Al-Anon interview with NIAAA Director Dr. George F. Koob

0:00 welcome to first steps down on recovery from now on and family group
0:04 today we're pleased to have a test doctor George Q
0:07 director at the National Institute on Alcohol Abuse and Alcoholism
0:12 for the NHL parlay new in this position renowned addiction neuroscientist
0:17 doctor koop has served as he and I cheerfully director
0:20 for almost six months he's here with us to talk about
0:24 research on alcohol use disorders including alcohol abuse and alcoholism
0:29 and their impact as it relates to the drinkers family members and friends
0:34 he and I AAA is one at 2:27 institutes and centers
0:38 that comprise the National Institutes of Health which is a part of the United
0:42 States Department of Health and Human Services
0:45 DNA chip away support and conducts research
0:48 on the impact as alcohol use on human health and well-being
0:52 it is a leading funder alcohol research in the world sector to thank you for
0:57 taking time with us today so soon after joining the NHL players tractor
1:01 are welcome sector cue from your experience in research
1:06 on alcohol use disorders how would you describe their
1:09 impact on the friends and family members a drinkers
1:12 the one word answers the impact is devastating
1:16 to a large extent the mobile word answers
1:20 that the children particularly adolescents but even younger children
1:23 friends and family members all can be affected
1:27 by an individual with an alcohol use disorder they
1:30 often are experiencing negative emotions
1:33 they feel stressed they feel alienated they can become aggressive
1:37 these symptoms can lead to low self-esteem
1:41 similar affects can occur with family and friends the Nile is a huge part
1:45 about cause I'm so the loss of trust
1:47 sneaking around up the individual to obtain alcohol on line about
1:51 use does all begin their up and contribute all these
1:55 the facts and then finally of course we know that to friends and family members
1:58 or cause disorder are
2:00 at increased risk for experiencing intimate partner violence interpersonal
2:05 comm forks you hear this in almost every case history of
2:08 interpersonal conflicts between significant others economic legal
2:12 and obviously downline health problems is a major
2:16 impact on the world around the
2:19 alcohol mister user and unfortunately that's
2:22 part of the pathophysiology that we have to deal with good follow-up question is
2:26 what should they do about it well
2:28 I mean one option is to seek professional help
2:31 obviously if you can get the individual to recognize that they have a problem
2:36 and they get them into some sort of treatment
2:38 that's wonderful but in luv that the other option is
2:42 you yourself get help and that then can me too
2:45 strengthening up yourself but also your ability to
2:49 get help for intervention brain thank you
2:52 ensure police a recent poster and billboard campaign
2:56 highly set 7.5 million children in the US
3:00 to live with a parent with alcohol use disorder and asks a question
3:04 says you're drinking affect someone you love have all the research conducted
3:09 and I chip away why do you think it is important that
3:12 this message be so widely communicated to the general public
3:15 translated in another way that means about one in 10 children
3:19 United States lives with apparent with a knock-on misuse problems
3:23 and as a result it's a two-way street
3:26 so disc you get in the way apparent being a good parent
3:30 but on the other side it of course come isolate to trial
3:34 which have devastating effects because they're really not getting a good
3:37 parenting
3:38 and so it becomes one of those loops that
3:41 just feeds on itself and gets worse over time and then
3:44 there's all the modeline we know that travel to term
3:48 binge drinks is much more likely to binge drink than a child whose parents
3:51 do not binge drink
3:52 me know that de comida dynamics in the family to contribute to the development
3:57 of our core use disorders and the children themselves when they grow up
4:00 so many people with alcohol use disorders reported family problems
4:04 including arguments in trouble communicating with the family members
4:07 led them to drink a voice so you have an effect on both ends did
4:10 exacerbated as development proceeds adolescent
4:13 may act like they don't need attention from the parents but this is a
4:17 an unbelievably critical period in their development when
4:20 they do any kind they do need model behavior they do need
4:23 structure in their lives and a person with an alcohol use disorder is barely
4:27 able the
4:28 maintain themselves much less take care of a child so that's for tips to be
4:32 really
4:33 a problem and that's what we're focusing on some of our research
4:36 mister how to address those issues and get the word out
4:39 so that children and adolescents of alcohol use disorder
4:43 parents will seek help and will do is we talked before
4:47 about trying to alleviate the deleterious effects of the situation
4:51 me break say call break the cycle burgers yes
4:55 well thank you ask for diseases alcoholism is often referred to as a
4:59 family disease
5:00 dude its negative effects and family members and friends
5:03 with TCS a possible directions for research which haven't yet been explored
5:09 the research that we're intending to engage in and we are already
5:13 engaged in are going to be research with a focus on
5:16 delivering health services for local use disorders was the biggest
5:20 issues we have is getting people to treatment
5:23 the data suggests a less than 10 percent up individual stock or use disorders
5:27 really
5:28 get any treatment all alright and so
5:31 it really is important were beginning to
5:34 get our head around focusing on primary care physicians
5:37 and then Jenny referral from primary care physicians in severe cases
5:41 to especially treatment programs we are
