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Our mental health is getting beat up during this pandemic: anxiety, depression, substance abuse and suicidal ideation are all on the rise. Andy talks about it with two inspiring guests: Stephanie Wittels Wachs, the host of Last Day, and Gary Mendell, the founder of Shatterproof. Both have moving personal stories and are out to change how stigma, mental health, and addiction are talked – and thought – about. Helpful links if you need them in the show notes.

Keep up with Andy on Twitter @ASlavitt and Instagram @andyslavitt.

Follow Stephanie Wittels Wachs on Twitter @wittelstephanie. Follow Gary Mendell on Twitter @gary_mendell.

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Check out these resources from today’s episode: 

• If you or someone you know is struggling emotionally or feeling hopeless, it’s important to talk to someone about it now. Contact one of the resources below for a free, confidential conversation with a trained counselor anytime.
  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Crisis Text line: Text “Connect” to 741-741
  • The Trevor Project: 1-866-488-7386
• You can find additional tips, tools and resources for taking care of your emotional health from the JED Foundation and the team at Last Day here: http://jedcares.org/lastday/.
• Listen to Season 2 of Last Day: https://lemonadamedia.com/show/last-day/
• Learn more about Gary’s work to end the stigma around addiction and his organization, Shatterproof, here: https://www.shatterproof.org/.
• For help finding high quality addiction treatment, visit https://treatmentatlas.org/
• Read the CDC’s report on rising rates of mental illness, substance use, and suicidal ideation during the COVID-19 pandemic: https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm?s_cid=mm6932a1_w
• Are you hoping to vote in the 2020 election? Are you confused about how to request an absentee ballot in your state? This website can help you with that: https://www.betterknowaballot.com/
• Pre-order Andy’s book, Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response, here: https://us.macmillan.com/books/9781250770165

 

To follow along with a transcript and/or take notes for friends and family, go to www.lemonadamedia.com/show/in-the-bubble shortly after the air date.

Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia. For additional resources, information, and a transcript of the episode, visit lemonadamedia.com.

Andy Slavitt

Welcome to In the Bubble with Andy Slavitt. This is Andy Slavitt. And I have a really important show today, it is about all of us, and how we’re doing in this challenging time. It’s gonna go right at the topic of mental health, addiction and suicide. Some of you may have seen the data, according to the CDC, 41% of adults in the US say they’re struggling with mental health or substance abuse. Related very specifically to the pandemic 11% of adults say they have seriously considered suicide in the last 30 days, which is more than double the 4.3%. That said the same thing when they were asked that question in 2018. So, let’s talk about it. Let’s just do what we do on the show. Let’s just talk about it directly with people who can be helpful. And I think I got two great people, that’ll be very helpful. The first is Stephanie Wittels Wachs. She’s the host of an amazing show, podcast, as a matter of fact, called the Last Day, and it just started their second season, where they’re talking about suicide crisis in America, she’s done an amazing job talking about addiction. And she’s just a really warm, wonderful, funny person. And we talked about this crisis at this time. Talk about Hunter Biden, and what’s going on and how Joe Biden reacted to it, and bunch of other things. But it’s kind of like a little toolkit and how to get through challenging winter. So hopefully, you’ll enjoy that. And then we’re gonna have a second conversation, which I think is also special. So, let’s talk to Stephanie.

Andy Slavitt 

Hey, Stephanie Wittels Wachs. How are you?

Stephanie Wittels Wachs 

Hey, terrific. How are you? Andy Slavitt.

Andy Slavitt

Terrific. Thank you for coming on the podcast.

Stephanie Wittels Wachs  

I mean, it’s truly my honor. And my pleasure. Thank you for hosting the podcast.

Andy Slavitt  02:02

It’s I enjoy it. It’s fun. It’s fun.

Stephanie Wittels Wachs 

Cuz you do it a lot. So, I’m glad that you have that.

Andy Slavitt  

Thanks, helping make the podcast.

Stephanie Wittels Wachs

I mean, let’s just keep thanking each other for the next half hour, I think that would be a really good way to go.

Andy Slavitt 

You know what, I feel good when people thank me. 

Stephanie Wittels Wachs 

Me too. I mean, it does kind of segue into what we’re talking about, which is like, mental health or any sort of negative experience you’re having with mental health. So much of it is about hopelessness and isolation and despair and loneliness. And so, if we did go around thanking each other, maybe that’s the solution. Don’t get me on that. But

Andy Slavitt 

No, but I think like helping people get out of that kind of feeling, which is what I really wanted to ask you about today a lot is, it’s got to help to know you’re not alone, it’s got an hope to know you get people that support you. And do you worry, especially with people isolating and as winter comes, in their connections are broken, to get a darker early, all of those kinds of things. Are you concerned?

