KoopCast

Addiction in Ultrarunning with Dr. Harlan Austin | KoopCast Episode #188

Thu Jul 13 2023

addictionendurance sportUltra Running

Description

The episode discusses the intersection of addiction and endurance sport, focusing on Ultra Running. Dr. Harlan Austin PhD, a licensed psychologist, shares insights on sport psychology, performance, and addiction. The discussion covers the distinction between clinical addiction and colloquial use of the term, factors contributing to addiction in athletes, detecting and assessing addiction, supporting individuals with addiction, recovery and resilience in athletes, and transitioning and long-term recovery. Key insights include the importance of understanding biosychosocial health, providing support without waiting for rock bottom, and the role of athletic identity in addiction.

Insights

Understanding Addiction in Athletes

Athletes have a higher rate of substance use disorder diagnoses compared to the general population. Coaches and professionals working with athletes should have a toolkit to understand addiction and connect athletes to help. Social context, striving for achievement, and reward are some factors that may contribute to addiction in the athletic population.

Detecting and Assessing Addiction

Addiction can be difficult to detect as addicts are skilled at hiding their addictions. The CAGE screener can serve as red flags for further investigation. Assessing biosychosocial health is important for understanding the impact of addiction on performance.

Supporting Individuals with Addiction

Being empathetic and providing support without waiting for rock bottom is crucial. Recovery requires ongoing effort and psychological support. Shifting from a chemical addiction to a process addiction can be problematic if it becomes unhealthy.

Recovery and Resilience in Athletes

Athletes possess resilience, which is key in overcoming addiction. Relapse should be viewed as part of the treatment process. Athletic identity plays a significant role in addiction among athletes.

Transitioning and Long-Term Recovery

Maintaining an athletic identity can be valuable throughout life. Transitioning from an Olympic athlete to post-Olympic life can be challenging. Education, treatment options, and community connection are important for long-term recovery.

Chapters

Introduction
Understanding Addiction
Factors Contributing to Addiction in Athletes
Detecting and Assessing Addiction in Athletes
Supporting Individuals with Addiction
Recovery and Resilience in Athletes
Transitioning and Long-Term Recovery

Summary

Transcript

Introduction

00:11 - 08:02

This episode of the podcast is about addiction and endurance sport, specifically within the sport of Ultra Running.
The guest is Dr. Harlan Austin PhD, a licensed psychologist with expertise in sport psychology and addiction psychology.
Dr. Austin has worked with professional athletes in various sports as well as professionals in healthcare and high-level executives.
The conversation aims to discuss the intersection of sport psychology, performance, and addiction.
The host shares his personal connection to addiction and his desire to provide listeners with an appreciation for people suffering from addictions and a toolkit to help those in need.
Dr. Austin describes his role as a sports psychologist at Premier Sports Psychology, which specializes in working with athletes at different levels.
Premier's Sports Psychology was founded by Dr. Justin Anderson and Dr. Carly Anderson.
There is an overlap between the worlds of athletes and addiction, making Dr. Austin a suitable guest for this topic.
The distinction between clinical addiction and colloquial use of the term is important to understand throughout the podcast discussion.
Dr. Austin's view on addiction will encompass both clinical diagnosis and a broader perspective.

Understanding Addiction

07:46 - 15:35

Addiction has two realms of meaning: popular psychology and clinical diagnosis.
There is no clinical diagnosis with the word 'addiction', it is referred to as substance use disorder severe or alcohol use disorder severe.
Addiction can be associated with chemical or behavioral/process addictions.
Addiction impacts multiple areas of someone's existence in a negative way.
Athletes have a higher rate of substance use disorder diagnoses compared to the general population.
Coaches and professionals working with athletes should have a toolkit to understand addiction and connect athletes to help.
Identifying signs and symptoms of addiction is crucial for referring athletes to appropriate help.
The intersection of athletics and addiction is complex, with various factors contributing to the higher risk among athletes.
Social context, striving for achievement, and reward are some factors that may contribute to addiction in the athletic population.

