was obviously a very hard thing for them to do, but it definitely put me face-to-face with reality.

    Ashley Loeb Blassingame:

    When you were homeless, what was the experience of the people around you? Did you have any epiphanies being in that environment and maybe meeting people that indicated to you where you were headed even further?

    Dr. Alexander Elswick:

    Yeah, I think the question almost gives the answer. That’s such a good question because that was exactly my experience. I was in Dayton like 45 minutes, and I met some folks at a McDonald’s who were homeless and also happened to be IV drug users. They showed me the ropes a little bit, let me run around with them. I think it was pretty clear to see that they made more than one comment about the fact that I didn’t look like them, which I think was all that means is I was earlier in the process. You talked about the stages. I might’ve been stage three, sliding to stage four or whatever, but yeah, exactly. Not to try to make any distinction between us at all, just that they pointed that out. Yeah, they looked rough, I mean, in every way.

    I had been injecting drugs for a few months at that point, but I hadn’t been out of healthcare for that long, for instance. So, I didn’t have any abscesses. I didn’t have injection site wounds. I didn’t have Hep C or HIV, even though I shared needles, which is just mercy of God or whatever, grace of God. But yeah, I think seeing some of that stuff is like a mirror because you’re like, “Okay, well, we’re in the same station together. Here you are and here I am, and now I see what it is.” I wasn’t cut out for taking that for very long.

    Ashley Loeb Blassingame:

    Yeah, no, I do understand that. I think also it’s a testament to within such a short period of time that you started injecting drugs that you were homeless. I mean, that’s how quickly that was just you were done. That was it. Being homeless has more to it than just not having a home. It’s being unprotected. You accrue trauma, you see trauma. It’s a different world. I think that piece goes unsettled. We just think about it being uncomfortable, but people who’ve been homeless for a long time doing that, you are making it harder and harder to come back from.

    Dr. Alexander Elswick:

    That’s right. To let me come back to that rock bottom point, that’s the only time that I bristle when we talk about rock bottom, because in general, I agree that it’s our consequences that drive us to change. But in the work that I do with our nonprofit, we work with so many people who experience chronic homelessness. We work with a guy named Caleb who’s been homeless in Lexington, Kentucky for 25 years. I just can’t imagine looking Caleb in the eye and saying, “The reason you’re not in recovery yet is you haven’t suffered enough.” It would be a vile thing to say to him. Oh, you haven’t had enough pain. You haven’t hit your bottom yet, Caleb. I know you haven’t had a home in 20… So, I think it’s a balance in some sense.

    Consequences are part of it, but you’re right, the more consequences you accrue, the more barriers you accrue, and then the farther and farther you get from a sustainable kind of recovery. The fortunate thing for me in some sense, as you’ve said, is that it happens so fast. I meet people all the time, good friend of mine, Jeremy, we were just talking about this not long ago, who’s spent 20 years in addiction. People will talk about our experiences like they’re the same, but they’re not.

    I accrued lots of awful things, but 4 years’ worth, not 20 years’ worth. That’s a lot of difference in trauma, in loss, and all the things. The ways that I was treated by police, by everyone, really people just treat you with disdain. Really quickly I was a scab. I was working for an attorney in Downtown Cincinnati wearing a suit and tie going to work every day like three months before, and now I’m homeless. I’m under a bridge, and I’m just a scab. Yeah, it was my first real taste of that.

    Ashley Loeb Blassingame:

    What does that do to somebody? Obviously, it feels like shit.

    Dr. Alexander Elswick:

    It made me angry. It made me so angry. It really put a chip on my shoulder, and it made me think about all the times that I’ve seen people in those kinds of vulnerable positions who seem like angry people. They’re just angry. You’re like, “What are you so mad at?” You’re like, “Well, man, it turns out they have a lot of reason to be upset.” There are a lot of things in their life that are upsetting that are beyond their control. I think the trauma, just awful things happen out there, and it’s awful.

    Ashley Loeb Blassingame:

    Let’s just take your situation. Three months earlier, you’re wearing a suit and tie and working for an attorney, and then the next thing, you’re under a bridge and homeless. How did you get there? Well, you started shooting drugs. So, when I talk about the disease model of addiction and I do a lot of talks with corporate America about getting addiction benefits, not just one-on-one addiction therapy, real addiction benefits into corporate benefit plans.

