Diseases of Despair

Nathan: 00:00:00

Okay, Corey, so what I'm gonna do here is I'm going to talk a little

Nathan: 00:00:06

bit about what is referred to as diseases of despair, and there's a couple of

Nathan: 00:00:12

researchers who have come up with the term diseases of despair and they've

Nathan: 00:00:18

broken them down into four different.

Nathan: 00:00:20

Types.

Nathan: 00:00:21

Okay, so there's four.

Nathan: 00:00:22

Mm-hmm.

Nathan: 00:00:22

, basic types of despair.

Nathan: 00:00:24

We're gonna go through each one.

Nathan: 00:00:26

I'm gonna ask your, uh, opinion about how they resonate with you personally,

Nathan: 00:00:30

and then I'll throw it a little bit of information for people just to

Nathan: 00:00:34

kind of let them know how it relates to drug and alcohol use right now,

Nathan: 00:00:38

how it relates to the toxic drug crisis in North America, et et cetera.

Nathan: 00:00:42

And then we'll look at some factors.

Nathan: 00:00:44

. And, uh, what we'll do later after that is, uh, I'm just gonna read

Nathan: 00:00:49

a few paragraphs from the book I'm reading right now, the Urge

Nathan: 00:00:53

by Eric Fisher and, um, cool.

Nathan: 00:00:55

Yeah.

Nathan: 00:00:56

And then I'll get your take on those as well on a personal level.

Nathan: 00:00:59

Okay.

Nathan: 00:00:59

These

Corey: 00:00:59

are all live and as it happens, cuz these, this is new for me.

Corey: 00:01:02

So

Corey: 00:01:05

, Nathan: we must add that side note there.

Corey: 00:01:06

Yes.

Corey: 00:01:07

Okay, so we're talking diseases of despair.

Corey: 00:01:10

The first one is cognitive despair.

Corey: 00:01:14

Which denotes thoughts connected to defeat, guilt,

Corey: 00:01:18

hopelessness, and pessimism.

Corey: 00:01:20

It may make a person perceive other people's actions as hostile and discount

Corey: 00:01:26

the value of long-term outcomes.

Corey: 00:01:28

So that's the first one.

Corey: 00:01:30

Cognitive despair.

Corey: 00:01:31

Have you experienced any of those terms?

Corey: 00:01:35

Yes,

Corey: 00:01:38

, Corey: all of the above for sure.

Corey: 00:01:39

Yeah, for sure.

Corey: 00:01:40

That is a pretty good summation of how I felt in the, particularly,

Corey: 00:01:45

maybe in the early and mid parts of my addictive behavior for sure.

Nathan: 00:01:50

Yeah, I, we've talked about this.

Nathan: 00:01:53

We both have a certain type of mindset that is prone to

Nathan: 00:01:56

cognitive despair, I think.

Nathan: 00:01:58

Yeah.

Nathan: 00:01:59

Um, we both tend to see things as the default setting a little bit

Nathan: 00:02:03

darker than we should and or not.

Nathan: 00:02:05

I say we should, I mean, I understand the evolutionary benefit of angst, but um,

Nathan: 00:02:11

but yeah, we've talked about it and the hopelessness one and pessimism, I think

Nathan: 00:02:16

is, those are two huge factors in a.

Corey: 00:02:19

Yeah.

Corey: 00:02:19

You know, and I, I'm gonna back it up further, like, you know, I just said

Corey: 00:02:22

it, that was early on in addiction.

Corey: 00:02:24

I think that sense of pessimism or the sense of cynicism and

Corey: 00:02:29

teetering on hopelessness was present earlier in my life.

Corey: 00:02:34

And, you know, in a meeting this week, I said, you know, I, I, I recall

Corey: 00:02:39

being a, a kid like six years old saying, what is the point of this?

Corey: 00:02:44

Right?

Corey: 00:02:45

If we all die, what's the point?

Corey: 00:02:48

. Nathan: Right.

Corey: 00:02:49

So, and experiencing, uh, experiencing, uh, death in your family early, how does

Corey: 00:02:54

that play out for somebody who's trying to reconcile their future as a child?

Corey: 00:02:58

You just, yeah.

Corey: 00:02:59

I mean, , of course that's going to, you're gonna have some questions, right?

Corey: 00:03:03

Well, I, yeah, and

Corey: 00:03:04

I think that that is in fact quite a common trait of someone who

Corey: 00:03:08

has experienced early childhood loss.

Corey: 00:03:10

Is that question or that feeling of hopelessness or like, uh, pessimism,

Corey: 00:03:16

cynicism of both the whole show.

Nathan: 00:03:17

Yeah.

Nathan: 00:03:18

Mm-hmm.

Nathan: 00:03:18

existential angst for sure.

Nathan: 00:03:20

That's a driver.

Nathan: 00:03:22

Okay.

Nathan: 00:03:23

Uh, the second one they've got listed here.

Nathan: 00:03:25

If I don't have the people who are responsible for this definition

Nathan: 00:03:29

listed, where are they now?

Nathan: 00:03:31

Oh, uh, uh, case in Deaton.

Nathan: 00:03:33

That's the two.

Nathan: 00:03:33

It's a man and a woman.

Nathan: 00:03:34

Uh, they're psychologists, I believe, who came up with this, this model.

Nathan: 00:03:39

I gotta credit them for that.

Nathan: 00:03:41

Emotional spare refers to feelings of sadness, irritability, loneliness,

Nathan: 00:03:46

and apathy, and may partly impede the process of creating and nourishing

Nathan: 00:03:50

interpersonal relationships.

Nathan: 00:03:52

Mm-hmm.

Nathan: 00:03:54

. Corey: So this one, I would say

Nathan: 00:03:59

last couple years before going off work and in, in addictive behavior.

Nathan: 00:04:04

That the emotional things that were weighing on me were getting in the way

Nathan: 00:04:08

of relationship building, of nurturing healthy relationships, of being, you

Nathan: 00:04:15

know, honest and vulnerable and, and in, in thereby in my tendency to isolate.

