Understanding Addiction and how spirituality can play a vital role in recovery with Dr. Olivera Bogunovic [Ep. #949]

 

This week’s topic: Understanding Addiction and how spirituality can play a role in recovery.

Hi everyone. Welcome back to our Monday interview show. I am very excited for our extra special guest today, Dr. Olivera Bogunovic. She was recently seen in the documentary film As Prescribed. She is the medical director of McLean Hospital’s Alcohol, Drug and Addiction Outpatient Program and assistant professor of psychiatry at Harvard Medical School. Today we’re going to be talking about awareness for certain medications which have become so widespread and there isn’t a lot of information about the potentially harmful effects. I have been receiving a lot of messages around addiction and wanting to feel more free in our lives and just, you know, having awareness, having tools is such an important part of the process. So I wanted to bring in Dr. Oliveira today to talk about a particular type of addiction and what she sees in her work.

 

About Dr. Olivera Bogunovic

Olivera J. Bogunovic, MD, is the medical director of McLean’s Alcohol, Drugs, and Addiction Outpatient Program at McLean Hospital. She divides her time between clinical and administrative and teaching activities, which include teaching medical students and residents as well as addiction and geriatric fellows. Dr. Bogunovic’s scholarly work and primary area of clinical innovation is in two major areas of investigation: developing effective treatments for benzodiazepine use disorders and developing innovative treatments for elderly patients with substance use disorders.

 

Guest Resources

 Website:

Dr. Olivera Bogunovic

Film:

AS PRESCRIBED

 

Episode Chapters

00:00 Introduction to Addiction Awareness
02:50 Understanding Addiction and Its Stigma
05:52 The Dangers of Prescription and Recreational Drugs
09:07 The Role of Benzodiazepines in Addiction
11:54 Therapeutic Approaches to Addiction Treatment
15:00 The Impact of Hormonal Changes on Mental Health
18:06 The Importance of Individualized Treatment Plans
20:53 Spirituality and Support in Recovery
24:05 Hope and Future Perspectives in Addiction Treatment

 

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OTHER PODCASTS YOU MAY ENJOY!

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• How the Power Foods Diet helps with Weight Loss with Dr. Neal Barnard EP. 877
• How Not to Age with New York Times best-selling author Dr. Michael Greger [Episode #873]
• How to eat to reduce anxiety with Harvard nutritional psychiatrist Dr. Uma Naidoo [Episode #867]

 

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Transcript:

Kimberly Snyder (00:01.501)
Hi everyone. Welcome back to our Monday interview show. I am very excited for our extra special guest today, Dr. Olivera Bogunovic. I hope I’m saying her name correctly. She was recently seen in the documentary film As Prescribed. She is the medical director of McLean Hospital’s Alcohol, Drug and Addiction Outpatient Program and assistant professor of psychiatry at Harvard Medical School.

Today we’re going to be talking about awareness for certain medications which have become so widespread and there isn’t a lot of information about the potentially harmful effects. We’re going get into all of that in today’s show. And I want to say that I wanted to bring this topic forward as well because as we’ve started to talk more about heart coherence with the new book, The Hidden Power of the Five Hearts, I have been receiving a lot of messages around addiction and wanting to feel more free in our lives and just, you know, having awareness, having tools is such an important part of the process. So I wanted to bring in Dr. Oliveira today to talk about a particular type of addiction and what she sees in her work. So, doctor, thank you so much for taking time to be with us here today.

Olivera Bogunovic (01:19.874)
You’re welcome, and I’m glad to talk about this important topic.

Kimberly Snyder (01:23.909)
Yes. Sometimes things we hear little snippets of information about certain medications, certain things that are, you know, circulating around, but it’s hard to know what is real, what is really harmful, the balance, especially between pharmaceuticals that help and addiction and overuse. So first of all, can you tell us a little bit about how you came into this work, Dr. with, you know, particularly working with

addiction and alcohol and drugs? Was it something personally that spurred you into this or what led you in your career?

Olivera Bogunovic (02:00.76)
So it was not anything personally, but during my training, I felt that there was a lot of stigma associated with the addiction. And I learned through my psychiatry residency program that this is a condition that can be treated as long as people are willing to ask for help. And it’s usually, you know, like the stigma, they’re addicts, they don’t wanna stop. So.