    When I talk to people about why this is important and how you get there, I’m trying to explain to them the disease model of addiction, but I think what most of those people experience are loved ones being assholes. I believe, and every chance I get, I say, “I want to start out by saying that, well, we’re in our addictions. We’re stealing from you. We’re mad at you. We’re total assholes, and we forget to mention that. We forget to lead with that. I know that it looks like this. I know that I’m acting like this and I’m not a lovable character in your life, but also feel sorry for me and please have empathy just like I have cancer.” I think that’s a very hard thing for people to swallow because the cancer patients aren’t breaking into their home.

    So, with that being said, when you talk about bottoms, when you talk about homelessness, when you talk about all of these things, how do you reconcile this disease concept with we did make some choices and we certainly had on the costume of a person who was a piece of shit? We can agree. We took the costume off. Turns out we’re not but we had that costume on. How do you reconcile those things for people?

    Dr. Alexander Elswick:

    My day job, I’m a professor at University of Kentucky. So, one of the things in my class that we do is we talk about models of addiction and then debate which has the most explanatory power, which actually does the most to explain and give us some understanding of why people do the things they do and how to help people. We talk about the difference between the traditional brain disease model versus what’s called a neurodevelopmental model or just a model that says, “Look, this is disorder. This is disorder in the brain. This is deep learning. This is deep brain change, but the brain changes as a consequence of lots of repetitive behavior.”

    The brain changes that way when you eat too many carbohydrates and too much sugar and you consume too much pornography or too many screens or too much whatever it is. One thing that I think is interesting is there’s some shared genetic material for most process addictions. So, you’ll have families in which you have maybe one sibling who has a substance use disorder and two other siblings who struggle with obesity. The siblings with obesity may look down their noses at the sibling who struggles with substances, and they have the exact same problem. The actual nature of their problem is the same.

    It’s the way that they medicate it turns out to be different. But to me, that’s always been pretty convincing and destigmatizing. When you see the neuroimaging side by side, you go, “Oh, wow, we actually are the same.”

    Ashley Loeb Blassingame:

    Yeah, it’s compulsive behavior. I don’t know what your experience has been. I’ve been sober 17 and a half years now, and the addiction is live. She loves to find other things to compulsively interact with. My girlfriend and I, same deal. The intensity of the things she’s gotten into over the last 20 years that I’ve watched her in sobriety, I mean, at one point, she was into the BDSM stuff and she started making leather whips. I mean, this is a 5’1 blonde, dental hygienist in Orange County. She knew nothing.

    The next thing I know, this girl is picking out leather to make them in her home. She’s like a connoisseur and she’s reading all these books. Over the years, she got really into doing lashes and she’s gotten in all these different things. Now we get to do it in healthier ways, especially the longer we’re sober theoretically, but it’s still there. We’re compulsively seeking relief.

    Dr. Alexander Elswick:

    Truly, that’s the best way to say it. I can make a problem out of anything. I combine problems with exercise and eating, which is a nice balance of problems. So, this is embarrassing. This is awfully embarrassing.

    Ashley Loeb Blassingame:

    I love it.

    Dr. Alexander Elswick:

    But in Kentucky, one of our guilty pleasures is sweet tea. If the rest of the world doesn’t know about it, it’s just tea that just has a gallon of sugar in it.

    Ashley Loeb Blassingame:

    100%.

    Dr. Alexander Elswick:

    The tea is now a conduit for sugar. It’s just a vehicle to consume more sugar.

    Ashley Loeb Blassingame:

    Sweet implies a hint.

    Dr. Alexander Elswick:

    Yeah, no, no. This is sugar tea. This should be called just sugar tea. I felt like I drank way too much of it. So, then I found these zero sugar sweet teas, and it’s like aspartame or something else that’s going to kill me that’s equally as bad as sugar. I just bought a 24 pack of them this morning after I’d had one because I’m like, “Yeah, now we’re going to hit these hard.” Yes, to your point, I can make impulsive-

    Ashley Loeb Blassingame:

    Or in the tea pain.

    Dr. Alexander Elswick:

    Yes, part of the pain.

    Ashley Loeb Blassingame:

    Just going hard. Yeah, it’s like that. In my house, we got really into sparkling water.

    Dr. Alexander Elswick:

    Oh, no.

