Introduction and Welcome

Part 1 of 2 · Ep. 806

John Dehlin [00:00:02] Mormon Stories is a production of the Open Stories foundation and relies solely upon the support of people like you, its listeners to help keep the podcast alive or to become a member of the community. Please become a monthly subscriber by visiting MormonStories.org and clicking the Donate button on the top right side of the page. All contributions to Mormon Stories are completely tax deductible and go towards producing the podcast and building communities and programs of support for Mormons like you. Thanks for your support. Hello everyone and welcome to another edition of Mormon Stories Podcast. I'm your host, John Dehlin. It is October 10, 2017 and as always, I am very excited to have our guest with us today. For those of you who have been following us, you'll know that we've been doing a little series on addiction kind of within a Mormon context. And so for those who've been following again, we interviewed a wonderful young man named Thomas about his opiate addiction. As a married Mormon, he's still remaining active in the church at this point. We talked about his experiences. Then we talked to Graham, another wonderful, courageous young man who talked about his opiate addiction. Both of those gentlemen started with, let's just say, prescription opiate medication and then moved to heroin at some point. Really appreciated those two interviews. And then we also interviewed Kirsten and David Udi. David became addicted to alcohol after his faith crisis and transition. So that interview was about mixed faith marriages, but also about alcoholism. And again, I just love talking to Kirsten and David. That was really powerful. And during those interviews I was just really fortunate to have Dr. Dan Lonergan reach out. And without giving too much away, Dr. Dan Lonergan is an expert in addiction. He's an anesthesiologist. He works in conjunction with Vanderbilt Medical center, which is, as far as I'm concerned, a top notch medical institution to be involved with. He specializes in pain management and addiction. He's also been through his own faith crisis and transition. He's currently in what he would describe as a mixed faith marriage of sorts. And so the interview is going to be basically two parts. Part one going to be Dan talking about his own journey. So for those of you who are always interested in the faith crisis topic, many of you have said, can we just have more just normal people talk about their faith transition? Does it need to be celebrities or extra special people in any way? The first part of this interview is going to address that need. Unless of course, Dan, you're going to describe yourself as extraordinary. I'm just being silly. The second part of the interview is going to be talking specifically about Dan's experiences as an expert in pain management and on addiction. So that's going to be the agenda for today. We are broadcasting live through Facebook Live, so we welcome everyone who is joining us. We want to encourage those who are joining us live to please consider posting questions or comments in the Facebook livestream and we can incorporate your questions or comments into today's interview. That always makes it more fun. Before we jump into the interview, we just have some very quick announcements. I'll make them as fast as I can. If you want to support what we do, follow us on Instagram or Twitter ormondstories. Please like us on Facebook right now. If you haven't, go to your Facebook page, like the Mormon Stories podcast Facebook page and give us a positive review. Those positive reviews are really important so that people know that we're a good place to go. And if you want extra brownie points, please go to itunes, log in and give us a positive review. Positive reviews on itunes make us just it helps make our podcast successful. And then of course, finally, as far as ways you can help us, we really appreciate people who are able to donate to support what we do. We have a whole staff at the Open Stories foundation that makes all this possible. And your donations go to support the staff and the objectives and the mission of the Open Stories foundation, which is to provide support for people experiencing or impacted by religious transition. We have several podcasts and a nonprofit, and your donations make all that possible. So please don't be a freeloader. Please support us if you can. Less than 1% of our listeners actually donate, so if you enjoy our programming and listen, I'm going to guilt trip you and ask you to please go right now to MormonStories.org and sign up for a 10 or 25 $100 a month donation. Whatever you can afford, because that would really help. Another couple quick announcements. We do have a job position we're hiring for. We're hiring a web developer, somebody with WordPerfect experience who's got web design experience. It's about 10 hours a week minimum, $50 an hour. If you know a great web designer who really knows WordPress, and preferentially, preferably, if they're a Mormon Stories fan or Open Stories foundation podcast follower, I think they'd be a really good fit. So please email us@openstoriesfoundationmail.com with some references, with a resume, with some links to some of your work. We would love to evaluate you for that position. And then finally we have several events coming up. October 27th, finding spirituality and improving mental health during and after a faith crisis. That's in Utah county again. October 27, November 17 in Utah County, Navigating Healthy relationships. That's marriages, Believing family and friends, children. That's a half day workshop. November 17th, we're coming to San Francisco November 9th through 10th. We would love to see you there. For those interested, doing a Mormon Stories workshop. And next year in the fall, October 24th through 28th, we are going to be doing a cruise in the Bahamas. And we'd love for those of you who want to join us to please join us. Thanks for your patience as we do these announcements. These are the ways that we keep the Open Stories foundation alive. So we really appreciate your patience when you do that. So with that, it is now time to jump into the main part of our interview. So to begin, Dr. Dan Lonergan, welcome to Mormon Stories Podcast.

Dan Lonergan [00:07:09] Thanks, John. It's great to be here.

John Dehlin [00:07:12] All right, so as I've already introduced to our listeners, we're going to divide this up into two parts. We're going to first talk about your experiences as a Mormon and your own faith crisis, transition and navigating a mixed faith marriage and what that's been like. Then we'll sort of end that part and we'll start part two about tips from an expert, overcoming addiction. So if it's okay to begin, why don't you just kind of introduce yourself a little bit, just so that people kind of know a little bit more about who you are. What made you show interest in this podcast episode or series?

Dan Lonergan's Background and Upbringing

Dan Lonergan [00:07:53] I would say I'm probably one of your very ordinary guests. I'm not a celebrity or anything like that. I grew up in just outside of Kansas City and also spent some time in high school in Chicago and joined us to start from the, from my upbringing or you want a general introduction?

John Dehlin [00:08:15] Give a super quick overview just so people kind of know your experience and background.

Dan Lonergan [00:08:19] So I'm a physician. I work at Vanderbilt Medical Center. I'm a specialist in pain and addiction. I'm also a Mormon Stories listener. I've been spending many, many hours in the car with John over the last several years. I think I've listened to most of the episodes and in hearing the series on addiction, I just you had a lot of questions that I feel like I have answers to. So I reached out and thought maybe I could help you clarify some of your questions and talk a little bit about addiction and talk about some of the stigma behind addiction, especially in religious Communities. And I think it'll be a pretty productive discussion.

John Dehlin [00:09:06] Beautiful. And we want to thank Wayne, who's joined us, who says he's sending a donation right now. Mary Lou's joining us from Tucson. Thanks for joining us, Mary Lou. Lots of cool people have joined us so far. We've got about 50, so. All right, Dan, let's start with just your kind of Mormon background. Tell us a bit about your Mormon upbringing.

A Mormon Childhood and Teen Years

Dan Lonergan [00:09:28] So I think my childhood was kind of the Mormon dream. I had three older brothers. We were just a solid Mormon family, very active. My dad was the bishop in our ward outside Kansas City, and we just had a great life. My mom stayed at home with us. I just have wonderful memories growing up in the church. No abuse. We were very well cared for as children. Had a great ward growing up. We were very close. I think our youth group when I was 12 had over 100 youth in it.

John Dehlin [00:10:14] Oh, my gosh. What city was this?

Dan Lonergan [00:10:16] This was in Overland Park, Kansas.

John Dehlin [00:10:18] Okay.

Dan Lonergan [00:10:19] And we were just very tight as a youth group, and it was very much my identity, being Mormon. I was very proud of it. Just something that really defined me as a. As a teenager.

John Dehlin [00:10:32] Okay, and did you. Did you have any kind of formative, spiritual church experiences in your teen years that really. That really kind of were important for you?

Dan Lonergan [00:10:46] Yeah, so in the summer, I always did efy, and that was always a very spiritual experience. Also, every year we went to Nauvoo and we took part in the pageant, and that was also very spiritual. And then just the social interactions that I had were very uplifting. I wouldn't say that I had any pivotal moment where I became converted or anything like that. It was just a immersion in the culture, and that was my identity.

John Dehlin [00:11:21] The seminary graduate?

Dan Lonergan [00:11:23] Yeah. Yeah.

John Dehlin [00:11:24] Eagle Scout.

Dan Lonergan [00:11:25] Eagle Scout. All four years of early morning seminary. I was in it to win it.

John Dehlin [00:11:31] Okay. Did you try and gain a strong testimony as a youth? And if so, did you do Moroni's promise? Did you get it in other ways? Did you never get a witness that you wanted? How was your testimony forged in those teen years?

Dan Lonergan [00:11:48] Yeah, I'm a fairly obsessive person, so I was always being very proactive about doing what we were told and trying to be obedient and trying to gain a testimony. And. I remember feeling like I needed to reach scriptures and pray. I don't recall, you know, specifically employing Moroni's promise as a teenager, but I think that came later as I got ready to go on a mission and was at byu.

John Dehlin [00:12:25] Were you tormented by kind of Guilt and shame as a teen, any of the sort of less than positive side effects of being a Mormon kid?

Dan Lonergan [00:12:35] Absolutely. And it's interesting because I was actually a really good kid. I like looking back, I just. It's laughable the things I was guilty about. But I was so obsessed with being perfect and being good and being obedient that I was always feeling guilty about something.

John Dehlin [00:12:59] Okay. And so overall, was that a problem or was it just kind of an unfortunate minor side effect of being a Mormon teen?

Dan Lonergan [00:13:08] I'd call it pretty minor. I don't think it really. I don't think it ruined me. Okay. It may be more just a product of my personality and the fact that I'm fairly OCD and I had a tendency to take religion overboard as well.

John Dehlin [00:13:25] Okay. And so the. To flip side, the most positive aspects of your Mormon experience as an adolescent sounds like it was just the social interaction. What else would have been the most important parts for you as a Mormon teen?

Dan Lonergan [00:13:42] The community was definitely a huge bonus. Also, the identity, especially in high school. I was, I think, one of two Mormons at my high school outside of Chicago. And I took a lot of pride in having that identity and felt very comfortable in the fact that I didn't drink alcohol and, you know, was. Was very happy with the fact that I stood apart and was peculiar in my beliefs.

John Dehlin [00:14:13] Okay, so you were able to kind of live the standards and you enjoyed that.

Dan Lonergan [00:14:19] Yes.

John Dehlin [00:14:20] Okay. Anything we should talk about before we talk about your mission?

Dan Lonergan [00:14:26] No.

John Dehlin [00:14:29] Your by experience was. How was your BYU experience?

Dan Lonergan [00:14:32] Yeah, so I graduated early from high school and went to BYU and had a great experience there and then actually spent six months at BYU Jerusalem.

John Dehlin [00:14:42] Oh, before your mission?

Dan Lonergan [00:14:44] Before my mission, yeah.

John Dehlin [00:14:46] That's not normal, is it?

Dan Lonergan [00:14:49] Not really. But since I had a year and a half at byu, I was able to do that third semester at Jerusalem, and that was good mission prep.

John Dehlin [00:15:02] Okay, excellent. Anything you want to say about that BYU Jerusalem experience?

Dan Lonergan [00:15:14] It was amazing. We traveled. I think I had a much more naive view of religion at that point. And as we studied the Old and New Testament, a lot of the questions that I would later have in life, I don't remember thinking about when I was in Jerusalem and when I was studying the, you know, especially the Old Testament questions that I would later have, things that would really bother me. I don't remember when I was 18 years old having those same concerns. I think I was just more about traveling and having fun and the culture at BYU Jerusalem was very tight. You know, we just had great friends there. And it was fun, and, you know, we were exploring new places, so there definitely wasn't anything to complain about.

Mission Experiences and Early Doubts

John Dehlin [00:16:10] Well, what were your spiritual highlights at that Jerusalem center experience? Were there any spiritual highlights for you?

Dan Lonergan [00:16:19] I opened my mission call on the shore of the Sea of Galilee. That was a very spiritual experience. But interestingly, I didn't have a lot of spiritual experiences like walking where Jesus walked or being in the Garden of Gethsemane. I don't remember having really profound spiritual experiences. Not that it wasn't spiritual at all, but I just wasn't really overwhelmed by anything that I can remember.

John Dehlin [00:16:52] Okay. All right. Anything about your mission? Where'd you serve your mission?

Dan Lonergan [00:16:58] Australia. Adelaide.

John Dehlin [00:17:00] Okay. Anything about your mission experience that's kind of worth mentioning as a part of your story?

Dan Lonergan [00:17:09] I've listened to several of your other podcasts where you talked about, you know, like, Brazil, and I don't recall where you served your mission, but you talked about some of the pressure to baptize. And there was some of that culture in my mission as well, with the aboriginal people. And there were some problems that we had in our mission with basically missionaries buying kids fried chicken and taking them down to the river and having group baptisms and just huge numbers of inactive members of the church and people who weren't converted. And there was a big push while I was on my mission to clean that up, and it caused a lot of controversy and, you know, political discord in the mission.

John Dehlin [00:18:06] Okay, and so you were more of the cleanup side, or did you participate in some of that?

Dan Lonergan [00:18:12] The cleanup side was more in the second half of my mission with a new mission president. Okay. And the new mission president was highly criticized because baptism rates fell so dramatically. And I was able to. I was an assistant with him. And so I was able to kind of see the inside story of what was going on. And. And that was kind of my first exposure to church politics. And it was very eye opening for me. And I. I learned through that experience that I have a distaste for politics. I did not enjoy being involved in that.

John Dehlin [00:18:52] Got it. Okay. Any other experiences from your mission worth mentioning? Was that baptism thing a faith crisis for you? If you were to later have a faith crisis, were there anything, any other things that sort of became cracks in your testimony that started on your mission or not really?

Dan Lonergan [00:19:13] Yeah, actually, the first huge crack in my testimony was kind of a subtle experience. When I was tracting, I actually, in the middle of Adelaide, Australia, tracked it into a Seventh Day Adventist minister from California. He was actually an African American gentleman And he stood at the door and talked to us. And he asked me, you know, hey, what's the deal with the blacks in the priesthood ban? And I kind of hemmed and hawed and kind of gave him, you know, well, we don't really know. And kind of the typical Mormon explanation. And he says, here's what I don't get about you guys. Why don't you just admit you were wrong? Why don't you just admit you made a mistake and say you're sorry and move on? And, you know, I didn't really have an answer for him. We ended up leaving and I went and sat at a park bench. I just told my companion I needed a minute. And I just realized he was right, that I was making all these excuses for something that was just wrong. And it had a very profound impact on me. And I wish I could talk to him because that was a very short five minute interaction, but he completely made me realize that I was making excuses for something that I didn't need to make excuses for and that it was. And I realized at that point that it was okay to just say, yeah, that was a mistake. Yeah, I'm sorry that my religion was involved in that and I didn't need to try to bear that burden on my shoulders.

John Dehlin [00:21:00] So maybe you didn't like being an apologist.

Dan Lonergan [00:21:04] That's true, yes.

John Dehlin [00:21:05] Yeah.

Dan Lonergan [00:21:06] Although I dabbled in it for years.

John Dehlin [00:21:08] Right, okay. So that. So you would say those might have been a few cracks. Anything else you want to mention about your mission experience?

Dan Lonergan [00:21:18] Overall, it was a great experience. I learned a lot. I don't regret those two years at all. And there were other things that cracked my testimony on my mission. You know, I often had the sense that we were manipulating people. I used to call the commitment pattern, the manipulation pattern, because I felt that a lot of the techniques we were employing were more sales techniques than anything. And I. It made me very uncomfortable while I was on my mission that we were using some of the techniques we were using in order to gain converts.

John Dehlin [00:21:55] Yeah. Okay. So the manipulation of the sales tactics. Yeah, did so if you worked with aboriginals, is that what you said or just your mission? Not you.

Dan Lonergan [00:22:09] Yeah, I did as well.

John Dehlin [00:22:10] Were there any issues around race that came up in the mission? Race or racism or. Not really.

Dan Lonergan [00:22:20] I think there were, but I don't know that I was really attuned to it at the time. And I don't want to revise the history and make things up. But aside from the history of racism in the church, in terms of the 1978 policy, I encountered that frequently because people would bring it up, but. And there were also cultural barriers with the Aboriginal people and the Caucasian Australians. There were huge cultural divides. And how much of that was. Was racism and how much of it was just, you know, cultural barriers? And, you know, I'm not really sure, but I didn't really see any blatant racism while I was there.

John Dehlin [00:23:13] Do you have a sense for whether Aboriginal Australians were allowed to be baptized prior to 1978?

Dan Lonergan [00:23:22] My understanding is that that was not pursued prior to 1978.

John Dehlin [00:23:26] Okay, so it affected them even though there wasn't necessarily African blood per se.

Dan Lonergan [00:23:33] Yeah.