Factors Contributing to Addiction in Athletes

15:07 - 22:13

Athletes often associate celebration and reward with their achievements in sports.
The social context of athletes plays a significant role in their behavior, including celebrating victories and dealing with losses.
Athletes may model their behaviors after those around them, especially when it comes to using drugs or alcohol for self-medication.
The accelerated opportunity for athletes to experience highs and lows in sports may lead them to develop habits of substance use earlier in life.
High caliber and amateur athletes alike tend to have an 'all-in' mentality that can translate into addictive patterns, whether it's related to training or substance use.
There is a biological component involved for athletes, as engaging in sports releases dopamine and other neurochemicals that create feelings of reward and pleasure.
Exercise has been clinically proven to have positive effects on mental health by changing neurochemicals in the brain.
Not everyone who engages in exercise becomes addicted, just like not everyone who drinks alcohol becomes addicted. However, a percentage of the population does develop addiction tendencies.
Signs and symptoms of addiction will be discussed further.

Detecting and Assessing Addiction in Athletes

21:55 - 29:03

The speaker shares a personal story about a former ultramarathon runner who was addicted to heroin during their coach-athlete relationship.
The speaker reflects on how they completely missed the signs of addiction and beat themselves up for not recognizing it.
They discuss the difficulty of detecting addiction and how addicts are skilled at hiding their addictions.
The speaker introduces a screener called CAGE, which consists of four yes or no questions to identify potential addiction issues.
The CAGE questions include asking if the person has felt the need to cut down on their substance use, if they have been annoyed by others criticizing their behavior, if they have felt guilty about their substance use, and if they have needed to use substances first thing in the morning.
The speaker emphasizes that the CAGE screener is not a diagnosis tool but can serve as red flags for further investigation.
If someone trips a couple of red flags, it is suggested to assess their overall biosychosocial health and its impact on performance.
Assessing biosychosocial health involves looking at factors such as what substances are being consumed and gathering information about thinking, feeling, mood states, etc.

Supporting Individuals with Addiction

28:48 - 35:39

Gathering information on an individual's thinking, feeling, and external factors is important for understanding their ability to perform at their best.
Different avenues (bio-psycho-social) can be explored to investigate further based on personal biases or expertise.
Meeting individuals with addiction where they are and focusing on their motivation to achieve positive change is crucial.
Referring individuals to professionals who have experience in the area is appropriate and should be done with sensitivity.
Shame is a significant component of addiction, so providing support and countering shame is valuable.
There is no universal rock bottom for everyone, and individuals can choose when to make a change without hitting a specific low point.
Being empathetic means allowing someone to get worse before they can get better.
You don't need someone to hit rock bottom in order to help them change.
You can't control or cure someone else's addiction, but you can provide support and set up conditions for change.
The journey of recovery happens on the individual's timeline, not yours.
A significant percentage of the general population, including athletes, will experience addiction.
Some people who recover from one addiction may develop a new addiction, such as exercise or training.
Shifting from a chemical addiction to a process addiction can be problematic if it becomes unhealthy.
Engaging in exercise and running has significant benefits compared to addictive substances.
Internal work is necessary to understand psychological needs and ensure healthy engagement with new behaviors.
Recovery requires ongoing effort and psychological support in addition to removing the substance.
Helping others involves addressing their psychological needs and providing ongoing support.

Recovery and Resilience in Athletes

35:16 - 42:38

Athletes have a mentality of continual improvement, which can be applied to personal growth and recovery.
High-level elite athletes often have more resources and support systems available to them, increasing their chances of success in recovery.
Physical health can act as a protective factor for athletes in the long-term recovery process.
Some athletes apply the same level of intensity to their addiction as they did with their training, leading to negative outcomes.
Most people recover from substance use disorders with time, multiple attempts at treatment, and perseverance.
Resilience is key in overcoming addiction, and athletes often possess this strength.
Relapse should be viewed as part of the treatment process rather than a failure, similar to other medical diagnoses.
Athletic identity plays a significant role in addiction among athletes when there are threats to their identity as an athlete.
Self-medication through substance use can be a coping mechanism for athletes facing challenges to their athletic identity.

Transitioning and Long-Term Recovery

49:11 - 56:52

Athletes facing retirement or major failures may experience a threat to their identity and resort to self-medication.
Maintaining an athletic identity can be valuable throughout life, even as it evolves and changes.
Transitioning from an Olympic athlete to post-Olympic life can be abrupt and challenging, especially when the choice is not in their hands.
Recoveryanswers.org is a great resource for information on addiction, recovery, and treatment.
SAMHSA.gov is a national organization that provides access to well-established and safe addiction treatment centers.
Addicttoathlete.com is a community of people in recovery who use sport as a means of healthy recovery.
Education, treatment options, and community connection are important aspects of long-term recovery from addiction.
Having a network of supportive individuals is crucial during the recovery process.