Welcome to the Embrace Family Recovery Podcast, thank you for joining me for this final episode with Geoffrey Golia, the former Clinical Director of the New York Center for Living. Geoffrey has recently joined the New York City Criminal Justice Agency as Director of Clinical Services for the Queens Supervised Release Program.
Today we discuss the importance of maintaining hope and learn about current substance abuse trends our young adult population is facing.
Let’s get back to Geoffrey.
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See full transcript below.
Geoffrey Golia 00:01
You’re listening to the Embrace Family Recovery Podcast, a place for real conversations with people who love someone with the disease of addiction. Now, here is your host, Margaret Swift Thompson.
Margaret 00:29
Welcome back, thank you for returning for this final episode with Geoffrey Golia, the former clinical director at New York Center for Living. Today, our discussion is about keeping hope alive. And the most common substances and issues that are facing young people today in our society.
Geoffrey Golia 00:51
The Embrace Family Recovery Podcast.
Margaret 01:06
I think the other thing that you inspire when you talk about this is that though we might meet you in one of the most challenging and scary times, you offer a language that’s empowering and hopeful. Like when you look at every crisis, there’s an opportunity. You know, I don’t think that’s the first thought of the families when they first come in the rooms they are thinking, oh my gosh, our world’s coming to an end, this is going to be awful. It’s never gonna get better.
Meeting people like I do along the path where say this has started at 13, and they’re now 30. They’re pretty beat up by the journey, and the repeated patterns and the getting the hope and then the oh no, and then the scary and almost losing them and all they’re alive. Okay, there’s chance, you know, that whole roller coaster. How would you speak to someone who’s at that point, because I know a lot of my listeners are. Their young people, if their parents are adults, and have been doing this ride and journey with addiction and substance use disorders and mental health issues for a long time.
Geoffrey Golia 02:10
As I breathe I hope, I say to myself all the time, as I breathe, I hope, right? That’s the thing that keeps us going, whether we’re in this work, or whether we do something different, right, we want to have a level of hope and optimism moving forward. And for the parent who has been doing this for a long time that is depleted. And yet, it reemerges when they start doing their own work. And this sounds a little counterintuitive. But if they stop tying that to their kid’s recovery at this moment, and start tying it to their own recovery and the work that they’re doing. And they’re not saying I don’t love my kid anymore, they’re just saying if they start to focus on what they can control, what they can manage, then they can start to build a capacity for hope and optimism.
Because the other piece around that is that while they are especially for younger kids, it’s weird. I’m gonna kind of hold to a dialectic here two opposing views. On the one hand, parents have a tremendous capacity and responsibility towards their kids, especially the younger kids, as they get older, though, I think they still have a capacity to shape motivates,
Margaret: Right.
Geoffrey Golia: But at the same time, young people have to want it, right, they have to find that way to 59th Street, whatever avenue they use, they have to find that way, whether they’re enhancing motivation, whether they surrender whatever. They do need to engage in their own recovery. But the parent can then acknowledge, right that like, all I can do is what I can control. And there’s a correlation, if not a causation between a parent engaged in their own recovery, in their own work in their own treatment, in their own exploration of their own lives and what they’ve been through. And that capacity to hope, right? You know, the practice of psychotherapy, for me is the practice of a lot of things. But that includes instilling a level of hope. Right? And in this journey, the recovery journey, that’s a piece.
And I guess, also if we take the destination away from it,
Margaret: Yeah.
Geoffrey Golia: Right. That’s that other piece, right success, failure, the destination of this. No I mean, the idea is that we’re living and we’re doing the best we can.
Margaret: Today.
Geoffrey Golia: Yeah, Donald Winnicott said, you know, as parents, we just have to be good enough. And I think that that’s another important piece here. The perfect is the enemy of the good. I’m just giving everyone the hashtags
Margaret 04:22
Good! It’s new. Yeah. But you know, what I love is when I talk to families, what they walk away with, and they tell me not from necessarily my work, but any work with professionals is it’s those little nuggets that help reinforce the hope and give them the thought and in the dark moment, they can remember that and feel okay, well, I can do this for another few minutes. I can do this for another day.
Geoffrey Golia: That’s right!
Margaret: And that’s just what it takes.
Geoffrey Golia 04:46
And I would be remiss if I didn’t mention the roots, right. I think like you know. One thing is that you know, for me is that whenever I say something like just for today to a young person, oh, it’s just the stuff that you hear in AA. I say, it’s true and people repeat it because It’s true, and it’s effective. And these are meats, right? If we want to use the, you know, some of the language of our time, right? These are mind viruses in a good way, right? They’re things that get into us. And they help us conceptualize recovery and help us, you know, conceptualize all of this.