John Dehlin [00:23:33] Okay. Okay. All right. So where'd you go to college after your mission?

Marriage, Medical School, and Growing Questions

Dan Lonergan [00:23:41] So I went back to byu.

John Dehlin [00:23:42] Okay. Anything. Anything of note happen on your mission that at BYU that's worth mentioning?

Dan Lonergan [00:23:50] I took religion classes, and I can remember in some of my religion classes just feeling like things were buttered up or that we weren't thinking critically or, you know, just feeling like, as I'd read the history, just having concerns that things weren't as I always thought they were. But I was very. I don't know if I was scared. I was very hesitant to really pursue deeply into those concerns that I had. I generally tried to stay with the recommended books, and I consider myself kind of a scholar of Mormonism, but I wasn't willing to branch out into more secular histories.

John Dehlin [00:24:41] Okay, so you were pre med at byu?

Dan Lonergan [00:24:44] Yeah, I was a neuroscience major.

John Dehlin [00:24:47] Neuroscience. Wow. Okay. All right. So did you meet your wife at BYU or after?

Dan Lonergan [00:24:54] Yeah, actually, my wife and I knew each other when we were kids, and then we met back up at byu, and she was actually at UVSC at. At the time.

John Dehlin [00:25:05] Okay.

Dan Lonergan [00:25:07] And we started dating, and we dated for about almost two years and then got married. We had a very long courtship.

John Dehlin [00:25:13] Yeah, super long. It's egregiously long.

Dan Lonergan [00:25:16] Right.

John Dehlin [00:25:18] Okay, so by the time you left byu, you were married?

Dan Lonergan [00:25:22] Yes, So I got married a year before I left BYU.

John Dehlin [00:25:25] Okay, and then was it med school? Right after BYU?

Dan Lonergan [00:25:28] Yep. We moved straight to St. Louis and did med school.

John Dehlin [00:25:34] All right, so when did your faith crisis start?

Dan Lonergan [00:25:38] So my faith crisis sort of developed. Well, actually, I should say something that's relevant to part two. While I was in med school, my oldest brother passed away. So my. My father found him four in the morning on the couch. And my oldest brother had had some chronic pain issues and had had several brain surgeries and was on some pretty heavy medications to treat his pain. And, you know, it's never really been conclusive how he died, but basically it's most likely that he died of sort of a drug combination or drug overdose type of situation. So that was when I was in my second year of med school. And that heavily impacted my family because we had kind of had this really tight family. And then this tragic event that happened, I think really changed the dynamic a lot. My parents have never been the same because they. They continue to grieve his loss. And it also gave me a whole new perspective on addiction, pain, medicine, how these things can kind of creep up on people and how tragedy can strike when you don't expect it. So that really framed my ways of thinking over the next. I guess it's been, you know, 14 years, 13 years.

John Dehlin [00:27:21] I'm so sorry about your brother.

Dan Lonergan [00:27:24] Thanks.

John Dehlin [00:27:25] Is there a sense that it was just an accident or something else?

Dan Lonergan [00:27:30] It was definitely an accident, but, you know, my sense is that he was using a lot of medications to treat his symptoms, and the combination of those medications, maybe, maybe using too much of them, had a. Had a fatal consequence.

John Dehlin [00:27:48] Got it. Okay. So that shaped your focus in med school.

Dan Lonergan [00:27:53] Yeah, definitely.

John Dehlin [00:27:54] Okay. What else do you want to share up until. And including what, you know, how your faith crisis began?

Dan Lonergan [00:28:02] So in med school and residency, we really learned to think critically and to, you know, there's a big focus on using evidence based medicine, on using science, on not just believing in things, but making decisions based upon what the evidence shows and not based upon our anecdotal experiences or emotional experiences. And so I learned this way of thinking. And throughout med school and residency, the levels of cognitive dissonance increased.

John Dehlin [00:28:36] Right.

Dan Lonergan [00:28:37] Where as I was learning science, the things I believed in my religion were not lining up.

John Dehlin [00:28:49] Do you remember any examples that were kind of important to you at the time? As this conflict was arising?

Dan Lonergan [00:28:59] I was always curious about the word of wisdom examples, because I'd always said on my mission, you know, the word of wisdom was inspired. And all these things have been over the years backed by evidence. But, you know, then I'd read studies like, oh, a glass of red wine is actually good for your heart. And, you know, there were things that I would learn that maybe weren't consistent with what I believed in. And, you know, obviously things like evolution. And just as you learn the history of the world and how things have evolved, some of the things in the Bible just kind of become more difficult to believe.

John Dehlin [00:29:41] Yeah, sure. Kind of the literalistic Mormon stuff.

Dan Lonergan [00:29:44] Yeah.

John Dehlin [00:29:45] Age of the earth, global flood, evolution, Adam and Eve.

Dan Lonergan [00:29:49] Yeah. So I was abandoning things like that. You know, every year I was just abandoning all these beliefs that, you know, I just didn't accept anymore. So I was becoming very nuanced in my beliefs and unwilling to accept some of the older arguments about the way things were.

John Dehlin [00:30:11] So you were kind of becoming liberal?

Dan Lonergan [00:30:14] Yeah, for sure.

John Dehlin [00:30:15] Did you have any role models for being a liberal Mormon where you kind of felt permission to go that route? Any inspirations, role models, anything? Books, podcasts, whatever?

Dan Lonergan [00:30:28] I would home teach with a professor at Vanderbilt, and I think he lives in your area now. I think he's at Utah State. But we would secretly talk. We would sit out in the car outside my house, and I didn't even want to go home teaching, but I wanted to sit and talk with him about all these things I was dealing with. And he was very liberal in all of his beliefs, and he was a convert, and so he would help me sort through all these things, and he made me feel like it was okay that I was abandoning these beliefs and becoming more liberal and I could still be a good Mormon. And he kind of made me feel at ease with some of this progression in my ways of thinking.

John Dehlin [00:31:11] How'd you guys find each other? How did you identify each other?

Dan Lonergan [00:31:15] Well, we were in the same ward, and we were both at Vanderbilt, and so we would. We would talk a lot, and I quickly, you know, he was very open about how liberal he was, so I felt comfortable in sharing with him some of my thoughts, and it turned out they lined up.

John Dehlin [00:31:30] So that kind of illustrates the value of people being vocal at church. If those who attend. When you're vocal, one of the positive things that comes from that is it can allow other people to find you and to find a friend that they can talk to. Yeah, that's cool. Okay, so you've got this friend. You're becoming more liberal. You're starting to have doubts. How did it progress?

Dan Lonergan [00:31:56] So through residency was so difficult, and we had moved to Nashville. I did residency at Vanderbilt, and it was so difficult because I was at the hospital all the time. And so there were many Sundays where I didn't go to church. I was basically becoming more immersed in a more secular culture, spending a lot more time at the hospital and relying less and less on the church community.

John Dehlin [00:32:25] When and if someone was going to say, oh, my gosh, well, that's it. You stopped reading the scriptures, you stopped going to church. That's what happens. That's what caused you to lose your faith. If somebody wanted to kind of paint that as a negative script, as a cause, how would you Respond to that.

Dan Lonergan [00:32:44] Well, that's what I felt as well. So that's exactly what I was thinking. And so when I was asked in 2014 to teach, or I guess it was 2015, I was asked to teach early morning seminary, and. Oh, right. And so. So my thought was, okay, this is my chance to kind of get back into it. Right. This is my chance to kind of immerse myself back into the scriptures and kind of give back to the church and really delve into the Gospel. And so that's why I accepted that calling, was because I thought my time at the hospital and becoming more secular was kind of damaging me spiritually and

John Dehlin [00:33:35] as a highly conscientious sort of OCD personality type, that probably was always causing cognitive dissonance in the back of your mind, Right?

Dan Lonergan [00:33:45] True.

John Dehlin [00:33:45] Yeah.

Dan Lonergan [00:33:46] Yeah, definitely.

The Seminary Teacher Calling That Changed Everything

John Dehlin [00:33:47] Okay. So the fatal seminary teacher calling.

Dan Lonergan [00:33:54] Yeah, it's happened to a few of us, I hear. So I took that calling and I was really dedicated with was Old Testament to just make matters worse. So I started teaching seminary, and within a few weeks, I just started realizing how far gone I was. So I told my seminary class that I didn't believe in Noah's Ark. I mean, I know that's not part of the curriculum, but I just got up there and I said, look, I just can't accept this story. I mean, this is just ludicrous. And so my question was, can I still be a Mormon? Can I still be a good Mormon and not even believe in Noah's Ark? You know, and everyone in the class, you know, the new generation, they're pretty liberal, so they were fine with it.

John Dehlin [00:34:44] But you're. You're off script. If I'm. If I'm your CES advisor, I'm thinking as I'm monitoring, you know, because they do. They send out evaluators. I'm thinking, as I'm. As a moderator, Dan's off script. We got to get Brother Lonergan back on script.

Dan Lonergan [00:35:02] Yeah. And they had definite concerns about me. I had the moderators observing me more than once. And, you know, I have a beard and I ride a motorcycle. And, you know, I'm an academic. You know, I work at an academic institution. So I was on the radar from the beginning, for sure.

John Dehlin [00:35:18] Yeah.

Dan Lonergan [00:35:20] So when I was teaching seminary in November 2015 was when the policy came out against the children of gay couples, and my shelf was already about to fall. But this policy came out, and it just was astounding to me because I thought we'd made so much progress in the past several years, and Then this policy came out, and I just couldn't understand what the church was doing. But what really cracked me was getting on Facebook and just seeing how my LDS friends were defending it and talking about how it was about love. And basically without any critical thought at all. Within the first day or two, so many people were defending this policy, and I just started to realize that the church basically had taught us not to be critical, and I just couldn't take part in it anymore.

John Dehlin [00:36:41] Plus, I'm sure you're remembering back to your mission time where you were making excuses, and I wonder if that was bugging you at all. Like, seeing people do what you had done on your mission, that bothered you.

Dan Lonergan [00:36:52] And since then, I had learned all the details of our history with racism in the church. And I know very well the timeline of what happened and kind of how those events unfolded. And, you know, I'm very confident in saying that that was not revelation and that God was not behind, you know, early Mormon racism. And so I just kind of see this playing out in front of my own eyes. You know, it's like history is repeating itself, and I just didn't want to be a part of it. So I'm halfway into my time teaching seminary, and I'm basically starting to talk to my seminary kids about this policy, and the kids are all mad about it, too.

John Dehlin [00:37:44] Oh, really? They're mad about it?

Dan Lonergan [00:37:46] Yeah. But, you know, I have some very liberal. You know, I had some very liberal students in the class that were very worked up about it.

John Dehlin [00:37:55] Interesting.

Dan Lonergan [00:37:56] And so we would commiserate with each other. So. Also off script.

John Dehlin [00:38:01] Yeah. Okay, so you're starting to, like, go off script with, you know, just. Just kind of developing relationships with these kids in ways where you're all kind of raising your eyebrows at each other, kind of scratching your head, wondering what's going on. Yeah.

Dan Lonergan [00:38:20] And I started to be concerned about the psychology of what I was doing, because so much of the CES manuals, if you go through and you look at the purpose of most of the lessons in the CES seminary manuals, it's all about obedience, and it's all about perfect obedience. And I just started to be very concerned about the message that I was giving these kids, because I just knew there's no way they're going to live up to what is expected of them in these. In these lessons. And so I totally changed the tune from being about obedience to talking a lot about mercy and grace and about things that are relevant to them in their lives. And. And it got to the Point by the last half of the year that I could hardly even teach from the manual anymore because there was basically nothing in it that I agreed with.

John Dehlin [00:39:15] Yeah, that's hard. Your eyes had been opened. You had partaken of the tree, of the fruit, of knowledge, of good and evil. Your eyes had been opened and you couldn't go back to the garden.

Dan Lonergan [00:39:30] Yeah. At the same time, I didn't want to cause some big controversy by quitting. And so I just kind of lived in silence and just tried to hold it all together and finish out the year. And, you know, I didn't want anyone to know. But I did secretly in I think was February or March after one of my seminary classes, I just had this urge to do something really bad and I went and I got in a Starbucks drive through and I ordered a cup of coffee.

John Dehlin [00:40:03] Oh, that was your apple. You took you particularly apple.

Dan Lonergan [00:40:06] Yeah. And the crazy thing is I'm in this Starbucks drive thru and I'm just, I'm like looking around like, is anyone going to see me? And I know how ridiculous this is, but I just realized, I'm sure your

John Dehlin [00:40:19] colleagues in medical school were living off of coffee, right?

Dan Lonergan [00:40:22] Oh, absolutely. And I was living off caffeine pills. Oh, wow. I mean, I was, I was taking ever since I'd been in med school. I mean, I had to like take several caffeine pills every morning just to, just to get by. And I knew it wasn't healthy.

John Dehlin [00:40:36] But I'm guessing coffee is more healthy than caffeine pills.

Dan Lonergan [00:40:40] Oh, absolutely. Yeah.

John Dehlin [00:40:42] Okay.

Dan Lonergan [00:40:42] And so I just, I just started to realize as I stopped believing how ridiculous it was for me to be taking these pills every morning to wake myself up. And I just thought, you know what, I'm just going to have a cup of coffee.

John Dehlin [00:40:59] I'm just curious, why is caffeine and coffee more healthy than caffeine in pills? If, you know, maybe you don't know.

Dan Lonergan [00:41:07] I just think the psychology of it is unhealthy to be taking a pill and you have this huge surge of caffeine, whereas coffee is much more titratable. Right, right. So you sip your coffee through the morning. You know, it might take me an hour or two to drink a cup of coffee. And I know if I'm getting a little too much and I can kind of titrate it to the right level.

John Dehlin [00:41:29] Right.

Dan Lonergan [00:41:29] And I also tend to consume a lot less caffeine with coffee because it's not uncommon that I'll come back at lunch. And you know, most of my coffee is still sitting on my desk and it's cold and I throw it out. But you know, if you're taking two caffeine pills, you might, you know, that might be equivalent of four cups of coffee, you know, right away in the morning where, you know, if you're drinking coffee, you're just not going to consume that much caffeine.

John Dehlin [00:41:51] Got it.

Dan Lonergan [00:41:52] So. And also just the psychology of being dependent on pills.

John Dehlin [00:41:56] Yeah.

Dan Lonergan [00:41:57] You know, maybe that can be a

John Dehlin [00:41:59] slippery slope for some.

Dan Lonergan [00:42:01] Yeah, maybe. And it's just so interesting that I was willing to do that as a believing Mormon, but I wasn't willing to drink a cup of coffee. And you know, it's just, it's stupid, you know, and I just recognize that in myself and I just realized that my behavior didn't make sense.

John Dehlin [00:42:20] Yeah, kind of. Kind of. And we'll get to this, I'm sure. Kind of like maybe for some, medical marijuana would be much more healthy than opiate, you know, prescribed opiates. And yet a Mormon won't let them do the former sometimes. But would it be okay with the latter? And the latter can become deadly. Okay, sorry, I didn't mean to derail.

Dan Lonergan [00:42:39] Or a similar example, you might be okay with taking a Xanax at night to help you get to sleep, but you won't have a glass of wine. But the glass of wine is much healthier for you than the benzodiazepine, Right?

John Dehlin [00:42:52] Yeah, totally.

Dan Lonergan [00:42:54] And that's a very, very common problem in Mormonism.

John Dehlin [00:42:58] Yeah. All right, we've got two comments. We've got the awesome. Carson Calderwood, a former Mormon Stories podcast alumni who writes coffee is theorized to have its correlation to a decrease in morbidity due to all the antioxidants it contains. That benefit outweighs the small negatives of caffeine. So that's Dr. Carson Calderwood weighing in. Hi, Carson. And then Spencer asks you a question. Dan and I want to thank listeners for making comments and questions. We want to include them. Spencer asks, you sound like you were a cool seminary teacher. How did your seminary students attendance progress throughout the year? Also, were your students more interested in your off script discussion than the lessons they got in Sunday school? So those are two questions. Thanks, Spencer, for writing in.

Dan Lonergan [00:43:49] I had 24 students and all 24 graduated and we had nearly perfect attendance.

John Dehlin [00:43:56] So they liked going off script with you?

Dan Lonergan [00:43:59] Oh, yeah, I think so. I mean, I got a lot of good feedback. A lot of parents were very upset when they found out I wasn't continuing.

John Dehlin [00:44:07] Okay, very good. All right. I had the same experience. It's kind of like Dead Poets Society. When students get. Seminary students get a teacher that's actually awake and alive and curious and willing to talk about lots of different stuff that's relevant to their lives, they actually enjoy it more, I think.