Nathan: 00:04:21

Absolutely.

Nathan: 00:04:22

I, I a hundred percent agree so far in that the first one is kind of like

Nathan: 00:04:27

a, a default setting for me as well.

Nathan: 00:04:30

And then the emotional despair was what I believe led to the,

Nathan: 00:04:34

the problem in a more acute sense.

Corey: 00:04:36

Yeah, I think so too.

Corey: 00:04:38

I think it, it's like it's the next, the next big building block

Corey: 00:04:43

on top of the cognitive despair.

Nathan: 00:04:45

Absolutely.

Nathan: 00:04:47

So the third one is, Behavioral despair, which describes risky,

Nathan: 00:04:53

reckless, or self-destructive acts, reflecting little to no consideration

Nathan: 00:04:58

of the future, such as self-harm, reckless driving drug use, risky, uh,

Nathan: 00:05:03

risky sexual behavior, and others.

Nathan: 00:05:05

So behavioral despair.

Nathan: 00:05:08

, risky, reckless and self-destructive acts with no consideration of the future

Nathan: 00:05:13

or little consideration of the future.

Nathan: 00:05:14

Mm-hmm.

Nathan: 00:05:15

. Corey: So I think that this

Nathan: 00:05:19

loading, immediate gratification.

Nathan: 00:05:22

You know, I, I knew a person in one of my meetings who called it the fuck its

Nathan: 00:05:27

. Nathan: Right, right.

Nathan: 00:05:28

Yeah.

Nathan: 00:05:29

You, you

Corey: 00:05:29

know, like where you just, you, you don't care about

Corey: 00:05:32

the long-term consequence.

Corey: 00:05:33

It's the short-term.

Corey: 00:05:34

Short-term.

Corey: 00:05:36

Entirely.

Corey: 00:05:37

Yeah.

Corey: 00:05:37

And that dopamine response, that's kind of what we're talking about there.

Nathan: 00:05:41

Absolutely.

Nathan: 00:05:42

And it's a little bit, when I looked at it, I thought maybe it's a chicken and an

Nathan: 00:05:46

egg scenario that people can get confused about when somebody's using drugs.

Nathan: 00:05:50

Right?

Nathan: 00:05:51

It's like, well, maybe their behavior is this way because they're using drugs.

Nathan: 00:05:57

Mm.

Nathan: 00:05:57

You know what I mean?

Nathan: 00:05:58

Yeah.

Nathan: 00:05:58

Whereas I believe many times it's that the behavior.

Nathan: 00:06:03

Because of the first two items, you don't believe you have a future.

Nathan: 00:06:08

Therefore, what is the purpose of long-term goals and, uh, with,

Nathan: 00:06:14

uh, loneliness and a lack of connection, you're basically, you

Nathan: 00:06:18

have no support to back you up.

Nathan: 00:06:19

So those two, the first two things make the third thing so attractive, right?

Nathan: 00:06:25

Yeah.

Nathan: 00:06:26

I

Corey: 00:06:26

mean, yeah, because if, if you think about it like a, a

Corey: 00:06:30

piece of cake, Lit, like a literal piece of cake gives everyone sugar.

Corey: 00:06:35

Mm-hmm.

Corey: 00:06:36

gives everyone like a, a bit of a dopamine kick where you're just

Corey: 00:06:40

like, oh my God, this is so good.

Corey: 00:06:41

Mm-hmm.

Corey: 00:06:42

, but for the person who is lonely or the person who doesn't have

Corey: 00:06:47

connection, doesn't have all these other things that we've been talking

Corey: 00:06:50

about and that we were talking about just in that last conversation.

Corey: 00:06:53

That's where the hooks can come in.

Corey: 00:06:55

The hooks of addiction can come in and I use a piece of cake, but I could be

Corey: 00:06:59

talking about, I could be talking about a drug, a chemical drug, just as easily as

Nathan: 00:07:03

well, for sure.

Nathan: 00:07:04

Yeah.

Nathan: 00:07:04

It's uh, , it's the setup, right?

Nathan: 00:07:08

It's the setup, yeah.

Nathan: 00:07:09

Not the, not the substance, uh, necessarily.

Nathan: 00:07:12

And lastly, we have biological despair.

Nathan: 00:07:16

We're talking diseases of despair, of which there are four types.

Nathan: 00:07:20

Lastly, biological despair, which relates to dysfunction or dysregulation

Nathan: 00:07:26

of the body's stress reactive system and or to hormonal inst.

Nathan: 00:07:32

Yeah.

Nathan: 00:07:33

What are your thoughts on that one?

Corey: 00:07:34

This to me is like that feeling when I was going to work of noticing

Corey: 00:07:40

in hindsight or even in the moment, noticing an elevated heart rate.

Corey: 00:07:45

Um, noticing that as on my drive to work, I would get to the same place in my town

Corey: 00:07:51

a block and a half away from the hospital and feel the same way physiologically.

Corey: 00:07:57

Mm-hmm.

Corey: 00:07:58

and that sometimes that would relate to a taste in my.

Corey: 00:08:01

You know that I talked about in my first episode, you know, that the,

Corey: 00:08:06

the feeling of anxiety and stress, the feeling of an el, a perpetually

Corey: 00:08:12

constant, uh, elevation of cortisol Yes.

Corey: 00:08:15

And adrenaline and, and how that could get enmeshed with a sort

Corey: 00:08:19

of an addictive symptom or an

Nathan: 00:08:21

urge of course.

Corey: 00:08:23

Yeah.

Corey: 00:08:23

Yeah.

Corey: 00:08:24

And so this is why environment and not changing, not changing the environment,

Corey: 00:08:29

not changing the other factors is a, such a recipe for, um, risk.

Nathan: 00:08:33

Yeah.