    Ashley Loeb Blassingame:

    We’re really, really into sparkling water. So, we had a fridge, a separate fridge in the garage, and I had a guy on here who compulsively got into planting rose bushes. I’ve just never related to something more where we are compulsive seekers of relief and satisfaction, and it’ll come in any way, shape, or form. What you see over time, if you remove the drugs and alcohol and I’m still the alcoholic, the ism. I still have the thing, and I see that thing in my kids. I see that thing and it’s a thing. It’s identifiable and it doesn’t require drugs or alcohol. I think that’s the part where we can say it’s not a choice or it’s a disease or whatever.

    Whatever this thing is that we have, this confluence of genetic factors, it’s there way before you ever introduce pornography, food, whatever it is. That’s the part I think people can get their arms around if they understand what it looks like.

    Dr. Alexander Elswick:

    Yeah. My dad used to comment on the way that I drank a Coca-Cola. We had a one soda day rule as a kid, and he would just say, “It’s odd how much you’re trying to savor that. You’re trying to get so much more out of it than a normal person.” It’s always stuck with me. That’s true of everything I do. I’m so desperate to get the most out of things, to be the best at things in an obnoxious way, in a way that’s like, “This is not important to life-“

    Ashley Loeb Blassingame:

    Correct.

    Dr. Alexander Elswick:

    … but I’m going to be the best at it.

    Ashley Loeb Blassingame:

    100%.

    Dr. Alexander Elswick:

    Sometimes I’m not sure exactly how precise my diagnoses are or sometimes how precise everyone else’s diagnoses are, but they’re just these indicators that point to, yeah, I’ve got problems with compulsivity, with anxiety. My partner, and I share this with permission, has ADHD. So, she and I always joke that we should have a band called the neurodiversities. We would be an odd, odd band, honestly, really weird. We both have very narrow interests, repetitive interests. Definitely shades of mental illness all over the place.

    Ashley Loeb Blassingame:

    I find people who don’t have it to be really frustrating.

    Dr. Alexander Elswick:

    Yes, they speak a different language.

    Ashley Loeb Blassingame:

    Or uninteresting. I went to business school and I went to a school where I was like, “well, this is where I should be with all these very intelligent whatever people.” They were. They’re incredibly accomplished and intelligent and all the things. They’re boring as fuck. I want to stir some stuff up and it’s part of it. It’s part of the good and it’s part of the bad. It’s part of what people love about me and it’s part of why I don’t fit in those areas. It can.

    I can do it, but it takes energy for me to suppress this character that lives underneath all this stuff. I think growing up in also a privileged family, that piece of you gets in the way of what people want for you. I’m sure that that piece of you that is neurodivergent isn’t on the path, isn’t part of the path for most of the people. So, it’s hard to pretend for a really long time.

    Dr. Alexander Elswick:

    Yeah. Well, my mom always said I was going to be a Supreme Court justice. As soon as I got some drug trafficking charges, it became very clear that that was not going to happen. We were going to have to take a new path, mom. So, my greatest liability will become my greatest asset, and I’ll just do this for a job.

    Ashley Loeb Blassingame:

    Exactly. Yeah. How much did you have on you to pick up a trafficking charge?

    Dr. Alexander Elswick:

    Eight ounces to five pounds of cannabis. So, it was a little bit. It was more than I needed for myself to be certain, but there’s so much more to that. If you do a deeper dive, it’s easy for people to just go, “Okay, look, you broke the law, so you need to experience these consequences.” That’s fine. But losing school was really, really bad for me and uniquely bad for me, because I like to fancy myself an intellectual person. It’s one of the things I think I’m good at. I’ve always been good at school. I prided myself on academics. Despite all of the fuckery that I was doing, I had a good GPA. I was still working on establishing a future for myself. All of that was taken from me, and it’s not immediately clear to me that that’s a consequence of my drug use.

    Ashley Loeb Blassingame:

    Tell me more about that.

    Dr. Alexander Elswick:

    What I mean by that is one of the exercises we do in my class is I have my students put up let’s think of every conceivable consequence of drug use under the sun. We put up all the social consequences and the physical health consequences and the mental health and the legal and I mean economic, everything you can think of. We put them all up on the board and then we say, “Okay, now that we’ve got all these myriad consequences of addiction, let’s take a step back and think about which of these are actual direct consequences of drug use and which of these are consequences of the way that society feels about drug use?” So what I mean by that is we’ve criminalized addiction. That’s a decision that we’ve made, a decision that we as a society made we feel about drug use.