Dan Lonergan [00:44:29] Yeah, it's more stimulating, more relevant. Yeah. And they don't sometimes get those discussions at church, so they're really. When you have a really critical discussion where you explore a lot of different sides of the issue, they really like that. And a lot of them were really into it.

John Dehlin [00:44:48] Joey asks, were there attempts to censor you during your lessons? Did anyone telling you to the bishop, or did parents start complaining? Was anyone on to you during that year?

Dan Lonergan [00:45:01] Yeah, but I. Everyone was pretty good about it. I got a lot of good feedback. There were a couple comments that I had, but that wasn't the majority. The overwhelming majority was that people were happy with what I was doing.

John Dehlin [00:45:14] All right, so you. That summer, tell us again what you did that summer. Did you bail or what'd you do?

Dan Lonergan [00:45:20] So right when seminary finished, I met with my bishop and I told him, basically, I'm not a believer, and I gave him my temple recommend and told him, I'm done.

John Dehlin [00:45:31] So that would have been summer of 2016.

Dan Lonergan [00:45:34] Yeah.

John Dehlin [00:45:35] So a little over a year ago.

Dan Lonergan [00:45:38] Yeah.

John Dehlin [00:45:39] And you offered your temple recommend?

Dan Lonergan [00:45:42] Yes.

John Dehlin [00:45:43] A lot of people want to keep that just in case they get invited to a wedding or a reception or, you know, some type of missionary farewell. What made you decide to just let that go and to volunteer it versus have it taken from you?

Dan Lonergan [00:45:58] I just wanted to be authentic. I wanted to be honest, and I just was okay with letting it go. I've been to. I've been to a wedding since then and done the, you know, walk of shame. Out, outside, not allowed in. And so I know what that feels like now, and I'm okay with it. I'd just rather be honest about with people about what I believe in. And I just don't want to be manipulative or dishonest about it.

John Dehlin [00:46:28] Sure. A lot of people, it's not so much. You know, there's a lot of honest people generally that still don't. That still really struggle with this issue. And some of it is just weighing the honesty with the collateral damage or the pain or the suffering that will come from. From disappointing parents, disappointing in laws, disappointing grandparents, disappointing siblings and all that. What did you face is your situation where those things really weren't. You said you were raised in an Orthodox home. I don't know what your wife's family were like. But to what extent did you feel like you would be paying a social or familial cost from not only giving up your temple recommend, but also just kind of like, disengaging with the church? Was that tough for you?

Dan Lonergan [00:47:23] It was. One thing I was doing was I was listening to these podcasts, so I was learning from other people's experiences what not to do. And I still made a lot of mistakes, but I was kind of recognizing it in other people's stories, some of the mistakes that I might make. And I think I was a little more careful than I otherwise would have been. So that helped me a lot, and there was a lot of pain.

John Dehlin [00:47:50] Which podcast? Do you remember any podcasts that you listen to, either podcasts overall or episodes that were particularly helpful? No pressure if nothing comes to mind. I just. I like to give listeners resources in case there's something that's helpful.

Dan Lonergan [00:48:05] Yeah, I don't remember any specific ones, but a theme over and over, and you've talked about this a lot, is to not just dump all your concerns on your spouse or on your parents and not try to convince them that Mormonism isn't true or, you know, talk about some of the historical issues that we have or issues in the scriptures that we have, because they're not necessarily in a place that they're ready to hear that. So I was a little more careful, although I made some mistakes with my wife where I unloaded a little bit too much on her, and we had some tough times because of that.

Coming Out to His Wife During the Faith Transition

John Dehlin [00:48:54] Okay, so with extended family, it sounds like you didn't do the dump. Talk to us about what that was like. How much was your wife aware of your faith crisis that happened over a year or so? How much did you include her versus not? And then what was it like that before or after, during that time where you just ended it with the bishop?

Dan Lonergan [00:49:21] So I was gingerly letting her know my concerns and kind of dancing around it a lot, and she was absorbing it and listening to my experience. I got really lucky because her cousin visited from Canada who had been through a faith transition in the year previous, and we were able to sit as a group and talk about his faith transition. And in our discussion, my wife realized that I was basically on the same page as he was. And so it was an indirect way to introduce her to, you know, how far off the rails I was. So it helped having that third party in there to kind of be a mediator and she could look at him and she had respect for him and what he had gone through. And so then she could apply some of that same consideration to what I was going through as well. And it softened the blow a little bit.

John Dehlin [00:50:21] So others kind of prepared the way a little bit for you, your cousin or your wife's cousin.

Dan Lonergan [00:50:26] Yeah. She also has a very good friend. Her best friend is a very non orthodox Mormon with very nuanced beliefs. And so that has also softened her over the years to be much more accepting of people who. Who don't necessarily fit the mold.

John Dehlin [00:50:42] So that's kind of data for people as they're trying to decide whether or not to come out. It sounds like what you're saying is every time someone comes out, it makes it easier for others to be authentic.

Dan Lonergan [00:50:56] Absolutely.

John Dehlin [00:50:58] And so that's just an interesting thing for people who are going through a faith crisis, whether or not you leave the church, becoming open and with close family and friends about your transition can be a really helpful thing for others who are going through the same thing.

Dan Lonergan [00:51:15] And we laugh about this now, but years ago I had told her, said, hey, I don't know if I can believe this anymore. I don't know if I can do this anymore. And she basically said, stop being stupid. You know, you're just going through a phase. Stop being stupid. And we both laugh about that now because she didn't really realize how serious it was at the time, but she really just thought she could just tell me to, like, stop being stupid. Read your scriptures, you'll be fine.

John Dehlin [00:51:39] Right, right, right. Okay. So once you kind so talk about, like, at what point did it really become a stress on your marriage? Like by the time you dropped that bomb, was she, like, accepting it already? Was she wanting you to do that? And you know, to what extent was that kind of finality, that moment of finality in summer of 2016, something that was difficult for your marriage?

Dan Lonergan [00:52:08] I think she. My wife's an amazing person. And from the beginning, she always said, I'll always choose our marriage over anything else.

John Dehlin [00:52:17] I love that. Yes. Will you give her a hug from John de Linde? It could be your hug. I will, but it has to be a proxy. Say I hug you for on behalf of John Dehlind.

Dan Lonergan [00:52:28] I will do that right when I get home.

John Dehlin [00:52:31] I love it when the spouse chooses the marriage over everything.

Dan Lonergan [00:52:36] She's never wavered on that. She hasn't. So she has been rock solid by my side, supporting me 100% of the way. And she tempers me too, because sometimes I get angry about things and. And sometimes I want to be really Negative. Like. Like a couple weeks ago, we were talking about my faith, and I mentioned to her that I felt like I'd been duped because all growing up, I'd gotten a certain message that then historically turned out to be not really the truth. And she says, who were you duped by? And I started thinking about that, and I don't really have an answer to that because everyone we know in Mormonism is a believer, so no one's intentionally duping us. And I think even the leadership. I can't speak for the leadership in Salt Lake, but I can speak for our local leadership. They're very genuine people, and our bishop and our stake president seem like very good men. They've been very good to me, and I really, genuinely don't think they're trying to deceive or dupe anybody. So she's been able to give me a good perspective as I've been going through this, to not be so negative that I'm just basically wanting to, you know, torch the whole religion and just, you know, be done with it, because there are a lot of good things about it.

John Dehlin [00:54:05] That's great, and that's great. You're able to be open to her feedback, you know. Yeah, that's great. Okay, so. So as you've brought her along, she's been committed to your marriage and has even been a helpful resource for you?

Dan Lonergan [00:54:20] Absolutely.

Leaving Church Activity and Ward Relationships

John Dehlin [00:54:21] Okay, so. So from. It's been about a year and a couple months since you kind of disengaged from your ward. Did you stop attending completely?

Dan Lonergan [00:54:35] No, I still go. We go. She teaches Sunday school, and she teaches, like, every other week, a Sunday school class. So oftentimes I'll go with her, so my face is still seen there, but it's usually just to go to her class, and then I leave. And I've kind of gotten in this habit of going to Sonic and getting the kids. Like, I get the whole family food. And so then I'm in the church parking lot with, like, all our Sonic, and the kids actually love it, so they're, like, really excited that I leave church to go to Sonic.

John Dehlin [00:55:09] Oh, you time it. So by the time you get to pick them up, you've got the food.

Dan Lonergan [00:55:13] Yeah, so I've got the food in the car. You know, everybody's got their burgers and their drinks. And so it's kind of become a funny family tradition that during priesthood, I go and get Sonic. So

John Dehlin [00:55:26] I love it. Okay. And has the ward left you alone? Has. You know, what has it been like for you in terms of how your ward has treated you.

Dan Lonergan [00:55:38] We've got some great friends in the ward. Some of our best friends are in the ward. We're still very close with them. That hasn't changed at all. The bishop reaches out to me on a fairly regular basis. He's always been very friendly and supportive. For the most part, I'd say it's been about right. Like they haven't been bugging me and I haven't gotten a lot of contact, but it's enough to kind of know that they care. So I have no complaints as far as that goes. I think they've been playing it as well as they can given the circumstances.

John Dehlin [00:56:13] And you don't have to deal with like whether or not you say, make certain comments in Sunday school or priesthood just because you don't go. That's how you avoid that dilemma.

Dan Lonergan [00:56:21] Yeah, I had issues with that before where I was making comments and ruffling people's feathers and I just decided I couldn't. I just didn't want to deal with that anymore.

John Dehlin [00:56:33] But you still go to soccer meeting or not?

Dan Lonergan [00:56:36] Sometimes. Sometimes I go to sacrament meeting and then go to my wife's class. And my wife is very. She's a very liberal thinker as well, so I enjoy her class.

John Dehlin [00:56:44] Okay. A lot of the real dilemmas that people have as they're losing their faith and going through a crisis, especially in the mixed faith marriages the believer wants. Do you have children? I guess five kids. Five kids, okay. So a lot of the non believing sort of folks are like, oh my gosh, I don't want my kids in this. You know, some will say cult or I don't want my kids exposed to racist, sexist and homophobic teachings. Or I don't want my kids raised in a church where I'm viewed as a doubter, as a bad person. And so they get really stressed out and upset about the idea of their kids having continued exposure. Others don't mind. Talk about how you thought through that yourself.

Navigating a Mixed-Faith Marriage and Family

Dan Lonergan [00:57:35] Yeah, we're still kind of going through that. You know, my daughter is seven, our fourth child, she's about to turn eight. And so it's an issue, you know, is she gonna get baptized? Who's gonna baptize her? I'm trying to sort through some of that because I'm not gonna be able to be, you know, take part in that.

John Dehlin [00:57:57] Now sometimes, sometimes a bishop will let a non believer do a baptism. It's only an Aaronic ordinance and they want you engaged versus not. Have you considered that approach? Just like hey, if you'll let me, I'd still like to baptize my kids. Just seeing if they'll let you.

Dan Lonergan [00:58:15] Yeah, I didn't honestly know that was

John Dehlin [00:58:18] possible, but it definitely has happened.

Dan Lonergan [00:58:21] I guess I could explore that as an option. I'd have to think about it whether or not I want to do that versus having my dad come in and do it or, you know, or someone else. But we also have our two oldest kids. Are we adopted from foster care? And so they're African Americans. So that kind of plays into it as well, like with the history of the church and some of the things they've encountered at church. And you know, our son is 21 and our daughter is a senior in high school. And so they've kind of watched me go through this. And I think so far it's actually been a pretty positive experience for everyone because we've been able to communicate with our children. It's okay what you believe. We're not going to force you to believe something. We're not going to force you to go to a certain church. You're always going to be part of this family. You're always going to be welcome here, no matter what. And we've even had discussions with our younger kids about that as well. Like, you know, no matter who you are, as long as you're a good member of society and you treat people well, like that's all that matters to us. You know, I don't care what they believe. And to me that's been a really healthy discussion to have in our family.

John Dehlin [00:59:44] How about the idea? You know, a lot of times the non believer wants to make sure the kids know about Joseph Smith's polyandry. The kids know about Book of Abraham, wants the kids to know about the racist past. And there's this tension between believer and non believer. And I don't mean to characterize your wife as a believer. I'm just setting up the average dichotomy. You know, how have you guys navigated what, how much to disclose to the kids? And when.

Dan Lonergan [01:00:12] I'm pretty open with the kids if they want to learn, I don't really hold back. I think my wife kind of keeps me in check not to be too negative or be too vulgar or, you know, expose young kids to things that maybe they shouldn't be exposed to because some of the history is pretty shocking. But you know, my 11 year old, she's very mature and very curious and we've had a lot of great discussions about it. She's also perfectionist. Like I was. And so I'm able to temper some of that perfectionism and kind of get her to give herself a break. And instead of wanting to go to byu, now she wants to go to Harvard. So that's been a big step. Not that I necessarily have anything against byu, but I think she'll be, you know, she's just very bright, and I think she's thinking more outside of the box now. And I just enjoy seeing that. And my wife sees the value in that as well. So in a lot of ways, we're seeing eye to eye in ways that you might not expect.

John Dehlin [01:01:20] And it sounds like it's not a tug of war between you and your wife about kind of what the kids should know or not or how authentic you can be. It sounds like she wants you to be authentic, but she can be authentic. And neither of you are feeling threatened that you're trying to win over your kids?

Dan Lonergan [01:01:38] Yeah, it's not really been like that. The biggest challenge comes usually on Sunday morning when. When she's getting everyone ready to go to church and I'm kind of like, do I want to go or not? And, you know, sometimes we butt heads about that. Like, am I going to be with the family or not? You know, and some Sundays I just do not want to go. Like, I do not want to be there. I emotionally, I feel like I can't handle it. And sometimes I just kind of have to suck it up and be with the family and go. And other times she's kind of like, hey, I get it. You know, just do your own thing.

John Dehlin [01:02:14] Got it. Okay.

Dan Lonergan [01:02:17] But for her, I. For her, she's not really concerned about doctrine. She's just more concerned about our family and us being together. And, you know, for her, the gospel is kind of all about just the family. And, you know, if. If someone comes up and tells her that Mormonism isn't true, she's not going to be phased by it at all. It really is not going to affect her that much. So she may be a more nuanced, active member of the church than what we're used to seeing. I'm not sure.

John Dehlin [01:02:51] But she's a family first Mormon.

Dan Lonergan [01:02:54] Yeah.

John Dehlin [01:02:55] That's huge. Okay. And so things like word of wisdom, a lot of the believing spouses are really concerned about garments, about word of wisdom, about tithing. How do you guys, what are you able to share about how you've navigated that?

Dan Lonergan [01:03:20] So I pretty much became pretty firm that I did not want to pay tithing, and I was a full tithe. Payer until I was 38 years old. I'm 39 now. I mean, until basically midway through my seminary teaching year, I was a full time payer. Never missed from being a full tithe payer to not paying at all. And you know, I just had a lot of concerns about where the money was going. I wanted to see that, you know, I wanted to see where it was going. I wanted to make sure it wasn't going to build a mall or going to build, you know, another temple in Utah or, you know, things that I didn't, that weren't relevant to me. So we talked early on when I was going through this crisis and decided that she was okay with us basically deciding charities that we would devote our time and money to. We started actually contributing to a Presbyterian church to a fund that funds clinics in Guatemala. And then we actually went to Guatemala through with those funds and did a medical mission. So it's almost like our tithing to that church actually sponsored us to go and spend a week in Guatemala and we did medical work in Guatemala. And it was such a rewarding way to pay tithing.

John Dehlin [01:04:43] She went with you?

Dan Lonergan [01:04:45] Yes, and my daughter went with us too.

John Dehlin [01:04:47] Oh, that's amazing. How does your wife get over the guilt? Does she, number one, want to have a temple recommendation and two, how does she get over the guilt of being a free rider, of benefiting from the church but not paying for her participation?

Dan Lonergan [01:05:03] I don't want to speak for her. I think she does feel like she needs to pay, like when the girls go to girls camp and you know, she feels like she needs to make a contribution that she feels is adequate. And then I'm not sure she's had to deal with temple recommend interview yet.

John Dehlin [01:05:23] Okay.

Dan Lonergan [01:05:25] And I think she's still trying to sort it all out, so.

John Dehlin [01:05:29] Got it. Yeah. Still, it's still kind of early a little bit, right?

Dan Lonergan [01:05:32] Yeah.

John Dehlin [01:05:33] Yeah.

Dan Lonergan [01:05:34] So. And you know, I've kind of, I've kind of dragged her along in this process and she's trying to preserve our marriage and preserve our family. And you know, she's been really sensitive about my process and I think, you know, there's gonna come a time very soon where I'm gonna have to show the same consideration to her and she may push back a little bit and want to. Want to do some of those things. I'm not sure.