5:45 engaged in developing additional evidence-based prevention and treatment
5:49 options for excessive drinking
5:51 and alcohol use disorders across the life span
5:54 right now focusing on underage drinking and adolescent drinking but
5:58 I see a time when we may be able to move even further down the line to
6:02 middle school another domains in the prevention arena
6:05 on the other hand we're working with organizations like the American Society
6:08 of addiction medicine
6:10 will be working with samper to affect brief interventions
6:13 that appear to be quite effective in the primary care setting in limini
6:17 alcohol use disorders so we've got a big program on going with this
6:21 I think it's important for the world to understand that and alcohol use disorder
6:25 for alcoholism or addiction and general is a brain disorder
6:29 and merchants scare people off because we know very
6:33 well that treating a brain disorders with behavioral treatment is effective
6:37 in changing the brain
6:39 as much as sometimes for better and pharmaceutical treatments this is
6:43 clearly the case and depression
6:44 obsessive-compulsive disorder we suspect it's true with alcoholism
6:48 there is some evidence for that in some other work that's been done on
6:52 executive function in alcoholics that shows that your
6:56 frame decision-making circuits can
6:59 in a sense recover you don't grow back to pathway that got destroyed by the
7:03 alcohol but you can
7:05 recruit other pathways to help you anyone other behavioral treatments from
7:09 alcoholics anonymous Thu cognitive behavioral therapy can
7:13 address some of these issues and hopefully strengthen the brain so
7:16 you know I think it's important for people to understand that making it a
7:20 brain disease does not
7:21 obviate responsibility but it doesn't the nato policy either
7:25 it means that in fact we know now that to bring has an enormous capacity for
7:30 plasticity even into adulthood
7:32 and that basic understanding the brain function is helping all of us who work
7:36 on
7:37 psychopathology very interesting thank you
7:40 what do you think is single most important message
7:44 the general public should know when it comes to understanding how to deal with
7:48 an alcohol problem
7:50 in a friend or family member of course
7:53 this is the biggest issue and of course me
7:56 problem is how do you get your loved one to get help
8:00 there are a range of treatment options available these
8:03 can the the hero interventions as you well know there are medications and
8:07 actually help
8:08 one on the way and often can speed up the process of getting an individual
8:13 into a behavioral treatment our behavioral intervention
8:16 you know where do you start it's difficult to say i mean this is a real
8:19 challenge
8:20 for individuals it can be a family getting together and
8:23 effect in an intervention it could be placing with the
8:26 family physician who may be a long-term friend of the family
8:30 you know sometimes just a physician saying you know your liver enzymes are
8:33 elevated
8:34 is enough to trigger an intervention because the person starts to realize
8:39 that
8:39 their excessive drinking is having no its ideological fact even know
8:43 you know from my perspective behavioral change that's torture is is also a
8:47 physiological fact but went to Macy's at my liver enzymes
8:50 sometimes I really you know it's hard and then finally you know it's really
8:54 really important to realize
8:56 for parents and many people whole to one of the greatest contributions to life is
9:00 the perpetuation of light switches
9:02 their kids behaviour modelling do you wanna see that any children
9:07 I'm in other words the tremendous impetus for Sikkim
9:11 change in behavior is to be a role model for your own children
9:15 so it's a critical piece that can be added into what we would call
9:19 motivation for change and try to call these things are important to emphasize
9:23 said you know
9:24 we do have treatment options we really
9:27 do encourage family members and friends to be proactive
9:31 and lookout not only for themselves but do the best they can
9:35 to look out for the family member that's affected and you need to emphasize
9:39 very very strongly that to some extent mimicry is
9:42 is one of the greatest neurobiological parts our life as a primate
9:47 we do what we see and children in particular where their brains are
9:51 malleable
9:52 are learning what they see and we know they're even runs to do this in the
9:56 brain
9:56 is critically important for future behavior just kinda a
10:00 follow-up to that Tues Eve that when
10:04 friend or family member is ever dealing with
10:07 alcoholism in someone else that they may need extra help themselves
10:12 in going through this oh absolutely know I've had
10:15 many of my colleagues over the years to join down on because their parents
10:20 had alcohol problems and they found it very very helpful
10:23 for protecting them against their own vulnerabilities
10:27 I think when you have any stressor on a family structure
10:30 that's gonna require extra energy on your part
10:34 to resist it obviously it could be you're living in a war zone
10:38 but having a family member who has alcohol use disorder
10:41 is pretty much a quick one and no one would question that if you lived in a
10:45 war zone
10:46 or god forbid some tragedy occurred an earthquake
10:49 in your particular town mental health professionals would come and then
10:53 there would be an enormous at least initially energy in trying to help
10:57 people get through that
10:58 well having an alcoholic and your family I would argue is a quote want
11:02 sorry such a cute thank you for talking with us about research
11:06 on the affected alcoholism as it relates to the drinkers
11:10 family members and friends and thank you everyone for listening to first step
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