Stephanie Wittels Wachs 

I mean, I’d love to say that I’m not. But yeah, I think this is deeply concerning. I think the fact that we’ve been stuck at home alone for the last seven, eight months, that the kids are not in school, that they don’t have connections to the things that tend to bring them joy. This is all really concerning. I mean, what we talked about the season a lot in last day is that suicide prevention doesn’t actually have to do with suicide prevention, it has to do with making sure you are making life worth living for people. And so, if we are suddenly having all of these connections taken away from us, and people are feeling lonely and isolated, it is really concerning.

Andy Slavitt 

I want to be defiant, like, I wish I could say, well, we’re not trading off our physical health and our mental health, that they’re both so important. And in fact, taking risks with your mental health is no better than taking risks with your physical health. But I don’t know how to make that practical for people.

Stephanie Wittels Wachs 

Yeah, it’s really tough. You know, we’re actually doing an episode right now about suicide contagion. So, we are trying to pull apart these myths that we hear a lot, you know, or really just talk about is suicide contagion real? The idea that, you know, once you hear about a suicide, there’s an uptick, right. And well, first of all, it’s interesting to talk about it on a show about a virus that is spreading, because the idea is mental health contagious is a question that we’re exploring what is what is a mask for mental health, in essence, and I think that it’s a variety of things. Anyone in mental health would tell you, it’s not one thing. It’s a bunch of different factors. So, if we are going to be physically isolating ourselves, how can we fill our buckets up in another way? Right? Because that, you know, that’s it. It’s really hopelessness. And so, if you’re disconnecting, and you’re taking care of your physical health, by social distancing, then you’re right, you have to find that balance. It’s tricky.

Andy Slavitt 

I love that idea of a mask for mental health and just thinking about that metaphor. And that’s really why the expression, social distancing is not necessarily the right one. Physical distancing, yes. But that finding ways to make sure you’re not socially distancing. And even I mean, I’m going to put this challenge out there. And I’ve put it out to other people, finding ways where you can occasionally not physically distancing, for example, as tests become more prevalent, you know, I got a, I got an email from somebody who said, My spouse is a cancer patient, we were invited over to a dinner party, it would really do him a lot of good to go, because he hasn’t seen a lot of people. But I’m really worried. And you want to tell people like that. You can have it all. But it’s sort of like we are with our kids. Like, when my kid would climb the jungle gym, Lana would yell, be safe, and I would yell, have fun. And then we would both have to look at each other. Go, you got to do both.

Stephanie Wittels Wachs  06:17

Yeah, I mean, look, my kid is six. She’s been on computer school for seven months. She’s not excited about it. She’s so social. She’s so enthusiastic, and lively and adventurous. And she asks a gazillion questions. And, and now when she goes to school, she’s just like alone in the living room. And as a parent, I mean, it’s devastating to see and doing the work that I do. I focus so much on isolation, and loneliness, and hopelessness and as a society, you know, suicide isn’t something that’s new, I think that it is talked about more, addiction, overdose is not new, we are talking about it more, I think we are reframing the way that we understand it to be something that really is a chronic illness and not something that should be stigmatized and kept in the shadows. I think the more that we do that, the more people realize, you know, I’m not the only one that feels this way. That’s a connective tissue.

Andy Slavitt  

Right. So, you’ve just gone very deep over the last few months into understanding suicide. And, and I want to get to that in a minute. But I do want actually start where you just were with the judges with addiction, I want to actually hook it to a recent news item, which is Rudy Giuliani and others, really kind of putting a bright spotlight on Hunter Biden. And then the country watching Joe Biden’s reaction to Hunter and these leaked messages, where he told his son, how much he loved him, and that he was beautiful, and that he valued him. It’s such an opportunity for people to figure out what message to give to this very mixed set of emotions people feel towards people who are having addiction challenges. Maybe we start there?

Stephanie Wittels Wachs  08:07

Yeah, so I think wouldn’t one thing that was so striking about that moment, and I was watching that moment with my parents, who lost their son, to heroin, a heroin overdose. Yeah. And it was really profound for us to hear him say, I told him, I was proud of him. Because like, listen, if your kid had cancer, if your kid had any other kind of disease that was really hard to beat, you would say, I’m proud of you. I know this is a hard fight, I know that this sucks for you. But I’m here with you, I’m not going to like drop you off at the hospital until you like, get better. Or I’m hitting the road. We shouldn’t be approaching illness and disease with an ultimatum. And so, I think, Joe, I’m just gonna call him Joe. I’m just gonna put it out there and call him Joe. I think him embracing the idea of feeling proud of his son that is struggling with something is really important. And it’s something that we have got to spread. I can’t think of any other word to the rest of our country to the rest of the world.