John Dehlin [01:06:02] Got it. Okay.

Dan Lonergan [01:06:04] So as far as like, word of wisdom, you know, I've. I've very much enjoyed trying different wines and different bourbons and as an addictionologist, I kind of understand BR. And I feel very comfortable at 39 years old trying some alcohol. And I'm not really paranoid that I'm going to become an alcoholic. But I also have discussions with my kids about the wisdom in some of those guidelines. And, you know, we somewhat try and play a middle ground there, helping the kids to make decisions based more on science and evidence and how their brain develops and kind of understanding the risks and. And making decisions that way and not so much based upon something that I don't believe is true.

John Dehlin [01:06:56] Yeah. Like, one thing I can tell you as I study the data on disaffection of faith crises, that well over a third, I think now of kids raised in the church, of us members raised in the church, are leaving the church. And I think for the. For the younger generations, it's even greater. So I can see a lot of wisdom in teaching your kids responsible, moderate alcohol use simply because. And just education around it, because at a minimum, one out of three of your kids is going to leave the church. And they can either learn in the home with a good education and good role models, or they can try and learn on their own. And sometimes they learn in a much less safe way. Do you think that's a reasonable, smart thing to think about, even for a believing spouse?

Dan Lonergan [01:07:56] Absolutely.

John Dehlin [01:07:57] As an addictionologist, I ask.

Dan Lonergan [01:07:59] Yeah. There's some really good science that you can teach your children to help convince them not to expose their brain to chemicals, especially before they're 21 years old. Ideally, I tell my kids, ideally, if you can get to 25 and not expose your brain to chemicals, and I include caffeine in that as well, get your brain to 25, your brain's fully developed, all those pathways are well established, and your chances of becoming addicted to any chemical beyond the age of 25 if you've not been exposed to it, are very slim. Not saying that that's impossible, but people who are exposed to opiates and alcohol and marijuana in their teenage years, when their brains in development are at much higher risk of becoming addicted to those substances later in life.

John Dehlin [01:08:52] Got it. That sounds really smart.

Dan Lonergan [01:08:56] Yeah. And my kids seem to respond to that a lot better than saying, like, hey, there's this rule that we don't know why it is, but God says to do this, and this prophet in Salt Lake says to do this, and you should do it because you need to be obedient. If your child has a faith crisis, you don't want them just going crazy because all of a sudden they think it doesn't apply anymore.

John Dehlin [01:09:20] So you're saying have reason be an authority for them, not just some white old dude, so to speak.

Dan Lonergan [01:09:28] Yeah, I would say reason is more convincing, and it's more lasting. And it also gives them a better, you know, when they're telling their friends why they don't drink. I mean, maybe that's a better excuse than, you know, trying to explain some religious belief. So I think it's different for every child, but for my kids, it seems like that's worked pretty well.

John Dehlin [01:09:54] Are you comfortable talking about garments and how you guys navigated that? Because that always comes up.

Dan Lonergan [01:10:00] Yeah, I just. I do think it's fascinating that underwear is such a big deal. I love riding my motorcycle. And I can tell you, when I stopped wearing garments, I, like, went out on a motorcycle ride, and I was like. I knew it was not rational, but I was terrified, and I just had to get over that. And I love wearing normal underwear. Love it.

John Dehlin [01:10:26] And has your wife been supportive of that?

Dan Lonergan [01:10:29] Yeah, she's okay. She. She hadn't really said anything.

John Dehlin [01:10:33] Okay. So overall, and I'm gonna ask you to speak for yourself and for her, but you. You can say whatever you want to as you speak for her, but overall, you know, number one, do you feel like the faith crisis. Your faith crisis has been overall positive on your marriage? Let's start there. Overall positive or negative or neutral on your marriage?

Dan Lonergan [01:11:00] Overall positive because we've grown so much, but it has been painful.

John Dehlin [01:11:05] So like lifting weights, it's painful, but it made you stronger.

Dan Lonergan [01:11:10] Yes. And I think I wouldn't take it back. So we are in such a better place than we've ever been. And that's not to say we don't have our struggles all the time, but we are so much more authentic with each other. I'm not afraid to talk about things that are on my mind. And she knows me better than she's ever known me. There were many, many years where she didn't even know what was going on in my mind because I was afraid to bring it up because I didn't want to cause contention.

John Dehlin [01:11:46] Right. So better on your relationship, better on authenticity between you. Stronger in the end.

Dan Lonergan [01:11:56] And our friendships are so much better, too. Like, the friendships that we have are just so rewarding, and we just really enjoy spending time with authentic people. And we're okay with some of the acquaintances that. That maybe weren't as authentic. We're fine that those have gone by the wayside.

John Dehlin [01:12:17] Better friendships. How about as parents? Do you feel like you're better parents than you were as orthodox Both orthodox,

Dan Lonergan [01:12:25] I think, so time will tell. I mean, certainly people would argue with that, that we're putting our kids at risk by leaving the church, or, you know, that I'm putting my kids at risk by not being a good example to them, or, you know, there's all sorts of fears that play into this. But I've gotten over that to some extent, and I've had some wonderful discussions with my kids about faith and about, you know, what we believe in and how we treat other people. And, you know, this generation that's grown up now, they're just very thoughtful and they really want to treat other people well. They're very concerned about people being treated equally and fairly. And we've just had some really great discussions about that. And I think my kids respect me where I am, and I'm able to respect them, so it's good.

John Dehlin [01:13:16] So here's a hard question. Do you think your wife would say, overall, she's glad you went through a faith crisis, or do you think she. And maybe you don't even know the answer, or do you think she would say, I wish I could have my Orthodox Dan back?

Dan Lonergan [01:13:34] I don't know. I mean, I'm speaking for her. I would say I think she likes who I am now, and she expected when we got married that I was the Peter priesthood type, you know, and that I was going to be the rock of the family. And me having a faith crisis basically turned her world upside down. But I think we can both look back on it now and see how it will bring us more happiness and more authenticity with each other and a deeper relationship. And there's not the same kind of fear. There used to be. We can talk to each other about pretty much anything and not fear, you know, how the other person will react. And that just wasn't always the case in our marriage. So I hope it's better.

John Dehlin [01:14:25] Beautiful. Do you feel like you're more of an honest person now than you were before?

Dan Lonergan [01:14:31] Yeah, I'm pretty. I'm more open with people, even with my patients. I'm willing to discuss things that maybe I wouldn't have discussed before. I always had this fear of leaving a bad impression on the church or I felt like I was like a representative and, you know, so you're always walking on eggshells. You don't want to say something that will make the church look bad or you. I don't really worry about stuff like that anymore. I just, you know. And I also have accepted my own, you know, that I'm just a man and that I'm not perfect and it's not expected for me to be perfect. And so I'm just okay with, like, people knowing stuff about me that, you know, like just doing this interview, you know, it's like people know stuff about me now. This has been, you know, they're vulnerable moments. But I don't really care what people think about me. It doesn't matter. So in that sense, I'm, I think, more honest and more authentic and just willing to be me and willing to accept that I'm a messed up person just like everybody else and we're all just people and it's okay.

John Dehlin [01:15:39] Patricia writes, living a double life is unhealthy. How's that? Patricia writes, thanks for making that comment, Patricia. Dan, what have you. Have you tried to piece together a sense of spirituality for yourself? Do you still believe in God? Do you still consider yourself a Christian? Do you still pray? Have you found. Are you secular? And even if you're secular, is spirituality important to you? Talk about that for just a second.

Secular Identity and Spiritual Searching After Mormonism

Dan Lonergan [01:16:07] Yeah, I'm very secular. If you had interviewed me six months ago, I probably would have defined myself as agnostic. I mentioned to you that we went to Guatemala and we went with the Presbyterian Church and did some makeshift clinics there. And I had this experience while we were there. On the fourth day we were there, we were in this really awful part of Guatemala City in this little concrete one room schoolhouse. And we had like 120 patients in this little room that we're trying to treat. And I just had this very poignant experience that God was with us. And it was just one of the most spiritual experiences I've ever had in my life. And to me, what that meant was, wherever I am now, it's okay. And I don't need to be at a Mormon church or in a Mormon temple to have a spiritual experience, especially one that was so profound. And John, I wish I could tell you what I believe about God after that experience, because I really don't know, because I understand the psychology of it. I understand that our emotions can be deceiving. But to me, regardless of that, that was a special experience for me. And I have hope that there's something else. I have hope that when I die that that's not the end. But you know what? If it is? I'm going to live every day to its fullest and make sure I take advantage of every opportunity I have when I'm here to be happy and to be good to people, to have as full a life as possible. So I don't really have specific doctrinal beliefs anymore, but I do have a spirituality. And I think I'd even say that I've still tried to maintain some mysticism in my life because I just don't think it's unhealthy to have that.

John Dehlin [01:18:26] I love it. So, yeah, there are a lot of post Mormons that become atheist and agnostic, but there's also a lot that remain Christian or turn to Buddhism or other types of things or just remain kind of nondescript spiritual believers. And I love it that you are finding what works for you.

Dan Lonergan [01:18:51] Yeah, it's an ongoing process.

John Dehlin [01:18:54] Yeah, I love it. All right, so Wayne asks, are you seeking? Are you hopeful? Are you spiritual? I think you've kind of answered that. But did you. Do you have anything to add to Wayne's question?

Dan Lonergan [01:19:09] Yeah, I would say I am a seeker. I'm more interested in just finding truth. And I'm not opposed to finding truth in other churches. I do really enjoy going to other churches. I've expanded out and as a family, we try. I mentioned that my wife teaches Sunday school every other Sunday. And so as a family, we've tried to, on those off Sundays, go to other churches, explore other things. And I've really enjoyed that process as a family. And I enjoy spirituality still. And I really seek that out. And I. I like to read a lot. And so I'll still read Christian themed books. I read books on the historicity of Jesus and I also read books, you know, written by Christian apologists, so to speak. And I'm just much less threatened now about, you know, finding truth. And I'm just willing to look for it wherever, wherever I can find it.

John Dehlin [01:20:12] I love it. Do you feel happier and more mentally healthy for yourself now?

Dan Lonergan [01:20:21] Yeah. I mean, what's going on in here is pretty messed up sometimes. What do you mean?

John Dehlin [01:20:28] What do you mean by that?

Dan Lonergan [01:20:30] Just in general. I mean, I still struggle. I struggle with a lot of depression sometimes for no rhyme or reason. Sometimes I have really hard days in clinic and I'm just really, you know, down and just hating people and just, you know, wanting to be left alone. And I've dealt with a lot of materialism and trying to, you know, abandon that. And, you know, as a man, there's just things that, that go on that, you know, you're trying to deal with. So I don't want to make it seem like I live this blissful life, because I don't especially, I should say,

John Dehlin [01:21:06] if you have the personality type of high anxiety, that's Just rumination is going to be part of your battle.

Dan Lonergan [01:21:12] Right, right, Absolutely. And there are many nights where I just lay in bed and I can't shut my mind off. My mind is just. Just churning, burning. And, you know, that's just the way it's always been. And, you know, that's not new.

John Dehlin [01:21:26] That's not new.

Dan Lonergan [01:21:27] No, no, that's not new at all. But I have abandoned this idea of perfectionism, so. And I've been much happier in that regard, just accepting myself for who I am. I'm a decent guy. I'm a good family man. I'm a good dad, and I don't need to be perfect. And I'm much more okay with that now than I ever was when I was a more orthodox believer. When I was more orthodox, I always felt pressure to do more. I always felt like I wasn't good enough. I always felt like I wasn't doing enough. If a bad thought came into my mind. I felt like I was like a bad person. And I was always playing these games with myself. And I have been able to. To abandon a lot of those games that I used to play in my mind about me being, like, some sort of evil person or not being a good Mormon or, you know, thinking God was mad at me or, you know, stuff like that. I don't miss. I don't miss those thoughts at all.

John Dehlin [01:22:27] So in that sense, it's been an upgrade to kind of let go of perfectionism and anxiety about God's judgment and your worthiness quote.

Dan Lonergan [01:22:38] Yeah, the worthiness thing. Like when we went to Guatemala with the Presbyterian Church, you know, they were just, like, I told the pastor, I said, look, just so you know, I'm really struggling with my beliefs. I'm not even sure I believe in Christianity, you know, as you would define it. And he's like, okay, that's fine. We're just glad you're here to help. And, you know, I was like, that's it, you know, aren't you going to interview me? Don't. You're not gonna kick me out of the trip. And he was fine with it. We went and we had this wonderful experience, and it was just such a great lesson to me that, you know, not all religions are like that. And, you know, there's not that judgment and that worthiness criteria that's always hanging over our head.

John Dehlin [01:23:22] If you had to forecast maybe this is impossible to do, the extent to which you think your wife and your family will remain active versus maybe fall away, do you even have a crystal ball to Forecast?

Dan Lonergan [01:23:38] I don't know, but I'd say the chances that everyone will stay active are a lot. Much less now than they were two years ago.

John Dehlin [01:23:44] Sure, sure.

Dan Lonergan [01:23:45] Do I see my kids going on missions? Probably not, but, you know, I could see that maybe some of my children will be, you know, nuanced Mormons, where they grow up kind of with a nuanced belief system, maybe like a New Order Mormon type type of beliefs, but a belief set that they grew up with. So it's more normal for them and they don't feel like they're outside of the box. And as the culture progresses and as the religion progresses, that they may be able to feel like they fit in and identify as Mormons. I mean, I still identify as a Mormon culturally.

John Dehlin [01:24:26] Yeah.

Dan Lonergan [01:24:26] Yeah. So, you know, I don't see that it's not going to be a part of our life. I think it will be.

John Dehlin [01:24:34] Got it. All right, so as we wrap up this part of the interview, any final things you want to say to either people in faith crisis, people in a mixed faith marriage, either the non believer or the believer? Any final things you want to say about navigating that and what you've learned or what advice or wisdom you want to share?

Dan Lonergan [01:24:56] I guess I've learned that it's not the end of the world. You can get through it, whether you're the believer or the non believer. Just be open and just deal with the pain and get through it, and it's. You can survive it. And I also just want to emphasize, you know, sometimes these interviews do focus maybe more on the negative because we're talking about the transition. But I have just met the most beautiful people in Mormonism my whole life, and I don't want to marginalize that at all. I mean, this religion has these wonderful people. I think the church actually takes it for granted how wonderful their people are. And those relationships I have with our Mormon friends and even people who are still really active and true believers, they've just been really good relationships. And I think if you're just honest with people and try to stay positive, most people will accept you. And at least here in Tennessee, I don't find that it's a deal breaker with your friendships. And if it is, it's probably not that big of a deal.

John Dehlin [01:26:14] I love it, so hang on for the ride. But lots of positive things can come out of a faith crisis transition, whether you stay in the church or leave. Is that what you're saying?

Dan Lonergan [01:26:28] Yeah, I would agree with that for sure.

Transition to Part Two: Addiction Medicine

John Dehlin [01:26:30] All right, well, this concludes part one of my interview with Dr. Dan Lonergan. I want to thank everyone for tuning in. We've still got a great audience. I'm just going to take literally three seconds to end this interview, and then we'll start up again with part two, which is going to be about your experiences as an expert supporting people with addictions and treating people with addictions and preventing addictions and recovering from addictions once you've had them. So, Dr. Dan, thanks for joining us today, and we look forward to part two in just a second. Thank you for joining us today on Mormon Stories. If you enjoyed this episode, please help us make more like it by becoming a monthly subscriber@mormonstories.org thank you very much.

Part 2 of 2 · Ep. 807

John Dehlin [00:00:02] Mormon Stories is a production of the Open Stories foundation and relies solely upon the support of people like you, its listeners to help keep the podcast alive or to become a member of the community. Please become a monthly subscriber by visiting MormonStories.org and clicking the Donate button on the top right side of the page. All contributions to Mormon Stories are completely tax deductible and go towards producing the podcast and building communities and programs of support for Mormons like you. Thanks for your support. Hello everyone and welcome Back to part two of my Mormon Stories podcast interview with Dr. Dan Lonergan. It's October 10, 2017 4:20pm Mountain Time and we had a wonderful first hour and a half talking to Dr. Daniel about his upbringing in the church, his mission, his time at byu, his faith crisis as he was in med school and as a seminary teacher, leading to his departure from the church after the November 2015 policy and after struggling with teaching Mormonism to his seminary students. He also gave us a lot of great tips and experiences on navigating a mixed faith marriage. His wife is a progressive, nuanced Mormon, but he no longer describes as sort of a Mormon believer. But we've talked about how they've made that work, how they've always put family first, and how they've navigated some of the most difficult, common challenges for people in a faith crisis. So it's been a wonderful, it's a wonderful first part. For those who haven't listened to it, it's definitely worth listening to. Dan even talks about how he's reclaimed some of his own spirituality after identifying as an agnostic. So it's cool. Check out that interview. Now we're going to do part two where we talk about addiction and we're going to be talking about it from the standpoint of an expert because this is what you do for a living. So if it's okay, as we begin, where should we start in terms of our discussion about addiction? I think I have for the first part, just ask you about the most common ways that people get addicted. So you know, you talk about you're going to be talking about a biological component, you know, the sort of the brain and how it works, maybe if there's any genetic components or situational components to the development of addiction, etc. So why don't you just talk about the model for how people oftentimes get addicted?