    The natural consequence of me using or selling cannabis wasn’t to get kicked out of school. It wasn’t to get arrested. That’s a choice that we make as a society, and it’s something that didn’t serve, in my opinion, the interest of society and certainly didn’t serve my own interest. So, I frequently write letters to advocate on behalf of kids who are being kicked out of school under zero tolerance policies. What you’re doing is you’re taking a kid who’s already experiencing strife. You know this. If he’s using drugs in a problematic way, you know there’s either some mental illness or some trauma underneath it to begin with.

    Ashley Loeb Blassingame:

    You and I know this, but does society know that?

    Dr. Alexander Elswick:

    No, you’re right. They don’t. I think these aren’t people who are unwell. They look at us as people who are bad, who are making bad decisions.

    Ashley Loeb Blassingame:

    Do they respond to your letters?

    Dr. Alexander Elswick:

    In some cases, not so much. I think it just depends on the circumstance. I think the argument in many cases would be like, “Okay, we need to protect the campus community. This person’s introducing cannabis to the campus.” Come on now. I don’t think any reasonable person believes that about a college campus. There’s so much weed on that campus. They didn’t need me. Life went on without me. So, I think it’s a little bit of a red herring to talk about it in terms of public safety. The point I was making earlier is you’re taking people who already have mental illness, already have trauma, already have this marginalized experience, and then you’re marginalizing them further.

    So, then when I got kicked out of school, I lost my daily purpose. I lost my future, I lost my social fabric, I lost all my friends. It left the most incredible vacuum in my life at the time that I needed stability the very most. It was the perfect conditions for an addiction. So, sometimes when I tell the story, we tell it like, “Hey, I’ve got addictive genes and I got this addictive substance. One plus one equals two.” I think that’s a fine way of looking at it, but I think the more textured way of looking at it is that there were more factors at play. One of them is that I experienced a social death two months prior to getting a prescription that gave me a friend when I was lonely. I think that stuff matters.

    Ashley Loeb Blassingame:

    How would you design it differently? We say we’re criminalizing addiction. So, what if you had five ounces to five pounds of cocaine, are we criminalizing addiction? Is it about the substance? Because to me, if you’re bringing five pounds of cocaine on, to me, cocaine is the true gateway drug, right? You’re like, “Well, I’m doing cocaine, might as well do blah, blah, blah,” and they’re putting fentanyl in it and that sort of thing. Is it the substance? Is it the addiction? How do you look at it from that perspective?

    Dr. Alexander Elswick:

    Look at it a couple of different ways. I mean, number one, I certainly don’t want people selling illicit drugs in our communities. It’s not something I want to encourage. I do think that there should be a consequence for it. But number one, the research, huge, massive body of research shows that it’s not the severity of the punishment that acts as a deterrent. I mean, you could make drug possession a capital punishment, and people are still going to use and possess drugs. That’s the reality. What works as an effective deterrent is the solidarity and the certainty of the consequence. So, how quickly is it going to come and how certainly is it going to come?

    So the problem with that, first of all, is that there’s no certainty when you’re drug trafficking that you’re going to get caught. Lots of people get away with it for a little while. I think the other problem is I’m a firm believer that the war on drugs is a miserable failure because it’s predicated on the premise that we can create drug-free societies. I think that’s ludicrous. I think drugs always have been and always will be. That’s why I take a harm reduction approach that’s grounded in the reality that people use drugs. We’re not going to ignore it. We’re not going to overlook it. We’re not going to whistle in the dark and pretend it doesn’t exist. The reality is people use drugs.

    I drive outside of Lexington to a nearby county, Jessamine County, and they have a sign as you enter the county that says, “This is a dare drug-free community.” Every time I drive past that sign, I just laugh to myself. I think I shot so much dope in your all’s community for it to be a drug-free community. It’s really the same conversation we had with abstinence-based sex education, and we did abstinence-based sex education for years. We just said, “We’re going to live in denial and we’re going to pretend that kids aren’t going to have sex and we’re just going to demand that they don’t have sex.” Guess what? They had sex. Hormones are too strong. They do what they want to do.

    So, somewhere along the line, we got wise and we said, “We’re going to take a harm reduction approach that actually equips kids or people with the ability to reduce the harms associated with sex.” I don’t know why we keep making the same mistake with drugs and alcohol. We teach such a clear cut abstinence only, which is really confusing to kids, because most of their parents drink alcohol. Many of their parents use tobacco products. Many of their parents are vaping. Lots of their parents increasingly use cannabis. There’s texture to this conversation that has to be had. Kids aren’t stupid. So, the drugs are bad, drugs are bad refrain is really tired and counterproductive, I think. It sends us in the wrong direction.