Andy Slavitt 

Yeah, when Hunter called himself a loser. It was heartbreaking. In his email to his dad, it was heartbreaking. And you know, you know how much you want your dad’s approval? And how, how that must have felt. And you just think about God, can we actually model this level of compassion? Now we’ve started this, I assume that everybody in the world has listened to last day. And they should. And I have to tell you that and I’ve told you this before, but I’ll tell this to the audience. It is a combination of, well, the best podcast and one of the best pieces of art slash journalism storytelling that I’ve ever heard, as well as incredibly difficult for me to listen to at times. It is a show about something very Are you sad that you made a very funny and real. And I think if people want to get that feeling for yes, there’s some serious things that go on in the world. And yes, there’s some awful things go on in the world. But it doesn’t have to knock us completely out. If we deal with it. We bounce back. The Last Day did that in the first season was about addiction. The second season, why don’t you tell us about that?

Stephanie Wittels Wachs  10:27

Those are very nice things that you just said to me, Andy, thank you. I’m glad that you like the show. And I’m glad that you think it’s funny because like you being told that I’m funny is the most important thing. For me. Yeah. So we, we wanted to go into season one with this question of what could we have done differently, I think a lot of people who are struggling with a family member who’s on the roller coaster of addiction, or if you are struggling yourself, there’s not like a manual, we have a lot of ways that we treat it like our 30 day programs, and all of these, frankly, really terrible ways that we’ve learned to treat addiction that don’t work long term. 

And if you’re left as a family member, having lost somebody to one of these untimely deaths, you’re thinking, well, I could have done more. And we want to do explore that. And we want to explore if that’s true. And as a society, like, how can we zoom in on these losses that we’re having in these statistics, and humanize them? To try to understand this larger epidemic, we always knew that for season two, we wanted to talk about another, quote unquote, epidemic, that’s hard to understand that’s getting worse every day. That’s deeply stigmatized. And so, suicide felt like the natural place to go. It’s also we built a really phenomenal community with last day of people who were like, Hey, thank you for expressing the insides of my body, I felt completely isolated and alone and judged and misunderstood. 

12:00

But I listened to you, and you’re the same. And so that’s been really hopeful and healing for a lot of people. In the messages that we received over the season, suicide kept coming up again, and again, there’s a link between those two, suicide and addiction because they both deal with what in Nzinga, who we both love calls the magic formula, right? Where you have to find all of these different ways to make your life filled with purpose. And that mental health isn’t necessarily just about like, being depressed or, you know, pull yourself up by the bootstraps, I think we feel a lot in America, at least it’s about like, how do I enrich my life? And how do I attack it from a bunch of different angles, like you would any disease or chronic illness. So, we decided we tackle suicide for season two, I keep calling it a Rubik’s Cube. 

Because whereas when you die of an overdose, as a family member, at least I can be like, Oh, God, that substance killed my brother, that substance had fentanyl in it, that drug dealer dealt my brother, something that killed him, and you can sort of put it outside of him in a way, right. And you can blame something with suicide, it’s a lot trickier, because the person is the one who’s ultimately making this choice. And unpacking that, and figuring out why. And trying to figure out the root of all of that and trying to figure out how to talk about it in a way that is not going to harm people. Because just by the nature of how we speak about it, it can be really detrimental to people who are already struggling with us. And the idea we keep coming to over and over. And this season is like once the idea is planted in your head and you have access to means and you get to this one moment where you just feel like I’m ready to make all this stuff in it. 

Andy Slavitt  

How do you overcome that? What do you what do you do to address that?

Stephanie Wittels Wachs  

That’s the entire season. 

Andy Slavitt 

You’re not gonna tell me?

Stephanie Wittels Wachs  14:00

No, I’m not. Andy do you think I’m gonna give you the answer right now? Or do you think I’m gonna just say.

Andy Slavitt  

Your advertisers would not allow that. 

Stephanie Wittels Wachs 

They would not. But I mean, that really truly like? It is extremely layered and complicated. If you’ve heard any last episode, you know, we’re like, yeah, it’s this and also this, but then this, but then let’s actually turn it on its head and look and look at this. And this issue is even more complicated, I’d say.

Andy Slavitt  

Now, for something we like to call advertising.

Andy Slavitt  

I’m thinking about my listeners now jealously, listening to this and saying, you know, I’m feeling a little bit download feeling a little bit depressed, and maybe they’ve had those thoughts. You know, I know what I would tell them without having done all the work that you’ve done, based on my own experience. answers and so forth. And if you give nothing, I would come up with my lame answers. But what would you tell people?

Stephanie Wittels Wachs 

I’m actually curious about what people think they should say, you know, because I don’t think that any of us really know what we should say. So, you tell me what you would say. And then I’ll tell you with my education, what I would say,

Andy Slavitt  

Sure, the first thing I would say is, we self-stigmatize worse than people stigmatize us. So as bad as you might be feeling or alone, or you might think it’s weird, you are probably preventing yourself from dealing with, when it’s a very normal thing, a very common thing, and get help. Things are so much easier with help than without everything is easier. With help, everything is better. With help. Number one, number two, I guess I would say, these feelings, these highs and lows, are all very temporary. And sometimes they feel like when we’re in them, they feel like they’re gonna last forever.

