Akron's St. Thomas Hospital was the first in the world to admit alcoholics for treatment. That was in the early days of Alcoholics Anonymous.
A doctor carrying on that tradition at that hospital today has an inside understanding of what it takes to get sober. On this Week’s Exploradio, Dr. Nicole Labor shares her insights on treating addiction .
Bold tattoos wind around Dr. Nicole Labor’s arms and peak out from under her shirt collar. Inked onto her right hand are two molecules that hold special meaning for Labor.
Dopamine and serotonin are neurotransmitters produced by the brain that regulate pleasure, gratitude and other good feelings.
“Everything that you do in life that you enjoy comes from one of those chemicals," says Labor, "that’s it.”
She says the chemicals tattooed on her hand keep it real for her as a reminder of the biology behind cravings.
Labor grew up in New Jersey, a bright kid with what she calls a normal family life.
But early on she discovered she craved alcohol more than her friends.
In college she used drugs of all kinds.
Eventually prescription opioids joined the mix, "and that rapidly progressed to heroin because it was so much cheaper, and it was a lot easier to find.”
Meanwhile she had entered medical school.
“I had scheduled all of my rotations at different hospitals in and around Newark, N.J., because that’s where my drug dealer lived and that was where the best dope was and the cheapest dope.”
By her third year of med school, still shooting heroin, Labor had hit rock bottom.
“One day I was in a rotation in New Jersey and there was a psychologist at the family practice, and I had gone in and said I was having a panic attack. She asked me about my history and I was wearing a sweater and I pulled up my sleeves and showed her my arms and said, ‘I don’t know what to do.’”
Labor went into detox, spent months in rehab, plus a year of outpatient treatment while finishing medical school.
“So I have 12 years clean now. But I still go to meetings, I still have a sponsor, I still work a program; that’s how I stay clean.”
She voluntarily continues monitoring by the Ohio State Medical Board.
Labor says more than 80 years later, the medical establishment still struggles with defining addiction as a disease.
“We still judge the people that do it. We still have opinions about what kind of people they are,” says Labor.
“We say, ‘yeah it’s a disease, but it’s not like cancer, it’s not like diabetes.' And my response is, 'No, you can’t have both. It’s either a disease or not. If it’s a disease it is just like cancer and diabetes and it deserves to be treated the same way.'
Addiction is a disease of the brain’s reward centers says Labor.
“Part of the brain that becomes addicted, that old limbic system, the midbrain area – they have no control over that. Nobody has control over that. That becomes dysfunctional; it actually breaks down.”
Labor describes it this way.
“You’re in the desert and it’s day five with no water and your organs are shutting down and you’re literally going to die. And I hand you a bottle of water. But I tell you if you drink this, I’m going to take your kids, your job, your wife, your house -- you would drink the water. Everyone would. There’s no macho person out there who thinks they can withstand this, it’s not possible.”
“So you drink the water, satiate that tiger, the midbrain, so that the urge to live is taken care of, and then other part of your brain comes back on line and starts going, ‘Oh my God, I can’t believe I gave up all that stuff for water,’ and you start trying to manipulate me into giving your stuff back.That’s exactly what addicts do.”
Taming the tiger
The ‘water’ that Labor gives patients with addiction is Suboxone or other drugs that ease detox and give the addict time to develop stronger coping skills.
“These medications are tools that I have in my toolbox, and they have a specific purpose and they take pressure off that midbrain to allow me to strengthen the frontal cortex.”
The frontal cortex is the seat of reason, which she says needs to tame the tiger of dependency running wild in the brain’s reward center.
Akron is the birthplace of AA. Labor believes its 12-step program is still the best way to empower sobriety.
“I think spiritual growth is the ultimate goal, and so however you get there is fine with me," says Labor.
"In my experience both personally and professionally the 12-step groups are the quickest and easiest way to get there.”
Treating addiction is a calling for Nicole Labor, along with breaking down the stigma that goes with it.