Nathan: 00:08:34

It, and, uh, it's interesting how you can look at these four in the way we just did.

Nathan: 00:08:39

It's sort of a, uh, 1, 2, 3, 4 naco punch, right?

Nathan: 00:08:44

Isn't it?

Nathan: 00:08:44

Yeah.

Nathan: 00:08:45

And the fourth one keeps you in the pocket.

Nathan: 00:08:47

It's the one that locks you in.

Nathan: 00:08:49

He's got the third one is the, , right?

Nathan: 00:08:52

Yeah.

Nathan: 00:08:52

That's the one that staggers you and then you're, you're down for the count and

Nathan: 00:08:57

the fourth keeps you from getting up.

Nathan: 00:08:59

Yeah.

Nathan: 00:09:01

So, wow.

Nathan: 00:09:02

Wow.

Nathan: 00:09:03

Interesting, right?

Nathan: 00:09:04

? Very, yeah.

Nathan: 00:09:05

. So what I'm going to, I'll, I'll just, I'm gonna give a little more of a

Nathan: 00:09:10

explanation as to the definition of, uh, and factors that are contributing

Nathan: 00:09:15

to diseases of despair right now.

Nathan: 00:09:18

And after I do that, then we'll, we'll look at a couple paragraphs, okay?

Nathan: 00:09:20

Yep.

Nathan: 00:09:22

So diseases of despair.

Nathan: 00:09:24

Um, we talk, we, we talk the first four basic types, and then there's some effects

Nathan: 00:09:30

that are going on right now, such as being under the influence of despair

Nathan: 00:09:34

for an extended amount of time may lead to the development of one or more of

Nathan: 00:09:39

the diseases of despair, such as, so you've got diseases of despair causing

Nathan: 00:09:46

suicidal thoughts or drug or alcohol.

Nathan: 00:09:48

If an individual has a disease of despair, there is an increased

Nathan: 00:09:52

risk of death from despair.

Nathan: 00:09:54

So we, we see that these dis diseases are, they're type of

Nathan: 00:09:58

social disease really, right?

Nathan: 00:10:00

Yep.

Nathan: 00:10:00

And they lead to deaths of despair, which are classified as suicides, drug

Nathan: 00:10:06

or alcohol, overdoses or liver failure.

Nathan: 00:10:09

Mm-hmm.

Nathan: 00:10:09

Okay.

Nathan: 00:10:10

So we got those three that are going on right now.

Nathan: 00:10:13

Uh, a little bit of backstory on, we're gonna talk.

Nathan: 00:10:17

I'll use the US data and I'll tie it into Canada, but we're

Nathan: 00:10:20

talking North America here.

Nathan: 00:10:21

So mortality and morbidity rates, which, uh, morbidity, if you don't know, is

Nathan: 00:10:27

the rate of incidents of disease in a population as denoted by a percentage.

Nathan: 00:10:33

So mortality and morbidity rates in the United States have

Nathan: 00:10:37

been decreasing for decades.

Nathan: 00:10:39

As we go along, things have generally gotten better.

Nathan: 00:10:42

If we look at, uh, from 1970 to about 2013, mortality rates fell

Nathan: 00:10:49

by 44%, and morbidity was on the decline even amongst the elderly.

Nathan: 00:10:54

So we were doing pretty.

Nathan: 00:10:56

cardiovascular disease and cancer.

Nathan: 00:10:58

The two biggest killers in middle age are also on the decline, so

Nathan: 00:11:03

those are still like, we're still improving there, even with obesity

Nathan: 00:11:08

being uncontrolled, especially in the US but in Canada as well.

Nathan: 00:11:13

So, We still have those, those two there, and we're not considering

Nathan: 00:11:19

obesity being under control at all.

Nathan: 00:11:21

Despite those improvements, white, middle-aged Americans are experiencing an

Nathan: 00:11:26

increase in premature deaths, especially in those caused by suicide, drug

Nathan: 00:11:32

overdose, and alcohol, liver disease.

Nathan: 00:11:35

. I will add to this that although middle-aged white Americans are

Nathan: 00:11:40

increasing rapidly, they have just caught up to the, to black and Hispanic

Nathan: 00:11:47

ethnicities who have been suffering at higher levels for quite some time.

Nathan: 00:11:51

Yeah.

Nathan: 00:11:52

So this is the first time that we're seeing, especially in our

Nathan: 00:11:56

generation, what's happening is all of a sudden there is almost.

Nathan: 00:12:02

As of the latest data, I believe there's now no difference in races, uh, across

Nathan: 00:12:09

North America for, uh, diseases of despair that end in deaths of despair.

Nathan: 00:12:14

So we are interesting are all Yeah.

Nathan: 00:12:16

Isn't it interesting.

Nathan: 00:12:17

And it's particularly between, uh, the ages 20 to 44.

Nathan: 00:12:22

So there's two factors that they've looked at that are playing into this.

Nathan: 00:12:27

One is education.

Nathan: 00:12:29

. So if you are, if you have an education level that's below or less than a

Nathan: 00:12:34

bachelor's degree, you're at increased risk of dying from diseases of despair.

Nathan: 00:12:39

And then interestingly, um, people who live in rural areas, so in the,

Nathan: 00:12:46

I think the study they're looking at was mostly in the Appalachian

Nathan: 00:12:48

areas of the United States.

Nathan: 00:12:50

So, uh, it's, uh, West Virginia down, I think.

Nathan: 00:12:53

Mm-hmm.

Nathan: 00:12:53

. Mm-hmm.

Nathan: 00:12:54

, um, a ridge, that ridge on the east side of the, the states.

Nathan: 00:12:58

So, in that area, people who were more, uh, living in more

Nathan: 00:13:02

rural areas were more at risk.

Nathan: 00:13:05

And the first thing that came for to mind for me was that maybe that's

Nathan: 00:13:09

because of a lack of communal support.

Nathan: 00:13:11

Like they just don't have the resources to, like, I think you're

Nathan: 00:13:15

more, you're probably more prone to self isolate just because of the.