But the other piece of it, the installation of Hope is the hope that we get from engaging with other people who are dealing with the same thing we are. So, go to AA going to NA going to MA going to CoDA going to whatever, at the same time going to Al-Anon right? Engaging with folks who are loving people who are struggling with active addiction or in recovery, all of these things are vital. One of the sort of presumptions of presuppositions of group therapy, is that that installation and development of hope among those folks, because they feel less alone, because they’re engaging with people who are dealing with similar things.
Margaret 05:45
What is it connection is the opposite of addiction.
Geoffrey Golia 05:50
Yes, yes, yes, the opposite of addiction is connection.
Margaret 05:53
And it’s true. From a family perspective, what I always say alone, in my head, my term is Monkey Chatter, the Monkey Chatter as a family member, that leads me into fix, manage control will just eat me up and drive me there. As a person in recovery with addiction. If I stay quiet, and alone, my disease will outsmart me, outmaneuver me and convinced me that’s the right thing to do.
So, if I’m willing to get in the rooms, on either side of this coin, with people, whatever room that is, I’m 12 Step. That’s my recovery. But that doesn’t mean the others don’t work. There’s great options out there, getting around people who are finding traction and ways forward in their life, that seems to be hard to even come by for a person. It’s like a mirror being shown to you, right, when you can’t see it in yourself, but you see it in the person across the room, I can try that.
Geoffrey Golia 06:43
I can try that. And listen, one of the challenges with the young folks is around, I think, having them step into humility. And it’s not because I think that they’re arrogant at all. But it’s because I think that a natural defense of some of the powerlessness of being an adolescent, where you sort of have an adult body, and a child’s mind, and you live in a world where you don’t have like, all the freedoms, and yet you have built in responsibilities. You know, there’s a sense in which overconfidence is a natural state there. But also, I think, a defensive state in a lot of ways. And I think that it is counterintuitive for a young person to be humble, to say, I don’t know. To be open to the feedback of others. But I also think that there’s a tremendous capacity to do that when they’re around both young people and peers, and also, I think, supportive adults who can model that. And who can tell them that, like, you still have a lot of value and a lot of power. Even if you say I don’t know, and in fact, as we get older, I think, you know, we at least some of us write me value saying I don’t know. I love saying I don’t know that my daughter and she does ask very challenging why questions which I don’t have the answers to. But I think for the young people to in group and I’m in those groups from time to time facilitating, you know, how can you build capacity to be open to the suggestions of other people and actually then go out and maybe try that thing that might help you and support your recovery.
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Margaret 08:11
Hi this is Margaret Swift Thompson of the Embrace Family Recovery Podcast!
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09:14
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Margaret 09:25
A word that’s come up that I think is another way to help with hope. But also to understand the nature of the challenge with which we find ourselves if we’re in one of these situations, is counterintuitive. Like our brain, our heart, our body is screaming to do something and yet we’re taught a skill set that is the opposite of that scream. And leaning into that uncomfortability of making that choice or that decision is tough. I don’t think for just adolescence, I think it’s tough for the parents, I think it’s tough for all human beings. And so just having grace, that’s another word I use a lot. Having grace with ourselves and with each other is just a human gift we give each other. Because I think the parallels in this journey and I would assume Geoffrey, you feel the same on the family side, and the person who’s identified as a patient are uncannily similar. The good news in that is, both can do their work and show the recovery process and help each other without actually telling each other what to do or trying to do it for each other.
Geoffrey Golia 10:38
Yeah, well, it happens in so much in the actions and behaviors, right, we like to say that, you know, actions speak louder than words, which is definitely a key of role modeling there. But um, do things, you know, by its fruits, right. You know, one thing that you notice with young people, when they are actually embracing recovery is that other aspects of their life get better? It’s not always the case, right? Sometimes if there was substance use was medicating serious mental illness, then you might start to see that flare up, right. But with comprehensive and multidisciplinary treatment, right, you can start to see that but generally speaking, right, once those issues are being managed and addressed, you know, one way that we know is, oh, they’re doing better in school, and they got a job and like, they’re going to college. And so, you start to know it by those things. And then there’s a really nice sort of feedback loop between those two kinds of separate systems and recovery, as you characterized it.