That kind of spurred my interest in this field because I saw a discrepancy that once they get treated, people would do really very well. Of course, it takes time for anybody to accept treatment, and this is a condition that people have to take their time and their own understanding that they need the help. But once they need help, this condition can be treated very successfully.

Kimberly Snyder (02:50.789)
And when you say, when you were talking about this whole range of drugs and alcohol, can you share, because to me addiction also moves into other parts of our lifestyle. see a lot of people addicted to food, for example, or addicted to certain patterns. When you’re talking about drugs, can you talk about recreational drugs that fall into that category as well as prescription drugs?

Olivera Bogunovic (03:12.044)
Yes, so the recreational drugs that fall into this category is the cannabis, especially now that it’s becoming legalized. And the other drugs are drugs like opiates. So opiates can come in the form of prescription opiates, medications that have been used for treatment of pain. Initially, we did not know about their addictive potential, but later we learned about it. And then like heroin also in the family.

those drugs benzodiazepines that can be prescribed for treatment of certain conditions but can be abused and then we have the other drugs that are cocaine, psychedelics and other other drugs in that category.

Kimberly Snyder (03:54.077)
I hear a lot, especially in LA doctor, about more people using ketamine recreationally. Do you see that in your work as well?

Olivera Bogunovic (04:02.39)
Yes, that’s what happens as well. You know, it’s also one of these medications, like we talked about benzodiazepines, opiates, ketamine. They can be prescribed. They’re very powerful drugs for treatment of certain conditions. But of course, there is a big risk of also a potential for abuse.

Kimberly Snyder (04:20.219)
And so what are some of the things that happen to the body and to just in general, what are some of the harmful effects of abusing these opiates? And I bring up ketamine because as a resident of LA, we live here, doctor, we also live in Hawaii. I’ve even seen, I’m not kidding, this sounds kind of crazy. I’ve seen party invites go out saying BYOK, meaning bring your own ketamine.

It’s become a party drug. It’s become something people bring to parties. I mean, it’s widespread.

Olivera Bogunovic (04:55.466)
It’s widespread again, you know, this is the big danger is used to for treatment of certain conditions under supervision of the doctors. But of course, you know, the body can develop to certain drugs, the physiological dependence, but also the psychological dependence that is even more powerful and that can put especially for folks who do have a propensity towered substance use disorder disorders. They can gravitate toward these.

medication and potentially abuse them. So that is a big problem that is out there and spread out.

Kimberly Snyder (05:32.305)
Because sometimes I think we categorize, know, cocaine speeds up your heart rate. can, you know, have cardiovascular issues, like all sorts of issues. But then we think, if something’s prescribed, it, you know, it’s not going to be really harmful to the body. Can you speak a little bit, let’s say if someone does abuse, what would happen to your bodily organs? Let’s say the ketamine and these types of opiates.

Olivera Bogunovic (05:52.07)
So again, like any medication, when it’s prescribed and when it’s monitored, it can have a beneficial effect. But when you start using the drugs, it leads, first of all, to addiction, but also can have a negative effect on other parts and affect other organs in your body. So think the more dangerous part about it is when you abuse those drugs, it can lead to respiratory depression.

Kimberly Snyder (06:10.62)
Yeah.

Kimberly Snyder (06:19.443)
Mmm.

Olivera Bogunovic (06:20.202)
overdose on those medications. And it’s very important to know that and to be aware of that because as we all know, opiate, everybody’s familiar with the opiate crisis and the number of overdoses and deaths. And, you know, sometimes even people think if they have the naloxone kit, they can save themselves, but that’s always questionable. Who’s there going to be there to be responsible to save you? So it’s very important to know the dangers that

abusing those drugs in a tendency to get the high, you can actually overdose and die.

Kimberly Snyder (06:57.611)
And then there’s this other class of drugs, hard word to say. Benzodiafines. Here we go. Kalanapins, Xanax, Valium, Ativan, Restorol. Sometimes, doctor, I will say in my party days in the past, you would see people bringing particularly Xanax to clubs and combining it with alcohol to get a certain effect.

Olivera Bogunovic (07:04.28)
Beard pains or diazepines?

Kimberly Snyder (07:25.169)
And just to feel something, to zone out. I mean, I’ve seen these drugs being used quite a bit. And of course they have to be prescribed and then they’re shared. Can you talk a little bit about the over prescription millions of people are using these? In fact, piece of research here says that 30 % over the past decade, there’s been a surge, an increase in 30 % over the past 10 years. Is that true?