16:00

But they’re not. And there’s a light at the end of the tunnel, there’s a light at the end of tunnel with this virus, there’s a light at the end of the tunnel, with the you know, the challenges our kids are having at home, there’s a light tunnel, with everything and all it takes to set one day that next morning. We’re like, holy crap, I feel pretty good today. And you know, on those days, remember, you might have friends that aren’t doing so great. And I find like, this is gonna work. The third thing comes in is like, what kind of things make me feel better. 

16:29

If I’m calling someone that I think may be hurting worse than me. I feel better. I start telling them things that I’m probably telling myself at the same time. And then you know, medication works. And like if people look at medication, and they say, God, I’m okay, but I’m on medication. It’s like, yeah, you’re almost I have cancer. I survived it, but I had to take chemotherapy. What weakness? what weakness? So, I had this conversation with somebody the other day, who’s like I’m doing okay, but I’m but I’m taking a low dose depressant. And I’m like, what’s the but part? You’re doing, okay, that’s great.

Stephanie Wittels Wachs

Amen. Yeah. So, first of all, you are hired, you can now come host the show, because that that that’s a really good list. I mean, getting help seeking help. You know, we talked to this guy in Episode One who was called literally the guardian of the Golden Gate Bridge is really macho guy. He was the highway patrol guy for the Golden Gate Bridge. And so, he talked to a lot of people who were in a really bad place hundreds and hundreds and hundreds over the years. And it’s a fascinating episode. But he says in the episode, you know, I was this macho dude. Like I had, like, jumped out of planes, I rode a motorcycle. And it gripped me that he would find himself riding his motorcycle home, stopping and screaming into the night like screaming. And then he realized he wasn’t okay. 

He was supposed to be this helper. He was supposed to be the guy that was sweeping into save the day. And he was dealing with all of his own demons. So, he, like you said, went to get mental health treatment went to see a therapist, did some trauma therapy got on medication? You know, like medication prescribed safely by your doctor is phenomenal. My husband I was struggling who’s on our medication these days. You know, I mean, it’s so true de-stigmatizing it. And if you feel like this, this moment, where you are just at a low, text a friend, call a friend, you know, say something? And if you get that text, if you’re on the receiving end, you say, Hey, can I come over? They say no, go over there. Anyway.

Andy Slavitt  18:40

It’s a privilege. If you get a text like that from a friend, they love you. They’re counting on you. That is a wonderful place to be to be able to help somebody.

Stephanie Wittels Wachs

You know, it’s so true. And I know there are people listening to the show, I know there are that are saying, well, that’s not true for me, or no one would care if I wasn’t here. Or it would just be so easy if I could end it. And that is not true. I want to tell you, if that is you, and you’re thinking that you are so wrong, you are everyone in your life is going to be very damaged by that you are loved. You are valued. We have to keep reiterating this to people

Andy Slavitt 

Completely, completely. Related to that. We had an episode with Jason Kander, that people should go back and listen to Jason’s a very brave guy he went through. He was in Afghanistan, and he came back. And he had this sort of charmed life and he was running for office and he wanted to be president. And one day he just took himself out and said, I back from Afghanistan for X number of years, and I’ve got to finally admit that I have Post Traumatic Stress Disorder. And I asked him, why did it take you so long to admit that to yourself, and he said, you know what, Andy? Because I didn’t think my PTSD was worthy. Because I was not a frontline infantry person, I thought there’s no way that my PTSD could be as real as someone else’s. And then I realized, my brain doesn’t know the difference between relatives, my brain only knows what it’s feeling. 

Stephanie Wittels Wachs  20:16

That’s right. 

Andy Slavitt 

So, he said, you could, you know, you could witness a squirrel getting run over by a car. And you can have PTSD that could have that’s traumatic for you, your brain doesn’t go Wait a minute, that trauma rates, three on a scale of nine, therefore, you know, it’s just your brain does what it does, and you just have to kind of deal with it. And I thought that was very insightful.

Stephanie Wittels Wachs

It’s so it’s so true. And I wonder what would happen if, in that moment when we have that, Oh, I’m feeling this. It’s not that important. What if we just picked up the phone and called a mental health professional? What if we googled, you know, just talk to somebody else, take that feeling? And instead of negating that feeling and pushing it down, just open up about it, maybe you’ll go talk to somebody and be like, you know what, you’re right, your PTSD? It’s fine. I doubt it. Because we feel what we feel. But that’s the moment where, like, reach out for help right then,

Andy Slavitt  

Right. So in the show notes, I will have links to some of the places you can do that to where you can just click on the link, and it’ll take you right to tell that’s the thing now with this COVID thing is like everyone right in your computer screen, as soon as you one word we can get a therapist will do a whole bunch of different services. It really, that really helps.

Stephanie Wittels Wachs  

We are partnering with the JED foundation for this season.