    So, take us back just for a second to complete the thought because I think you’re right. I certainly am not saying let’s just let people use drugs willy-nilly. My core belief really is my brain, my own neurochemistry punished me far worse than anyone or any society can ever punish me. It doesn’t matter what you do to me, you can’t create the hell that dopamine downregulation and anhedonia and just being freaking miserable creates. So, I really believe addiction carries with it its own natural consequences that drive people towards recovery.

    That’s why recovery is the norm and not a minority experience, but in my experience, generally, consequences don’t drive people in the right direction. To the conversation we had about homelessness, where can it be a consequence that drives you towards change maybe? But if you accrue those consequences too long, it’s going to do the opposite. You have some people who will say, it’s a nudge from the judge that got me sober. I get that and I’m not invalidating that experience, but I would also say I have far more friends who are mired in the web of the criminal legal system and it didn’t nudge them towards recovery. It’s kept them back the entire time.

    Ashley Loeb Blassingame:

    Did you end up getting sober at the Salvation Army?

    Dr. Alexander Elswick:

    I did, yeah. To be honest, I checked in, couldn’t handle it, left, was homeless for a little longer and then came back. But yes, ultimately, yes.

    Ashley Loeb Blassingame:

    What couldn’t you handle about It?

    Dr. Alexander Elswick:

    The treatment centers I went to previously were really nice. Mom and dad dipped into their pockets, and you had pretty nurses come and rub you on the back and say, “Can I get you an ibuprofen? How you feeling, honey?” I don’t mean that even to be disparaging. What I really mean is I got really good quality care, compassionate care from people who care. The Salvation Army is filled with people who care. Please don’t hear me wrong on that, but it’s a shoestring organization. So, the way that they fund, the way that we fund our own treatment is through processing the donations. So, you’ve seen those big Salvation Army trucks that drive around.

    They would bring in these wire cages of clothes, and we would roll them out off of the trucks and into an elevator, send them up the elevator to the third floor where it was like 100 degrees and you’re standing on hard concrete. For eight hours a day, you processed making piles of shirts and pants and that was it. That was while you’re withdrawing from heroin. So, they called it work therapy, which is not something I’ve ever seen in the clinical literature, but it’s fine. I give them a pass because they pretty well saved my life. So, I couldn’t handle it. I mean, really, I was withdrawing and I would play that game where I would say, “I’m not going to look at the clock until two more hours have gone by.”

    So I would look down and try to go about my work and then I would say, “It’s probably been about two hours.” I’d look up and it’s been 27 minutes. I just can’t do it. I walked out the front door and eventually realized my real lack of options and said, “Okay, that really miserable option might actually be my best option.” It was long-term, it was six months, which for me was critical. I think it’s probably the most significant element. People ask all the time, “What was it about the last rehab that was special?” I mean, clearly, they’re not credentialed the way that the other treatment centers were. But to me, the critical factor was one, the length of time.

    Then not only did I spend six months in inpatient treatment, but the day that I left inpatient treatment, my family helped me transition into an intensive outpatient program. So, I didn’t spend a single day unsupported. Now, as I’m transitioning back to Lexington, I was spending three hours, four days a week in IOP. Then after those six weeks were over, immediately that day was my first appointment with a therapist. So, I don’t think we understood this exactly at the time, but when we look back, you go, “Oh, we created a continuum of care because you have a chronic disease. So, it requires long-term support.”

    The mistake we were making prior to that was these acute episodic treatment centers, we’re going to give you a 30-day bit, not much support afterwards. You got to figure it out. The problem is when you know the brain science, you know that after 30 days, you still have this brain that’s pretty well addicted, pretty still changed, and deep reprioritized. So, for me, time was among the biggest factors.

    Ashley Loeb Blassingame:

    It says that in the literature, the time and the therapeutic connection, therapeutic alliance, the relationship that you have with your therapist, not how many degrees they have or any of that, those two are your largest factors for whether or not someone is going to be successful. I liken this to chemotherapy in my constant comparison of addiction to cancer. You wouldn’t expect a doctor to give you a chemotherapy treatment that they didn’t believe was going to either arrest or severely impair this ongoing disease state.

    Twenty-eight days came because that was the amount of time you could be gone without having to be reassigned. Then they took that information, those 28 days, those 30 days, what have you. So, because of that period of time and the way that the military was, it basically became the standard of care, but it isn’t the standard of care based on what works. It’s the standard of care based on what people are willing to pay for and what people were willing to do.