Olivera Bogunovic (07:54.488)
That is correct. you know, as I said, benzodiazepines are the medication that can be used for treatment of not only psychiatric, but some medical conditions like seizures, spasms, but they’re prescribed also in psychiatry for the treatment of anxiety disorders. Again, this class of medication can create physiological and psychological dependence, and especially in people who abuse them, it can lead to addiction. But also,

these drugs, even when prescribed, you have to be very careful because it’s very important to know how to come off these medications and how to taper them off safely.

Kimberly Snyder (08:37.971)
So as a doctor, how do you work with someone that may need them for, you know, anxiety or certain condition? Where’s that line between allowing them to have access to something that can help them versus cutting it off completely, or, know, they start to get addicted and overuse it. It seems like a delicate line. And I bring this up, doctor, because my past addiction back in high school was food. So I had eating disorders and it’s a delicate thing because you still have to eat.

But then you’re confronted with this thing every day that has, know, psychological, there’s a lot of challenge and emotional issues with it. So yeah, so how do you deal with someone where you don’t want to just take it away?

Olivera Bogunovic (09:18.008)
mean, it’s very important to talk to the patient and inform them about the medications that you’re going to prescribe. So just giving them the benefits of the medication, but also what are some adverse events and how to carefully take the medication. you know, just kind of getting the patient to be an active participant in the treatment of this condition is the far most important thing. And then, you know, this is a type of medication that should be used short term in psychiatric practice.

about for about three months, most three to six months. And then when those medications are to be tapered, it should be done very slowly so that the body can adjust to the decrease of the medications and come in so that the patients can safely come off the medications because they do create a form of physiological dependence, your body gets addicted to it. So once you take it off, you will experience some withdrawal symptoms.

and withdrawal symptoms with benzodiazepines can be dangerous.

Kimberly Snyder (10:22.055)
So since there’s this tapering off process and people have this underlying challenge, is anxiety or whatever they’re dealing with, what other therapies do you couple with the actual pharmaceuticals? Therapy work, talk therapy, cognitive behavioral therapy?

Olivera Bogunovic (10:40.056)
So any therapy can work. It’s just kind of empowering the patients that they can do it and that you’re gonna help them and that it may not be the easiest process, but that they can do it. And you know, like if you have that approach with the patient, that’s half of the treatment. They need to believe the physician and following also the response of the patient and how they’re dealing with the tapering, that’s another powerful tool. So.

You see how they’re doing it, doing, and then you decrease slowly. you’re doing it too fast, then pause a little bit. But the patient has to be an active participant from the get-go, knowing about what they’re prescribed, what are the side effects, what are the adverse effects of the medications, and how long they will prescribe, and how will you work with them to get them off these medications.

Kimberly Snyder (11:30.739)
You know, some people, as you know, well have more addictive personalities. So they may have this information, but they still want, right? And I have a couple of friends who are in 12 step programs where for the long term, they’re in meetings, they’re in community. there’s a spiritual aspect. What do you think about some of these longer term addiction, stabilizing programs or how are you? Yes.

Olivera Bogunovic (11:54.67)
Well, they’re definitely helpful. know, also, you know, any any treatment works as long as you embrace it. Correct. So for some people, the 12 step programs are very powerful. The A meetings are very powerful. Of course, you need a treating physician when you’re prescribed benzodiazepines and when you’re coming off the benzodiazepines. So it’s a combination of, you know, a patient centered approach and what is going to best work for the patient and using all

the things that are working for the patient. So using their strengths, using their supports, using their meanings, all of this can lead to a positive effect at the end of the treatment.

Kimberly Snyder (12:42.243)
Yes, I imagine they’re getting obviously they’re getting something from these medications, right? Like let’s talk about I know someone on Kalanapin, for instance, it would help them go to sleep or help calm the mind. So I imagine when they’re tapering off, because they’re getting something from taking this pill, there has to be some type of replacement something in like a stress management tool or meditation practice or community or something else. Otherwise, to your point, it can just keep going on and on and then

Olivera Bogunovic (13:11.744)
It can be going on and on, but of course, like with any patient with substance use disorder, correct? They’re used to an immediate gratification. So teaching somebody that the gratification is gonna come, it’s not just gonna be immediate, it’s half of the treatment in addiction. So just knowing that there will be some form of gratification, but the question is only to be patient and to know when it’s gonna come, that is half of the treatment.