Andy Slavitt 

Tell us about that.

Stephanie Wittels Wachs  

We felt like it was really important. Because this isn’t my personal story this time around. And I really feel a responsibility to get it right. It’s like you can’t talking last season about addiction, I could really draw from my own, like mental file cabinet of experiences. But with this, I haven’t experienced suicide firsthand. And there are a lot of rules, literally journalistic rules on how you’re supposed to talk about it. So, we felt like, we want to get it right. We don’t want to do harm. So, we partnered with the Jed foundation who does this. This is their entire the entire mission of their work. And it’s been an incredible partnership. We do editorial meetings every week with them we get on we’re like, Hey, this is what we’re thinking about. Is this story going to work? Is this going to harm someone and they’d be like, Oh, God, don’t tell that story. 

22:25

You know, don’t do that. Or if you tell it, be aware of this, and this and this thing that you could get into. And so, it’s been wonderful. They have set up a page called jedcares.org/last day, where you can go get resources, you can find mental health resources. And the other thing I would say is, we are tackling the notion in and of itself this season, that it’s too hard to listen to. Right? We have talked a lot about trigger warnings. And what we’re encouraging people to do is if you feel like you can’t listen to this, listen to it, if you need to pause, pause, go take a breath, go watch a puppy video, take a walk around the block, come back, you know, there is growth, there is meaning there is self-reflection that we have to offer. And I think we’re very strong, not in like a cowboy, strong way. But in like that resilience of the human spirit way. And if we allow ourselves to hear people’s stories, it can be really therapeutic.

Andy Slavitt 

You told us about the season. It starts when?

Stephanie Wittels Wachs 

The first episode is up now. And we have new episodes that drop every Wednesday.

Andy Slavitt  

Fantastic. Same day as one of our shows drop.

Stephanie Wittels Wachs 

I think so I think I’ve heard of it. I think I might be on it now. Yeah, so you listen, Wednesdays to in the bubble and you listen to last day and you have like a really enriching experience.

Andy Slavitt  

It’s a great day. It really is and what else what else do you need? You can skip a meal. Just listen to our podcast.

Stephanie Wittels Wachs  

Eat podcasts.

Andy Slavitt  24:00

Congratulations. I think you’re just getting started. Good luck on this season. I think it’s gonna be just an amazing experience to listen to. And you still are one of my favorite people.

Stephanie Wittels Wachs 

I mean, I will take that in and tell you are also one of my favorite people. So, I’m glad we’ve had this love fest today. Thank you. All right, bye.

Andy Slavitt  

Don’t go anywhere. We’ve got to go earn some money to donate to charity.

Andy Slavitt 

Okay, Stephanie, thank you for that. Thank you for sharing all that. Thank you for doing the difficult job you do making such an important show on such important topics with such great care. Now we’re going to talk to someone I admire very deeply. His name is Gary Mendell the minimum a few years ago. He is the founder of an organization called S1hatterproof, which if you haven’t heard of it, He started on the back of losing his own son, and all the rawness, he felt over losing his son. He wanted to basically bring an end to the way we deal with and talk about addiction in this country. It’s done in a spectacular way. He’s making a massive impact. It’s a really moving conversation, and I hope you really like it. I hope you like Gary as much as I do. So, let’s talk to Gary.

Andy Slavitt  25:37

Gary?

Gary Mendell  

Andy, nice to see you again. Last time I saw you was pre-COVID out in San Francisco.

Andy Slavitt  

It’s great to see you. We were in a hotel lobby,

Gary Mendell 

In the hotel lobby, exactly.

Andy Slavitt  

I have to say that when we met, that meeting really affected me. I mean, I remember I remember it was a probably over a year, maybe year and a half ago. But I almost remember every detail of the time we spent together. And that doesn’t happen to me a lot. My memory is not, doesn’t usually hold these things. But I was really impacted by what you’re doing. And I want people to get a chance to hear a little bit of what I heard. And then we maybe we can talk a little bit about what’s going on. But you started this amazing organization called Shatterproof. And in my view, one of the reasons I’m such a big fan of yours, I think it’s potential to be a game changer. And I don’t see a lot of things like it. So maybe, you know, you tell us a little bit about start by telling us a little bit about Brian, and what kind of person he was. And then if you don’t mind, and then we can move from there.

Gary Mendell  26:46

Sure. You know, Brian was when Brian was born, he was the child every parent dream of as a young child, always smiling, always hugging me my little companion. And as he started to grow up, he as a young child, he did many of the things that young children did, or do, you know running around the backyard chasing butterflies, having trucks, little trucks, toy trucks lined up around lined up around his room, where he would just fanatically play with them. But then as he grew into a teenager, he did many of the things that teenagers do, including Brian bearing pot. And for Brian, that’s where things changed. You know, as you know, statistically, about one in 10, who tried drugs and pot at a young age and the year before high school or somewhere around then about one in 10 become addicted, and are started to start to use drugs more regularly and then become addicted. 