Nathan: 00:13:19

Kind of the attitude and also the, the actual geo geographical location problem.

Nathan: 00:13:25

You simply don't have the people around you.

Nathan: 00:13:28

So, um, not that cities are, you know, by their nature more, uh,

Nathan: 00:13:33

communal, but you know what I mean.

Nathan: 00:13:34

You

Corey: 00:13:35

do probably have greater access to, to healthcare though.

Nathan: 00:13:38

Yeah, absolutely.

Nathan: 00:13:39

And that might be, that might be the sole factor, right?

Nathan: 00:13:43

Mm-hmm.

Nathan: 00:13:43

They, they haven't elucidated what.

Nathan: 00:13:45

What is causing that, but that's, that's part of the, uh, part of it as far

Nathan: 00:13:49

as an, the numbers game is concerned.

Nathan: 00:13:52

So if you've got a bachelor's degree of education, at least you have

Nathan: 00:13:56

some protection and, uh, they're, they think that that plays into

Nathan: 00:13:59

your, your outlook for the future.

Nathan: 00:14:01

Right.

Nathan: 00:14:02

Preliminary indications in Canada and the United States demonstrate that the

Nathan: 00:14:06

trajectory of drug overdose related deaths was exacerbated by the pandemic in Canada.

Nathan: 00:14:12

Drug overdose related deaths stabilized prior to the onset.

Nathan: 00:14:17

Onset of Covid 19.

Nathan: 00:14:18

I'll put a little addendum in there.

Nathan: 00:14:20

And by stabilized they mean our atrocious numbers.

Nathan: 00:14:23

Were continuing not getting worse.

Nathan: 00:14:25

, right?

Nathan: 00:14:26

Not getting better.

Nathan: 00:14:27

Just leveling out.

Nathan: 00:14:28

Okay.

Nathan: 00:14:29

Yeah.

Nathan: 00:14:29

Which is still horrific.

Nathan: 00:14:30

Yeah.

Nathan: 00:14:31

So in Canada, drug overdose deaths o overdose related deaths stabilized

Nathan: 00:14:36

prior to the onset of covid 19, but increased after the onset of

Nathan: 00:14:41

Covid 19 in the United States.

Nathan: 00:14:44

drug overdose related deaths increased prior to and accelerated

Nathan: 00:14:49

after the onset of Covid 19.

Nathan: 00:14:51

So I'll ask you there, I guess, what do you think is going on as far as,

Nathan: 00:14:57

uh, those numbers are concerned?

Nathan: 00:14:59

Like they seem to be having a, a significant impact on, uh, death

Nathan: 00:15:04

from these diseases of despair?

Nathan: 00:15:07

Yeah,

Corey: 00:15:08

so emotional despair.

Corey: 00:15:10

way up, biological, despair, way up, cognitive despair, probably up.

Corey: 00:15:15

Mm-hmm.

Corey: 00:15:15

. So each one of those factors has probably significantly increased.

Corey: 00:15:20

Yes.

Corey: 00:15:20

Isolation, increased.

Corey: 00:15:21

Mm-hmm.

Corey: 00:15:23

resources decreased.

Corey: 00:15:24

Right?

Corey: 00:15:26

Um, like resources in terms of healthcare, in terms of social

Corey: 00:15:29

resources, in terms of human connection, all of those things dropped off.

Nathan: 00:15:34

Uh, financial resources, speaking loss, financial

Nathan: 00:15:36

resources, losing their jobs.

Nathan: 00:15:38

Plays into, um, when I looked at those numbers, I thought hopelessness, right?

Nathan: 00:15:43

Yes.

Nathan: 00:15:44

When you're looking to the future and you're in the middle of a

Nathan: 00:15:48

lockdown, all of a sudden your world's been turned upside down.

Nathan: 00:15:51

You don't know whether or not you're gonna have a job.

Nathan: 00:15:53

You don't know how long things are gonna go on like this.

Nathan: 00:15:56

You don't know if there's an end game.

Nathan: 00:15:58

These are very real and impactful psychological factors

Nathan: 00:16:02

for human beings that, mm-hmm.

Nathan: 00:16:03

. Uh, there's actually quite a few studies going on right now.

Nathan: 00:16:07

Sort of suss out what kind of an impact we're looking at, but I thought it

Nathan: 00:16:11

was interesting that that's thus far having a, uh, that much of a significant

Nathan: 00:16:16

impact on our, our toxic drug crisis.

Corey: 00:16:20

Yeah, and, and to go back to what you said at the beginning, , I

Corey: 00:16:24

think probably, although it impacted everyone, the people with less

Corey: 00:16:30

education, maybe without a degree.

Corey: 00:16:32

So maybe there was less job security or their jobs were different so that it, it

Corey: 00:16:37

they weren't essential services maybe.

Nathan: 00:16:39

Um, it's a meaningfulness too, right?

Nathan: 00:16:42

Yeah.

Nathan: 00:16:42

Uh, the, the meaningful, uh, how meaningful your job is.

Nathan: 00:16:46

. If you have less than a bachelor's degree in education, you're more likely to be

Nathan: 00:16:50

in a factory type, uh, production job.

Nathan: 00:16:53

Where sometimes that's fine for people, but other people are gonna

Nathan: 00:16:57

find it difficult to derive real meaning and get job satisfaction

Nathan: 00:17:01

from that kind of a environment.

Nathan: 00:17:03

Mm-hmm.

Nathan: 00:17:03

. So I think that plays into it as well.

Nathan: 00:17:06

All right, Corey, so what I'm gonna do now is, Read you four paragraphs

Nathan: 00:17:12

that I have highlighted from the book, the Urge by Eric Fisher, which

Nathan: 00:17:18

I'm currently just about finished.

Nathan: 00:17:21

If I would stop highlighting stuff, I would probably be done.