    Dr. Alexander Elswick:

    Yeah, it’s effectively like medical malpractice in some sense. It would be an inappropriate thing to treat any chronic disease on an acute basis. We know that. The thing that always angers me, really upsets me about it is it was in recovery that I learned that doing the same thing over and over again and expecting a different result is the definition of insanity. I cannot think of a better way to characterize our entire treatment system. I met guys who’ve been to treatment 15, 20, 25 times, and it’s a really simple answer. It’s not because of their honesty or their open-mindedness or their willingness or all the ways we want to moralize it. It’s because they have a chronic disease. It’s being treated acutely.

    That’s what happens when you treat a chronic disease acutely. It doesn’t work. Then the real sad thing is when it doesn’t work, what that looks like is relapse and we blame that on those people. We gave them insufficient care, but we blame them for that. It’s a problem. It’s a problem because for instance, we talk about the treatment gap. So, like 90% of folks who need treatment allegedly won’t receive treatment this year. So, that’s always a stat people include to try to clamor for more treatment centers. The interesting thing is when you do a deeper dive on those data and you ask those 90% who stand in the gap why they didn’t receive treatment, the vast majority of them say it’s because they don’t believe that they need treatment.

    So, you could debate whether or not they’re experiencing denial and ambivalence or whether or not they’re correct, but either way, these are folks who are not treatment seeking. You know what I mean? So it means so much more of recovery is going to have to happen outside of the context of treatment centers. The vast majority of people in recovery today got there without formal help. So, it’s such a treatment centric model that we have when we know that so many of the foundational things that make healthy human beings healthy people in recovery are things that come from community.

    Ashley Loeb Blassingame:

    I say on this podcast all the time, community is not optional. So, if you’re trying to figure out a way where you can do this without community, then you should just let it go and go back to what you were doing because it’s not optional. It’s not like a nice to have and what you do who, your community is fine, but community in and of itself is not optional.

    Dr. Alexander Elswick:

    Totally agree. I wonder if we’ve all had the experience of trying it first without community. I went to meetings and it couldn’t have been a less social experience for me in the beginning. I did everything in my power to sit right by the door, to talk to no one, to show up one minute after the meeting started and to leave one minute before the meeting ended, just to avoid all interaction. So, yes, I know that well.

    Ashley Loeb Blassingame:

    So tell me about how you developed your community. Are you still going to meeting? What does that look like for you?

    Dr. Alexander Elswick:

    Yeah. So, the Salvation Army was really a 12-step based program, so that’s really where my recovery ideology started. I was a true 12-step disciple for three, four years. The 12 steps are a part of what has saved my life. It’s a part of what fundamentally changed me. It’s a part of the reason why when people meet me today, I’m so different than I was before. I attribute so much of that 12 step programs and that gave me the community that comes with that, which is just this community of people who are abstinent, who are trying to live the same way you are and struggling with the same mental illness and all the same stuff.

    That was critical for me, but I’ll also tell you that there came a time when I started asking myself if I was still getting the same from 12-step meetings as I had in the beginning and I felt like I wasn’t. There was a lot of fear and trepidation, because I had really been taught that if I stopped going to meetings, I was probably going to relapse. I had some of those really rigid beliefs in my head. But I’ll tell you that since then, I’ve been on a journey of learning about other ways, other approaches to recovery, other pathways to recovery, learning other ways to be supported. One of my favorite meetings is a harm reduction works meeting that we offer through our organization at Voices of Hope.

    It’s a mix of people in abstinence-based recovery, people on medication for opioid use disorder, people who are continuing to use substances as a part of their recovery, and people who are continuing to use substances in active addiction and who would say, “This is pathological and problematic and I need help.” It’s the coolest space in my mind to be around that combination of there’s experience and there’s wisdom and it’s raw and it’s real. I really don’t have anything critical to say about 12-step programs. That was so good for me. It’s really not a but. It’s an and. I’d encourage everyone to see that there’s a whole recovery sphere out there that so many of us don’t know about.