Genetics, Risk Factors, and How Addiction Develops

Dan Lonergan [00:03:01] Sure. So 50% of your tendency to become addicted is genetic. So if your parents are alcoholics, then you have significantly more risk to developing an addiction. So 50% of your tendency, you can't even control. Now you can control your exposure and you can control your environment, but the genetic aspect you're stuck with, then there's. That's about 50%, 50%.

John Dehlin [00:03:35] That makes taking any drug almost like Russian roulette, Because there are things you can control, but there are some things that are out of your control. And oftentimes I'll have 99 people tell me, oh, now I just drink an occasional beer, an occasional glass of wine, or occasionally smoke some marijuana. And it's never been a problem. I've never become addicted. It's become this healthy, normal thing. It's. And that's the experience for the majority of post Mormons or liberal Mormons that I talk to. And then there's sort of one out of. What would you say, 100. What would you say? Do you even have a sense for the percentage of people that start drinking alcohol or start experimenting with drugs that become addicted? Is there even a way to estimate.

Dan Lonergan [00:04:21] It's different with different drugs. So specifically with opiate addiction, which is more of my expertise, one out of five people are at significant risk of developing an addiction. So if I just take a random sample of people off the street and I expose them to a pain pill, 20% of those, one out of five are going to have significant risk of developing an addiction.

John Dehlin [00:04:47] From that point, just imagine playing Russian roulette with five chambers. That's what you're talking about, right?

Dan Lonergan [00:04:54] Right. That's exactly what we're talking.

John Dehlin [00:04:56] That makes opiates extremely serious.

Dan Lonergan [00:04:59] True.

John Dehlin [00:05:00] And I'm talking about prescription opiates, not heroin. You know, that's serious, too. But I'm also talking about prescription opiates,

Dan Lonergan [00:05:08] which is why the government is being so aggressive. State and federal governments are being so aggressive at limiting exposure. So they're limiting. They're basically cracking down on doctors. And this isn't necessarily going to curb the modern epidemic, but it prevents a future epidemic. Or they're trying to keep it from getting worse.

John Dehlin [00:05:30] Got it.

Dan Lonergan [00:05:31] And they're trying to prevent exposure so we don't add more addicted patients to the mix.

John Dehlin [00:05:37] Do you have a sense for the prevalence of alcohol, the risk of alcohol addiction? Do you even know the number on that?

Dan Lonergan [00:05:43] Alcohol is a totally different animal because alcoholism tends to take decades to develop. Right. So oftentimes people are exposed as teenagers and then they're heavy drinkers during college, and they're kind of setting up this path to becoming an alcoholic. And a lot of times we'll look at, you know, college kids and we'll be like, I think he's going to be an alcoholic someday. Right. But. But they're not necessarily an alcoholic now. It's just that they're kind of following that path. And it does take. You know, a lot of times, people don't really develop heavy alcoholism until their fourth or fifth or sixth decade. Right. So it's a lot different than a drug like oxycodone or heroin, where you become addicted very fast. And especially drugs like cocaine, stimulants, methamphetamines, you can become addicted with just a single exposure. So, you know, it's apples and oranges. Alcoholism is a whole different animal. If you're a very responsible drinker and you don't start till, you know, in your 20s and you're not heavily drinking, the chances that you're gonna become an alcoholic are pretty slim.

John Dehlin [00:06:53] Okay, and is it worth talking about marijuana right now just in terms of genetic or other sorts of, you know, rates of risk?

Dan Lonergan [00:07:03] Yeah, I mean, I think marijuana is gonna fall some. You know, it's not in the extreme spectrum that opiates or stimulants are going to fall in. Clearly, marijuana is much safer and there's much less risk. In fact, there's hardly any risk of fatal overdose from marijuana. So the problem with marijuana, it's so politically charged that it's hard to even have a good discussion about, you know, a good scientific discussion about it. And as a disclaimer, I'm not a marijuana expert.

John Dehlin [00:07:37] Sure.

Dan Lonergan [00:07:37] It's not. It's not legal in Tennessee, so it's not something that I prescribe. It's not something I recommend for patients. But I do want to be clear that marijuana is not dangerous from a fatality standpoint, like pain pills are. Like, opiates are. Opiates are extremely dangerous drugs and are killing people by the tens of thousands. Marijuana is not killing people. I mean, there might be, like, circumstantial, you know, cases where, you know, someone might drive under the influence and it becomes fatal in that way. But. But you're not reading about people dying of marijuana overdose.

John Dehlin [00:08:14] And so I've heard a lot of cannabis advocates say that marijuana is way safer than alcohol, too. Is that. Is that true in your experience?

Dan Lonergan [00:08:23] I don't have any data that I have pulled up where I can make a statement either way, but I. I'd say I would put them as fairly equivalent. So, you know, I don't know if one is safer than the other, but I wouldn't be that surprised, you know, if that were the case I've heard

John Dehlin [00:08:44] that, you know, you don't use marijuana usually and become violent. Marijuana doesn't impair your driving like alcohol does, as I've heard. This is. I've never tried it, so I'm just speaking from the people that I've spoken with. And it doesn't have the risks of addiction that alcohol would. What would you say about that?

Dan Lonergan [00:09:08] I would say that's probably fairly controversial. And I'm not sure. I'm really. It's just not my area of expertise.

John Dehlin [00:09:15] Okay, that's fine. That's fine, that's fine. Okay, so somebody asked how far back does that genetically go? So let me ask that in a different way. How do you identify whether or not you have a family history? And what's a family history that's kind of noteworthy versus not?

Dan Lonergan [00:09:33] Well, the closer the relative, the more relevant it is. So if it's a brother or sister or parent, then it's going to be a lot more relevant than an aunt or an uncle or, you know, the further removed you get, the less relevant it is. But, you know, your DNA is your DNA. The point of saying that, that a lot of this is genetic. Some people just don't have the tendency in their DNA to feel good after taking a pain pill. So a lot of my patients don't like the way pain pills make them feel. That's why a lot of patients come to see me, because they know that I do other things than pain pills. That. That's not really my focus. So if you're just not genetically hardwired to have that euphoria and to have that addiction component, then you know, it's probably just not going to happen to you. But you. Most people will know with opiates based upon the experience they've had after surgery. If you've had surgery and you're given a pain pill and it makes you feel really good, then you might be one of those 20%, you know, that one out of five that's really at risk. And if you take a pain pill and it makes you feel nauseated and you feel yucky and you don't like how it makes you feel, then you're probably in the 80% that's not at risk. So the genetic risk is 50% of your tendency you cannot control.

John Dehlin [00:11:04] Got it? Okay, keep going. So there's the genetic component. What else is there? The factors that contribute to addiction.

Dan Lonergan [00:11:15] Social components. Like, if you grew up in a family where there's a drug culture where you're exposed to drugs, obviously you're going to have more likelihood of developing an addiction. If you expose a young brain to drugs, then those pathways become more established and you're more likely to have problems as you get older, more likely to have problems with addiction. There's also economic factors. So we see really high rates of drug addiction in these coal mining towns where the economy's been devastated, where people don't have jobs. Some of these rural American towns where their main industry in the town has been devastated, have really high rates of addiction, and they have really high fatality rates from opioid overdose.

John Dehlin [00:12:12] Okay. So socioeconomic factors, early exposure, social sort of drug culture.

Dan Lonergan [00:12:20] One other big one is adverse childhood experiences. Aces. This is big in the psychology literature. If you've had as a young child sexual or physical abuse, then that's linked to much higher risk for addiction later on in life. And there's some really good research that's, that's showing those links.

John Dehlin [00:12:46] Physical, sexual. Is that what you said? Abuse?

Dan Lonergan [00:12:49] Yeah. Physical, sexual. I would even throw an emotional abuse in that.

John Dehlin [00:12:55] Neglect or neglect.

Dan Lonergan [00:12:57] Yeah.

John Dehlin [00:12:58] And what do you. I mean, why would that make. Why do you think those types of abuse would make someone more likely? Just because it's malformation of the brain, disruptive, excessive trauma, ptsd.

Dan Lonergan [00:13:15] Yeah. And maybe they develop unhealthy coping mechanisms to deal with the trauma. And so then when they're exposed to a drug that helps them feel good, perhaps that feeds into some of those unhealthy coping mechanisms. You know, the psychology of the brain is so complex. And then when you look at brain development and how complex that is and why someone who's been abused would be more likely to turn to drug abuse. I mean, it seems intuitive. I just. I'm not sure how to fully explain it on a scientific level.

John Dehlin [00:13:50] Okay.

Dan Lonergan [00:13:51] I'm sure there's people that can.

John Dehlin [00:13:53] So to summarize, consider staying away as much as possible from opiates and alcohol and other stimulants. If you have a close family history are part of a social or familial scene that has a drug culture, stay away from it for sure. In your early years. Like you said before, he's 25. If you're in a poor socioeconomic status, it's a real risk. If you've been a victim of some sort of childhood abuse or if you tend to be someone who just doesn't have healthy coping mechanisms. Generally, those are all additional reasons to avoid this stuff.

Dan Lonergan [00:14:35] Yeah. And just one thing I want to clarify is that addiction does affect all economic levels in society. So even Though I really emphasize some of these towns that have been economically devastated, that have high overdose rates. You can't predict someone if someone's an addict based upon their income. So there are plenty of people, and I could give you plenty of examples of patients who are in very high profile jobs, who have very good incomes, who have very good family situations, who have basically the perfect life and they're addicts.

John Dehlin [00:15:15] So doctors, lawyers.

Dan Lonergan [00:15:17] Absolutely. So I'm not saying that you can use these things to predict who's going to be an addict, because, you know, people who are addicted come in all families and all walks of life and all religions and all cultures.

John Dehlin [00:15:33] It's more about managing your risk profile.

Dan Lonergan [00:15:35] Right, exactly. Yeah. And I think the most important thing take home point is avoiding that early exposure, because that is something you can control. If you avoid chemical exposure during your teenage years and early twenties, then you've really mitigated your risk factors.

John Dehlin [00:15:57] Got it. Okay, so really quick, let's talk about alternatives. Just before we get into addiction and recovery. Let's just say someone thinks that they are at high risk or they just want to avoid the Russian roulette of drugs or alcohol. Let's start with opiates. Let's say that someone breaks their leg or hurts their knee or has back surgery and they just want to avoid opiates. You say that you provide alternatives. What are the types of things you provide or that others might provide to keep someone from going down a risky path?

Opioids in Medical Practice and the Prescription Crisis

Dan Lonergan [00:16:38] Okay, so for most surgeries, you're going to be exposed to an opioid. It's really common to use fentanyl or dilaudid or really potent opioids during surgery. So now if you tell an anesthesiologist, hey, I want to do my surgery without any opioid exposure, we can do that. Most of our anesthetics that we use to actually make a patient unconscious require opioids. And there's a lot of medications that we can use that are non narcotic type medications that are good for pain relief. For example, gabapentin is a medication that's really good for nerve pain. And there's medications that can be used in the perioperative period that don't involve opioids. That being said, it's not the end of the world if you need some opioid around surgery. So to have a brief period where you need some fentanyl or some dilaudid during a surgery or shortly after surgery, as long as if you feel like you're high risk, you know if you just basically put limits on that and reduce your exposure as much as possible, then you're gonna be in much better shape than if you go home with a prescription and stay on it for weeks or especially months at a time.

John Dehlin [00:18:02] That's what I was going to say. It seems like when they knock you out for a surgery and then you come out of it, that sort of opiate use seems contextually different than if you're going home with a bottle of pills, right?

Dan Lonergan [00:18:18] Absolutely. And the longer you're exposed after your surgery, so if you go from days to weeks to months, the more likely there is to be an addiction. So if you can limit that exposure to just hours or days, then you're going to be a lot better.

John Dehlin [00:18:34] Okay. And again, for those who with the bottle that they take home to list, again, the things that they can request that aren't opiates that can still manage the pain.

Dan Lonergan [00:18:46] So there's a whole variety of things, you know, from anti inflammatories like ibuprofen and Aleve, those can be very useful. Gabapentin is a medication that's really good for nerve pain. Lyrica is a very similar drug. There's also other classes of antidepressants and anticonvulsants that we use to help people with pain, things that are non addictive. So, I mean, I could provide a list of probably 25 or 30 medications that are not addictive that can be helpful for pain. Now, just because they're not addictive doesn't mean they don't have side effects. They might cause you to be really sleepy or, you know, you may not necessarily be able to function in everyday life on some of these medications. But for a brief period after surgery, it might be a reasonable option if you want to avoid opioids.

John Dehlin [00:19:43] A couple of comments or questions from our audience. To begin with, Tambi is mad at you. She says, I can't believe you didn't tell me you were going to be on the podcast today. That's from Tambi.

Dan Lonergan [00:19:59] Tambi is a great friend and she is. I actually mentioned her. She's the friend that helped my wife through a lot of her struggles and has been a huge support to us through this.

John Dehlin [00:20:12] All right, shout out to Tambi. Okay. A lot of people are asking about specific drugs. So somebody asks about Kratom. K R A T O M. That's Larry. Don't know, don't know. Okay, how about tramadol?

Dan Lonergan [00:20:27] Yeah. So tramadol is a very mild opiate and it also affects other receptors it affects serotonin and norepinephrine. And so tramadol is less addictive than morphine and oxycodone and hydrocodone, but it can still be addictive. So just because it's a mild opiate doesn't mean it's not gonna cause problems. So it's still something you need to be careful with. But you know, if I had to choose, I'd choose Tramadol over a lot of other types of pain medications, especially if you only need it for a short period of time.

John Dehlin [00:21:02] Go ahead and list the most prescribed, most dangerous, sort of cliche, dangerous opiates just so the people kind of got a general list going.

Dan Lonergan [00:21:13] So the most prescribed is probably hydrocodone in the U.S. the U.S. consumes huge amounts of hydrocodone and that's like Loratab or Norco, those are the trade names. Hydrocodone has the same potency as morphine. So 5 milligrams of hydrocodone is the same as 5 milligrams of morphine. And then stronger than that is oxycodone. And that's like there's short acting form like Percocet and there's long acting oxycodone, a 12 hour pill which is OxyContin. And OxyContin has kind of become famous because of OxyContin highway. And it's been pretty common drug of abuse over the last two decades. And then there's even stronger drugs like Dilaudid and Opana. These have kind of catered to the chronic pain market where people are in pain for decades and they need stronger and stronger drugs. And then there's drugs like fentanyl that are really potent. And fentanyl classically has only been used during surgery like an injectable form or as a patch. But now there's a lot of illicit fentanyl being produced and it's being laced in with heroin. And a lot of these deaths that we're hearing about are because people have been exposed to really potent fentanyl doses from heroin contamination or just illicit fentanyl use. And it's very hard to regulate the strength. So it's really deadly.

John Dehlin [00:22:54] Okay, and how does somebody, like, how does it happen that both from a physician standpoint and a patient standpoint, where addiction is allowed to sort of develop. I remember 5, 10, 20 years ago hearing that the pharmaceutical industry spent billions of dollars marketing their products to physicians, buying them vacations, buying them junkets, you know, showing up to the office and Providing lunch to the entire staff, snowmobile trips and skiing trips and Caribbean cruises, all under the guise of training. But really it was prescription drug companies buying off physicians. So maybe that's extreme, maybe that doesn't happen anymore. But talk about the business model for, for how physicians can become incentivized to over prescribe.

Dan Lonergan [00:23:57] Yeah, I think most, you know, all the activities you're referring to, we consider them unethical. So now there's very strict reporting guidelines. So if I accept, like if I do a trip sponsored by a pharmaceutical or device company to do training, which I do on occasion, they actually have to report that to a government website. And you can actually go and look me up and look at which companies have sponsored different things. And you can know how much support has been given to me from any various companies. So if I were so Purdue Pharma was going to bring me lunch or bring our clinic lunch, they would have to report it. And you'd be able to. That would be discoverable.

John Dehlin [00:24:40] Well, what's a website someone could go to for that?