Kimberly Snyder (13:21.744)
Yes.

Kimberly Snyder (13:30.355)
Mmm.

Kimberly Snyder (13:42.415)
Yeah, I imagine when people are tapering off certain dependencies, there can even be a lash, like emotional lashing out, violence, anger, certain big emotions.

Olivera Bogunovic (13:55.732)
Yes, so all that comes along in learning to be able to tolerate your emotions is something part of the treatment of addictions. Being able to sit with your thoughts and feelings is part of the treatment of addiction.

Kimberly Snyder (14:09.245)
So in this documentary, prescribed, one of the things that it was highlighting was how widespread this is. Just there’s so much unawareness. Can you share a little bit about what you talked about in the film and some of the bigger takeaways for anyone that’s more interested in this topic? Surprising facts or information?

Olivera Bogunovic (14:33.026)
So the biggest topic of it is correct. It’s a medication that I talked about that has a lot of indications can be used to treat different conditions, but knowing that it should be prescribed short term, knowing that this medication can cause a physiological dependence as well as psychological dependence and that coming off this medication should be a very thoughtful process.

So the film features patients who are not abusing benzodiazepines but who prescribe benzodiazepines. But again, from different circumstances, we’re not able to tolerate well the taper. And there is a small group of patients that has a very difficult time coming off the benzodiazepines. So I think therefore it’s very important to give the information to the patient because we don’t know who is gonna have the problem coming off the benzodiazepines.

Kimberly Snyder (15:00.851)
Mm.

Kimberly Snyder (15:25.529)
Right. Now on a separate topic, doctor, a separate type of drug, Zoloft, like some of these drugs for depression, you hear about people that are on these very long-term and sometimes doctors will say, you know, it’s fine. You can just be on this for years. Do you think that that could be a potential issue?

Olivera Bogunovic (15:37.858)
Good question, yes.

Olivera Bogunovic (15:53.696)
So the reality is that you can be on these drugs for years. The reality is that those drugs can help treatment of the depression. Some people have long chronic depression and need to be on some form of medication. But again, knowing that any medication that you’re on, you have to come off the medication slowly. And as long as you follow that recommendation, the likelihood is that you’re gonna succeed.

Kimberly Snyder (16:19.475)
Well, what if some people, you know, again, they just don’t really feel that they ever have to be on the medication. There’s some.

Olivera Bogunovic (16:24.898)
Well, again, like any medication, know, like any condition, you want to try it for the period of time. And when the episode of the depression is resolved, you then want to try to taper off the medications because some people have a single episode of depression and they can do well for a number of years until something, you know, comes out of their life, a stressful event or, you know, there’s a biological cause of the depression and the symptoms reemerge. And then you can be put on the medications again.

Kimberly Snyder (16:55.436)
How, what percentage of people you said biologically or genetically are wired for depression versus, know, maybe there’s a lifestyle shift or coping tools, emotional tools or nutritional interventions, or, you know, for some I know are more affected by seasonal affective disorder. How much in your work and your research do you see it’s really, I would say hardwired in, but you know, there’s a biological

genetic actual route.

Olivera Bogunovic (17:26.092)
Yeah, there’s always the biological genetic route. mean, what we’re learning more and more about certain illnesses is that there’s such, and for anything, there’s a genetic component to it. Unfortunately, we’re just learning about different illnesses linked to the genetics, and it’s gonna be a process until we kind of know about everything. So it’s very difficult to predict, but just kind of taking a good family history. And again, you know,

giving the explanation at the beginning of anything that having a patient be an active participant and knowing what can be is a very helpful approach in treating patients.

Kimberly Snyder (18:06.183)
What would you say are some signs and symptoms of someone that doesn’t, you know, hasn’t tried any of these medications yet and they’re struggling in their life and they would see a practitioner such as yourself to get some support along the way? What would you say in general?

Olivera Bogunovic (18:27.47)
I mean, as I said, every patient has their own story. So every form of treatment is individualized and seeing what will best work for the patient based on the clinical signs and symptoms, based on what the patient wants to get from the treatment. Again, psychotherapy and different modalities of treatment or psychiatry are very successful, but some patients may need the addition of medications.

for certain conditions and then evaluating which medication will be effective for this particular patient. Patient’s knowledge and understanding of what this medication can do, benefits, as well as side effects is a very important tool in the treatment and success for these patients.