And that was Brian. And that led to eight years of him going in and out of treatment programs, courageously fighting this disease. And like anybody going through this, there were some good times and bad times, there were times where he didn’t seem to listen to reason, which is part of the issue with this disease. But there were other times he was just so into it. I remember visiting one time in a treatment program in Florida, and I flew in late the night before. And I got up really early around like 6:30 because I just frankly wanted to walk into his room and just watch him sleep. I hadn’t seen him in like five or six months. I couldn’t believe I walk into his room at seven o’clock, which for Brian, that’s a really. And there he is on his bed. flipping through the pages, he had a light on and he’s flipping through the pages of his treatment book. 

And I walked in and here he heard me walking he looked up and with a big smile is he said dad I’m going to beat this, I’m gonna beat it. But addiction always doesn’t work that way, as we all know, and October 20, 2011. I was woken up in the middle of the night by my cell phone ringing. And when I picked it up, I was told that my son had just died. He was 25 years old. And he hadn’t used a substance in 13 months. But equally tragic. It wasn’t just the addiction that took Brian’s life. It was the feeling of shame he had every morning when he opened his eyes, of feeling like an outcast that caused him to wake up that morning and the history on his computer shows that he woke up research suicide notes, wrote a note of his own little candle. It took his own life alone, alone. So that’s Brian. But the inspiration of Brian is what led to the formation of Shatterproof.

Andy Slavitt 

Yeah and the inspiration of Brian which we’ll talk about a few minutes, has had a dramatic impact on people that you’ll never know you’ll never meet. And I think quite frankly, long past our time even will be this incredible legacy. And I want to talk about that a second. But to get there over those eight years, how did your attitude towards addiction change? And then in the subsequent years, what did you learn? As you think about how you originally viewed addiction, when it first became a problem in Brian’s life, versus what you became to believe? 

Gary Mendell  30:36

Great question. I didn’t evolve much over those eight years, in my over those eight years in my thinking, but I was wrong. Then I viewed it as Brian not having the willpower to stop using drugs. That’s how I viewed it. And I was wrong. And after Brian passed away, I began to research and really drill into how could I have let this happen as a father. And so, I started flying all over the country meeting with the best in this country has in research and prevention, policymakers, researchers. And I started to learn about so much that I didn’t know when Brian was alive. And now I fully understand that this is a chronic illness. And it wasn’t Brian’s fault. And now I fully understand public stigma, structural stigma, self-stigma, what he was going through, you know, people talk about, you know, stigma in the sense that people get directed to the criminal justice system versus the healthcare system.  Sure, that structural stigma, that it’s not taught in medical schools, the way other diseases are structural stigma, payment policies, in health insurance, not paid for the same way, structural stigma.

32:00

But how about the self-stigma? In a recent poll, about half of Americans said that those with this disease, it’s not their fault, it’s a chronic illness, have said it is their fault poor willpower poor upbringing. Fine. But I’d like to say to your viewers, that that’s less important. Because 80% of Americans, which included many who said, it’s a chronic illness, said, I’m not comfortable associating with someone addicted, as my friend, my coworker, my neighbor, married into my family. So that’s public stigma. But think about how someone like Brian feels, someone like Brian could get treated really well in a good treatment system, and then get out and face a society where 80% of Americans want nothing to do with it. The killer is when someone addicted begins to internalize that and believe it, and they start to think they’re right. I’m not worthy of getting a job. I’m not worthy of living in a nice neighborhood. I’m not worthy of talking to my neighbor’s daughter.

Andy Slavitt  

It’s all my fault.

Gary Mendell 

It’s all my fault. And you feel hopeless, with no self-esteem.

Andy Slavitt 

Right. This insight, which hit you, it sounds like over the course of studying this, and it changed the way you looked at everything. What did you do with that insight? What did you do once you had that? What did you feel like needed to be done?

Gary Mendell 

I knew I wasn’t ready. And Shatterproof is six years old. And I knew myself in the organization needed to build a foundation first before we could attack that. So, when we started Shatterproof, six years ago, coming from a background in business, I wanted to build a culture internally and a reputation externally. This is not just another small nonprofit, creating awareness. These are doers. They’re not writing white papers. They’re executing on what the research shows. So, we began getting policies changed, creating a track record, getting laws passed in states. And we became the leading organization in the country doing that over the last several years.

Andy Slavitt  34:09

Do you mind giving me an example or two of the type of laws that existed then and that you got changed? 