    Ashley Loeb Blassingame:

    Yeah, that’s huge. That’s huge. So, many of us don’t know about. I think as you start to do some exploration and if you feel like your needs aren’t being met, I think that’s part of recovery is figuring out what it is that you need. If you have a need not being met, I don’t know if “normal people” are like this, but I can tell you that people who struggle with addiction are, which is that if you have a need that is growing and you try to ignore it, it will fulfill itself. It’s like Jurassic Park. Nature finds a way, my friends, and so it’ll happen. The next thing you know, you’ll wake up and you’ll be like, “Uh-oh, what did I do?” Instead, you can be an active participant in helping to solve that need and brainstorming and finding ways.

    Dr. Alexander Elswick:

    Somebody said that treatment’s discovery and the rest is recovery. I think that’s true, that the real recovery is, “How are you going to do this long-term? How are you going to do it in society where you got to live?”

    Ashley Loeb Blassingame:

    Yeah, absolutely. Well, also, most importantly, how many people are calling you the Huberman of Kentucky?

    Dr. Alexander Elswick:

    You know what’s funny about that? My brother-in-law just introduced me to some of his stuff two months ago, and I’ve already devoured I mean so many hours of his content. It’s great stuff. He’s a smart guy.

    Ashley Loeb Blassingame:

    Yeah, yeah, yeah. I was like, “God, you’d remind me of what would be like the Huberman of Kentucky, the people’s people.”

    Dr. Alexander Elswick:

    I love talking about this stuff. I always tell people with this podcast, you really don’t need to thank me for coming on, because if we weren’t doing this, I’d be bothering my partner with stuff like this or bothering someone, talking to the wall.

    Ashley Loeb Blassingame:

    What do you hope to see in your students in terms of what they go out and do in the world?

    Dr. Alexander Elswick:

    Yeah, a couple things. One of the things we do on day one is talk about the power of language and talk about de-stigmatize language. We don’t just do like here, say these words, not those words. Those are the bad words. We really do a deep dive on why it matters, how it changes, the recommendation of a judge, of a social worker, changes a mom’s heart, changes a police officer’s heart, and it really matters. It matters in tangible ways, not just in political correctness. So, we talk about language and we start there, make sure that throughout the semester students find a way to talk about addiction in a way that’s dignifying and it’s humanizing, which I think is just important. I think it really, really goes a long way, frames a respectful discussion.

    Then we don’t try to force a perspective, but we really try to do a good job of showing the merits of abstinence only, the merits of a harm reduction approach, the merits of all these various approaches to recovery, different models of addiction, different understandings, and let students land where they will. One of the things we do some years is I’ll give them a card that represents the different models of recovery. So, a blue card for this model, orange card. Throughout the semester, they can use the cards to indicate where they see the model or how that’s changing in their mind and all that thing.

    At the end of the year, two years ago, we had a student who still stood firmly on a moral model of addiction, and she said, “This is still my belief.” I say, “I’m comfortable with you leaving this class with that belief as long as you’ve given a measured reasonable discussion, you’ve participated. That’s acceptable to me.” So yeah, really trying to change people’s minds about harm reduction, about medication, about people who use drugs, and then increasingly about drug selling, which is not something I ever saw myself doing. It has nothing to do with my own experience. Well, maybe it does a little bit, but research shows 80% of people who sell drugs use drugs and about 40% have substance use disorders. It’s one way or another.

    These are our folks. I feel that way as a person who runs a recovery community center. This is all a part of the same community. It’s all a part of the same problems. That really neat black and white thinking where you go, “Okay, people who use drugs aren’t bad, but the people who sell them are bad” really isn’t fair either. You got to get to a much more granular level to really understand that. If you want to go further, I believe in most cases, these are folks who are doing it as a last resort option anyways. We could go on and on, but that’s what we’re doing in the classroom.

    Ashley Loeb Blassingame:

    Awesome, awesome. Well, can you tell people where they can find you and where they can learn more about what you’re doing in your organizations?

    Dr. Alexander Elswick:

    Yes, definitely. So, we’re on all the social media. It’s voicesofhopelex.org, and you can check out the website. We have a center in Downtown Lexington, two locations in Downtown Lexington, and all kinds of cool stuff. A mobile unit that goes out to places where people who use drugs frequent, all kinds of stuff, and then keep an eye out for brilliant, fascinating research to be published.

    Ashley Loeb Blassingame:

    Yes. Do you have your own social media?

    Dr. Alexander Elswick:

    I do, but it’s just the good old-fashioned Facebook. I’m a geezer, so that’s all I got, but it’s just Alex Elswick. You find it there.

    Ashley Loeb Blassingame:

    Okay. Awesome. Awesome. Well, thank you so much for being here. I know it’s what you’d be doing anyway, but I appreciate you doing it with me here and it was awesome talking to you. Thank you.

