EP #139

Summer Content Series: The Science of Alcohol on Our Brain, Body & Spirit

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Hey, it’s Molly from alcohol minimalist. What do you do in this October? I would love to have you join me in my more sober October challenge. What do I mean by more sober October, it simply means that we’re going to add in more alcohol free days than you currently been doing, whether that’s one or two or 31. It’s up to you, you get to set your own goal and that’s why it’s more sober October, you can check it out and learn more at get got sunnyside.co/molly It’s totally free. I’ve got prizes, I’m going to be going live every week to announce the prize winners. And it’s just going to be an awesome event. So I would love to have you join me. You can learn more at get.sunnyside.co/molly and you can get registered today. Welcome to the alcohol minimalist podcast. I’m your host Molly watts. If you want to change your drinking habits and create a peaceful relationship with alcohol, you’re in the right place. This podcast explores the strategies I use to overcome a lifetime of family alcohol abuse, more than 30 years of anxiety and worry about my own drinking, and what felt like an unbreakable daily drinking habit. Becoming an alcohol minimalist means removing excess alcohol from your life. So it doesn’t remove you from life. It means being able to take alcohol or leave it without feeling deprived. It means to live peacefully, being able to enjoy a glass of wine without feeling guilty and without needing to finish the bottle. With Science on our side will shatter your past patterns and eliminate your excuses. Changing your relationship with alcohol is possible. I’m here to help you do it. Let’s start now. Well, hello and welcome or welcome back to the alcohol minimalist podcast with me your host Molly Watts coming to you from Oh, it’s very hot Oregon, still very warm. Then in the 90s this weekend, and and we’re unfortunately caught in a cycle here in the at least in the Portland area where we’re getting a lot of wildfire smoke coming up from the south again. And so we’ve got this, and he’s an air quality’s not very good, isn’t as bad as it was a couple of years ago. But it’s not great. It’s not fun. And I think it’s supposed to be on the cooldown here. But again, you know, it’s summer and I’m I’m loving it. I know that the rains are coming soon. And so I’m trying to soak up all this this warm weather while I still can. Hey, this is one of the last episodes in the summer content series. I’m sort of toying around with the idea of doing one more, I really only had this last one or this week is the last one scheduled. So we’ll see. Well, you’ll have to tune in next week to see what I come up with if I decide to so this particular episode, I’m just delighted to share with you. Molly Kimball, who was on the show this year, was very popular. And she was she is responsible for a program down in Louisiana called alcohol free for 40. And it’s it’s been very successful. And we talked about that a lot. I’ll link her episode that I talked with Molly in the in the show notes. She has her own really successful podcast and she did a great episode talking all about the health and nutrition aspects of alcohol with with with an MD and that’s the episode that I’m sharing with you today. So this is from fueled with Molly Kimball. And I know you’re really gonna enjoy it. I hope you’re having a great summer I hope you’re enjoying the month of August I have been you know traveling a bit and spending time outdoors spending time with my family. And if you didn’t hear it, I had a a webinar last week and I have opened making peace with alcohol so I would love to have you check it out. You can learn more over at my website, www dot Molly watts.com. Again, here is Molly Kimball from her fueled podcast. This episode is called The Science of alcohol on our mind, body and spirit. I’ll see you next week. So Dr. Garber, thank you so much for taking the time out you’re very welcome. I’ll I’ll let you do your intro and kind of give us the full scope of of your affiliations and what you do what you’re currently doing and what your research has been in the past. So my name is Dr. JC Garbutt for majority of my career about 45 years I was a professor of psycho It returns Carolina Chapel Hill. And the research side is that the Bowles Center for Alcohol studies, also, Chapel Hill. And my work has really been focused on both understanding sort of the biology of alcoholism, alcohol use disorders, and also figuring out ways to help people move forward and get treatment for alcohol problems, including the use of medications and my primary interest over the last 20 something years as we’ve been developing medications for alcohol use disorders to help people make progress and their health. And you studied a lot of the effects of alcohol. So these things that we’re aware of, or we know these things happen, I’m hoping that you can help us understand the why. And I think when we there’s a lot of myths around alcohol that you and I will be talking about. And then a lot of things that it truly has a it has a physical effect that in some cases, we’re not even aware that sometimes what we’re turning to alcohol to help us with is actually harming us. So one in particular that we had talked about briefly before, is stress and anxiety. And that’s something that I’ve talked with our listeners before, on this podcast of a lot of times we, you know, we turned to alcohol as a stress reduction, I’ve had a rough day, a long day, a stressful situation, I’m gonna have that glass of wine or pour that cocktail. But that’s not really it’s not really something that helps us reduce stress. So tell us more about that. It’s a great question is very important one, alcohol, which is a very simple little molecule, it has all these very complicated things in the brain. And we’re just continuing to learn much more about it. So one of the things we know is that, and intriguingly is that alcohol has an acute has sort of an anti stress effect, or anti anxiety effect. So people do feel kind of more relaxed, less tense, less stressed, as the alcohol is being consumed, that, as you mentioned, after work or coming back, and having a few glasses of wine or feeling, feeling those kind of positive feelings. The thing we’ve learned really over the last 20 to 30 years is that, at the same time, alcohol is doing this acutely. It also can be activating stress systems in the brain. So the following day, our stress systems are actually more active. And what happens then over time, is weeks or months or years go by the stress systems can become quite active such that one may be drinking in order to calm down the stress systems, they’ve activated with alcohol. And what people find many times is they have a period of time away from alcohol, they feel oh, I’m feeling more relaxed, the feeling, not as not as irritable, not as stressed, not as tense. I didn’t know I could feel this way. I thought, maybe only alcohol can make me feel that way. And we now know this sort of biologically that it does activate immune systems in the brains. And that, so it’s kind of a push pull thing, I feel acutely relaxed, but then over time, it’s making things worse. And am I right that it almost like it lowers our threshold, our ability to handle the stressful situation. So if something is a level three of a stressor, it can make us almost perceive it as a 789 10. That’s would be one way to put it. So we think about stress and how our brain reacts to stress. We have systems in our brain that get activated in a way that alcohol is sensitizing those systems. And so when we have a stressor that would say activate it to one level, after drinking over time, it may activate it to three or four times where it’s where it was. So this is our fifth year doing our alcohol free for 40 challenge here in New Orleans, and excited that we’re taking it throughout the state for this 2020. And when I first started it, it was 2016. Right after Mardi Gras was our first time, but in 2015, as I had pitched it to my editors at the newspaper, hey, is this something we can do? So let me do my own self experiment. And so I had gone in, I’d asked my doctor to do all the lab markers that we talked about. And I said let me give myself a week. And I wanted to see also wanted to see what kind of changes are going to be in one week. But what I noticed that was so I kind of did myself as my own experiment. I thought if I’m going to be asking our community to do this, I need to see how it feels. And so, you know, we always have a lot going on. There’s always a lot of things that you know, everybody’s got