Gary Mendell  34:14

Absolutely. We started out our first year, first year and a little bit into the second year getting laws passed the Nalaxone access and good samaritan laws. Someone’s at a party falls down, not breathing. The rest of the people at the party going to call for an ambulance. Well, not when the ambulance comes. If a police car comes with it, and the person who made the phone call or the people the party going to get arrested. But a good samaritan law says if you make the phone call, no questions ask, ambulance comes in please comes in, puts the person in the ambulance takes him to the hospital. No issue. So, we got laws passed in several states with a good samaritan law. The next one is now Johnny is laying they’re not breathing when the ambulance comes in. Do they have no Nalaxone with them to save his life. Otherwise, he’ll die in the ambulance on the way that hospital. 

Well, many states didn’t provide for it. And so, we pass laws and met in several states saying those administering it, no civil liability Nalaxone is so safe, you can give it to anybody who’s not experiencing it, it’s not going to harm them, but protecting that person. So, they’re not afraid to administer Naloxone and giving the ability of pharmacists to prescribe it without a doctor’s prescription, it should be over the counter. So, we passed many laws, then we became the leader in the country getting required the use of prescription drug monitoring programs, if you’re a doctor and someone comes in, says, I hurt my elbow playing golf, I need 20 Vicodin. In the States, we got this law passed, you cannot prescribe that Vicodin until you’ve checked the electronic health records, and determined if this person has had a prescription of opioids in the last year, and if the person has, where and how and why. 

36:02

And then we’ve also passed laws requiring continuing education in the prevention and treatment of addiction in certain states. And then we became one of the lead advocates for the CDC helping them getting their guidelines issued on the safer prescribing of opioids. 

Andy Slavitt  36:17

I know you have even more examples. But I think those are good to give folks, the thing that I learned from you and people like you, that I’ve trained myself to do it, please correct me if I don’t have this exactly right. is in my mind, when I hear about someone with an addiction problem, or who’s using I trained myself to say, cancer or diabetes, and say, so someone says, I won’t give someone treatment because they haven’t been complying with their program. I say to myself, okay, if somebody had cancer, and was doing something harmful, they maybe they weren’t complying with their medication, would the center turn them away? Or if they if they weren’t monitoring their blood sugar, what a doctor in a million years be permitted to not, not take them. And so, to me, that mindset change that you helped to engineer. Once you do that, once you say addiction, is just diabetes, it is something that you are afflicted with, it’s not your fault, then the way you look at policy, the way you look at treatment, the way you look at the way you should be able to ask for help among your neighbors. It’s completely different.

Gary Mendell 

Absolutely. There’s not much there’s nothing to correct, there you have it exactly right. There’s one subtle addition to it. It’s a treatable disease. And that’s how this social isolation stigma, the public stigma begins to change. Because remember, about half the people in that survey said, it’s not their fault, it’s a chronic illness. But 80% said, I’m not I don’t want to associate with you in any form. It’s because the view is this is not a treatable disease. But this is not my opinion, this is 100% backed up in the Surgeon General’s report. success rates for those treated for addiction are 100%, comparable with someone getting treated for diabetes, hypertension, or asthma, 100%, comparable same success rates. 

38:26

So, the public needs to understand that number one, and number two, we have to have a treatment system that delivers evidence-based practices, because then it’s because otherwise success rates won’t be there. And that’s the other big part of our work is transforming the treatment system in United States, there’s three pillars of our work, that all have to work synergistically together. One, we have to transform the treatment system, the United States, it’s completely backwards, it’s fixable, it’s blocking and tackling, we’re doing that. Two, we need to end the stigma. Three, we need to give information support and resources to families, both prevention and treatment, and recovery, my group retreat and recovery a lot together. That’s why I used to work both but also preventative. So, we need to get information out to families, so they have the basic information which they don’t have today. I didn’t have it.

Andy Slavitt

I want to ask you about addiction at the time of this pandemic. And what reflections you’ve seen what data you’ve seen under addiction and what’s happening to people who have chronic addiction or have some triggers in this in this time.

Gary Mendell

Absolutely. Intuitively, before I saw data, myself, and I suspect you and most people would think people with addiction are going to do are going to index far worse in this type of environment than most. The social isolation. People with addiction need each other for support. The not being able to get to your treatment programs or get your medications, the anxiety of losing your job, the anxiety, if you lost your job, how am I going to pay my rent? intuitively, this would index a lot higher for those with this disease in mental health issues, then the population in general, the data is backing this up. Unfortunately, in the month of May, there were 42% more overdoses in this country in May 2020, than May 2019, 42%. And I would have expected something like that. So, it is hard to read it and see it in the numbers printed, but it makes sense.

Andy Slavitt  40:45

So, if you’re talking to if someone’s listening, the show who has they know they have a challenge with substance abuse, or they have a child, or a brother or a sister, or a parent, which happens, unfortunately, so often, with a substance abuse problem. What would you tell them? What advice would you give them? What do they need to hear?

