YouSaid · the spoken record

Dr. Sarah Wakeman

lines on the record: 127
first: 2025-05-22
most recent: 2025-05-22
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“I think they needed science based treatment and compassion and empathy, and I think they needed a world where addiction was not seen as something to be ashamed of or something that we judge, but rather something that is a problem. You know, the shift from like, you are the problem to like you have a problem and we can help you with this. And I think too often we have approached it as if like you the person are the problem.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Something differently could something else have changed? And I think people can feel angry and sad and guilty and be left with that.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, I think you feel powerless. You feel like you want to do something and you either don't know what to do or feel like everything you've tried hasn't worked. I think, again, because people have been exposed to this idea that it's an issue of willpower or choice, which really implies that if people wanted it bad enough, they could just stop. And so if you're a family member, then that's easy to feel like, oh, they don't love me enough, you know, that they're not choosing me over this substance. And so I think often people feel deeply hurt and they've been through experiences that have created trauma for themselves. There's a lot of trauma within families who are experiencing this. And then they're sometimes given really bad advice, you know, that you have to like kick someone out or this whole concept of kind of tough love and that people need to hit bottom. And so sometimes people, you know, either do that and then wrestle with the guilt of was that the right thing or not, or they feel bad even like being kind or loving to their family member. So I think there's a whole mix of feelings. And of course, if you lose someone, you always wonder what if, like, could I have done?”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah I think like many people I had kind of a personal threat. I had a family member who was impacted by addiction who actually died when I was in medical school and so that was a sort of a pivotal moment I think that coming at the same time that I was learning all of the science I was realizing like wow, I wish I'd known this when I was younger and dealing with family members and friends who were affected by this and that we've gotten it so wrong and most people don't have the kind of tools and knowledge to do things differently and so you know you sort of, there's that saying when you know better you do better and I think I kind of wanted to put out into the world what I wished was there for other people.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Totally. I mean, it makes me think of a patient I saw this week who really wants to stop drinking and is able to go for a few weeks, but his life is pretty empty. Like he's not working right now. He doesn't have a lot of relationships. So when he's not drinking, he's sitting at home, like watching TV by himself. And it doesn't take very long for him to think that the thing that's going to give me relief is having a drink. And so then the question becomes less about the molecule of alcohol and more about like, how do we fill up people's lives? How do we form connection and build community and build a sense of identity and purpose and engagement outside of the relief of substance use?”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Often being left alone to grapple with that experience by yourself, and so what's traumatizing to one person may not be traumatizing to someone else. And, you know, take the pandemic, for example. I've talked to people who like being stuck at home and alone and bored was deeply traumatic. Other people were fine. They like were in their living room, you know, doing whatever and found ways to connect and to live their lives and did okay. It was the same experience, but it was experienced very differently by different people. So it's less about the actual experience and more about the impact on that human, how they're left feeling. And often it's about feeling disconnected. We often talk about the opposite of addiction is not sobriety. It's actually connection. It's how do you build that connection with other people again?”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yes, that's a great question. Trauma at any time can put you at risk for addiction. The earlier that happens, some more sort of long lasting the impact can be. So when we think about the brain, you know, your brain doesn't really fully form until early to mid-20s. And so both in terms of trauma, but also in terms of early substances.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Totally. It's an anti-anxiety and a pain medication sort of all in one. And I think often this is part of the area where I think just getting more awareness and education about alcohol is so important because we see that as a way of like treating ourselves, right? And it's very easy to have that get out of control. And I think especially if in your head you think as long as I'm not like drinking in the morning or missing work because of drinking or having problems with my relationships, I'm fine. But actually there's so many health problems and even life problems related to alcohol that people may make different decisions for themselves if they had that awareness earlier on.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“gives them pain relief whether that's emotional or physical, that's a very real thing. That's a powerful system in our brain that gets activated when you're drinking.