a lot on our plate. One thing that had been happening over time, I’ve been doing TV segments for years at this point, it’s been 10 years, 12 years weekly, but at this period of time that I was doing my own little self experiment I had been experiencing when I would do a TV segment live, or when I would be in front of a group of people presenting something I’d been doing for, like, I mean, 15, almost 20 years presenting to people, I was having a very high reaction to that to the stress. And I was, you know, sometimes you get those jitters right, when you first start a presentation, I think that’s normal. But you can kind of dial it back and you get control of it. I felt like it was rising, and I wasn’t able to bring it down like that. And even on live TV in front of a large room of people, or whatever it was. And I thought, wow, but I thought it was just, you know, it’s kind of one of those things where we can always excuse it to something else, we always put it on something else. I was like, Well, gosh, I have so many, so many other things going on, or I have a lot on my mind, or I have a lot that I’m you know, trying to fit in and my anxiety is going up? Well, just in that one week that I gave myself to that first step to try that alcohol free. I had several events, and I didn’t experience that. And I thought, wow, this is a game changer, that even just going you know, being three days, five days now seven days into not drinking and being in situations that were eliciting that response, to not have it. For me that was life changing? Well, and it’s something we see. And I think even more than I you know, a lab test or a lead marker, are those kinds of things people experience like stress, like anxiety, like sleep, those things, I think are the most sensitive kind of markers of positive change. And people have a period of time away from alcohol, they realize, Oh, I’m feeling different, oh, maybe I’m less irritable and less anxious and less stress. We know that alcohol, in some cases can actually contribute to like the onset of a panic attacks. And so when the person gets an environment like you’re describing, what would have been mildly anxious, it could potentially trigger a full blown panic attack, which is extremely uncomfortable. Anyway, it was it was starting to feel that way. And this isn’t something I like, you know, I’m putting it here on our podcast. But I would feel heart racing, my ears roaring, you know, things were starting to like the the room is going down. And I’m like this, this is live TV or like this is in front of hundreds of people that can’t happen. And why like why now? And so, to me, it was a very, that, to me was the one of this one of many, but a huge motivator to say, Wow, this is a change worth asking our community to try. And that’s a lot of the feedback that we’ve gotten. I think it’s important for people as they go through something like an alcohol free for 40 challenge to pay attention to these things. Do you have recommendations for people of how to how to tune into that? Because I think a lot of times we’re so busy in our day, we don’t always stop and pay attention to those reactions. Do you have people journal? Or what’s been your experience and how to get people to really notice that? Well, it’s one of just being aware of what may be happening, if you have a period of time when you say free from alcohol, then just kind of I mean, journaling could be an idea. I mean, to kind of be aware every so often take stock of how you’re feeling what you’ve noticed about yourself, how’s your sleep, how’s your interaction with your spouse, or your friends or other people and it’s like less irritable and angry. And so those awareness kind of people even hear that from people around them in their lives. I go, you know, you’re, you’re less irritable, you’re not, we don’t get into arguments as often or use, you’re calmer and so there can be external kind of affirmation of that in. So but I mean, I think, however, one wants to assess it or look at it as kind of take stock of it either through journaling, or just being aware and kind of every so often, like, hey, how am I doing? What am I feeling? And those are good markers to look at. Like you said, they’re, they’re really almost impossible to really accurately measure like you would do say lab bloodwork. But during the 40 days, as someone goes, Man, 40 days is a long time. Once we start paying attention to these little micro benefits, it’s easier to kind of stay on track. You mentioned sleep. This is one where I think it’s another let me jump in and say something because you mentioned your 40 days is a long time and one thing we know in treatment community and this is not I know this has reached a lot of people who maybe aren’t really what we consider should be getting treatment per se but is that it’s the one day at a time philosophies extremely helpful idea to utilize rather than oh my gosh, 40 days, I’m never gonna get there. No, it’s not that it’s alright today. I’m just not going to. I’m not going to drink today and the depth before for one knows it. Two weeks go by three weeks go by and then you’re there. So that’s I think that’s a useful way to sort of think about this phenomena rather than oh my gosh, you know, I can’t I can’t drink for 40 days. Right? It’s it’s it It seems like a giant undertaking. And to that point to, I think, as you look at, I’m not going to drink today, like you said, I think kind of putting it was instead of thinking what you’re not going to do, thinking of what you’re going to do instead, what’s that positive replacement behavior you’re going to do instead of drinking? It also what you’re kind of doing for yourself, potentially, we may get into it more you say later about some of the health effects, like you’re doing something positive for your health, positive for your emotions, positive for your relationships, and those are useful things to help kind of keep you to be motivated. Right, right. And so, so on the topic of sleep as being kind of another health benefit. This is one that I think and even in past years of the challenge, people say, Oh, it’s so much harder for me to fall asleep at first because they weren’t having the alcohol. So tell us about that. Like, how and why does alcohol make it easier for us to fall asleep, but explain to us just how it disrupts our sleep patterns. In a way it’s kind of like with the anxiety that I mentioned earlier that the initial effects of course, it is a sedative medication. So if you drink alcohol, you will get sleepy, you’re gonna get sleepy because you drink more and more eventually can even get into a semi comatose state. So it’s a very, it’s a sedating, depressant drug, right? It’s like someone falling asleep, or they passing out. Although telcos, as I mentioned, simple but complicated molecule, because when one at the initial stages of consuming the alcohol, it has this kind of activating that to where people feel alert, and they’re talking more, and they may feel this little euphoria, genic rush, and they just feel I mean, they, you know, that’s it, that’s the cocktail party was all about is it’s a social lubricant, you know, people interact more, they have more energy, they do think, but then that starts to fade. And then as the consumption level goes up, then the more sedative depressant effects begin to take over. And some people can use it, yeah, they have a few drinks, and then I go to bed on May I’m tired and fall asleep. Well, a lot of times what happens, it’s also disruptive to our sleep cycle. So later on at night, and after the number of hours, sleep may be disrupted, people more likely to wake up, they’re less likely to have total sleep time to have to get into you know, deeper stages of sleep and have more restful sleep. So it’s a sleep disruptor. We know that over time, particularly as one drinks regularly and drinks more heavily, potentially, they can become more disruptive to sleep. And so one of the things we see, when people have a period of not drinking, I mean, like, a few weeks or something like that. But often they will say, Wow, I’m sleeping so much better, I feel so much more rested, I’m sleeping longer, I don’t wake up as often. So it’s that sort of disruptive effect that then began to dissipate. And they’re actually finding their sleep improved. But initially for a number of days, or even a week or so they may not notice that and they really have to stick with it over time to really see the full benefits. And he is at that point to looking for other things at bedtime to help with that transition into sleep. It’s not alcohol. And so putting your phone away getting that screen light away, getting out an old