Dan Lonergan [00:24:43] I don't know off the top of my hand, but off the top of my head. But it is a government sponsored website and I could get that link for you later.

John Dehlin [00:24:51] Okay. Maybe send that to us.

Dan Lonergan [00:24:53] Okay.

John Dehlin [00:24:54] Okay. So you can see if doctors are being bought off, basically. How else might be doctors inappropriately or appropriately incentivized to maybe allow a patient to become addicted? How does that happen?

Dan Lonergan [00:25:09] Well, I've learned a lot about this from my patients, specifically from the patients that I treat for addiction, because they'll tell me the things that they used to do to manipulate doctors. One is they'll tell you that they have 10 out of 10 pain and that they're miserable all the time. And as a doctor, you're feeling compassionate, you feel bad for them. And they say the only thing that helps is this medication. And so you may not have any other options, you may not have any other ideas. Everything else you've tried hasn't worked. And so you don't want to send this patient home without the treatment that they think is good for them. So a lot of doctors have good intentions, but they end up prescribing these pills over a long period of time and not really recognizing that the patient is addicted. And the patient may not recognize it either. A lot of patients don't believe they are struggling with addiction. They sometimes don't have insight into their own behaviors.

John Dehlin [00:26:10] Right. And again, because they're starting to become addicted, they're going to want to say, even if they're fooling themselves. They're going to want to say how terrible the pain is because they want the drugs. Right. And doctors don't have a way to measure internal experiences of pain. And so is there anything a doctor can do to really vet legitimate pain versus illegitimate pain?

Dan Lonergan [00:26:38] Yeah, I mean, you can't even really talk about pain in terms of legitimacy, because even an addict, in fact, I would say especially an addict, will experience a lot of pain. So, in fact, that's probably the most intense pain. They're not lying when they say their pain is 10 out of 10, because if they don't have that drug and they go into withdrawal, it is extremely painful, and it's real. And so for me, as a physician, if someone tells me they have 10 out of 10 pain, I just. I mean, that's their experience. They feel it's severe. And so I usually don't even question that. Now, I can look at MRI results. I can look at CT scans, I can do a physical exam. I can determine if their pain seems out of proportion to their injury or to the pathology they have. But sometimes people who are addicted kind of know that process, and they know that there are certain things that you can't measure as well as others, or you'll have patients. You know, this doesn't happen so much anymore with electronic medical records, but years ago, you'd have patients bring in MRIs that they bought on the Internet, you know, and it's not even theirs, but it shows, like, a serious spinal problem, you know, and the patients would convince doctors to give them drugs based upon those images that. That were falsified.

John Dehlin [00:27:57] Interesting. So a lot of gaming on the part of patients, right?

Dan Lonergan [00:28:01] Yeah. And I think also some patients kind of develop these behaviors over time, and it becomes part of who they are. And, you know, it's not necessarily intentional or manipulative, but, you know, sometimes it kind of sneaks up on people. One thing I want to be really clear about, because this is really commonly misunderstood, is that there's a big difference between. Or there's a difference, a clear difference between addiction and physical dependence.

The Science of Addiction and Dependence

John Dehlin [00:28:34] Yeah. Talk about sort of the chemical nature of addiction and dependence and how the opiates work and how they interact with the receptors and that sort of thing so that people can kind of understand what's going on.

Dan Lonergan [00:28:48] Right. So, John, if I gave you four hydrocodone a day for a year, and let's say you didn't even like the way it made you feel, or you didn't like you never got high from it. You never overused it. But on schedule, you took four hydrocodone per day for a year and then just stopped. You would go into withdrawal. That's physical dependence. But through that year, you never demonstrated any inappropriate behavior. You never manipulated me as a doctor, you never manipulated your pharmacist, you never stole medications from anyone else. Just because you went into withdrawal when we took that medication away does not make you an addict. I would say in that situation, you're not an addict, you're physically dependent. Addiction is a behavioral problem. So addiction is really characterized by compulsive behavior and inappropriate behavior surrounding drug use in this context. Okay. And even though the patient knows that this behavior is not good for them, they continue to do it in a compulsive fashion. So really, when I'm talking about addiction, I'm talking about more of a behavioral issue. And when I'm talking about physical dependence, I'm talking about the natural response of the body to a drug that's been administered over a period of time.

John Dehlin [00:30:16] And doesn't dependence, does the dependence have to include negative symptoms upon the cessation of taking the substance?

Dan Lonergan [00:30:26] Absolutely.

John Dehlin [00:30:28] Is that the main sort of a criteria? Yeah.

Dan Lonergan [00:30:31] Or, you know, if, if you don't have it, you may feel some cravings or you may start to feel sick, or like you said, you may have physical symptoms. Like in the case of opioid dependence, you'll have nausea and vomiting, flu like symptoms, increased urination, severe body aches. Most people who go through a withdrawal episode describe it as like the worst they've ever felt and they just wish they would die.

John Dehlin [00:31:04] So it's worse. So opiate withdrawal is worse than whatever condition they were medicating usually.

Dan Lonergan [00:31:10] Oh, absolutely. And this is one of the problems is that if someone comes in with chronic pain and I treat them with an opioid, and then we do that for a long period of time, then they may think they need the opioid because anytime they try to stop, they have severe pain. And usually the first place that pain will manifest is in the place where they initially had pain. So a lot of patients are kind of tricked by the drugs into thinking that they still have pain. That's what they'd feel like if they weren't on the medication, which is not true. That's just a withdrawal period. And to make matters even worse, there's a condition called opioid induced hyperalgesia where patients actually have worsened pain because they're on an opiate. Basically, exposure to that chemical over time makes their Pain receptors more sensitive. And so a lot of my patients that I see who have been on opioids for a long period of time actually have worse pain than they would if they had never been put on the opioid in the first place.

John Dehlin [00:32:15] So it actually makes the pain worse over time.

Dan Lonergan [00:32:19] Yeah, and I tell all my fibromyalgia patients this, and I'm sure we have some listeners who have been diagnosed with fibromyalgia. The worst thing you can do if you have fibromyalgia is get on opiates, because opiates will make your fibromyalgia worse. Opiates, long term use of opiates will actually make your generalized pain worse. But patients don't recognize it because in the short term, it actually makes them feel better for a few hours. It relieves those symptoms temporarily. But over time, over years or decades, they're actually becoming worse and worse and it contributes to reduce quality of life.

John Dehlin [00:32:53] So for someone with migraines or fibromyalgia, sort of chronic back pain, what are the alternatives?

Dan Lonergan [00:33:01] So, like, chronic back pain is really my specialty. We've got the most proven things for long term treatment of back pain and fibromyalgia. Yoga, aqua therapy, core strengthening, you know, basically self management of your body and keeping your core strong and keeping your muscles strong. The patients who do that have better outcomes than patients who go the route of medication management. And that applies to a lot of conditions.

John Dehlin [00:33:34] I've even heard that back surgery oftentimes leads to more back pain than if you just use things like exercise and core, core strengthening and yoga and stretching. Have you heard that as well, that sometimes back surgery actually makes the back pain worse?

Dan Lonergan [00:33:52] Yeah, there's really good evidence behind this. The reason you would have back surgery is if you're losing feeling in your legs, if you have such severe spinal stenosis or such compression that basically the nerves are no longer functioning. Obviously, if you're losing control of your bladder or your bowels, the first person you want to see is a surgeon. But if you go in with low back pain and have surgery for low back pain, there's not a very good prognosis, meaning you may have as much low back pain or worse low back pain after your surgery than you did before. Now, obviously there's success stories of people who had just axial low back pain without any nerve compression, who had surgery, who did better. But there's also a lot of stories and a lot of evidence that a lot of those patients don't do better and in fact do Worse.

John Dehlin [00:34:45] Got it. Okay. So the types of scenarios that are inappropriate for a physician maybe necessarily to liberally prescribe opiates, again, you're saying, are fibromyalgia, in many cases, chronic lower back pain. What other types of chronic or other types of pain, painful situations should someone just really not even. Or someone. Should someone be really skeptical about receiving opiates for other than what we've mentioned?

Dan Lonergan [00:35:23] I'm going to generalize this in a way that I probably shouldn't because every patient is different, every situation is different. We're always working toward improved functionality. Obviously, if someone is in so much pain that they're suicidal, I'm a lot more likely to aggressively treat their pain than, you know, someone who just comes in who's, you know, having a hard time. But what I'm going to say is, generally speaking, the evidence is pointing to the fact that we should only be using long term opioid therapy for palliative type conditions.

John Dehlin [00:35:59] Someone dying.

Dan Lonergan [00:36:01] Yeah. The most obvious is cancer pain. Right. So there's very good evidence that opioids can improve quality of life in patients suffering from cancer. There's also pretty good evidence that people, my patients with severe spinal stenosis who are toward the end of their life might get a really good functional response from being on some opioids. And I've got a lot of examples of the little old lady who comes in, she can barely walk, she can't get out of bed, she's not taking any medications. And then I put her on a very small dose of hydrocodone. All of a sudden she's feeling like a million bucks. And at 80 years old, am I really worried about the long term side effects of opioid therapy? Not really. Because, you know, it doesn't matter as much what's going to happen 20 years down the road because she's probably not going to be with us anymore. The most important thing is that I help her maximize these final years of her life. So any sort of situation that I determine to be palliative, I'm much more likely to promote long term opioid therapy. Whereas any situation that's in a young, healthy person who has a painful condition or who's been through a trauma or, you know, I'm going to try to not use opioids if possible and instead

John Dehlin [00:37:15] use the other things you've already mentioned.

Dan Lonergan [00:37:18] Yeah, and you know, I mentioned like physical therapy and yoga and aqua therapy, you know, water aerobics and things like that. But there's also injections that we can do there's non narcotic medications that we can use that are not addictive, that are better for long term use. And I also put in spinal implants, I put in spinal cord stimulator devices where I can send electrical energy into the spinal cord and actually intercept pain signals as they travel from the low back and legs to the brain. And that's a way to help people with pain that doesn't require opiates. So there's a lot of strategies that we have. A lot of patients won't come see me because I'm a pain specialist. What they don't realize is that my specialty is actually promoting alternative types of treatments that don't involve pain pills. But we still kind of have this old school way of thinking about pain that if someone's in pain and they go to a pain clinic, they're going to get pain pills. And we definitely need to move beyond that as a culture.

John Dehlin [00:38:30] Couple comments from our listeners. Jeremy writes benzos. I'm assuming he means benzodiazepine. Is that the right.

Dan Lonergan [00:38:37] Yes.

John Dehlin [00:38:38] They said they ruined his life. Withdrawing was so horrible. He was only taking what the doctor prescribed. No one told him that when he chose to quit using them, his life would be literal hell. Any comments about benzodiazepines?

Dan Lonergan [00:38:53] Benzodiazepine withdrawal is awful. And if I have a patient come in that's been on benzodiazepines for a long period of time, I'm usually encouraging them to get off of them, but I'm encouraging them to do it very slowly, usually over a period of about a year, especially if they've been on it for a long time because the body becomes so physically dependent on the chemical and specifically inability to sleep and you know, the withdrawal symptoms, I would say they're not as severe as the immediate symptoms of opioid withdrawal, but they just last so long. And benzodiazepine withdrawal is also very dangerous. So it's like alcohol withdrawal. If someone's an alcoholic and they just stop immediately, they can have DTs. Benzodiazepines are the same.

John Dehlin [00:39:49] What's a DT?

Dan Lonergan [00:39:51] Delirium tremens, where like an alcoholic goes into withdrawal and it can be fatal if they don't.

John Dehlin [00:39:56] It can be fatal.

Dan Lonergan [00:39:57] Yeah, yeah, it can be fatal. So typically we think of opioid withdrawal as non fatal and benzodiazepine and alcohol withdrawal as potentially fatal.

John Dehlin [00:40:06] That's interesting. That's interesting. So that's a case where alcohol can actually be more dangerous than opiates.

Dan Lonergan [00:40:13] Yes. In that Particular situation.

John Dehlin [00:40:16] Yeah. And benzodiazepines. Christy writes, please note, yoga is horrible if your issue is bulged discs. So that's Christy's feedback to us.

Dan Lonergan [00:40:29] I would say the. I understand what she's saying, but the evidence actually does not support what she's saying for bulging discs. Degenerative disc problems in the back. Yoga is one of the best things that patients can do. And in her situation, it might have been not good. But in general, the evidence shows that it's actually more helpful than most medication type treatments we offer and maybe even better than surgery and physical therapy and all sorts of other things your doctor might offer to.

John Dehlin [00:41:01] You got it. She mentioned twisting. I don't know if that's important distinction, yoga versus twisting.

Dan Lonergan [00:41:09] Well, the interesting thing is most people think that when they have back pain that we used to prescribe bed rest to people. Well, now we know that that's probably the worst thing people can do. And so now I'll tell people, move as much as you can. I want you to keep working, I want you to keep moving. 80% of people will get better. And in her situation, maybe the twisting actually worsened the disc bulge or kind of exacerbated things in some way. But generally, generally the evidence is pointing in the other direction of what she's saying.

John Dehlin [00:41:40] Jeremy writes acupuncture helped his back pain and incontinence issues. Any thoughts on alternative medicine and acupuncture specifically?

Dan Lonergan [00:41:49] Love it. Yeah, I'm a big fan of acupuncture and seeking out.

John Dehlin [00:41:54] That's not. Woo.

Dan Lonergan [00:41:56] Well, I'll tell you what, there's some good evidence for acupuncture and it's so much safer, right? It's safer than being on a medication. I've not heard of anyone having. I mean, people can have side effects to acupuncture, but there's not dangerous side effects. So if you have the means to try acupuncture and to try some of these alternative modalities and especially like cognitive behavioral therapy and some of the psychological avenues, those are very good avenues to take in addressing chronic pain.

John Dehlin [00:42:28] Got it. Okay, great. Let's see. Patricia writes that acetaminophen with aspirin works great for her. So a vote for good old aspirin or I'm sure Advil and ibuprofen are also useful for a lot of people. She's basically saying use tramadol over Norco. So vote for Tramadol as a superior to Norco.

Dan Lonergan [00:42:57] Well, tramadol is much more mild than Norco, so I would agree that if you've got to choose one or the other, it'd be better for you to be on Tramadol and not on Norco or hydrocodone just because it's a much more mild opiate.

John Dehlin [00:43:09] Right. Okay. I'm going to ask a question I've already asked. Are there. You know, you hear in the newspaper about these doctors that, like, have these prescription mills where they're just raking in the money intentionally or knowingly over prescribing people. Does that happen still? How rare is it or how common is it? I guess another way to ask this is how are their addictions being sustained? Because you would want to think that there'd be doctors that give a limited prescription and then stop and they could be wise enough to know whether a patient's had enough.

Pill Mills, Benzodiazepines, and Warning Signs of Addiction

Dan Lonergan [00:43:48] Yeah. So typically we refer these clinics as pill mills. And in Tennessee, there's been dozens of these shut down over the last several years. So there were doctors doing this. And a lot of these doctors weren't even pain specialists. They're in other specialties. They might retire and just open up this pain clinic. And whether or not their intentions are good, I'm not really sure. It doesn't seem like they are because I don't know how some of these doctors can really feel like this is a good thing for patients. And when you look at the doses that they're administering to people, it's shocking how many pills some patients are getting. And they're getting oxycontin, Oxycodone, Opana, and they're getting Xanax and muscle relaxers, and it's really devastating.

John Dehlin [00:44:42] And doctors make their money. How do they get a cut from each prescription? Or is it just they charge for the visit?

Dan Lonergan [00:44:49] Typically, these types of clinics are cash clinics, and they're just paying for the visit. So, you know, whatever the dollar amount is, you know, $200 a visit, and then a doctor is able to see, you know, 50 or 100 patients a day, and they're raking in a lot of money.

John Dehlin [00:45:04] So you can make a lot of money as a doctor that way.

Dan Lonergan [00:45:07] Yeah. And you're also at risk of losing your medical license. So they. But, you know, it's surprising. The state talks about how hard it is to shut these clinics down for some reason. You know, if doctors document things in a certain way and justify what they're doing in a certain way, it becomes very hard for the government to actually come in and shut them down. So some of these behaviors continue on even though we know that how Devastating. They are.

John Dehlin [00:45:36] Got it. So when it happens, it happens because they're hard to shut down. They're hard to regulate.

Dan Lonergan [00:45:43] Yeah. But I will say in Tennessee, they are regulating very aggressively. And a lot of the clinics have shut down, and there's a lot of patients who cannot get their drugs. There's just not a source for their drugs anymore. One of the things you're seeing from that, some of the patients just get off the opioids. Other patients actually turn to the street and start getting into illicit substances when prior to that, they never had the fatality rates. Even though the prescription fatality rates are going down, the illicit drug fatality rates are actually going up. And so the overall fatality rates are still rising.