Nathan: 00:17:24

But, um, there's a lot of good information in there.

Nathan: 00:17:26

So I've got four paragraphs that pertain to our previous discussion

Nathan: 00:17:30

that I'm gonna read here, and I'll just get your thoughts after each one.

Nathan: 00:17:32

Okay, cool.

Nathan: 00:17:33

Yep.

Nathan: 00:17:34

Paragraph.

Nathan: 00:17:36

The Canadian psychologist Bruce Alexander has articulated this idea as

Nathan: 00:17:41

his dislocation theory of addiction, which asserts that the most important

Nathan: 00:17:47

and fundamental cause of addiction is not the biological effect of a

Nathan: 00:17:52

drug or some inborn vulnerability to addiction indiv in individuals,

Nathan: 00:17:57

but rather a society's wounds.

Nathan: 00:18:00

Importantly, That pain doesn't need to be the kind of concrete loss

Nathan: 00:18:04

such as the poverty and disease experienced by any culture or

Nathan: 00:18:08

group that we're gonna talk about.

Nathan: 00:18:10

There is also a psychological dislocation that can be just as toxic,

Nathan: 00:18:14

such as being torn from a culture and traditional S spirituality,

Nathan: 00:18:18

losing freedom and self-determination and lacking opportunities for

Nathan: 00:18:22

joy, joy and self-expression.

Nathan: 00:18:25

Even for those of us who are not suffering from such tangible deprivations today, we

Nathan: 00:18:31

are just as vulnerable as our ancestors, if not more so to the psychospiritual one.

Nathan: 00:18:37

What are your thoughts on that?

Nathan: 00:18:39

Yeah, that's a, that's a big one.

Nathan: 00:18:40

Yeah.

Corey: 00:18:41

Yeah.

Corey: 00:18:41

Certainly rings true for me.

Corey: 00:18:44

The thing it took me back to is how I was feeling.

Corey: 00:18:47

You know, I, I was divorced, I became a single parent, had a lot of.

Corey: 00:18:54

a lot of bills to pay a lot, you know, financially I became sort of locked into

Corey: 00:18:58

a, into a pretty desperate feeling state, which took away some of the feeling

Corey: 00:19:04

of freedom or feeling of choice that I had with, with my job in particular.

Corey: 00:19:09

And so it, you know, the thing, the word that comes up is like,

Corey: 00:19:12

it was, it really locked me.

Nathan: 00:19:15

Yeah.

Nathan: 00:19:15

When I read this, I see people's opportunities and

Nathan: 00:19:19

autonomy being taken away.

Nathan: 00:19:21

Yeah.

Nathan: 00:19:22

By circumstances that are out of their control.

Nathan: 00:19:24

Yeah.

Nathan: 00:19:25

And while I don't necessarily agree that it, it's, you know, it's not, this was

Nathan: 00:19:30

just an assertion that, and it was one theory that was put forward at a time.

Nathan: 00:19:35

Um, we know that there's many factors of addiction and you can't.

Nathan: 00:19:39

Nail it down to one, but it's interesting how this psychologist

Nathan: 00:19:43

kind of looked around, saw the cultures that were suffering.

Nathan: 00:19:46

The First Nations cultures are a great example of what happens when you, you

Nathan: 00:19:51

take away people's purpose, their meaning, their spiritual connection, their ability

Nathan: 00:19:56

to live their life, the way they wanna live their life, and lock them into

Nathan: 00:20:00

a, a paradigm shift that they had, you know, no interest in being a part of.

Nathan: 00:20:05

Right.

Nathan: 00:20:06

. Yeah.

Corey: 00:20:07

Hopelessness is still an undervalued

Nathan: 00:20:10

human condition, isn't it though?

Nathan: 00:20:12

Yeah.

Nathan: 00:20:13

I mean, the more I look, the more I read, it just keeps coming up.

Nathan: 00:20:17

Mm-hmm.

Nathan: 00:20:18

, it's hopelessness and, uh, I used to laugh about it in pharmacy because

Nathan: 00:20:22

I would always, uh, I had a joke with a, a pharmacist early on about

Nathan: 00:20:26

how our situation was despondent.

Nathan: 00:20:29

Mm-hmm.

Nathan: 00:20:30

, like, there was no way we could, there was no hope for winning.

Nathan: 00:20:32

Right.

Nathan: 00:20:33

Yeah.

Nathan: 00:20:34

This was, you know, previous to my issues.

Nathan: 00:20:37

And I, I look back at that and I think, huh?

Nathan: 00:20:40

Despondent is a big factor.

Nathan: 00:20:42

Yeah.

Nathan: 00:20:43

And it, although we were joking about it, there was a lot of truth and still is.

Nathan: 00:20:47

Well, it still is.

Nathan: 00:20:48

There's more truth to it than ever in the profession of pharmacy.

Nathan: 00:20:52

And I'm sure if you talk to any nurse who's practicing right

Nathan: 00:20:55

now, , despondent would be.

Nathan: 00:20:58

Something they could use to describe the situation.

Corey: 00:21:01

Oh my God, yeah.

Corey: 00:21:01

There, there's no hopeful language being used in that, in the profession.

Corey: 00:21:06

I don't

Nathan: 00:21:07

think.

Nathan: 00:21:08

No.

Nathan: 00:21:08

Uh, no.

Nathan: 00:21:09

Hopeful language and optimism is hard to generate.

Nathan: 00:21:11

Like, I mean, I was, yeah, I was just talking with, uh, a pharmacist that

Nathan: 00:21:15

I've known for a long time yesterday, and I tried to take an optimistic kind

Nathan: 00:21:20

of turn on the conversation when we were talking about how pharmacists

Nathan: 00:21:23

are gonna be able to prescribe and.

Nathan: 00:21:25

you know, just watching that bounce off this pharmacist as if No, they immediate,

Nathan: 00:21:30

like, it's not, it doesn't matter at all.

Nathan: 00:21:33

They're going to screw it up.