fashioned book, you know, things that are gonna kind of walk you lead us through that path of relaxation without alcohol. Yeah, in fact, there’s a whole we call it sleep hygiene. And sort of when we work with people, we talk about, oh, they need to improve your sleep hygiene. And there’s a whole series of things and one could look on the internet or get a series and probably you know, 10 to 15 Different things once you don’t eat right before you go to bed. You don’t eat in the bed. If you’re not sleeping, you don’t just lie there in bed and toss and turn, get up, get out, go do something and try to come back when you rested. Keep your room cool, don’t try not to watch television and you know, emotionally stimulating things. There’s a whole series of things one can do to help sleep better, but one of the most important things is just a little bit of patience, particularly from the standpoint of transitioning fades from alcohol to like not drinking as much alcohol. Just take some time and one of the things we don’t want to do is for people to say I’m not sleeping doc or give me a pill because that can be that has its own problems and its own detrimental effects potentially we can come back to create almost a trading. Yeah, that’s right. Yeah. So we it may be a quick fix, but it’s also one that comes with some problems. On the note of sleep hygiene, one of the things that I highly recommend is sleeping with your smartphone and the other room and I put mine just in the bathroom which is just right around the corner so I still use it as my alarm. It’s It’s, I can hear it, it’s in the other room. But it makes whenever I wake up, I’m not tempted to look at it, I don’t see the light from it at night. And also, I think most importantly, when I get into bed, I’m not losing that mind numbing 30 minutes or an hour that a lot of us scroll through our phones, when we’re really not fresh. And so as soon as I put it in the other room, and I get in the bed, I’m not tempted to do that. So I think finding, finding out what your sleep hygiene is, and like you said, being patient, with, you know, stress, anxiety, sleep, I think these are some of the ones that are things that we really feel. But I think a side effect of alcohol that we can also, in some ways, we don’t feel it in some ways we do is inflammation. And so can you talk with us about kind of the systemic whole body inflammation that happens? You know, I know that sometimes if we drink a lot, we would, our rings are tired, our eyes are puffy. But that’s not all. That’s not the only places the inflammation is happening. Well, one of the things I think we found out about alcohol, we’ve already known is that negative health effects, particularly heavy levels of use. And one of the issues of it’s important to realize is that when alcohols broken down in the body, the first thing is broken down to this thing called acid aldehyde. And that’s just the chemical name, but it’s a toxic compounds. And it it really damages cells, we think it’s has carcinogenic properties. And it’s very, it’s a major player, we think in terms of the negative effects of alcohol. And then the acid aldehyde, in turn is broken down to acetic acid vinegar in the body. And that’s how alcohol is broken down in the body. But so these these effects, though, they do and they act, they activate inflammation, they activate negative immune systems. And so we’re beginning just beginning to understand sort of the immune effects of alcohol throughout the body, including the brain, and which is a very complicated story. But the bottom line, is it Yes, is activation of inflammation, activation of some negative immune responses that affect a variety of cellular functions in organ systems throughout our bodies. But we’ve also realized that even lower levels of alcohol can contribute to health problems over time. So we used to think like I think we said earlier that it’s been reported that alcohol is a positive effects small amounts alcohol good for your health, you know, that’s an that’s been modified here. And we realized that it might have small amounts, alcohol can help some things like such as like the risk of heart attack the risk of ischemic stroke. But at the same time, small amounts of alcohol can increase from like high blood pressure risk breast cancer through a liver, gastric ulcer or a variety of other cancers. So when you look at alcohol on the big picture, we are now viewing it as more than the negative side of it is kind of emerged alongside those positive effects, and people have to make decisions and personal choices about what they what they want to do once they have that knowledge. And once they become aware of some of these other issues. Do you have the stats off the top of your head on breast cancer and the correlation with alcohol and increased risk of breast cancer? Well, I don’t I mean, what we do know is that even small levels of consumption like wondering today, there is evidence of some increased risk. Now the risks, that increase is small, and I don’t have the precise percentage on head. It’s small, but it’s there. And as the consumption goes up, the risk begins to go up. And so and this is the case across a number of different, like high blood pressure. High blood pressure to me is one of the more interesting because over the years, I’ve done these clinical trials, we would have people come in and they would have high blood pressure and they were drinking heavily. And we work with them, they had an interesting change to drink, and many of them would reduce their drinking and some of we become abstinent. And very often their blood pressure would begin to normalize in many situations where they actually to get off their blood pressure medicine, just because they had changed their drinking habits in their blood pressure returned to normal. And and that’s easy for people to monitor because you there’s blood pressure cuffs everywhere. So it’s something like yeah, that’s a very straightforward one. I mean, clearly, there’s also there’s what we call essential hypertension, which means a lot of people have just high blood pressure. We don’t know why they have Is it a habit? And they need medicine, and it’s not going to get better when they stop drinking. And so it’s important. It’s not like stopping drinking is a cure all for blood pressure. I don’t want to get that impression but suitcase is an important factor. And it’s one that a lot of times is overlooked. And on the breast cancer, I did a quick search and pulled up the Susan G. Komen. And they have a bunch of stats around it. And the I feel like this was, I feel like it’s, I don’t use the word staggering, but I kind of think so. So the pooled analysis from 53 studies shows the relative risk of breast cancer goes up by about 7% for each alcoholic drink, consumes everyone drink and increases 7%. And then those who had two to three drinks per day, have a 20% higher risk compared to women who don’t drink because of the way that it’s highly significant. It’s yeah, and so I think, you know, alcohol, of course, changes the way that you know, our a woman’s body metabolizes estrogen. And that’s going to help play a role and risk of breast cancer. So I think to your point of, you know, there’s these mixed messages about the health benefits of alcohol, looking at what are your risk, you know, if your risk is is higher for breast cancer, if you have hypertension, and you don’t have any issues with, you know, cholesterol or a history of cardiovascular disease otherwise, and it’s probably not the best, best thing for you, you know, and so, but that I always say that the liquor industry and the wine industry have done a great job of telling us how good it is for us. Well, yeah, I mean, we’ve got, we have sort of been under the impression and the medical community sort of was promoting that it wasn’t that long ago, the doctors might say, we’ll have a drink or two. And it’s a very complicated question. And as I said, we’re we’re drinking culture. So we like to drink we, we enjoy drinking, and there’s not it’s not that alcohol is evil or anything, it’s just that one needs to get a better perspective on it overall health risks and benefits. And also these other things, we’re talking about how you see, or do you drink tea daily, usually having one or two drinks, as far as your anxiety as far as your sleep, or as your inability. Those are things in addition to the sort of like health risks, I think, and that’s one of the things with the challenge that we always kind of make sure to say this isn’t about saying that alcohol is bad, but it’s helping people kind of evaluate their relationship with it. And a lot of people will use it as a