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, well, alcohol is a really complicated one because alcohol has lots of different effects on the brain. So any drug or substance that can cause addiction is going to release dopamine. That's sort of a primary driver of many things that we find rewarding, whether it's sex or food or alcohol or drugs. But alcohol also, so it binds to the part of our brain, a system called GABA, which is sort of our anti-anxiety system. So it's the same system that anxiety medications like people may have heard of Adivan or Lorazepam or Xanax, these medications that are kind of sedatives and anxiety meds. Alcohol acts on that part of the brain. And it actually then causes a release of your endogenous opioids in your brain. So like your brain's natural painkillers. So that's actually why one of the medications that's effective in helping people stop drink actually just blocks the opioid response in the brain, which doesn't make sense when you first hear about it until you understand these neural mechanisms that actually your sort of natural painkiller system is activated by drinking. So when you hear someone talk about alcohol,”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Done actually in Europe as well that looks at the number of adverse childhood experiences you have. And it's a linear track increase in terms of your risk of substance use disorder. So if you think about what's happening in the brain with substances, you know, when we use alcohol or drugs, all sorts of feel-good hormones are released, right? Dopamine, your endogenous opioid system, which is literally your natural pain reliever. And if you take someone who's experienced trauma, there's great relief that people can find in substance use, since we saw that in the pandemic, like what was going on in the pandemic? People were scared, they were bored, they were lonely, they were stuck at home, they didn't have their usual routine. Some people were losing people that they loved. And so we saw all of this escalating substance use. And it was actually most pronounced in people who are frontline workers. So that could be a healthcare provider. It could also be someone working in a grocery store or a convenience store who had to work through the scariest times of the pandemic. And also people who are caregivers. So those are kind of the two groups that had the biggest increase in their.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, so that's a really great question. Like, what drives people to use substances? It's actually probably the most important question, even in my work. You know, if you don't understand what someone substance use is about or related to, how are you ever going to address it or help them address it? So trauma is probably the single biggest driver. So, you know, you often hear things like cannabis is a gateway drug. I would say trauma is the gateway drug. If we look at many, many studies, they're kind of two different things that drive someone's risk of addiction. One is genetics. It's about 40 to 60 percent genetics similar to diabetes in terms of someone's risk. That's not a done deal, obviously. There are people with strong genetic risks who never develop addiction and people without that who do. The other half of the equation is based on kind of your exposures and your experiences. And one of the number one drivers is what we call adverse childhood experiences. So there are this famous study called the ACES study, which is stands for adverse childhood experience. And it's been replicated. There's a recent one.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, so obviously COVID was one driver. One of the main other drivers was substance-related deaths. So actually immediately following the onset of the pandemic, so beginning March, April of 2020, we saw a 23% increase in alcohol-related mortality, and we saw the highest rates ever we've seen of drug-related overdose deaths. And that actually impacted U.S. life expectancy up until this year. This is the first year that we've seen that change.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, great question. The pandemic was not kind to addiction, so we saw rates of alcohol and drug use and deaths related to those increase significantly after the onset of the COVID pandemic. That has started to level out. So for drug use related deaths, we're now back at the pre-pandemic levels, that there was a very significant increase during the time of the pandemic. And that's really not surprising when we think about what are the things that drive people to use alcohol or drugs in a problematic way.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Why guarantee that many people listening have been touched by addiction, either personally or in their lives because of stigma we tend not to talk about?”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“And maybe helping you, right? Yeah, so it's not addiction. So there's a difference between physiologic dependence, meaning if you don't drink your cup of coffee, you're going to get a headache and addiction, meaning that you're spending all your day and all your money buying more and more coffee. We don't really see this, but buying more and more coffee despite your girlfriend nagging you about it and you're late to work because you're purchasing coffee. We don't really see that so much with coffee, but that would be sort of addiction.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“The other are drugs, so that can be opioids like heroin or pain pills or fentanyl. It can be cocaine or stimulants like methamphetamine or prescription stimulants, sedatives that people may take for anxiety like benzodiazepines, cannabis. And so there's a whole sort of range of substances that can be addictive. And how addictive a substance is is really related to sort of how much dopamine is released in the brain. I know you've had a wonderful episode with Dr. Lemke about dopamine. So you've talked about that a bit. And there are different sort of addictive indices of different substances. So cannabis is less addictive than methamphetamine, for example, but all of those substances can cause addiction in people.