    Dr. Alexander Elswick:

    Thanks for a great conversation.

    Ashley Loeb Blassingame:

    Well, I’m just going to go and tell people that we had Huberman on my podcast.

    Scott Drochelman:

    I think that’s fair. As soon as you said that, I was like, “Yes. He’s given me major Huberman vibes.”

    Ashley Loeb Blassingame:

    He’s a professor, he’s got the vibe, he had his own experience.

    Scott Drochelman:

    Tattoos.

    Ashley Loeb Blassingame:

    Tattoos. He’s got the jawline. He’s awesome.

    Scott Drochelman:

    If he put on a podcast called the Elswick Lab, I’m tuning in. I’m ready.

    Ashley Loeb Blassingame:

    Tuning in. Ready. I also like that he’s on a school campus and he is pushing people to explore the different modalities, the different meanings, the different moral complexities and textures of addiction as a chronic problem, a chronic disease, illness, however you want to characterize it. That is really a great part of stigma reduction, which is helping them change language, even if it’s just for that period of time, creating any normalcy around those terms, the changing of the language and putting people into the workforce and the world who have actual knowledge and understanding about the topic.

    I mean, the struggle, of course, is that they’ve self-selected into the class. Even so, we have so many people who probably have taken similar classes and have not left with really exploring all the different avenues of recovery and all the different ways that addiction presents itself. It sounded like his class was really robust that way and really about thinking through your beliefs from a perspective, not just of what society has decided is good or bad.

    Scott Drochelman:

    Allowing that space for people to come to their own conclusions about what’s best and actually have them be based in some actual education versus just maybe whatever their parents told them or what they heard on TV or whatever they’re forming their opinion based on, that was pretty shocking. I mean, I appreciated that he was open to the counter, but I was surprised that somebody made it all the way through his class and like, “Nope, moral approach. That’s me, man, all day long.”

    Ashley Loeb Blassingame:

    I respect it.

    Scott Drochelman:

    After all that, I mean, yeah, he’s just stuck to the guns for sure.

    Ashley Loeb Blassingame:

    Yeah. At that point, you have to respect it. There’s a famous AA story where a speaker is talking about how he was going to do a shit ton of time or the judge offered him treatment. All right, a stint of time or you can go to treatment. The speaker says, “Of course, I took the treatment and easier, softer way, whatever.” At the end of an AA meeting, speaker meeting, oftentimes people will line up to just shake the speaker’s hand and thank them for sharing and maybe a couple words here or there. The story is that this was a circuit speaker and a man comes up to him and shakes his hand and goes, “I took the time, sir,” and walks away.

    Sometimes that alt perspective or that sticking to your guns, you’re like, “Well, not how I would’ve played that hand, but I respect you sticking to your guns.” The speaker’s whole thing was like, “I’ll admit to being an alcoholic if it serves me. I just am not going to admit to it if it doesn’t.” He’s like, “Guess what? It served me.” They’re like, “Take the treatment or the time,” and the guy’s like, “took the time.”

    Scott Drochelman:

    Took the time, the gumption on him.

    Ashley Loeb Blassingame:

    Yeah. I’m not admitting shit.

    Scott Drochelman:

    Well, I hope what Dr. Elswick talked about is encouraging for folks that there’s lots of ways to get to recovery and that maybe his story was inspiring to you or you might have found some of yourself in his story. We are rooting for you this week, as we always are. We’re hoping for the best for you this week and that whatever you need is coming your way. Ashley, is there anything you want to leave the people with this week?

    Ashley Loeb Blassingame:

    This week, check out Voices of Hope, a peer-driven recovery community organization on Instagram, on any of your social media. Check them out, let’s support them. It’s an awesome, awesome organization. Additionally, if you are interested in one of those alternative recovery options, check out Lionrock.life, where they have a peer support group called community, which is not 12-step based, not God-based, and not abstinence-based. You define your recovery however you want or need to, and that is how the group will support you. Of course, have a wonderful week. We’ll see you next time.

    This podcast is sponsored by Lionrock.life. Lionrock.life is a diverse and supportive recovery community offering weekly over 70 online peer support meetings, useful recovery information, and entertaining content. Whether you’re newly sober, have many years in recovery, or you’re recovering from something other than drugs and alcohol, we have space for you. Visit www.lionrock.life today and enter promo code C

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