Nathan: 00:21:34

Yeah.

Nathan: 00:21:35

You know, , I just, I mean, I, I couldn't keep up the facade, you know?

Nathan: 00:21:40

No.

Nathan: 00:21:40

Like, I know that we all know it, you know, it's, they just,

Nathan: 00:21:45

the evidence is overwhelming.

Nathan: 00:21:47

But anyway, yeah.

Nathan: 00:21:48

So that's that one.

Nathan: 00:21:50

Uh, the next paragraph will be shorter, I promise.

Nathan: 00:21:53

So here we go.

Nathan: 00:21:54

This is the core of addiction as dislocation theory.

Nathan: 00:21:59

Beyond soothing the concrete effects of physical dislocation,

Nathan: 00:22:03

people use drugs to address an alienation from cultural supports.

Nathan: 00:22:08

This kind of alienation is what Emily Durkheim, the founder of

Nathan: 00:22:12

Modern Sociology, called Anami.

Nathan: 00:22:16

The social condition of a breakdown of norms and values resulting in

Nathan: 00:22:20

an existential lack of connection to meaning and purpose, both this

Nathan: 00:22:25

sense of dislocation and the actions of addiction supply industries,

Nathan: 00:22:30

uh, whether that's pharmaceutical or illicit drug supply industries.

Nathan: 00:22:35

Some scholars argue are the core drivers of today's opioid epidemic.

Nathan: 00:22:41

So she's asserting that the, the condition we discussed before, the

Nathan: 00:22:45

addiction as dislocation theory and the aggressive nature of, especially in the

Nathan: 00:22:51

us the marketing of pharmaceuticals.

Nathan: 00:22:53

Mm-hmm.

Nathan: 00:22:54

, um, we know that played a factor, but, you know, what are your thoughts

Nathan: 00:22:58

on the, on that paragraph so far?

Corey: 00:23:01

That the machine that we speak of so regularly is more harmful than

Corey: 00:23:06

it is good if it, it is generating the feeling of hopelessness.

Corey: 00:23:09

It is taking away the feeling of self-determination and autonomy.

Corey: 00:23:13

Then just by that alone, which is a lot , then it's doing more harm than it is.

Corey: 00:23:18

Good.

Corey: 00:23:18

That's what comes

Nathan: 00:23:19

to mind for me.

Nathan: 00:23:19

Yeah.

Nathan: 00:23:20

Yeah.

Nathan: 00:23:20

This kind of illustrates the.

Nathan: 00:23:23

the importance of considering how much you are going to change your lifestyle

Nathan: 00:23:28

and maybe profession if you are in a situation where your profession

Nathan: 00:23:32

is, is contributing to your problem.

Nathan: 00:23:34

Mm-hmm.

Nathan: 00:23:35

like it was for me and you, you can see how dangerous it is to continue to

Nathan: 00:23:41

sit in that, go back and sit in that environment when you know, even on a, a

Nathan: 00:23:45

large, uh, social scale, you can see how these things have a determining factor.

Nathan: 00:23:50

Absolut.

Nathan: 00:23:52

Okay, next one is shorter still.

Nathan: 00:23:54

So, case in Deaton, these are the two who, who came up with the diseases of despair,

Nathan: 00:24:00

uh, to psychologists labeled these deaths from suicide, drug overdoses, and alcohol,

Nathan: 00:24:05

liver diseases, deaths of despair.

Nathan: 00:24:09

In 2017, there were more than 150,000 deaths of despair in the United States.

Nathan: 00:24:16

More than half the numbers of US combat deaths in World War II, all

Nathan: 00:24:21

in one year, and many of them among people in their twenties and forties.

Nathan: 00:24:26

Wow.

Nathan: 00:24:26

Yeah.

Nathan: 00:24:27

Wow.

Nathan: 00:24:27

Right.

Nathan: 00:24:28

That's how , I mean, the only thing I, uh, that I would add to this

Nathan: 00:24:33

is that they're not considering the, the nature of the drug supply.

Nathan: 00:24:37

Right?

Nathan: 00:24:38

Yeah.

Nathan: 00:24:39

Right.

Nathan: 00:24:39

So, with that statement, what are your, uh, thoughts?

Corey: 00:24:43

Oh, you know, in the current trend that you, you know, you

Corey: 00:24:47

five minutes, two minutes online, the trend is this promotion of

Corey: 00:24:51

the focus of on mental health.

Corey: 00:24:53

Mm-hmm.

Corey: 00:24:54

, and obviously that.

Corey: 00:24:56

greatly needed, but just what, what that makes me think is that it is so much

Corey: 00:25:00

worse than we all understand it to be.

Corey: 00:25:04

Mm-hmm.

Corey: 00:25:04

. It is a, what a tragic state of affairs that we're in as a society, if that

Corey: 00:25:10

people feel that hopeless and desperate.

Nathan: 00:25:12

Yeah.

Nathan: 00:25:13

And again, I, I can't state this enough that the ramifications of hollowing out

Nathan: 00:25:20

the core of our population demographic, that is already in big, big trouble.

Nathan: 00:25:26

, I mean, how this is not front and center problem number one in this province.

Nathan: 00:25:32

I just can't, I cannot understand the shortsightedness of our leaders mm-hmm.

Nathan: 00:25:37

On this.

Nathan: 00:25:38

Mm-hmm.

Nathan: 00:25:38

. Mm-hmm.

Nathan: 00:25:39

. It's just mind boggling.

Nathan: 00:25:41

I mean, we know that we're going into a situation where we've got a inverted

Nathan: 00:25:46

pyramid, basically, population wise, and now we're talking about taking.

Nathan: 00:25:53

You're basically eliminating the support structure right

Nathan: 00:25:56

underneath the baby boomers.

Nathan: 00:25:58

Yeah.

Nathan: 00:25:58

What do you think is gonna happen?