reset. They don’t have an intent of going alcohol free forever. But they’re using it kind of as their annual reset to kind of bring things back and check after holidays and things have kind of been, you know, that period of abundance and kind of like, you know, just let me get back to a more moderate approach. When we’re talking about inflammation, you know, you were talking about the, the effects there. I think, one of this, the benefits that we’ll hear a lot is that people’s kind of general aches and pains, their joints and the stiffness and stuff, that all improves. So when we’re talking inflammation, we’re talking about inflammation that can increase the risk for things like, you know, heart disease, certain types of cancer, but also sometimes it can be that inflammation, someone feels like arthritis, inflammatory arthritis. Okay, yeah. I mean, I mean, I think we’re, we’re just set just beginning to understand how alcohol and the immune system sort of interact, and are. But one thing we do know is that when people do reduce their alcohol use or periods of time when they’re not drinking, a lot of these things can, can get better at something that I would encourage people to do. If you’re if you’re doing the challenge, one of the things that we do is we take a close up photo of people’s face, and this is someone if even if you’re listening, and you’re not in our area to come to our actual kickoff event, you’re doing it on your own easy get someone to take a really and like a tight shot of your face, like when you don’t want to share with anybody. So you can see your skin texture, the circles under your eyes, your your the clarity in your eyes. And that I think what people really see where we really see that a visible change is the reduction in puffiness, those dark circles under the eyes, the puffiness around the eyes. And I think it’s kind of a visual, if we can see what this is what we’re just seeing in our face. Imagine what’s happening throughout our bodies. Well, there you’re probably head of the medical community because that hasn’t been looked at as much as a marker. Close up photo the face. That’s a very interesting idea. We had the first year that we did it where we did everybody’s markers. We didn’t do a photo of the people. We encourage people to take their own photo, but we didn’t have a photo booth or anything set up. And we had this one guy and he said, I’m getting my picture taken right and No, we weren’t playing on it. And he was like, couldn’t believe it. He was like, standing up against the wall already. Like it is picture taken. And so one of our team had her iPhone and she said okay, so she snapped up photo of him and then a few other people who came behind and like one of their pictures taken. Wow, when we did it at the end, all of them had improvement. But that one guy who really wanted his picture taken, he looked like a different person his after look like the person that you wanted to set up with your friends before? Didn’t. And it was like, wow. And that’s when we said, this is stunning, you know, we’re going to include this and part of our metrics to give people really kind of this full inside and out visual of what happens to their bodies during this challenge. And the clinical trial methodologist didn’t mean evidence based medicine, as you say would be well, wouldn’t it be interesting to then sort of randomly assigned people get their photos, some of them? Don’t drink for others continue there, and then see how the, the groups compare? Right? Yeah, it was. And that’s a nice motivator for people, you know, everybody’s like, wants to, they’re zooming in, they’re looking at their pictures, they’re looking at their eyes and all this stuff that puffiness in their face. And then seeing that before and afters. I think that is a big motivator for a lot. And you and I talked a little bit earlier, before we actually started our podcast, but talking about the cultural shifts that starting to happen around alcohol and the the shift and attitudes around how we view it. Tell me more kind of what you’ve seen on this and kind of what you see is where it’s headed. Well, I think kind of the first awareness that I had was this idea, this dry January that was coming out of England a few years ago. And that seemed to be like, oh, there’s a social movement. So I hey, let’s just take a month off and not drink and and it began to snowball. And really millions of people were doing it then it jumped over here to the United States. And then these other things began to happen things like you know, mocktails began to be talked about and they were like mocktail bars where people go and get these kind of elaborate, interesting fancy drinks, but they don’t have alcohol in them. And that folks can go out and be friends or do something and have mocktail don’t necessarily have to have alcohol in it. So that was interesting. And then and then some of the folks I work with some of the treatment talked about this thing called Silver curious sort of a website, or it’s a web group where people can check out hey, we’re, we just want to see what it’s like to be sober for a while or something like that. So there’s these, these different phenomena that we really hadn’t heard about before. And they were sort of simultaneously beginning to happen kind of makes one wonder, is the culture starting to sort of think differently about alcohols? Do you think about these challenges to sober October sober, curious, dry January are alcohol free for 40? I think the thing that they all have in common is that they’re relatively light hearted challenges. And it’s, you know, it’s a it’s a nice way for someone to dip their toe and they don’t have to make a giant commitment. They’re not, you know, confessing that there’s a big problem. It’s not you know, it’s something that they, they’re fun, they’re light and it puts a positive spin on it. You know, you put fancy alcohol free cocktails somewhere and you know, call it a mocktail. One of the things that we do with our restaurants and bars throughout our regions is work with them to include, you know, the low sugar kind of eat fit, still lower sugar, but mocktails on their menu and we have mocktail meetups, we have happy hour workouts talking about replacement behaviors. You’re getting the group together, who’s all doing the alcohol free for 40 challenge and those who can make it come into that Friday afternoon. Happy hour workout followed by, you know, their alcohol free mocktail. So ways that you’re putting a positive in versus just what you’re not doing that drinking. Yeah, no, I think is very important. And that’s really some innovative and positive things there. Yes. All right. Well, thank you so much, Dr. Garvin. I really appreciate your time with us. You’re very welcome. Have a great day. A just a quick break to talk with you for a minute about Sunnyside. You hear me talk about it on the show often. And it really is my number one recommendation for a mindful drinking app. People use this tool in my groups in my classes and they tell me all the time, how much they really appreciate the fact that Sunnyside is a very positive reinforcement. And what I mean by that is that when you track your drinks, and let’s just say you planned for one drink and you ended up having to if you’re honest and you track that second drink, you’re not going to get a message that shames you in any way or reprimands you, you’re actually going to get positive reinforcement for tracking a drink that you didn’t plan on and some ideas of some suggestions for going and grabbing a snack or getting some water Sunnyside is like having a coach in your pocket. And I love that. You can try it for a 15 day free trial go to www.sunnyside.co/molly that gets started today. So we’ve covered a lot about the physical effects of alcohol, this physical manifestations from anxiety to stress, impaired sleep inflammation, covered a lot of these in depth with Dr. Garbutt. So switching gears a bit to more of our behavioral changes, action steps, things that we can do on that day to day to day basis throughout this alcohol free for 40 challenge and beyond to really quite frankly, make our lives a lot easier not even just as it relates to doing the alcohol free for 40 challenge, but tuning into a lot of the the reasons why we may do certain things and why we may make choices whether it’s related to alcohol or anything else that aren’t best for our bodies. So I’m joined here today in my living room by Dr. Dave Galarneau, board certified psychiatrist and addiction specialist with Ochsner health. He’s also the Medical Director of the addictive behavioral unit at Ochsner. And I’m also joined with us we’ve got