Gary Mendell 

The first advice I would be would be a little bit more pragmatic, which is go to treatmentatlas.org, that will first ask the person looking for treatment, or someone who knows them to take a 13-question assessment that takes 10 minutes that was developed by the Gold Standard American Society of Addiction Medicine. And to take an assessment to determine which type of care do you need? Do you need residential? Or do you need outpatient? Because to your point earlier, when people Google, the advertisers who can afford it are mostly residential, and I’m not against residential, I just believe that what the science shows you should go to is what you should go to not, which I happen to see what’s advertised more. So that’s number one. 

Number two, if you happen to be in the six states where we’ve now launched quality information, or close by within a couple hundred miles of a state, you can then search for treatment programs in those six states where we have quality data, and compare treatment programs, side by side to see who is delivering quality and who’s not. So that’s the more pragmatic approach, and an emotional approach. Whenever I speak to someone during COVID, or pre-COVID, or for the next 20 years, whenever I speak to someone, I always say when we get off this phone, my recommendation to you is I’m going to connect you with a professional. But in the meantime, we get off this phone, either walk down the hall, or get on the phone, or get on an airplane and hug the person in your family who’s dealing with addiction. 

42:47

And don’t just tell them you love them. Because we all say that. I said that all the time. But do you feel the empathy towards someone who’s struggling with this disease? Just like someone who could be struggling with cancer. I’ve talked to thousands of people in the last seven years, who are addicted, I have never met one who said they reached up to the sky one day and said God addict me. It has connection with some people. When you use a substance with other people it doesn’t. This is a treatable disease. And your loved one not just needs to know you love them. They need empathy, compassion, and admiration for fighting through a difficult disease every day. That’s what I would recommend.

Andy Slavitt 

You know, I’d love to leave it on that note, I think what you said about admiration is so beautiful, and so important. It’s not just sympathy that people want. But all of the things that you saw in them on their best days are still there. And the fact that you still see them will, I think help them see them as well. The resources that you’ve put together, we will have them in our show notes. So please go to the show notes. Gary, I’m so admiring of what you’re building. The Legacy you’re creating is so powerful. It fills me with optimism. It really does.

Gary Mendell  44:18

Well, Andy, thank you. And a closing note on my end is yes, this was started out of love I had for Brian and what he would want, but it’s now grown into well beyond Brian. I’m inspired every day by so many wonderful people all across this country. That it’s well beyond Brian’s wish it’s every parent’s wish. It’s every family’s wish to do this. And I want to thank you and what you’re doing getting this out in the hundreds of thousands who have joined with us to create this change. So, thanks.

Andy Slavitt 

Thanks, Gary. And thank you, Stephanie. And thank you, I hope you got something out of those conversations, we will keep coming back and talking about this issue because it’s important part of life during the pandemic. And, you know, I think it’s just I know, it’s strange for me to say, because I’ve never met some of you in person, probably most of you. But, you know, I hope you’re doing okay. And hope you’re getting through this and you matter. And I love having you part of the show. And so, you’re certainly doing it for me. And I hope that that’s mutual. 

Let me tell you about an upcoming shows. We’re going to show on Wednesday, about what it’s like to get Coronavirus from the White House, maybe even the president. Maybe even on Air Force One. We have Michael Shear, who is a New York Times reporter covers the White House beat who yes, he got COVID-19 from the White House, and they never even bother to call and tell them the fascinating story, you’re gonna love this. That’s coming up on Wednesday. The following week, we have a little thing called an election. And we have two shows saddling the election, the first on Monday is a toolkit for you to play while standing in line to vote. 

46:13

And if you’re not standing in line to vote, you can play it while jogging, you could play while doing other things. But only if you’ve already voted. It’s gonna be a fun show. We’re putting a lot of effort and energy and creativity into what we think you’d like to listen to when you’re voting, we’ll have some nice surprises on there. And then we will have following that a show on Wednesday probably will come out a bit later than we normally pop these things onto your phones or your computers. As we covered what happened. And of course, I know you want to hear about what happened in the election from me, because I will have an opinion. 

But though seriously, I will have some people on the show who are experts who will break it down for you. And we’ll do it in our own inimitable way and hopefully that you’ll feel like you got what you voted for. And hopefully we’ll have some clue of what’s going to happen in the case. Thank you so much. As always for tuning in. I really do appreciate you and we’ll talk later Bye Bye. 

CREDITS

Thanks for listening to In the Bubble. Hope you rate us highly. We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced to show our mix is by Ivan Kuraev. My son Zach Slavitt it is Emeritus co-host and onsite producer improved by the much better Lana Slavitt, my wife. Jessica Cordova Kramer and Stephanie Wittels Wachs still rule our lives and executive produced the show. And our theme was composed by Dan Molad and Overhill and additional music by Ivan Kuraev. If you can find out more about our show on social media @lemonadamedia. And you can find me @aslavitt on Twitter or @andyslavitt on Instagram. If you like what you heard today, most importantly, please tell your friends to come listen, but still tell them at a distance or with a mask. And please stay safe, share some joy and we will get through this together. Hashtag stay home