Nathan: 00:26:00

You know, I mean, this is a very, uh, a strange situation to be a part

Nathan: 00:26:05

of, to watch it unfold and to watch the, to see how much more prominent,

Nathan: 00:26:10

um, like even in the pandemic, yes, it, I mean, I understand it was a

Nathan: 00:26:15

crazy time for everybody, but nobody is talking about how we are under.

Nathan: 00:26:21

The, the situation we are in and have been is way more dangerous.

Nathan: 00:26:25

Yeah.

Nathan: 00:26:25

And has been for a long time.

Nathan: 00:26:27

Yeah.

Corey: 00:26:28

You know, the, the, the only other thing that makes me

Corey: 00:26:30

think too is that we are the people that are in positions of power.

Corey: 00:26:33

The people that are calling the shots are also certainly in despair.

Corey: 00:26:38

In their own, in their own way.

Corey: 00:26:40

Oh, sure.

Corey: 00:26:40

I don't think, I think in many times they are not the, sort of the victims

Corey: 00:26:45

of financial despair or of, of being powerless or hopeless mm-hmm.

Corey: 00:26:50

because they are the ones that are, that are wielding the sword,

Corey: 00:26:52

but, But you can see the, the hurt, you can see the, the anguish.

Corey: 00:26:57

You know, there was just as an example, and not to get too far into like American

Corey: 00:27:00

politics, but one of the most profound examples of this to me was in the United

Corey: 00:27:05

States two weeks ago, they were voting for the speaker of the house and this

Corey: 00:27:08

sort of Republican, Trump, Republican Kevin McCarthy is, is trying to get

Corey: 00:27:13

voted in to be the speaker of the house.

Corey: 00:27:14

And it took like, 14 votes and he kept, you know, publicly getting rejected.

Corey: 00:27:19

No, we're not, we don't accept you.

Corey: 00:27:21

And then he, and this is all on camera, and he's, you know, trying to rally

Corey: 00:27:24

support and going to this person, going to this person and trying to

Corey: 00:27:28

plead his case and No, you're rejected.

Corey: 00:27:30

And they vote again.

Corey: 00:27:31

And he, and he rejected and, and it was like, , it was like the child on

Corey: 00:27:35

the playground who kept going back and getting rejected and, and you could

Corey: 00:27:38

just see this guy's sort of psyche on display, uh, and the ugliness there.

Corey: 00:27:44

Mm-hmm.

Corey: 00:27:44

and the, the human despair.

Corey: 00:27:46

Right.

Corey: 00:27:47

And, and this is not someone who I would be supportive of as a, you know,

Corey: 00:27:50

like sort of a, a Donald Trump guy.

Corey: 00:27:53

He was, the opposition to him was trying to sort.

Corey: 00:27:56

Maintained some or regained some normalcy.

Corey: 00:27:59

Mm-hmm.

Corey: 00:27:59

, and he ultimately ended up getting in and the people who, the people

Corey: 00:28:04

on his side, the Republicans on his side, were finally caved and weren't

Corey: 00:28:08

able to sort of sustain the pressure.

Corey: 00:28:10

Mm-hmm.

Corey: 00:28:10

and I look at those people too and say, well, there's, there's human despair

Corey: 00:28:14

at play there too, that they couldn't sort of maintain their own boundaries.

Corey: 00:28:18

Right.

Corey: 00:28:19

And finally ended up saying, yeah, fine.

Corey: 00:28:21

And they voted him.

Corey: 00:28:22

Yeah.

Nathan: 00:28:23

And yeah, that, that's a, that's a great example of, uh, The state

Nathan: 00:28:28

of, uh, how the state of politics is.

Nathan: 00:28:30

I mean, we know that it's a, a clown show at this point as far as Yeah.

Nathan: 00:28:35

Uh, you know, the structure of our leadership in Canada and the states.

Nathan: 00:28:39

It's just, there's nothing left that resembles what you would, I

Nathan: 00:28:42

think, describe as a democracy.

Nathan: 00:28:44

It's just a, yeah, intangible, nebulous, cloud of mayhem, . But, uh,

Nathan: 00:28:50

it, it does illustrate a good point.

Nathan: 00:28:52

And that's that, uh, those people are human too, and they are struggl.

Nathan: 00:28:56

And, uh, maybe the chaos or the lack of action is a, a little bit.

Nathan: 00:29:00

Um, I, it certainly can't be excused, but you can see that the structure

Nathan: 00:29:05

of the, the bigger machine is kind of maybe holding back a lot of people from

Nathan: 00:29:10

making progress, I guess you could say.

Corey: 00:29:12

Yeah.

Corey: 00:29:13

And we do a really good job of looking way back in history and saying, well,

Corey: 00:29:17

N Napoleon, he was crazy and Adolf Hitler was crazy and they had all of

Corey: 00:29:22

this early life stuff that happened to them and, and they were on drugs and

Corey: 00:29:25

they were this, and they were that.

Corey: 00:29:26

But this too is happening in the present that people are, the people

Corey: 00:29:30

that are making these decisions for us as a society are also in

Corey: 00:29:34

their own way hurting and, and.

Corey: 00:29:37

I have some empathy for them, but I also want to say like we have to change that.

Corey: 00:29:41

I would hope that we can find people who are, who have figured

Corey: 00:29:45

out their despair a little bit better to rule our, our countries

Corey: 00:29:50

That's my hope at

Nathan: 00:29:51

least.

Nathan: 00:29:53

. Well, you gotta have hope.

Nathan: 00:29:54

Uh, like

Corey: 00:29:55

imagine a, imagine a campaign, a political campaign where the, the

Corey: 00:29:58

politicians says, well, I've really done what I can in the last number of years

Corey: 00:30:03

to, to look at my cognitive despair, , and to look at my emotional despair.

Corey: 00:30:09

And I've formulated really good, strong, powerful connections in my life.

Corey: 00:30:13

Yeah.