Dr. Doug Alexander. He is a second year psychiatry resident with a lengthy background of volunteerism with local recovery programs. So welcome you guys. I’m excited to have you all here. Thanks for having us. Yes. And may I say this is such a lovely living room. Oh, thank you. I appreciate it. And we have the door open because it’s a gorgeous day here in New Orleans. So we may have birds chirping in the background. I hope we do. But yeah, thank you. It’s a very, very nice day here. Thanks. So talk I guess, give us a little bit of background, each of you with what your roles are. So Dave, starting with you as medical director of the addictive behavioral unit, and kind of what your what your role is day to day there. Sure. We have a Intensive Outpatient Rehabilitation Program at Ochsner. People come it’s a four to six week program that come Monday through Friday. And we really try to work with people who have alcohol and drug use disorders. So a little bit more significant issues. And a lot of the folks who I think are doing the 40 and 40 challenge, we work day in and day out with the patients around how to change their behaviors and what they can do to kind of start a new lifestyle. And I think that those are very applicable to what the folks who are doing this challenge will be doing as well. I agree. I agree. Because for some people 40 days seems like an eternity if they haven’t done it. Yeah, even if they’re even if they’re just a casual drinker 40 days, it feels like a really long time. And so, Douglas, tell us your your background, kind of your role, second year psychiatry resident. That’s right. I’m a second year psychiatry resident, which means I’ve gone to medical school, and I’m now studying psychiatry to become a board certified psychiatrist. We rotate through several different areas of psychiatry, as residents and one of those areas is addiction. I have a very strong personal and professional interest in addiction. I intend to pursue an addiction fellowship after I finished my psychiatry residency. And I’ve been involved with the recovery community in the New Orleans area since 2007. And tell us you shared just a little bit before we started the podcast, but a little bit of kind of what what was the drive for you to go to medical school and to pursue this. So I’m in recovery myself. And when I started to pursue sobriety for myself, I became very involved in the recovery scene in New Orleans. And it became clear to me very soon after that, that this is the community that I wanted to, to work with in a professional capacity. And so I started college at Delgado and now I’m here today and for those of you who aren’t in the New Orleans area. Delgado is our community college. So starting with community college courses, because you had never been to college before. That’s right. I was I was 30 years old when I started college. That’s incredible. And when you applied to Delgado, you when you told them that you wanted to go you’re applying to the community college with the goal of becoming a physician, right, I walked in and said that I wanted to go to medical school and become a physician to work with people whose lives have been affected by substance abuse. And I was told that I need I needed to leave and come back the next day with more realistic expectations. And they gave me a beautiful brochure about their age back program, which encouraged me to become an air conditioner repair technician. And you said Yeah, so you just kind of put your put your head down focused and I kept my eye on the prize. And to me that’s so such a cool Orient. It’s one of those that at that point, it seems like there’s this giant mountain to climb this giant hurdle. And now here you are, like doing this and giving back and being able to care for people in that way that you are. So I think that’s incredible. I’ve had a chance to work with Doug for the last month on the service. And I can tell you, he’s a true natural and the addiction community is very lucky to have him and we’re looking forward to him joining our ranks in the near future. Yeah, I love it. I love it. So talking about the, with alcohol. There’s so many people respond to alcohol differently. And I think as people are listening to this, you know, both of you guys, you know, as as your role as psych resident as your role with Ochsner with a rehab program, y’all are again, dealing with more serious addictions and what you know, and a lot of people who are listening to this are like, Molly, come on, I’m just doing the 40 day challenge, I have a glass of wine every day, I’ve given this up for 40 days, we totally get that. But for a lot of people, there’s that slippery slope where a little bit over time becomes habitual, and they do feel like 40 days is an eternity to give up alcohol. Some people do have that question mark about, can I? Or what’s my How? How much do I feel like I need alcohol versus I’m choosing to have it? What happens? I guess, that slippery slope? And how are people differently? How are wired differently hardwired in our brains? And how do we all respond differently to something like alcohol. One thing I’ll just jump in with first is that 40 days, that can seem like a really long time, and, and when we work with our patients, we try to get them to break it down into more manageable chunks. No one can predict the future and no one knows what’s going to happen. But we try to focus on one day at a time. And you know, if you think about, Okay, I’m gonna give up alcohol for 40 days, that seems a really long period of time. But if you say, Well, I’m going to wake up today, and I’m not going to drink today. And just worry about today, and then wake up tomorrow and see what tomorrow holds. That’s a good place for people to start as they face this challenge, I think. And we’ll be talking about replacement behaviors coming up too. And kind of some of those those things to put in. So as you do wake up and say, Okay, I’m not going to drink today, thinking of what we’ll be doing instead. But before that with with our brains, are there some people who I guess we always, you know, know that there’s people who have it alcoholism, for example, runs in their family, and you feel like every uncle or aunt kind of has this addictive, you know, has had a history of addiction. Are there certain personality? Is it personalities that are more addictive? Or type? Or is it what’s happening in our brains? With alcohol? What, what’s something just to kind of understand why would the same environments one person keeps that balance at moderation, and that’s easy peasy. Others feel like they’re kind of going down that slippery slope, same conditions, we all cope with things in different ways. And some people are prone to reaching for external things to change the way that they feel. And that’s one of the things that contributes to it. I know that that, you know, throughout life, we have different stresses, you know, social stresses that we face different changes in work, and, and alcohol as, as we all know, it’s something that some people drink because it tastes good, other people drink it because it helps take the edge off. And when that taking the edge off component of drinking, when a person starts to kind of over rely on that, and incorporate it into a daily routine, it becomes a regular coping mechanism. And that’s, that’s when things get a little bit risky is when the person becomes to rely on it. For that reason, and I like to think also nature and nurture model and some people, when we refer to nature, we refer to things like genetic predisposition, there’s definitely some of us, unfortunately, whose genetics are lined up against us and are more predisposed to addictive behavior and personality. And so they kind of more easily fall into these kind of problematic drinking and drug use behaviors. Other people you know, it has more to do with the environment. And the more that you tend to be around it and that you have exposure to it, it can get linked up in your in your brain through a reward pathway that uses a neurotransmitter called dopamine. But most people they have some combination of the two. And if you have set them off, both becomes that recipe for I don’t want to say disaster but both can be that recipe that kind of creates that perfect storm if you’re just medically predisposed, and are in an environment with people who are genetically predisposed to something like, you know, being sensitive to the effects of alcohol or sensitive, more prone to addiction. Would that be also the people who kind of have what they would define themselves as extreme personalities that they kind of do everything to access, whether it’s exercise or whatever it