Margaret 11:30
What are you say, in the last year, two years, you’ve seen as the most current changes within the population you serve? Are there any that stand out? Because I mean, we’re coming out of the pandemic, we’re seeing the increase in the fentanyl. I mean, there’s some really political, not that we’re going down that but just the divide, and the animosity towards human beings and the disrespect. You know, there’s a lot there. So, what are you noticing in your population that’s changed, positively or challenging?
12:02
Geoffrey Golia: Process addictions is a phrase that we kind of use. Things like social media, and phones more generally, you know, I certainly struggle with my phones, in large part because I have to use them for work. But they also happen to be a place where I connect with others. And so, you know, I have to think a little about that.
But, but to get back to your question, so one phone use and the impact and social media use thats had on our kids, you know, the surgeon general put out, I think, really, really scary and relevant report on the impact that social media has on young people. So I think that that is certainly an issue that we see. and it co occurs as it were.
Margaret: Right.
Geoffrey Golia: Certainly, the pandemic created a disconnection that was really challenging. It’s funny when the pandemic started, and I was actually doing a different kind of work. I was working mostly with young men coming out of jail and prison at the time. You know, this idea of social distancing. And I remember talking to some people and saying, well, we want to physically distance, but we want to socially connect,
Margaret: Right?
Geoffrey Golia: Because while we want to stay safe from this new and scary pandemic, we at the same time, don’t want to lose sight. And I think what happened was we did socially distance, not just physically, but that isolation. And that isolation was really challenging for young people.
And so, we’re seeing the outcomes of that, which I think we’re still seeking to understand from a public health and mental health perspective. But yeah, I mean, the social media use, the isolation, the increased rates of depression and anxiety. I absolutely think that the political and social divide in this country is something that is relevant and salient in these issues. And at the same time, we know that substance use cuts across everything. We know that substance use, it doesn’t matter. Your socio economics doesn’t matter whether you’re a Trump voter, whether you’re a Biden voter, whether you’re Republican or Democrat, or somewhere in between doesn’t care whether your race, there are maybe differences in terms of who has access in different geographical areas, but all things being equal. Substance use is the great equalizer in these situations. And I would say that’s also true when you go to an AA meeting, right?
Margaret: Yeah.
Geoffrey Golia: You sit around people and yeah, sometimes there’s different demographics, as it were, but generally speaking, you go to certain meetings, and you see people of all walks of life. But yeah, this is the constellation of factors that we’re dealing with.
And yeah, I mentioned it before. I’ll mention again, fentanyl is really scary. And the way that it kind of gets into everything with powders and pills and whatnot. And I think that we want to do a lot of education around fentanyl. We give out Narcan along which we think is great. Our psychiatrists can provide medications for addiction treatment, including naltrexone, vivotrol, buprenorphine supplicate and suboxone. I always want to maintain my scope. I’m not a psychiatrist, but can talk about what we do. But the fact is, is that all these things to address this and then of course, yes, our program and other programs have sought to be robust in the way that we address mental health issues as co-occurring with substance use disorders and so utilizing effective evidence based treatments.
But then finally, you know, what I’ll say is connection. Getting back to that. So, one thing we seek to do, and other programs do as well is sober outings and activities. Young people don’t think they can have fun without substances in large part because maybe they’ve never tried.
Margaret: Right?
Geoffrey Golia: Although, I don’t think that they were fun. I mean, if you come to us, it’s because they weren’t fun anymore. And in fact, they were leading to some serious challenges in your life. But we say, how can you go out to eat with your friends and not drink? And enjoy a meal? You know, we’re in New York City. So, our kids are foodies. You know, so we might do that. But also, like, yes how do you go and spend time with other people sober and be able to connect with them? And I think what they find is actually that is much more enjoyable. And they don’t have a hangover, but they also don’t have the shameover. What did I say?
Margaret 15:39
I love that word, too. That’s a new one. Shameover. That’s good.
Geoffrey Golia 15:44
Yeah, that comes from people with anxiety, right? You go to a party and you talked to a lot of people and you say, oh, did I say the wrong thing? Did I say something duh, and you sort of wrack your brain for that. But you know, our kids, they can have both, they can wake up and say, what did I do? What did I say was that really strike system anyway, it’s just a way that they can disabuse themselves of some of the anxiety from not just us, but also the non-adaptive socialization that occurs with use.