Corey: 00:30:13

And I'm doing all I can to, to work on my stress and my anxiety and

Corey: 00:30:17

my feelings of inferiority, , and,

Nathan: 00:30:21

well, this is, I mean, there's problems that, uh, that go back to.

Nathan: 00:30:27

I mean, really we've been marketed out of our ability to discern

Nathan: 00:30:31

what a good leader even is.

Nathan: 00:30:33

Yeah.

Nathan: 00:30:33

And to be honest, at this point, what happens in politics is secondary to the

Nathan: 00:30:39

structures that lie above it now, which is, you know, like the pharmaceutical

Nathan: 00:30:43

companies that we're able to do what.

Nathan: 00:30:45

Purdue did, and the, you know, these, these kind of structures

Nathan: 00:30:49

until they're held accountable, we are going to constantly be at the

Nathan: 00:30:54

mercy of marketing campaigns mm-hmm.

Nathan: 00:30:56

That are too slick for the average Canadian or American to navigate.

Nathan: 00:31:02

that includes both of us.

Nathan: 00:31:03

Yeah.

Nathan: 00:31:03

Yeah.

Nathan: 00:31:04

But the hope is, like you said, if we can, if we can increase our understanding

Nathan: 00:31:09

as individuals of our own cognitive needs as far as maintenance goes, then

Nathan: 00:31:15

perhaps that can have a spillover effect.

Nathan: 00:31:19

And eventually we'll come to an awareness as a culture that we need to make changes

Nathan: 00:31:25

on a big structural, uh, structural level.

Nathan: 00:31:29

So we must tend to the garden that we can touch.

Nathan: 00:31:32

Yes.

Nathan: 00:31:32

Yes.

Nathan: 00:31:34

, do you have one more there?

Nathan: 00:31:35

I realized this last one here is just a spillover of the, uh,

Nathan: 00:31:39

of what we've already discussed.

Nathan: 00:31:40

So I'm gonna leave that one and show mercy to you cuz you, uh, navigated

Nathan: 00:31:44

those very well, , incredibly lengthy.

Nathan: 00:31:48

That was

Corey: 00:31:49

fascinating.

Corey: 00:31:50

Really, really interesting.

Corey: 00:31:51

And can you tell us again where this literature came?

Nathan: 00:31:54

The explanation of the diseases of despair.

Nathan: 00:31:58

I mean, it, it's all over the web.

Nathan: 00:32:00

Uh, there's, if you go on Wikipedia and look at their first, like 17 resources,

Nathan: 00:32:05

they've all got, uh, case and Deaton studies in there that you can look at.

Nathan: 00:32:09

Uh, you can also, uh, search case and Deaton themselves, and they, you'll,

Nathan: 00:32:13

you'll see the work that they've done.

Nathan: 00:32:15

So that's, uh, that'll give you all the information on diseases of Despair.

Nathan: 00:32:18

And then the rest is from Eric Fisher's book, the Urge.

Nathan: 00:32:23

Which is, uh, written by a physician who struggled with alcohol himself and

Nathan: 00:32:28

he kind of weaves his own story that's very similar to ours in that he went

Nathan: 00:32:33

through the same type of kind of hampered system, uh, for healthcare professionals

Nathan: 00:32:37

where you have access to supports and you're kind of guided through this thing

Nathan: 00:32:41

that still makes absolutely no sense.

Nathan: 00:32:44

Mm-hmm.

Nathan: 00:32:45

. And you have to, you know, he talks about having to just be like, uh, Yeah.

Nathan: 00:32:49

Uhhuh.

Nathan: 00:32:50

I, I'll do what you say.

Nathan: 00:32:51

Just, uh, get me through this thing, right?

Nathan: 00:32:53

Yeah.

Nathan: 00:32:54

Um, a and then he weaves stories.

Nathan: 00:32:56

Uh, it's the most.

Nathan: 00:32:59

Detailed history of the, of drug policy.

Nathan: 00:33:02

I've ever seen some of this stuff I've, I've run across before, but

Nathan: 00:33:06

I've, this is the most far reaching.

Nathan: 00:33:08

Mm-hmm.

Nathan: 00:33:09

. He, he goes way back and he really demonstrates the politics of both

Nathan: 00:33:14

Democrats, Republicans in the States, how little it makes a difference,

Nathan: 00:33:17

who's in power, where it, it's just all it is, is a different kind of

Nathan: 00:33:22

coding on the same product, which.

Nathan: 00:33:25

You know, fear driven mass media campaigns in marketing mm-hmm.

Nathan: 00:33:28

to continue the status quo.

Nathan: 00:33:30

He refers to the treatment, uh, economy down there as the, what does he say?

Nathan: 00:33:36

The treatment industrial complex.

Nathan: 00:33:38

So it's, uh, I like that because it's, uh, it's, it's quite accurate.

Nathan: 00:33:42

Yeah.

Nathan: 00:33:42

Um, and when you see how much power they wielded in the nineties, especi.

Nathan: 00:33:48

Once, you know, when basically they were running a like stamp and print

Nathan: 00:33:53

campaign for insurance companies.

Nathan: 00:33:55

I mean, they had so much money they could push whatever

Nathan: 00:33:57

agenda they wanted, but yeah.

Nathan: 00:33:59

Yeah.

Nathan: 00:33:59

I'm rambling on now.

Corey: 00:34:01

Interesting though.

Corey: 00:34:02

I like that.

Corey: 00:34:02

The treatment industrial complex.

Corey: 00:34:03

I'm

Nathan: 00:34:04

gonna think about that . Yeah.

Nathan: 00:34:05

Uh, food for thought and maybe discussion later.

Nathan: 00:34:08

All right, Corey, thank you very much for, uh, your thoughtful replies.

Nathan: 00:34:12

It was really good.

Nathan: 00:34:13

All right, Corey, we will talk next time.

Nathan: 00:34:15

Thank you.

Nathan: 00:34:16

See you soon.

Nathan: 00:34:16

Bye.