is? digital, social media, people who kind of whether it’s alcohol or other things in their lifestyle, I guess if, if they have extreme behaviors, and other areas of their lifestyle, are many of them also more prone to kind of having the addictive components for things like alcohol. I think that people who have a lot of maybe compulsive behaviors or almost behaviors that are similar to addiction in other ways, like exercising a whole lot, or you know, being workaholics that you do see a lot of comorbidity with alcohol use and in that population, but that’s not to say that everybody who uses alcohol to access or is extreme in every part, right? Actually, I think that the issue is that when it comes to the genetic side of alcoholism and drug addiction, that there’s probably just a large number of genes that are involved, it’s not same as sort of like you have either blue eyes or brown eyes, there’s probably, you know, 1020, maybe even more genes. And so you can have a real, it’s a real diverse cohort of people. And so some people do kind of display what we call cross addiction, or, you know, an addictive personality where they can easily transition from one substance to another type of behavior, whereas other people just tend to be more focusing on problems with one particular substance or something like eating and then that seems to be an isolated issue. For them. It’s interesting about up eating in past years for the alcohol free for 40. Some people’s markers for things didn’t improve, like we thought they would, or especially like when we do body composition. And it was like when they came in for their post challenge labs, true confessions were coming out, because they’ve been hitting the ice cream, they’ve been hitting the sweets, and really kind of putting these replacement behaviors that were not good. And so much so that we started encouraging almost like a 2.0 version of alcohol free for 40, where it included, also sugars and white carbs, let’s pull that out. Because you know, we don’t want to put one one behavior and for the other. So when we’re looking at, okay, whether you’re doing this 40 Day Challenge with our alcohol free for 40. Or you’re listening to this podcast at some other time of the year, and you think you know what, I’m gonna kind of give it a go for 10 days 20? Or do your own 40 Day Challenge. What are some of the key strategies that you would say, you know, where do they start? Where do we start to be successful as possible throughout this one common acronym that’s used a lot and 12 step meetings is halt H al T, which stands for hungry, angry, lonely, tired. So just maintaining a state of awareness throughout the day and checking in with ourselves to make sure that we’re not pushing ourselves past the limit. Because a lot of times, you know, with work, we feel like we’re pressured to meet a certain deadline, or maybe we want to impress somebody socially. And sometimes when we’re doing those things will deny ourselves of basic things like food, not consciously, it’s just something that happens. And and I also try to get my patients to think a little bit about you to think optimistically, but to plan pessimistically that we want people to be motivated, this is a very doable thing is not rocket science, you know, we’re asking you to just, you know, not pick up a can or a glass and put it to your mouth and swallow. Having said that, it’s very basic, basic thing. But there’s a Zen quality to it, because it can be one of the hardest thing for some people to do. And so we tried to get people to think about when you have those moments, where you really feel an urge or craving, what is the plan that you can have in place that you don’t have to think about that you’ve you’ve already kind of thought through and that you can easily put that plan into action if you need it. And one of the things that I call it as we kind of communicate and we have our Facebook, social support with our alcohol free for 40 group and emails of them and so there’s a lot of kind of camaraderie and one of the things that we talk about a lot I call it the witching hours for people. And in you guys, I guess you all are the experts in this but I see those witching hours often for people are in their periods of transition. So the transition time for when they’re ending work and coming into their home life in the evening. Or they’re going into a social situation and they’re using turning you know using alcohol as the example but out Hall has to unwind when they get home, or if they’re going out, it’s to take the edge off. So they might feel like they’re releasing the stressors from that day. So they can be more fun in a social situation. But I feel those transition periods are what I call the witching hours. And we refer to that as something called people, places and things. And everyone I think is familiar from psychology 101, about the story about Pavlov’s dog how, you know, you take a dog, and you ring a bell, and you give it a treat. And you do that enough times and, you know, just ringing the bell, the dog will start to salivate because there’s a molecule, a little molecule in our brain called dopamine, which I mentioned earlier, which is in the dog’s brain as well. And it gets paired up with cues. And so what if you tend to drink, you know, and the transition from work to home, or if you tend to be a person who goes out on a Friday night and drinks, your brain is already linked up to that either that person or that place, so that time, and it starts to secrete a little bit of dopamine to get you ready, that reward is coming. And so the urges can be a lot more difficult during those periods. And so to try to go through and look at what are the what are the times or the situations the people that you typically would drink with and plan for those, those situations, because those are going to be potentially the hardest for people. I remember when I did my first alcohol free for 40 challenge. And I’ve mentioned this as our fifth year doing it. So it’s, it’s, you know, now I feel like an old pro at it. But I remember the first time we went to dinner and it was like, day one or two of an alcohol free for 40 challenge. And I remember that I ordered a bottle of sparkling water and asked him to bring a wineglass with it. That felt like getting those words out of my mouth, instead of saying, oh, we’ll have a glass of wine or whatever, whatever the norm was to say, I’ll have a bottle of sparkling water, and can you please bring a wineglass with it, it felt like every word was like forced coming out, it was so unnatural. And then once I got it in front of me, though, I thought, wow, and then five minutes, then it was a non issue. But it was that little, that moment of like point of decision making, pushing through it. And then once you get through it, it’s smooth. That kind of, as you said, planning for these people, places, things that can feel feel like that’s where you’ve typically drink. And that’s where you associate drinking with. I encourage the replacement behaviors, like you said, so you’re planning for it? And what are you going to do instead? So some of the things that we have is, what are you going to drink instead? And so we have people that if they’re drinking, you know, scotch every day to just expect them to switch to water isn’t going to work. But what are you going to have in that place that’s going to maybe give you and it might work, I mean, but for a lot of people, they’re going to want something different. And so I’ve talked about this guy a lot. We had this one interesting guy he was we call him our 83 year old Scotch drinker. Now he’s probably 87. But he did it. And he had never done the alcohol free for 40 challenge. He drank so much Scotch every single day, that when he stopped drinking scotch, they felt their icemaker was broken, because it was overflowing. But it was actually just because he was not fitting his ice in there. But he switched to kombucha, and he had never had Ken Bucha in his life and are at our alcohol free for 40 kickoff party. We have things like all the different flavors of kombucha by Big Easy Bucha our local brewery so that people can try it, taste it, and you can make kind of fancy mocktails with it, but also just that poured into a glass feels like something a little bit more substantial. That’s, that’s, um, that’s something that is very helpful in the early days of not drinking is, for example, if you go to a restaurant, when the server comes around, self identify as a non drinker is saying, you know, I’m not going to I don’t drink. So what other types of beverages Do you have. And in addition to being able to drink something, without alcohol in it, you’ve