Kimberly Snyder (19:13.263)
In general though, it seems like we hear a lot about the widespread numbers of anxiety and depression. So if anyone’s really struggling in these particular areas, these might be candidates.

Olivera Bogunovic (19:24.44)
So if somebody is struggling in this particular areas, and of course, if they come to you and their symptoms are so impairing that they cannot function, you want to offer them the medication. Some medications have an instant effect. And like if somebody has a severe panic disorder in this initial phases of treatment, the benzodiazepines can be a very important medication while introducing other medications that take some time to have the effect.

But as I said, it’s a different approach for different patients, but you know, when somebody who’s struggling with a very severe panic disorder, you want to prescribe them benzodiazepines for a short period of time so that they can feel a little bit better and to be able to address other symptoms of their illness in therapy, as well as other medications that take a longer time to take effect.

Kimberly Snyder (20:16.465)
I think it’s great to take this holistic approach, like you said, individualized versus all or nothing. We spoke to a guest who had bipolar disorder and she really tried a holistic approach and it became clear, you know, maybe some days it was helping a bit. She was changing her diet and things, but there were days where she didn’t really feel safe in herself and with her young children. So she did introduce, you know, with a practitioner like yourself, a period of

know, prescriptions just to get things to a point where she felt actually safe.

Olivera Bogunovic (20:53.324)
Yes, so again, it’s this individualized approach that I said, some patients may need the medication at the get go of the treatment depending on the severity, with some you can work with psychotherapy modalities. So it really is a very individualized approach, but certain conditions need a more aggressive treatment like bipolar disorder.

Kimberly Snyder (21:12.965)
I have an interesting question for you, doctor. Do you see certain junctions of hormonal transition? So for instance, someone going through menopause or someone recovering from postpartum or a man going into a phase where he’s lowering in testosterone, do you see that sort of playing into periods where they may be more vulnerable to anxiety or depression or some of these conditions?

Olivera Bogunovic (21:36.396)
Yep. So the hormonal changes in the body are a very important piece and that really affect the body more and more and we’re learning more about it because what’s very interesting, the onset of every psychiatric illness starts as we start going through the hormonal changes. Kids and children are generally very happy, but we see the first onset of symptoms when the adolescent starts knocking on the door.

Kimberly Snyder (21:53.861)
Right.

Olivera Bogunovic (22:02.124)
We see symptoms of depression, anxiety, eating disorders, because the body is going through a lot of changes. In the same way as we get older, you know, and we transition into a different phase of life into other older adults, the menopausal changes, the decrease in testosterone, that also affects the body. So as you can see, those major turbulences significantly contribute

Kimberly Snyder (22:06.012)
Yeah.

Olivera Bogunovic (22:27.894)
And of course, we see some women like big changes in life, like the birth of the child, know, the hormonal changes during that period of time as well, as well as times during the periods is also something that we see fluctuations. So hormones definitely play a significant role. And we’re actually learning more and more how much they’re contributing again. You you see very little percent of depression and anxiety in kids. They’re very happy in general.

Kimberly Snyder (22:56.23)
Yes.

Olivera Bogunovic (22:57.046)
And then comes the teenagers when they actually, the hormones start fluctuating in the body. So I think this is very important to, and not everybody has the same level of hormones. So it’s really very important, as I said, this holistic approach, understanding the mind-body approach is very important in treating psychiatric illnesses.

Kimberly Snyder (23:22.279)
Would it be combined potentially if you see someone going through this shift, some type of hormonal replacement therapy or something to also balance hormones?

Olivera Bogunovic (23:31.99)
Yes, yes. So it’s really, as I said, it’s very important. Of course, you know, with the brain of the kids that are developing, you have to be much more careful. But as we know, in the other stages of life, the menopause may be adding hormone replacement therapy, adding some testosterone for people who have low testosterone level is an important approach.

Kimberly Snyder (23:54.419)
There are some that are concerned about prescribing for children and teenagers until a certain age. What would you say to that, doctor?

Olivera Bogunovic (24:05.262)
would say to be very conservative with that because it’s a developing brain and we’re still learning in years about the effects of medication. So it’s a developing brain again. And especially during those turbulent times, it’s really very important to holistically approach a kid because anything can look like a psychiatric illness in a teenager.

