What happens after a person stops using?
In April 2020, I spoke with Cali Estes, PhD, an addiction coach with a background in clinical psychology. She works with people who want to stop using drugs or alcohol, and she also trains other coaches.
We talked about medication for opioid dependence, about why people feel lost once the drug is gone, and about the judgment people on medication can meet in recovery groups.
This is an archive episode, recorded when the show covered addiction and recovery broadly.
Why start with how a person feels physically?
At 0:53, I asked what she would do for someone who had just become stable on Suboxone and wanted to change their life. She said she starts with the chemistry first. In her view, Suboxone or methadone works as a bridge, and a person can step down from it later while the rest of life is rebuilt.
She described people who are sent to group sessions after only a few days of medication, while their bodies still ache and they cannot feel pleasure. So they absorb little. If you physically do not feel well, she said, you will not do anything.
At 4:35, I said that methadone is a good option for someone who needs to stop that day and cannot take any chances. She added, at 5:02, that she would rather see a person started on medication before an intervention than put on a plane while in withdrawal and throwing up.
How did her own family shape her view of medication?
Her husband, a drummer, began using heroin while she was building her private practice. Once he was off heroin, she said, he had no energy and kept going back to it. Methadone finally worked. He rebuilt his life on it and then stepped down until he was off it.
Unfortunately, people told her that her husband was not really in recovery because he took methadone. Her answer was that a monitored medication is better than heroin that could kill him.
Why did she move from therapy to coaching?
At 7:51, I said that the people who struggle most with drugs are often the people with the greatest potential. I wondered whether they need more motivation and coaching, not only help to stop.
She agreed, at 8:41. The people she worked with seemed to benefit more from coaching than from therapy, which kept going backwards. Yet the question nobody answered for them was “now what?” If you are not happy at work or at home, she said, you are not going to stay sober.
From 14:46, she described her sessions. A person gets five minutes on a timer to complain. When the timer goes off, the rest of the hour is about action.
How do limiting beliefs keep people stuck?
At 10:22, she described growing up in a family that said college, a house by the beach, and a new car were not for people like them. At fourteen, she decided to break that belief. Interestingly, what won her family over was a reframe: her success would let her help them and other people.
She teaches people to turn every “I can’t” into “what if you could?” In her words, drugs and alcohol are not the problem. They are a solution to a problem.
At 13:50, I mentioned a book that traces substance use to a feeling of helplessness, often rooted in childhood. The author argued that people need to catch that feeling early.
Can the drive for success become a problem of its own?
At 16:11, I brought up Grant Cardone, a success coach and author who tells people to turn their energy into an obsession with success. Still, she said at 16:34 that there is a fine line. Money and success can deliver the same rush a drug once did.
At 17:05, I said that women in business need to hear from someone they can relate to. She agreed that a strong woman is often seen as too aggressive.
Why do some people keep choosing narcissistic partners?
At 18:58, I asked about her work with people harmed by a narcissistic parent or partner. She said, at 19:21, that she usually works with the narcissist. Most people are afraid of them, and she is not.
From 21:01, she explained why simply leaving often does not work. A person with an empty bucket, as she put it, is drawn to someone who pours on praise at the start. In fact, until that bucket is filled, the person tends to pick the same kind of partner again.
Why do some facilities resist medication?
At 25:10, I said that many residential facilities were still against medication for opioid use disorder. She told me, at 25:22, that when she suggests aftercare with doctors and coaches on staff, she hears there is no money in it. In her view, some prefer a merry-go-round in which people keep coming back.
She agreed at 28:37 that the brain needs time to heal. She asked why anyone should feel terrible for months when there are tools to help now.
Are people on medication welcome in recovery meetings?
At 29:18, I shared a story from Dr. Adam Bisaga’s book, Overcoming Opioid Addiction. Bill W., a founder of Alcoholics Anonymous, met the doctor who started methadone maintenance and asked whether a medication like it could be found for people who drink. However, I said, Narcotics Anonymous was against methadone and Suboxone, so people on medication could not feel at ease there.
She described, from 30:03, how people on methadone are judged in rooms where others drink coffee, smoke, and eat sugar. At 31:45, I added that they are often expected not to share or do service.
Her alternative, at 31:56, is harm reduction. If someone wants to drink one beer fewer each day, she will help with that goal and then the next one. Of course, she said, it may work and it may not.
Who is Cali Estes, PhD?
Cali Estes, PhD, started her career as a clinician, earned a PhD in clinical psychology, and also works as a life coach. She has written two books, the first about her husband’s heroin use, and she runs an online school that trains recovery coaches in subjects that include harm reduction. Her website is caliestes.com.
What can listeners take away from this conversation?
Stopping a drug is only the start. A person who still feels unwell cannot do much with advice, and a person with no purpose may drift back. Her approach was to steady the body first and then ask, without judgment, what the person wants their life to be.
How do I approach this today?
My thinking has kept developing since this conversation was recorded. Today my practice is built on one idea that runs through all of it: when the body has adapted to a substance, the safest way off is usually gradual, with the smallest steps the person’s nervous system can tolerate. Physical dependence is not addiction.
A person who took a medication exactly as prescribed and now cannot stop it safely needs a plan, not a label. Where a medication can make the process gentler, I use it. Patients direct their own care, and a good plan includes the risks, the alternatives, an exit plan from day one, and the right to change course.
For opioid dependence I prescribe buprenorphine, which steadies the body so a person can rebuild their life without the cycle of withdrawal. Visits are monthly, or weekly when needed. Some people stay on it for a long time, and that is a legitimate choice. Others later taper slowly, using the same gradual approach I use for every other medication.