kind of framed yourself as somebody who’s not going to be drinking, and it makes it a little bit easier to get through the meal. Without having that thought of maybe I should. And something like the alcohol free for 40 challenge people have been able to say we have these wristbands that when people come to our kickoff event, it says hashtag alcohol free for 40 on these bright orange little, you know, there’s wristbands that everybody has for different stuff. And so they can they’ll, they’ll kind of point to it, um, do an alcohol free for 40 I’m not so it’s still kind of light and they feel comfortable saying that but pointing to the wristband or kind of acknowledging that. And then the people with them are like, oh, and then that also kind of starts that conversation. The other I guess, replacement behaviors, what are things that you guys have found successes in? For some, they’ve you know, people share that meeting friends instead of meeting friends for a drink, meeting friends for a walk and talk? You know, what are other things that and things that are getting you out of the space that you would typically be drinking? I also this may be sort of related maybe a little A little bit different. But I think you need to think of replacement behaviors also, in a sense of one of the, as Doug said, you know, the whole acronym hungry, angry, angry, lonely and tired, the lonely the boredom, you know, sometimes what the issue is, is that if you have large swaths of time that aren’t filled, you’re a little bit more likely to fall into cravings and negative thinking. And so sometimes it’s, it’s just putting in activities that you don’t normally do. So that’s something to think about as well. Many people have shared that they feel so much more productive during alcohol free for 40. Because that three hours that maybe they were drinking in the evening with someone sitting on the porch or dinner, and then led to hours after and then maybe also, they weren’t feeling so great in the mornings, or they didn’t, you know, get up as early, that the things that they’re able to accomplish, or maybe tasks or projects around the house that they have not felt like they had the time to get to, they actually do. They just weren’t taking the time. And so some of these creative projects that we think, Man, I should do, I want to do something with those things, or organize this or create something or start a pottery class, I’m glad you brought the pottery class because sometimes also if you if you do an organized activity, it’s not the focus is in drinking. And then sometimes that can be difficult in New Orleans. But if you’re going to a pottery class, or your there’s a group run, or you’re going to go to a movie or tour Museum, that’s something that you don’t have to worry about the social aspect of meeting someone, what are we going to order, how’s that going to work. So putting yourself in other places and things that you’re finding interesting anyway, and maybe just haven’t felt like we had the window of space in our day. But now using that I think you’re right, that that lonely, or even if you don’t really identify it as feeling lonely, but it’s empty time. Mindfulness is another great way to fill time because it not only fills time, but it also the process of mindfulness meditation, do the course of learning truths about oneself, it that very process is something that makes getting through the day without drinking easier, when we become more aware of our feelings, and the relationship between maybe our feelings and what we do our behaviors. And I think people should view the 40 days, as you know, not just you’re giving up something, but hopefully you’re getting something in return. And, you know, I know you’ve already focused a little bit on the health aspects that you’re getting. But I think you’re also you’re getting time, and maybe you get a chance to try things out that you normally wouldn’t do, learn a little bit something about yourself that you didn’t know, maybe find a new hobby or a new activity. And if you try to build that in as a growing period, that can be really helpful for people too. And like you said, the mindfulness and kind of tuning into these tuning into that, that self awareness. And I think as you’re going through these 40 days, paying attention to these other little micro benefits through the day, that you know, it might be that you’re sleeping better through the night that you’re seeing the physical benefits your faces and as puffy, your your mood is better, you’re dealing with stressors better, like I mentioned earlier, you know, for myself, personally experiencing less anxiety type reactions. And I think if we look at, you know, it seems like a big, big, vast goal, but if we start to look at each day, here’s all the benefits that I’m experiencing, it can make it easier for that next day to kind of follow one of the things that we’ve added in to alcohol free for 40 is happy hour workouts. And so doing different workouts led by different instructors, but at like 530 so that we’re covering there we’re doing that followed by something that’s an alcohol free fluid replacement hydration after right and workouts are great because they get the natural endorphins in our in our brain kicking up and that can make us feel pretty good. Just the way that a glass of wine sometimes for certain people can make them feel good. So it can be a little bit of a natural replacement. And I think that’s where the walking comes in. That’s one of the big kind of saviors for people whether it’s walking their dog walking with someone because even if you feel like okay, I’m not buy a gym, I don’t I’m not a big workout person. Even just moving, like Dave said is going to elicit these endorphins and kind of help us with that. So what about people? Sometimes just say hashtag people, but what about people who say you’re doing what? Or like, come on just some or you know you’re doing the a lot of people are like do weekends count? Or do Sundays count? Everyone’s kind of looking for that little edge at times. How to deal with people that whether they realize it or not, are leaving us feeling pressured to drink. I think that it helps to be polite but clear. about what the intention is. So rather than saying, Oh, I don’t really think I want to drink today, instead of that, say, Well, I’m not going to drink today, and make good eye contact when it’s said. And another way that it can be done is to blame it on somebody else. So, you know, I told my partner that I’m not going to be drinking or alcohol free for 40, right, and I’m doing alcohol free for 40. And, you know, if they found out that I drink tonight, they’d be really mad, right. So that’s another way. Yeah. And I like, like you said, blaming it on something else, if you feel like it, but I think I kind of look at it in the same way, when people come to us for nutrition for weight loss, when someone looks at food, and they say, I can’t eat that, well, that doesn’t feel very good. But if it’s more like, I’m choosing not to, or, but I have all these other things that I can eat, and I am eating, versus focusing on what we quote, can’t eat. I think the same thing with drinking, if we, if we go into it saying, I can’t drink or I’m not supposed to drink, versus, oh, I’m doing the alcohol free for 40. Just that little shift, and how we say it also is affecting our mindset. Ones, Woe is me. The others are positive, I’m doing this thing. And although there may perhaps be some awkward situations, I think, by and large, you know, when I work with the patients, we tend to build it up in our own minds more than it really is, most people don’t really recognize if you’re drinking or not, and, and they don’t really care. And, you know, certainly in high school, there’s a lot of pressure sometimes, but when you’re an adult that really does seem to drop off. And when you do run into pressure, often what you’ll find is maybe that person who’s doing the pressuring, maybe has a little bit of an issue themselves and people that tend to pressure, you know, or looking maybe for a buddy, because then that sort of, you know, justifies to some degree, their own behavior that maybe they don’t want to take a closer look at. But for the most part, when people don’t really struggle with alcohol, they don’t really think about it too much. What you just said, I kind of want to like frame all of those words and put them up on a big poster. Because I think that that’s very true. For starters, most people just don’t care. And a lot of times we go through life thinking, oh my gosh, did I offend that person? Or did I do this or that person had something was wrong? What did I do for that, and