Kimberly Snyder (24:12.741)
Yes.

Kimberly Snyder (24:30.459)
Right, right. And even, you if we look even more holistically, some could say that balancing gut health issues and making sure you have a healthy microbiome and getting the body in balance could also potentially help.

Olivera Bogunovic (24:44.418)
That is correct.

Kimberly Snyder (24:46.575)
Yes. In the center, do you have colleagues that also work with gut health or people’s diets or lifestyle or encouraging them to exercise more? Some of these, know, wider lifestyle prescriptions?

Olivera Bogunovic (25:00.224)
Yeah, well, we’re starting to kind of encompass the wild wilder, wider lifestyle changes, especially the diets, correct? Learning about which diets are important and just kind of like everything is, as I said, it’s a holistic mind body approach and exercise we know is a very important part of our life.

Kimberly Snyder (25:07.911)
Beautiful.

Kimberly Snyder (25:22.429)
So when you see what’s going on from your perspective, from your lens doctor, how do you feel about the state of things where it’s going? Do you feel hopeful? Do you feel like now there’s this amazing documentary you’re in and information is getting out there, there’s going to be more balance in the future? Or do you get sort of despondent about the addictions? How are you feeling as a practitioner in the weeds of this?

Olivera Bogunovic (25:43.969)
As a practitioner in the weeds, know, I always say where there’s life, there’s hope. have more and more new treatments coming and we’re learning more and more. So I think overall, you know, we can talk about like the busy lifestyle, the insurance health, health insurances and different approaches. But I think what we need to really remember, there’s a lot of information now out there about healthy lifestyle living that, you know, where the information is getting out there through social media, different venues.

Kimberly Snyder (25:48.211)
I know.

Olivera Bogunovic (26:13.802)
It’s going to be a process because like with anything like the social media brought a lot of good, but brought a lot of different things. So sorting through it overall, I think will come up more empowered because people are more educated.

Kimberly Snyder (26:27.527)
There feels like a sturdiness in you, doctor, right? In Ayurveda, you would say there’s kaffa, this groundedness. And I always wonder about practitioners that are working with people that are struggling. At the end of the day, how do you leave it behind? Or do you carry, like, do you feel so much sadness for these patients as a human, right? Or are you able to say, I’m helping them as much as I can and sort of leave it when you go home at night? Are you up late at night thinking about some of these patients? How does it affect you personally?

Olivera Bogunovic (26:57.694)
because the stories are there. We’re in this world together, you know. So you try to kind of take this more hopeful approach because again, a lot of these illnesses are treatable. And you know, thinking that you can make a change in the lives of the patients and that you give them hope is the most important thing at the end of the day. And being patient and knowing that, you know, like

Kimberly Snyder (26:59.879)
Yeah.

Kimberly Snyder (27:17.49)
Right.

Olivera Bogunovic (27:21.58)
you know, we’re not static, you know, and life will always not be like with all those problems. It’s like the wheels turn and something will change. And, you know, they won’t stay in this state forever. If the stressors are there, something will happen, correct? It’s not gonna, it’s not always like going down the pipes, you know? And as I said, you know, like addiction is a treatable illness. It’s the approach and belief that people can actually do it. And even if you have the doubts that the patient may not,

be able to do it, but giving them a hopeful message can actually bring some things and they can turn things around.

Kimberly Snyder (27:58.193)
And then, know, maybe more qualitatively, Dr. DeCircle, back like we talked about with some of these 12-step programs where there is a surrender aspect to higher power, you know, something greater than oneself. Do you see that? I mean, there’s the formal 12-step programs. We know there’s that component in AA, but do you see a component in your patients where they, you know, you have to see there’s something bigger than themselves, whether it’s…

Olivera Bogunovic (28:24.638)
So whether it’s they can believe in the higher power of the 12-step groups or spirituality, which is another aspect, is a very important part of the treatment. So that’s more and more centers are incorporating actually spirituality in their treatment of addictive disorders.

Kimberly Snyder (28:29.702)
Yes.

Kimberly Snyder (28:42.289)
I can say for myself, doctor, as recovering bulimic, for me, was, you can feel really small and isolated when you’re in these, and I know some of these conditions are different, but then as I expanded, you do feel that support spiritually. was one of the ways that I know I was able to heal myself.