Margaret 16:06
And I think it’s important to say for the families that one of the baffling parts witnessing this decline with substance use disorder, is it isn’t looking fun, it isn’t looking enjoyable, it is causing pain, and yet you still use. And the reality of the lack of awareness of it’s a pathological relationship with a substance or behavior that supersedes every other human need we have. And so, when you look at it from that lens, it’s telling them it’s really good still, even though they know on some level, it’s not really good. And or it’s the only way I’ll feel okay. Like to think how desperate one must feel to think this is the only way I can feel okay, not even good, but okay. And so again, it comes back to that love and compassion, right? For self for them, that the disease is beating them up regularly.
17:02
Geoffrey Golia: Yeah, it’s more powerful than them than that tenant, I think is one helpful way to conceptualize and sort of move into a space of recovery is to recognize that. You know, you’re not going to white knuckle this, you’re not going to beat it like that.
Margaret 17:13
No, I am so glad we did this. Is there anything that we haven’t touched on that you have a desire to touch on?
17:21
Geoffrey Golia: One thing when you asked about emerging issues?
Margaret: Yeah.
Geoffrey Golia: I did think about was a big issue we deal with in New York City is cannabis.
Margaret: Yeah.
Geoffrey Golia: It’s everywhere. And I’ll just disclose, you know, in my previous work in the criminal legal system, what we used to call the criminal justice system with a now called the criminal legal system. We were definitely in support of decriminalizing it, to the extent that because a lot of young men, particularly young men of color,
Margaret: Right,
Geoffrey Golia: were incarcerated and lost their futures or had their futures, endangered by mostly selling it. And I think that we’re in a space now where the pendulum has moved to this place where it is legitimately difficult for our young people to walk down the street, when they struggle with cannabis use disorder, they have a very hard time.
Margaret 18:05
It is difficult for this mother to visit her daughter in New York City and smell skunk every time I turn a corner, right. That’s my term. But I hear you and as I have compassion for the young people who may want to not smoke, and it’s everywhere, and that is not just New York now. It’s growing everywhere.
Geoffrey Golia 18:22
yeah, we’re just, it’s really tight in Manhattan and midtown. And so, I think that, you know, as a society, I think that it not just in New York City, but everywhere, right? Substances permeate everything we do, right beer commercials everywhere, bars on every corner, right? Those sorts of things. And we live in a free society. And that’s what happens. And my hope is that there’s a correction, that sort of back to the middle where maybe people are more mindful of their use of substances. And not because we always have to walk around thinking that people might have use disorders around us, but rather than because I just think like, I also think about like, my daughter’s school and other things. And so, you know, again, I don’t know if this is going to get to the pod so to speak. But I do think that like, as a society, I think finding balance between freedom and responsibility is a large social conversation. And it’s casting sharp relief when, yes, our program is working with young people who are seeking to be sober and in recovery from cannabis. And yet they’re faced with it a lot. And it is a real challenge right now.
Margaret 19:20
Well, and the thing that’s interesting is I can hear the alcoholic saying, well, I’ve been doing that now for decades. So cry me a river those of you who have to deal with marijuana in your face. Now, that’s very flippant, and I don’t mean that that way, but the other piece of it is walking in a public area and smelling it is very different than somebody having it in a glass, and we can’t control that for ourselves. Like I can’t avoid it. If I’m in that area where it is I can maybe try to go to areas where I won’t smell it, but I’m quite amazed at the commonality of it and where it is and where it isn’t.
So, what I would say on that though, I hear you and agree with you. And I think we have a lot coming our way that we’re going to have to navigate when comes to cannabis. What do you feel around alcohol? What do you see with your young people? Because that one seems to still be a silent killer. We know that. I see that. But it isn’t talked about because of course, we are talking about fentanyl, which is a very real issue. What do you see around patterns with alcohol?
Geoffrey Golia 20:19
I was talking with my family therapist about this because we were talking about the idea that cannabis has this kind of you take a kid and he smokes a lot of cannabis, right? He falls asleep playing video games, right, or something like that, right. But the long term obviously effect of the cannabis, there’s, there’s an association with psychosis, right? An association with this new cannabinoid hyperemesis syndrome, and what they’re getting right. So, it’s not benign at all right.
But the kind of acute use of alcohol, like it can be very dangerous, you know, in one moment, right, or one period of time, right, alcohol poisoning and aspiration for the lungs, you know, vomiting, those sorts of things. And so, there’s sort of that acute danger of alcohol, and then our long term, and we’re sort of like, have to engage in psychoeducation. To say, like, we really want to discourage people from using cannabis at an early age due to the effect it would have on their brains, we also want to be really critical of alcohol use, and not just because of the developmental issues that could exist there. But also because there can be an acute danger of alcohol poisoning and what can happen. And so, we always want to be extremely mindful of that.