usually, nine times out of 10 has nothing to do with us, it’s all about them. People are so concerned with what they’ve got going on their life, they don’t care what we’re doing. But I think exactly what you’ve said is the people who do care, and are the ones pressuring us to drink, a lot of times they’re looking for someone to drink with. And it can have leave them feeling a little bad about themselves, if they feel like they’re the only ones drinking. I’ve, we have friends like that. And so, especially through something like alcohol free for 40. If we’re at events, and there’s something you know, I’ll do a virgin Bloody Mary, because you can’t tell at all, if it is or isn’t. And you’ve just got something in your hand, and you’re not making a big to do of it. You’re not even making this big bold statement for those people who you know, are kind of the pushers, for lack of a better word. But I think it’s a very compelling reason to say that, you know, I’ve been thinking a lot about my health. And I want to see if subtracting alcohol out for a period of time makes me a healthier person. And it’s hard to argue with that. You know, and I think most people would pretty readily accept that as a reason. Yeah, great point, your bloody mary recommendation is on point because I love mixers. I don’t drink anymore, but I do love mixers. So that’s something that is very helpful is just to love a club soda with a splash of cranberry. And it looks fancy, I have it in my hand and I feel like I fit in. And nobody has to know versus a bottle of water, which just looks pitiful when everyone else is drinking and you’re it’s it’s broadcasting it. Whereas if you have a glass of something, one of the cool things is that some local restaurants and bars are offering eat fit mocktails throughout, specifically throughout alcohol free for 40. And we have those places listed on our website to guide people to because it’s kind of cool, like you know, you can go there and you’ve got this to fall back on that isn’t also loaded with a bunch of sugary mixers and stuff. Dealing with potential setbacks. So if someone says, Man, I had my game plan on I planned, as you said, plan up How did you say it? Think optimistically but plan pessimistically? So if they’ve done this, and they’ve kind of put all these things in place, but still the temptation got the best of them. What do you recommend how to how to do it if there is that potential setback, don’t let the setback define you. That’s, it is what it is. And Today’s a new day and the first day of the rest of our lives. So let it be what it is and pick up and keep going forward. I think sometimes we we build things up all or nothing. And in our head, there can be a tendency to Well, now I ruined it. So let’s just go overboard. And you know, I think people need to keep in mind behavioral change is hard, you know, the average amount of times it takes to quit smoking successfully, seven tries. And so, if you’re tackling something big, like behavioral change, and you have a slip up, that’s okay. Just pick yourself up and you and you go forward. It doesn’t detract from you know, if you go 38, out of 40 days without having a drink, well, that’s, you know, that’s a pretty big deal. I mean, that’s 38 days, you didn’t have a drink, and that’s definitely going to contribute to your health. So trying to reframe it from an you know, getting away from an all or nothing thinking to, you know, an improvement in your health, and that you’re doing the best you can you’re human like everyone else, and not letting that define and let it you know, if that one slip up, you kind of throw in a towel, like you said, Well, no, that’s the issue. Because it’s, you know, we’re, we’re letting that derail us more and more and more, that if that’s one slip up, and you’ve got 38 days, and you’re looking that you want to see your lab markers, and all these at the end, your two days are probably not going to wreck your results. Yeah, exactly. It’s also a great opportunity for self discovery, you know, what was I feeling when that happened? Maybe I can I can learn from this and learn more about myself. Because of because of the slip up? I think some of those questions can be the hardest things for people to look into. You know, because a lot of times, and I think that’s huge. And very, I’m glad you said that, because it wasn’t something that was in my head for us to talk about. But when we do look at why did I have that setback? Why did I have that struggle or that challenge, that’s the things that can lead to that sometimes are the hardest for us to admit to ourselves, because it might be the people closest to us, the things that we hold, hold the things or people closest to us. And that’s a hard thing to admit sometimes for ourselves, and when we take what we learned from that experience, and then we go back to the drawing board to our plan, and then edit our plan accordingly. You know, being mindful of the people, places and things and the triggers, and oh, now we discovered this as a trigger in thought about that. And then that can help us move forward. I found a lot of times it’s relationships around us and some of that sometimes it’s, you know, people that you you can’t you can’t and don’t want to not have in your life. I mean, if they drive you crazy, but if that person is your mom, like, gotta figure out a way to deal with this without wanting to have that. So, but I do think that really like you said, Yes, it was a setback, but using that, to explore the why behind it and kind of what’s driving that, I think that takes us the benefit of if we can kind of get under some of those and understand our reactions, and help manage those better in the future. That’s like a success well beyond this 40 Day Challenge. And it’s important to keep in mind that we’re not talking about weaknesses, or personal faults, or defects or anything like that, rather just truths about ourselves. And knowledge is power and learning who we are and what we stand for and how we react to the world around us. When we become more aware of that we become more capable of being you know, loving ourselves loving other people and doing what we need to do at work. And with our families. I couldn’t have said it better. I think if anybody is listening and has wondered, Am I am I gonna do the alcohol free for 40? I think when you start to do it, when you kind of think of all these, it’s these whole body whole body benefits, but for our body, our mind our spirits as well. They’re all connected in one mind, body and spirit. Alright, anything else you guys that we would want to add in kind of a final takeaway? Just that, you know, as we mentioned before, you know most people who are going to take this challenge are not the folks that that we work with, you know, day in and day out at Ochsner, but some some of you may be and if you find the challenge, pretty challenging and difficult and maybe you’re unable to complete, you know, think about coming and working with us, you know, in our intensive outpatient rehab program. We’d really love to help help you out and really feel like we could, and we’ll have the information for that website, email number and our podcast episode notes. Just to echo on what what you said. If this is very difficult to stay sober for 40 days and if you feel like you’re struggling with alcohol, New Orleans is an amazing city to get sober and we have a very lively and vibrant recovery community here because alcohol is so ingrained in our culture in New Orleans. We have We I have to have a very vibrant and lively recovery community here. So it’s a really cool city to be sober and it’s really amazing to look forward to doing Mardi Gras sober to go into jazz fest sober, to going to French Quarter fest sober. I mean these it’s an amazing city to be sober. And we have some really great resources, like the APU at Osher and really strong recovery in our 12 Step community as well. And we’ll have links to all of these things will have links to the alcohol free for 40 website, we’ll have links to the sites that doctors Dave and Doug mentioned as well. And you guys, thanks so much for you know, I’ve learned and been inspired from y’all. So thank you very much. I appreciate it. Thanks for having us. Yes, thanks so much. Thank you for listening to the alcohol minimalist podcast. This podcast is dedicated to helping you change your drinking habits and to create a peaceful relationship with alcohol. Use something you learned in today’s episode and apply it to your life this week. Transformation is possible you have the power to change your relationship with alcohol now, for more information, please visit me at www dot Molly watts.com