Olivera Bogunovic (29:02.622)
It’s a very important thing because when you’re having a problem you’re sort of in that rabbit hole and your world is very small because either you don’t want to reach out to people or you lost certain certain family members because of your behavior and that aspect of bringing in the spirituality can help you get out of the hole.

Kimberly Snyder (29:08.751)
Yes.

Kimberly Snyder (29:24.403)
Yeah. And so do you have any, you know, it’s individualized, are there places you recommend people or do you encourage them to just find their own aspects of spirituality or prayer?

Olivera Bogunovic (29:36.258)
I think it’s very important that you find your own aspect of spirituality because for every person it may be different. giving information about different options, venues, but really that has to come within yourself, the spirituality piece and what works for you.

Kimberly Snyder (29:55.505)
Yeah, I think there’s an important aspect of compassion when we’re talking about this issue. Like you said, doctor, in the beginning, sometimes there’s a mental stigma, sometimes there’s judgment, but there’s, we’re human and we’re all struggling and we’re all doing our best and some people are coping in different ways. And so there’s nothing to judge.

Olivera Bogunovic (30:14.814)
There’s nothing to judge. And that’s the most important thing is nobody, you know, I always tell my patients, yeah, I’m not here to grade you. You’re not here to get an A. I’m here to help you. You can grade me, but we’re not, yeah, I’m not here to grade you. And I think when that takes that, that performance away that you have to do well, it empowers the person to kind of let their guards down and ask for help.

Kimberly Snyder (30:25.018)
Right?

Kimberly Snyder (30:44.261)
Well, doctor, is there anything else we didn’t cover related to these prescriptions, the addiction? We talked a little bit about the film as prescribed, which we will link to in the show notes information to check it out for yourself. Is there anything else you want to share with us about extended use of these drugs or anything we didn’t get to cover, doctor?

Olivera Bogunovic (31:06.988)
I think even if there’s an extended use of these drugs, there is a way to get off the medications and people, and as long as you do it carefully with people who understand the mechanisms of it and the necessary treatment.

Kimberly Snyder (31:22.833)
Right, there’s always hope, like you said.

Olivera Bogunovic (31:25.25)
There’s always hope. Where there’s life, there’s hope.

Kimberly Snyder (31:28.431)
It also sounds like when you’re talking about this, having a plan, having a way to get off so it doesn’t feel abrupt or, you know,

Olivera Bogunovic (31:36.586)
Again, know, giving, knowing that, you you’re going to, it may be difficult, we’re going to do it together and there is a plan and we’ll stick to the plan is the message that I wanted to give.

Kimberly Snyder (31:44.284)
Yeah.

Kimberly Snyder (31:48.883)
Beautiful. And it sounds like a really important part is finding a partner or a practitioner who you trust, who can guide you through the process so you don’t feel alone, you don’t feel isolated.

Olivera Bogunovic (31:59.362)
That is correct.

Kimberly Snyder (32:01.135)
And so if someone, I know you’re Harvard, you’re in Boston. What if someone, is there a kind of directory if someone lives in Arizona or they live in LA where they might be able to find recommended?

Olivera Bogunovic (32:13.646)
So the American Academy of Addiction Psychiatry has a database of physicians who treat conditions and reaching out to them is one of the recommended steps.

Kimberly Snyder (32:17.798)
Okay.

Kimberly Snyder (32:24.953)
Wonderful. Well, thank you so much, doctor, for making time in your busy schedule to chat with us about this topic from a practitioner standpoint, from a research-based perspective, and also from a clinician, someone who’s actually working in the field. So we appreciate your insight and your wisdom so much.

Olivera Bogunovic (32:44.258)
Thank you for inviting me. It was a pleasure.

Kimberly Snyder (32:47.655)
And we will link to Dr. Olivera Bognovic’s information and the film in the show notes at mysolluna.com. Thank you so much for tuning in. Please share this podcast with anyone you think would benefit from this knowledge around this topic. It’s something we all want to help each other create awareness for with real information. So please share this with anyone that you think would benefit.

Otherwise, we will be back here Thursday as always for our next Q &A show. We will see you then. Take great care of yourself. And if you haven’t already, please leave a review for the show, which is a wonderful way to help others find this information. Lots of love and see you back here Thursday.

Olivera Bogunovic (33:33.474)
Bye.