John Dehlin [00:46:26] And that's. Okay. That's good to know. And that's what I think both of the gentlemen that I interviewed before said is they just turned to heroin because it was cheaper.

Dan Lonergan [00:46:36] Yeah. And it is. It's really cheap.

John Dehlin [00:46:38] Is it bad that we're talking about it? Like, I have this in my mind. Like, oh, my gosh, I just gave people the idea. But I guess that's pretty obvious to somebody who's hooked on opiates. So do we run the risk of encouraging it just by talking about it, or do you still think talking about it? Obviously, you must believe in talking about, or you wouldn't be here, but yeah,

Dan Lonergan [00:46:56] and if they'll stay online and catch the tail end of our conversation, then that'll be the most valuable thing, because what we're going to talk about is how you can get treatment and how you can get a hold of this problem, because there are really great treatment options available, and there's no need that someone needs to go to the street because they can get treatment for their addiction. They can get help, and that's just not a good pathway to take.

John Dehlin [00:47:22] Okay, so we'll get to that in just a second. Jessica writes, my mother is an opiate addict. I drink alcohol, smoke marijuana, and a little more, but I've never had an addiction issue. But as you said, alcoholics don't appear until later in life. What are the signs at late 30s that Jessica and others should look out for?

Dan Lonergan [00:47:42] Anytime there's compulsive use, then it's a concern or overuse. So if someone's going out and. And drinking so much that they make themselves sick on the weekend or dealing with, like, severe hangovers, or drinking large quantities of alcohol every day, or obsessing during the day about the next drink, or, you know, drinking compulsively when Your spouse doesn't want you to. Or.

John Dehlin [00:48:13] Or what if you're on opiates? What if you're taking opiates to manage some pain? What's healthy, responsible opiate use? And what are the signs for overuse and addiction or inappropriate use?

Dan Lonergan [00:48:27] Yeah, I would argue that there's. It'd be hard in a young, healthy person to say there's any such thing as, like, healthy opioid use, even if it's prescribed by a doctor.

John Dehlin [00:48:39] Okay.

Dan Lonergan [00:48:39] There's serious risk and dangers. Not to say it should never happen, but you should understand that there are serious risks involved with that kind of medical treatment. I would say with my patients who are on opioids, I always ask them, do you ever obsess about when your next pill is due? Are you counting down the time? Are you looking like, okay, my next pill is due at 1, it's 11. How am I going to make it through the next two hours? Are you overusing? Do you find at the end of the month that you've got fewer pills than what you should have? Are you always calling, like, on the day, on the minute when your prescription's due and really letting those pills control your life? And if so, that's not a way to live. And you may be showing signs of addiction. And, you know, there's other options and there's help and there's ways to get off of them. And I just don't want anyone to be living like that.

John Dehlin [00:49:42] Yeah, those are really helpful signs. So just if you're really Johnny on the spot about your next pill and filling the prescription, those are all really good. If you're noticing that they're not lasting as long, that's all super good. It's also worth mentioning that you should put opiates in locked safes or whatever, because as we learned from our past interviewees, kids and family members and even visitors to a home who are addicted will often go and go into people's medicine cabinets in their bathroom and steal opiates. Right?

Dan Lonergan [00:50:24] Yeah. And you know, that happens even people you trust. If there's someone that's the most honest person in the world that you would just trust with your life, they become addicted. They're going to do things that you would not expect them to do. And there's a scientific reason behind this. And I think it's important to understand that this is not a moral failing of the individual. When you become an addict, your frontal lobe stops functioning. And the reason that is is because the limbic system, the reward system, which is like the system in the middle of your brain, it completely overwhelms your executive functioning, which is your frontal lobe. So when someone's in the midst of an addiction, their frontal lobe, their executive functioning, their reasoning is not working. And so their emotional centers completely take over. And all they can think about is how to get that next pill or how to get that next high, or how to prevent further withdrawal. So what I want family members to understand is, you know, your loved one has not become a bad person. You're just because your loved one stole medication out of your medication cabinet.

John Dehlin [00:51:42] Or even if they're lying, even if they're lying, they're hiding, right?

Dan Lonergan [00:51:45] Of course they're gonna lie. That's what addicts do. And it's not because that you failed as a parent. It's not because they're a bad person. It's, it's not. You know, we need to look at this scientifically and understand there are pathways in the brain that have completely overwhelmed them. And if we treat the addiction, you'll see the old person come back. That person's not gone. And what you'll do is you'll see the old honest person come back and the person that would take the shirt off their back to help you come back, and the person that would never steal a medication from your medicine cabinet. So there is hope. Even though when something like that happens, it seems like there's no hope. But definitely lock up your medications. When it comes to pain pills, you shouldn't trust people.

John Dehlin [00:52:36] And it's not a moral question.

Dan Lonergan [00:52:38] Right, Exactly.

John Dehlin [00:52:40] Got it. There's a couple people making comments about this perception that if it's a prescription, it's okay, it's moral. So Melissa writes, she has a daughter in law whose mother is hooked on Xanax and Ambien, but it's okay in her mind because they're prescription. I'm sensing sort of a nod to Mormonism and the word of wisdom that somehow if it's, you know, if it's a hot drink or if it's coffee and tea, even a cold drink, somehow that's bad. But if it's not explicitly mentioned in the word of wisdom, then fair game. And what people are saying is, or even if, even if you're cautious, just because a doctor, this is what Stephanie writes. Just because a doctor gives you a prescription doesn't mean you should take the drug. Talk about that.

Dan Lonergan [00:53:35] Yeah, I think everyone needs to be very careful and you need to understand the risks of these drugs. These drugs. The reason these pharmaceutical companies have been so successful is because these drugs are really potent and they do what they claim to do. And there is good science and good physiology behind the mechanism of these drugs. They work. And because of that, there's risks associated with their use. And you should be. I ask all my patients, be very skeptical. Do your own research. Don't just trust what I say. Look at the long term side effects, look at the long term risks. And the less you can rely on pills for the most part, the better off you'll be when it comes to pain. Now I'm not talking about like diabetes or high blood pressure, other medical conditions.

John Dehlin [00:54:27] Right.

Dan Lonergan [00:54:27] But when it comes to pain, if you can find other coping strategies, and I say this about sleep as well. Taking a sleeping pill might help for the short term, but in the long term it's just going to cause more problems. So you should. Most people, unless they have like a really well diagnosed sleep disorder or something, you know, you're better off not starting down the road of taking sleeping pills. And I kind of think of pain pills is the same way.

John Dehlin [00:54:55] And Stephanie says Xanax, in her opinion, shouldn't even ever be prescribed. Thoughts on anti anxiety meds?

Dan Lonergan [00:55:03] I tend to agree with that. In terms of. By general practitioners, I don't think. I think if someone has like a really severe anxiety disorder to the point where they're not even functional in society and they're able to take a benzodiazepine and it actually helps them to function and hold a job, you know, there can be a case made for that for sure. And I'm not a psychiatrist, so I don't want to overstep my bounds, but I definitely think that benzodiazepines are over prescribed. I would not suggest using benzodiazepines for sleep. And I think even some people start on benzodiazepines like Klonopin and Xanax after periods of like the death of a loved one and they're using it to get through a grieving period and then they never get off of them.

John Dehlin [00:55:50] So a Xanax is a benzo.

Dan Lonergan [00:55:53] Xanax is a benzo.

John Dehlin [00:55:54] Yeah. Oh my gosh. Okay, that's good to know.

Dan Lonergan [00:55:56] Xanax, Clonazepam. Xanax is Alprazolam. Clonazepam is Klonopin, Valium, Diazepam. These are all benzos.

John Dehlin [00:56:07] Oh, wow. Okay. Because I've had people joke, oh, I need to take another Xanax. And it sounds like that's not something to joke about.

Dan Lonergan [00:56:13] Yeah, Just do An experiment. If you're an active Mormon, go in relief society. Just ask if anyone has a Xanax and see how many women reach in their purse.

John Dehlin [00:56:25] You think there's a lot? Probably it's over prescribed.

Dan Lonergan [00:56:29] Yeah.

John Dehlin [00:56:30] And it's dangerous, you're saying?

Dan Lonergan [00:56:32] Yeah. I mean, for sure. Especially dangerous. It's especially dangerous when combined with opioids. It can be fatal, it's dangerous in withdrawal, and it's dangerous for long term use in terms of long term side effects and not promoting quality life.

John Dehlin [00:56:53] Got it. Okay, that's. That's good to know. All right, let's talk about. Let's talk about recovery. There. There have been a lot of questions about the various medications or drugs available when somebody is an addict or is trying to recover from being an addiction. So talk about how someone can get better when they are addicted to opiates.

Utah's Opioid Crisis and Treatment Approaches

Dan Lonergan [00:57:21] Okay, before I do that, I want to share just a few stats with you that I think you guys will find interesting. Utah is seventh highest in opioid overdose. Seventh highest.

John Dehlin [00:57:38] Okay.

Dan Lonergan [00:57:40] And that's a 2015 statistics. So more up to date statistics aren't available yet. In Utah, opioid overdose outpaces deaths from firearms, car accidents and falls combined.

John Dehlin [00:57:55] Oh, wow.

Dan Lonergan [00:57:56] There's more people dying of opioid overdose than in car accidents and from firearms.

John Dehlin [00:58:01] Wow.

Dan Lonergan [00:58:02] About one person a day dies in Utah from opioid overdose.

John Dehlin [00:58:07] Wow.

Dan Lonergan [00:58:08] In the US About a hundred people die a day from opioid overdose. It's like a commercial airline falls out of the sky every day in the United States just from opioid overdose.

John Dehlin [00:58:26] Wait, you said how many?

Dan Lonergan [00:58:28] A hundred.

John Dehlin [00:58:28] Okay.

Dan Lonergan [00:58:29] In the United States.

John Dehlin [00:58:30] Okay. Yeah. That's about a commercial airline a day. Yeah.

Dan Lonergan [00:58:33] Yep. Since the year 2000, 183,000Americans have died from opioid overdose. 183,000. In Vietnam, 58,000 soldiers were killed. So three times the number of Americans have died in the past 16 years from opioid overdose than died in the Vietnam War.

John Dehlin [00:58:57] Got it.

Dan Lonergan [00:58:58] So this is a massive epidemic. This is the modern medical epidemic of our time. And one thing I want to say is we've got to get rid of the stigma. If we don't start treating this, it's going to continue to get worse. And if it hasn't affected you yet,

John Dehlin [00:59:18] it will either yourself or someone you love.

Dan Lonergan [00:59:22] You mean either yourself, your sons, your daughters, your parents, your loved ones, your spouse. If it hasn't affected you yet, it will. And I'm guessing most of the people that are listening this, it's affected in some way.

John Dehlin [00:59:38] Okay.

Dan Lonergan [00:59:38] Including myself.

John Dehlin [00:59:40] Okay.

Dan Lonergan [00:59:41] Okay. So we're talking about treatment.

John Dehlin [00:59:45] Oh, really quickly. Do you have a sense for why Utah is in the, you know, 80th or plus percentile in terms of deaths?

Dan Lonergan [00:59:59] I don't know. I was looking at the national statistics on this and the top state. I think the top state was West Virginia.

John Dehlin [01:00:08] And then that's the coal mining. The socioeconomic kind of theory.

Dan Lonergan [01:00:11] Yeah, I think so. And they're way up there. They're like double the next, you know, the second on the list. But then it's kind of scattered all over the map and I'm not really seeing any sort of clear religious. You know, it's not like all Bible Belt in Utah. It's. It's kind of all over the place. So I don't really know. I tried to, I tried to figure that out before doing this interview. And I.

John Dehlin [01:00:34] Some are gonna want to just say, oh, well, Mormons are more depressed because they, they don't, you know, they don't cope well. Or they, you know, use band aids drugs as a band aid and they don't talk about things openly. And it's a shame culture. And, you know, you could probably use, you know, find someone who's angry at the church, who's gonna just find everything that's wrong, you know, the LGBT problem or whatever, and they're gonna blame suicide on those Mormon related things. Is that fair? Is there not fair? Is there anything to it?

Dan Lonergan [01:01:05] Yeah, I mean, I don't know. I don't know if it's fair or not, but I just don't really think there's any evidence behind that. So I try not to jump to those kind of conclusions if, you know, there may be associations there. But, you know, it's a very complex issue. And it's not like Provo, Utah has the highest rate of opioid deaths out of the whole state. You know, the highest rates are in towns where their economy's been devastated and Ogden has a fairly high rate. So it's not necessarily like the Mormon centers that are really suffering the most.

John Dehlin [01:01:47] Someone could say the Mormons treat the non Mormons so badly that they've got.

Dan Lonergan [01:01:51] Well, maybe that's true.

John Dehlin [01:01:52] I don't know. And I'm not fishing for this. I actually like it when myths or unfair characterizations are dispelled. So I'm not fishing for it. I'm just trying to address what some would want to say.

Dan Lonergan [01:02:04] Yeah, and it could be an issue of prescribing habits. It could have to do with state Regulations. It might not have anything to do with religion factors at all. I'm just not sure.

John Dehlin [01:02:14] Okay, that's fair. That's good to know. Okay, so recovery. How does someone get better?

Abstinence Programs Versus Medication-Assisted Treatment

Dan Lonergan [01:02:21] Okay, so the Alcoholics Anonymous and Narcotics Anonymous model have been around for like 80 years, right. And we could go out and find plenty of people that have gotten better using AA and na. Would you agree with that?

John Dehlin [01:02:37] Yeah, sure. People swear by it because they have sponsors, someone looking after them, accountability, regular sort of sessions that provide support, a sense of purpose, the mantras, the steps. It was so respected that the church even tries to have their own version of it. Right.

Dan Lonergan [01:02:59] So in regard to opioid addiction, what do you think the failure rate is of Narcotics Anonymous and abstinence based programs like it? What would you guess? Is the failure rate high? Yeah, like probably about 90%. Wow, that's super high right now.

John Dehlin [01:03:19] So Narcotics Anonymous is not the best approach.

Dan Lonergan [01:03:22] And that's not what I'm saying. I'm saying Narcotics Anonymous alone.

John Dehlin [01:03:26] Okay.

Dan Lonergan [01:03:27] Is not the best approach.

John Dehlin [01:03:28] Got it.

Dan Lonergan [01:03:29] So if you're. If you have a loved one that is struggling with.

John Dehlin [01:03:36] Wait, Jessica's asking how you define failure.

Dan Lonergan [01:03:39] Failure would be relapse.

John Dehlin [01:03:41] Okay, that makes sense.

Dan Lonergan [01:03:44] And we're talking about repeated relapse. You know, people who do not stay in the program.

John Dehlin [01:03:48] All right.

Dan Lonergan [01:03:48] And who don't come back to the program and who fail.

John Dehlin [01:03:50] Okay.

Dan Lonergan [01:03:51] And the statistics are going to vary. Some people are going to say 70% failure, up to 90 some percent failure.

John Dehlin [01:03:56] Okay. Yeah.

Dan Lonergan [01:03:57] There's always a range, but generally seven to nine people who start the program are never going to finish.

John Dehlin [01:04:02] Okay.

Dan Lonergan [01:04:03] And some of those people in regard to opioid addiction are going to die from overdose. Okay. So if you have a loved one, someone you care about, and you're encouraging them to get treatment, telling them to just go to NA or read the Bible more or go to some abstinence based program is not the best advice.

John Dehlin [01:04:29] Okay.

Dan Lonergan [01:04:30] And if I have. If I ever have a child who has an opiate addiction, knowing what I know now, I'm going to get them into a medication assisted treatment program. Mat.

John Dehlin [01:04:44] Okay.

Dan Lonergan [01:04:45] And what this means, medication assisted treatment, is that we use medication to treat the cravings and the addiction. We combine that with the psychological resources, cognitive behavioral therapy, psychotherapy. And that also goes along with the NA and the AA model combined. What happens, though, is a lot of patients go to NA and they're feeling guilt because they're also receiving a medication to treat their addiction because they're considered not clean. Right. And so if family members are contributing to this guilt about a patient being on a medication to treat addiction, then it's really counterproductive. So what medications am I talking about? Mostly I'm referring to Suboxone, because that's kind of the latest and greatest medication used to treat addiction. The older clinics that are still around are the methadone clinics. Okay. But there's a big difference between methadone and Suboxone. Methadone is a full opiate. It's just really long acting. So what a methadone clinic is doing is it's giving an addict a dose of methadone every day that they can take. And it basically keeps them from going into withdrawal. And it's so long acting, it doesn't make them high. And so they just maintain on this full opiate, you know, and hopefully how is that better?