So, listen, we see young people for whom that is, in the old parlance, their drug of choice, or can be associated or a trigger for another drug of choice. And really, the view of our center, right is abstinence from all substances is the best way moving forward for our young people. And again, it’s will they never safely use in the future? It’s not really for us to say, what we’re saying is that there’s a strong reason both in terms of their presenting issues and behaviors, but also in terms of their development that says, you’re 13 to 30, probably best for you to avoid that.
Margaret 21:57
Right. Take us back. For the person out there who’s hearing about cannabis and psychosis. They’re like, wah, because some people have not heard of this, would you give them a little information about what you’re seeing what that looks like, for families out there?
Geoffrey Golia: 22:10
Certainly and I’ll cite my medical director, Dr. Collins, who just did a presentation for our parents a couple of weeks ago on this, but research is showing pretty significantly that especially for adolescent boys, utilization of cannabis is strongly, strongly associated with the development of psychosis. And psychosis that can look like what’s called substance induced psychosis, but also sort of exacerbating the onset of schizophrenia, or psychotic disorder. And so, there’s just strong evidence.
And I think one of the associations is that the higher potency cannabis, and the overuse of that with carts and oils and other things like that, is a strong contributor to that association. And so, it’s really key because I think, yeah, I think a lot of people grew up using cannabis and also to date myself, right, you know, my parents growing up in the late 60s and into the 70s. Right, and whether the weed was different than or now, I mean, I guess some people say. I don’t know, but everyone that have that argument, as much as and say that we do see this very, very high potency cannabis now, and those associations are increasing. And so, I think that that’s one thing we talk about. And then the other thing is the CHS. This cannabis or cannabinoid hyperemesis syndrome. Hyperemesis syndrome has to do with vomiting. And that is something that I have seen both in the residential and in an outpatient space, which is folks presenting with that syndrome. That is extremely uncomfortable. And there’s an association with the high potency cannabis.
Margaret 23:39
I’m sorry, you missed me. So that’s them vomiting that induces vomiting.
Geoffrey Golia: 23:43
It induces like consistent vomiting and other just a pretty extreme body discomfort and it takes a while to get out of it. And then it really comes from very consistent use of high potency cannabis.
Margaret 23:56
And so, they would present if they can’t stop vomiting in an ER with flu like symptoms where you can’t keep anything down. If they’re not asking about cannabis. Would they know that’s what’s going on?
Geoffrey Golia: 24:06
That’s a good question. I haven’t spoken to people in emergency departments, and I would actually follow up with my medical director about to sort of talk about that. But when we see it, the one thing that we do get worried about, of course is any kind of you know, medical issue, dehydration, just the pain of the vomiting or any other discomfort and it does need to be addressed on a medical level and then ultimately addressed on a clinical level.
Margaret 24:30
I learned something new, look at that. I find that every podcast there’s something I learned that I may have heard a bit about but don’t know about and I’m sure my families, some of them are not aware of it you know.
Geoffrey Golia: 24:38
Yeah, something to definitely look into.
Margaret 24:41
Yeah, it’s enough to survive it when you’re living in it. And then something happens, and you don’t necessarily know it’s an association to the use that you’re experiencing. So, it’s good for them to hear this. I so appreciate your time. I appreciate you coming on and sharing your wisdom. You have a very, very hopeful, intelligence, relatable way of presenting. I really appreciate you, in the way that you obviously care for the people that you serve and empower them to find their way and the people around them. So, thank you for your work. And thank you for being here today and sharing with us your wonderful wisdom.
Geoffrey Golia: 25:20
Thank you Margaret, that’s really kind to say. And I’m just gonna say right back atcha I think that you have a very warm and wise way about you too. And I appreciate this conversation, and I look forward to others in the future.
Margaret 25:31
Me too. Me too. Thank you.
Outro: I want to thank Geoffrey Golia for taking the time to be a guest on this podcast. I find his approach to teaching so creative, and informative, and relatable, and I appreciate him very much.
I’d also like to take a moment to congratulate Geoffrey on his new position as Director of Clinical Services Queens supervised released at New York City criminal justice agency.
Come back next week where I have the privilege of introducing you to Maeve O’Neil, who was raised in a household with both parents suffering from the disease of addiction. There’s no coincidence that many of us end up in this field helping people with the same illness that impacted our lives. You won’t want to miss Maeve. See you next time.
I want to thank my guest for their courage and vulnerability and sharing parts of their story. Please find resources on my website.
This is Margaret Swift Thompson.
Until next time, please take care of you!