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, lots of things. I mean, I focus mostly on alcohol and drugs. So alcohol obviously probably most common. I think we'll talk about that a lot today, which I'm excited about. And certainly when we look worldwide, 400 million people have an alcohol use disorder, meaning addiction alcohol. It's a lot of people.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Criteria, and then based on that, people can have a mild use disorder, moderate, or severe. And so moderate, severe is really what we think of as addiction. But it's that use despite bad things happening to you.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, it's a great question because we use that term colloquially a lot. You know, I'm addicted to Netflix or whatever. So addiction is really defined by use despite consequences. So continuing to do something in your life despite bad things happen to you because of it. So we talk of addiction. We talk of the four C's as a way to remember it. So one C is loss of control, meaning like you've tried to change and you haven't been able to. So you've tried to cut back or you've tried to stop and you couldn't. The other is compulsive use. So your use is like spiraling out of control that you're kind of using in a way that isn't really attached to your rational thinking. The next is consequence. So continued use despite negative consequences either in your life, your job, your relationships, your health. And then the last C is craving, which is this sort of strong psychological urge to want to use. Like you can't get the idea of having a drink out of your mind. And so it's really those four C's that we think about. And then we make the definition based on how many criteria people meet out of this 11 list of different criteria.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Oh, how much time do we have? Where do we begin? I mean, I think at its core, the biggest problem is that we've all been taught and sort of infused in this idea that addiction is an issue of behaving badly, that it's an issue of morality, that people really need to kind of knock it off and pull themselves up by their bootstraps, and that this is like a criminal legal issue, that it's an issue of willpower. And so if you believe those things, then why would you think that someone should get medical care? Or why would you treat them with compassion and kindness if you think that they're doing something wrong? And so really reframing how we think about addiction based on all of the science we have and what effective treatment looks like, which often is very different than what people may have experienced if they were trying to access care for themselves or a loved one.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“I'm a medicine doctor by training, so I still do some general medicine like in the hospital, take care of pneumonia and heart failure and in the outpatient setting, take care of people's diabetes and depression. But I train especially in addiction medicine, so I'm board certified in addiction medicine, and that's been kind of my life's work. I work in a big academic medical center in Boston, Massachusetts, where I would say my kind of focus professionally has been thinking about how do we bring addiction care back into the medical system so that it's not this separate and unequal and often very poorly done sort of siloed system, but actually just a part of the healthcare that people get. And then I train people. So I'm program director of our fellowship program. So I train doctors who want to be specialists in addiction medicine.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“My mission is really to change the way people think about and understand alcohol and drug problems and also to give people the evidence and the facts both to understand addiction, which are sort of problems related to alcohol and drug use, but also to just understand the science around, for example, how much should you drink? Is drinking healthy? Is it not healthy? There's a lot of misinformation out there, and I want to give people the tools to make the right decision for them in their lives.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Great question. One of the most effective tools we teach people is in culture. And they found that people drank much less after it.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“Biggest problem is that people haven't been given the evidence and tools to understand the diction, but also many rehabs don't offer the things that we know are actually affect you.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“One in three people may have a problem with alcohol at some point in their life, and slowly 2.6 million people every year die from alcohol-related causes because pretty much every organ in the body is impacted by it. You can see here this is a 43-year-old person where their brain looks away 90-year-old with dementia would look because of that brain damage over time from alcohol use. But what drives people to use substances, it's probably the most important question. And if we look at studies, one is about 40 to 60 percent genetics. And the other half of the equation is trauma. And so we hear someone talk about alcohol gives them pain relief, whether that's emotional or physical. That's a very real thing. That's because your sort of natural painkiller system is activated by drinking. It's an anti-anxiety and a pain medication sort of all in one.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT
“But even drinking that amount, your risk of breast cancer would increase by about 5%. Which for many people is very normal. So there's a lot of misinformation out there about how much should you drink, which I think people don't know. But I can take you through everything.”
2025-05-22 · The Diary of a CEO · How Alcohol Rewires Your Brain and Increases Cancer Risk by 40%! The Alcohol Doctor, Dr. Sarah Wakeman · IDENTIFIED FROM THE TRANSCRIPT