John Dehlin [01:06:21] How is that better than what they're doing?

Dan Lonergan [01:06:23] Because it's so long acting. It's so long acting, they're actually able to function and it gets them off the streets. Right. So instead of using heroin and shooting up, they're. They're using a controlled medication, but they're still on an opiate. But it's much better than being on methadone, is much better than being on heroin or being out on the streets. And a lot of people who go to methadone clinics are able to have full time jobs, they're able to be good parents, they're able to function. One of your previous guests talked about how he was going to a methadone clinic. I think it was Thomas.

John Dehlin [01:07:00] Right.

Dan Lonergan [01:07:02] And was having a good response.

John Dehlin [01:07:06] Okay.

Dan Lonergan [01:07:06] And so the last thing I would do is tell Thomas to stop doing that.

John Dehlin [01:07:10] Right.

Dan Lonergan [01:07:10] Because it's working for him.

John Dehlin [01:07:11] Right.

Dan Lonergan [01:07:12] And now ideally, at some point he'll be able to slowly wean off the methadone and get that behind him, but we don't want to get him off the methadone at the risk of him relapsing.

John Dehlin [01:07:21] Got it.

Dan Lonergan [01:07:22] Now, Suboxone is a partial opiate. So it's a very unique type of drug in that it's only partially activating the receptor. And so it's keeping patients from withdrawing and it's satisfying those cravings, but it's also not having the same effects of a full opiate. So it's a really cool drug in that it's preventing relapse, but it's also not creating the euphoria and some of the problematic behaviors that a full opiate was.

John Dehlin [01:07:58] Okay.

Dan Lonergan [01:07:59] And another unique thing about Suboxone is that we can prescribe it in a 30 day supply so you can go to the pharmacy and pick it up and you've got your 30 day supply and you don't have to go back to the doctor for, you know, until the next month as opposed to going in on a daily basis. So people who are in a Suboxone program who also are doing an NA program or doing psychotherapy or cognitive behavioral therapy, or meeting with a psychologist and working on coping skills that combined is the most effective way to treat opioid addiction. And if someone's really in the throes of addiction, they should be seeking out a program like that. And I would say the evidence is not in favor of an abstinence based program. So the reason why I'm emphasizing that so much is because here in Tennessee, where I am in the Bible Belt and probably in Utah, people are all about abstinence based programs. It's not science, it's not evidence based. It's really lacking in one of the key elements that people need to recover.

John Dehlin [01:09:09] Got it. Do you have any sort of disclosures about the company that makes Suboxone and your relationship or. I mean, just. I'm not making any accusations. I'm just wanting to make sure we have full disclosure.

Dan Lonergan [01:09:26] No, I'm not a shareholder and I don't have any financial interest in this discussion at all. And I should be clear, Suboxone is a trade name. The actual generic name of the drug is Buprenorphine, Naloxone. Buprenorphine is the drug that I'm talking about. That's the partial opiate. And the naloxone is put in there as an abuse deterrent to keep people from injecting it or doing inappropriate things with it. So it's a combination drug, but there's also other trade names. Would be Bunavale, Subsolve, and then Subutex is the name of the drug without the Naloxone. Just the Buprenorphine in it would be Subutex.

John Dehlin [01:10:09] Okay. Anything else about that treatment, whether it's somebody learning for a loved one or somebody who's addicted themselves, anything else you want to say about it? Sounds like what you're saying is Suboxone or some derivative thereof, plus either Alcoholics Anonymous or Narcotics Anonymous or psychotherapy is the way to go.

Dan Lonergan [01:10:33] Absolutely.

John Dehlin [01:10:34] Better than methadone overall. Anything else you want to say about that in terms of like how to maximize the chance of it taking, of it being effective?

Dan Lonergan [01:10:47] So one common thing that I hear family members say or even I hear doctors say this. They'll say, oh, he's just trading one addiction for another.

John Dehlin [01:10:56] Or someone else said that they're just using it as a crutch.

Dan Lonergan [01:11:00] Right.

John Dehlin [01:11:01] Okay.

Dan Lonergan [01:11:02] So this drives me crazy. Right? Because this patient has a severe disease that could very well kill them. Okay. And we have a treatment. Okay. Now, will a patient become physically dependent on Suboxone? Yes, a patient will become physically dependent on Suboxone. But as I mentioned earlier, there's a difference between being physically dependent on something and addicted to. Okay, So a patient on Suboxone. I'm gonna give you an example. A girl I treat for addiction. She's in her late 20s and she was on the streets. Okay. She was doing heroin, iv. She was prostituting herself to pay for drugs. She had lost her children and she had no hope for a future. She'd failed rehab, inpatient rehab, two times. Okay. She comes in and we get her going on a medication assisted treatment program where I start her on Suboxone. And she is also doing pretty intense psychotherapy twice a month, where she's learning about her past and she's learning better coping mechanisms, she's learning how to think more positively, she's learning how to eliminate negative relationships in her life. That person on Suboxone becomes. She's working for a maid service full time and has been promoted to being a manager. She just bought a car and a house. She's got her kids back. And she reports that she has a good relationship with her boyfriend and she's living a fulfilling life. Are you gonna tell that patient that she shouldn't be on Suboxone because she's just addicted to some other drug?

John Dehlin [01:13:13] Right? Yeah, that's pretty obvious.

Dan Lonergan [01:13:15] Yeah. I mean, it's an extreme example, but that's what people's family members saying. It's like you're just thinking like you're living in an alternate universe here. Like you've treated this disease and this patient's gotten better, and they're having this fantastic functional response, and their family members are shaming them about it and encouraging them to get off it because they think they're just addicted to another drug. Right.

John Dehlin [01:13:41] Is there a duration, an average duration, where someone goes from Suboxone and then kind of weans off it?

Dan Lonergan [01:13:49] Well, in the example I used someone who at a young age was using IV heroin. I would never encourage that patient to get off the Suboxone.

John Dehlin [01:13:59] So they might take it for the rest of their life?

Dan Lonergan [01:14:01] Absolutely.

John Dehlin [01:14:03] That's not a problem.

Dan Lonergan [01:14:04] I'm good with it. Because their Relapse risk is so high, if they get off the Suboxone and they start experiencing cravings, their chances of relapse into heroin and their chances of death are very high. Now if this patient comes in and she really wants to get off of it, I'll just recommend a really, really slow wean off of it. And I'll just keep a close eye on her. And if she starts having cravings, we'll bump the dose back up.

John Dehlin [01:14:28] What's slow?

Dan Lonergan [01:14:30] Probably in her case, someone in that severe an addiction, probably two years, a year to two years.

John Dehlin [01:14:38] Wow. Okay.

Dan Lonergan [01:14:39] But let's use another example. Someone's taken hydrocodone by mouth, you know, 40 milligrams a day, like four times a day, and they start to lose control. And so they get on Suboxone as a way to treat what's developing into possibly an addiction. That patient, I'm not going to recommend stay on Suboxone forever. I might recommend like a six month slow taper off of the medication. So it all depends on the individual patient and how severe their addiction is. But that's really a discussion I'm having with the patient. And it's not something I'm pressuring them about. It's not something I want the state to regulate. It's not something I want the insurance companies to regulate. Because we need to have the freedom to continue treatment if a patient needs it.

John Dehlin [01:15:30] Right, Got it. Okay. So are there other factors that help determine whether someone successfully passes through treatment or recovers versus not? In addition to choosing the right treatment,

Helping Loved Ones and Accessing Treatment Resources

Dan Lonergan [01:15:49] I think them becoming as functional as possible is really helpful. So anytime I hear that someone's gotten a job and is holding a job, that's a really good sign that they're doing better. Family relationships are important. It's important for people to have good support groups. It's important for people to have friends who aren't going to impact them in a negative way. Guilt and shame are really devastating for an addict. And so family members need to be really careful about that.

John Dehlin [01:16:24] What does that look like encouraging or increasing the guilt and shame versus not? What does that often take the form

Dan Lonergan [01:16:32] of reminding them of their past behaviors? Basically, some of the behaviors that we talked about, like maybe they stole a medication or maybe they lied, you know, bringing that up or making them feel unworthy or like they're not a good person, making them feel like because they have to be on Suboxone, they're not clean, making them feel like they, if they would have just gone to church more or read their scriptures more or prayed more that they would have gotten better. You know, it sounds like once, once

John Dehlin [01:17:11] they reach the level of an addict, you treat it like diabetes.

Dan Lonergan [01:17:15] Exactly.

John Dehlin [01:17:15] It's just a medical condition.

Dan Lonergan [01:17:17] And as a parent, if you have a type 1 diabetic as a child, you're not going to tell them not to take their insulin, right? And you may have a child who's an addict who needs to be on a medication, and they may need to be on it for the rest of their life. And you know what? That's life.

John Dehlin [01:17:33] What if irresponsible, and I'm playing a devil's advocate here, what if irresponsible decisions led to the addiction? What if they were. What if it wasn't just, I was sick, I had back pain, and then I got addicted? What if it was like you went to parties with bad people and you, you lied and you weren't living the word of wisdom and you were not in church and you started with marijuana and then it grew in slippery slope. And what if the person really is legitimately responsible for making some poor choices that led to the addiction? What would you say to a family member that wants to sort of say, hey, this was. You made bad decisions that led to this versus them being more of a innocent victim as a result of genetics and a doctor's prescription? You know what I mean?

Dan Lonergan [01:18:24] So this is Tennessee. So Everybody has type 2 diabetes. So I'll say, well, how's that different than you because you got type 2 diabetes because you didn't exercise and you didn't eat right? And you know what? As your doctor, I'm not going to treat your type 2 diabetes because you made poor decisions. And you know what? You've got this disease. Tough luck. That's life should have. You should have made better decisions when you were younger. It's. It's counter. It's counterproductive, right? We all do stupid things. So you know what? So what? Like just reminding, reminding them of all the stupid things they did over and over again is just gonna feel. Make them feel worse. And these are triggers for addicts, right? The guilt, the shame, feeling worthless. These are triggers that makes that make an addict want to use drugs, right? So causing feelings like that can be really devastating for someone who's in recovery. So we should be really positive. We should be look toward the future, not toward the past. And we should help people recover in a healthy way, get better coping skills, find better friends, be more positive with their thinking. And if we as family members help the recovering addict do that Then it'll really help a lot.

John Dehlin [01:19:55] Okay, so avoid guilt and shame. You know, incorporate family and friends support, social support, find the right treatment. Anything else that is associated with a higher chance of recovery.

Dan Lonergan [01:20:14] I mean, that's about all the evidence based ideas I have. I just think living an authentic life and being open and honest with your loved ones, with your spouse is really important. You got to get it all out there. It's like an abscess that's got to be drained. Once you get it out there, you're going to be able to heal. And so being open like that is another step in the right direction.

John Dehlin [01:20:44] Yeah, that's interesting, because in that case, some would argue religion doesn't encourage authenticity or openness. And in that way maybe isn't always good for, for someone who's an addict. And I would say in the people that I've interviewed, they've also said that being open and candid, getting your problems out again, seeing a therapist or talking to someone can really help make the difference.

Dan Lonergan [01:21:11] Yeah. And if you're going to church and everyone's prim and proper and everyone seems like they have the perfect life and, you know, you're there and you're a recovering addict and you're trying to sort through all your problems, you know, that may make you feel like, you know, you're not worthy and you're not adequate of this congregation, when in reality, everyone's got issues. Right. So if we're involved in a community where everyone's trying to cover up their issues and everyone's trying to hide their issues and everyone's trying to make it seem like they're perfect, then that may not be a healthy place for an addict to be.

John Dehlin [01:21:45] On the flip side, let's say you have a healthy church experience. Maybe your ward could be a really positive resource for you. Is that true?

Dan Lonergan [01:21:54] Yeah, absolutely.

John Dehlin [01:21:56] And maybe that's more often the case. And also I remember one of our interviewees just saying that the bishop helped pay for his treatment. That's kind of nice, right?

Dan Lonergan [01:22:05] Yeah, yeah, sure. And bishops can be really helpful and I hope bishops get training and know the proper resources and are encouraging people to go to evidence based treatment solutions. And, you know, I mean, I think the church is definitely moving in that direction. And it's variable who your leaders are, but they can be a really valuable resource.

John Dehlin [01:22:30] Got it. Okay, really quick because I'm at the point where I have to go pick up my daughter or my son. Any other things you would say, what about somebody who's poor and. Or Jobless. How do they take advantage of Suboxone or these clinics if they are poor and unemployed?

Dan Lonergan [01:22:52] So I did find out that Intermountain Healthcare has a free MAT program, medication assisted treatment program. So that may be available to people. And I think we need to really push our state governments and the federal government to provide treatment for everybody. And that would be money well spent. And we're working on that here at Vanderbilt and on a local level. And I know there are people working on that in Utah. And there may not be resources for everyone right now, but we all need to be pushing in that direction to make sure that resources are available to everybody who wants treatment.

John Dehlin [01:23:27] But there are clinics that offer discounted or even free support. Is that true?

Dan Lonergan [01:23:33] Yeah. And also the pharmaceutical companies have programs where if you have a limited income, they will sometimes provide medications for you for free. So you can look into those programs. Usually they're pretty accessible online and you can determine if you qualify.

John Dehlin [01:23:51] Okay, and then maybe as a last, maybe as a second to last question, let's say someone you love is addicted. Is there anything you can do or does it really have to come from the addict themselves hitting rock bottom?

Dan Lonergan [01:24:08] I think it depends on the situation. But if you're a family member and you know about these resources and you can utilize the resources when that person is in a vulnerable situation or when they've hit rock bottom and support them in whatever way that you can, then it's going to be a game changer. You don't want to take your loved one to the wrong program or to a non evidence based program and have them fail that first time or that 10th time. You want to take them to a program that's based on science and that's based on evidence and that is going to have a higher success rate than programs that might be abstinence based alone or you know, strictly religious based on.

John Dehlin [01:24:58] Okay, anything else as it relates to the addict's desire versus the concern, family member or friends desire.

Dan Lonergan [01:25:10] Yeah, just. Just love them and realize sometimes people are going to fail, sometimes people are going to relapse and hopefully it's not something that kills them or harms them seriously. And you know, sometimes like with quitting smoking, sometimes it takes several attempts and you know, try to stick with them and they're gonna do things that are really awful and they're gonna say things that are awful and they might steal your money and they might, you know, do things that really hurt. But there's still hope that you can have the person you knew back and there's hope that with modern treatments that we can get through this and get people better. And I've seen it, I'm telling you, I've seen it dozens, probably hundreds of times. People who have really serious addictions, specifically opioid addictions, get better and there is hope.

John Dehlin [01:26:10] And again, Suboxone plus some sort of therapy or talk therapy, social support is the way.

Dan Lonergan [01:26:17] Yes.

Closing Reflections and Farewell

John Dehlin [01:26:19] All right. Well Dr. Dan Lonergan, I really appreciate you coming on Mormon Stories not just to talk about your own faith journey, your mixed faith marriage, but also to deal with this epidemic that's hitting the United States and maybe the world, but even Utah and Mormons at a higher rate possibly than than the non Mormons. So please send us any links or resources you want. We'll add them to the post. And I just want to thank you so much for all you've shared with us. I believe it's going to save lives and I want to thank you for being willing to share. Any final words.

Dan Lonergan [01:27:02] No, I appreciate you having me. I hope it does save some lives. I hope some people listening will find this helpful and I appreciate you having me.

John Dehlin [01:27:12] All right, Dr. Dan, thanks so much. I want to thank everyone for tuning in. We had listeners join us for the whole episode. Lots of good feedback and questions from our listeners. So I want to thank everyone for joining us live for their comments and questions. For those who support Mormon Stories, the Open Stories Foundation. Thank you. For those who don't, Please go to MormonStories.org or the Open Stories Foundation. Start a 10 or 25 or $100 a month donation. Those are what keep us alive and that allow us to continue. We sure appreciate the support. Want to thank Amy Grubbs and Cody Layton of the Open Stories Foundation. They're our staff that keep things going along with the Open Stories foundation board, please tune in again for more Mormon Stories in the future. We sure appreciate all that everyone does. And if you have ideas or suggestions or if you want to appear, please email us@mormonstoriesmail.com and let us know of your ideas and we'd love to consider them. All right, thanks everyone for joining us. And again thanks Dr. Dan. Hope to have you on again sometime soon. Thank you for joining us today on Mormon Stories. If you enjoyed this episode, please help us make more like it by becoming a monthly subscriber@mormonstories.org thank you very much.

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