I believe medication for opioid dependence should be available wherever people need it. I prescribe in Florida only.
This page is educational. It is not medical advice, and listening to the episode or reading this page does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.
Full transcript
A note from Dr. Leeds: my guests speak from their own experience and expertise, and the terminology they use is their own. Whatever the topic, this show holds to one distinction: physical dependence on a prescribed medication is not addiction. This transcript is educational content, not medical advice, and nothing here creates a doctor-patient relationship.
Read the full transcript (36 minutes)
Dr. Mark Leeds [00:09] Welcome to The Rehab on the Mental Health News Radio Network. I am Dr. Mark Leeds and I will be your host. Join me in exploring the world of addiction treatment. How can we improve the ways that we help individuals to overcome addiction? The goal of treatment is to save lives and help people to get back on track to a path towards success and happiness in life. Dr. Cali Estes, welcome to the Rehab Podcast and thank you for joining me.
Cali Estes, PhD [00:51] Awesome. I’m glad to be here. Thanks for having me.
Dr. Mark Leeds [00:53] You know, when someone goes from, say, heroin or an oxycodone addiction and they get on Suboxone, I mean, they go from, like, you know, complete hopelessness to in a month or two being, like, totally back to normal and ready to face life and do what they want to do. Well, that kind of treatment, medication-assisted treatment with Suboxone tends to really be best for people in those situations, you know, critical, like, where they really can’t afford to fail. Now, if someone came to you at that point and they said to you, I really want to do something different with my life. Can you start with them from that point?
Cali Estes, PhD [01:24] Yeah, absolutely. We start with the chemical first. So if you’re physically not feeling well and you’re on heroin, you have to come off of it. And it’s going to take a long time for your brain to reset and your body to reset. So getting on Suboxone or Methadone is that stopgap. And if you’re going to go from sitting on the sofa, you know, nodding out, drooling, and you get on Suboxone or Methadone, two weeks later, you have a job and you get up out of bed, get on it. That’s my theory. My theory is any path to recovery, I don’t care what you use to bridge that gap, do it. And then step down from it. You don’t have to be on it for the rest of your life, but you can definitely use it to feel better. And then as you wean off of it, continue increasing your lifestyle. And that’s what I work with them. When they’re clear-headed and they’re on the Suboxone, the methadone, the marijuana maintenance, whatever they’re on, I work on their goals then because now physically they feel better. If you don’t feel good physically, I can’t help you. And that’s why I think so many treatment centers fail. We have this abstinence only policy where you have to go to treatment. You have to get off the drug and they take, you know, you’re using heroin for two years and all of a sudden you’re totally sober. You get seven days of Suboxone or methadone and bam, you’re sober and you’re sitting in group and you don’t feel good and you don’t feel good. What are you absorbing? You know, you’re, you chemically don’t feel good. Your body aches. You still have restless legs. You have anhedonia, which is flat affect. You don’t want to be there. Three weeks goes by. You still don’t feel good. And they send you home and they say, okay, great. You know, now go enjoy your life. And the person is just sitting there going, I still feel foggy. I don’t feel good. And then you have their wife or their husband going, okay, get up, get a job. You’ve been gone for 30 days and I’ve been managing these kids and paying these bills. And the person is just like, you have to be kidding me because their brain isn’t firing. So we need to start taking care of that stopgap and making sure, you know, and it doesn’t have to be forever. You don’t have to be on these things forever, but you have to feel good enough to have that coaching or that therapy to change your life. If you physically don’t feel well, you will not do anything, period. And I saw that with my husband, you know, we got him off the heroin and then he would just sit there and look at me and go, I’m bored. My brain, you know, I’m bored. My brain isn’t firing. I don’t feel good enough to work, but because he’s a drummer, he’s like, how am I going to play drums for four hours. I don’t have the energy. So he sits on the sofa and he’s like, my mind’s just racing. My body doesn’t want to work, but my mind is racing. And that’s the worst spot for an addict to be is having the racing thoughts and not feeling good. And then he would reach for heroin. And I said, what can we do? And we went to a sub doctor, went to methadone and methadone worked. And he got on methadone and then he started rebuilding his life. And then he stepped down, stepped down, stepped down and bam, he was off of it. But that was the stop gap. And a lot of people said oh well your husband’s not clean and I said you know you have the option of having someone on heroin offense and all that could die or you have them using a medically monitored device that’s not going to kill them that’s just you know why are we saying no why are we saying don’t try this product if it’s going to help them feel better and get them off the thing I don’t understand that mentality of people
Dr. Mark Leeds [04:35] Yeah yeah and I should say that I said suboxone and methadone is currently still the gold standard with at least 75% success rate. And it probably is the ideal treatment for a lot of people who are on the current street, heroin and fentanyl. We’ve had some difficulty transitioning people onto Suboxone and it can be done. But if somebody just really needs to get clean that day and not take any chances, methadone is a good option.
Cali Estes, PhD [05:02] Yeah, I love it too when we do intervention because a lot of times people will say, well, the person starting to detox, I’ll say, take them to the methadone clinic. Take them in, get them, get on appointment, get them on it. And guess what? They’re going to be fine when you get them to treatment because they’re not going through precipitated withdrawal. And a lot of people go, Oh, I never thought of that. Why would you drag somebody in precipitated withdrawal on a plane that’s throwing up? Why? We have other methods out there. You know, just because you say abstinence only, I’m like, that’s kind of inhumane at this point because we have science now to show us what we can use.
Dr. Mark Leeds [05:36] Yeah yeah and other countries are doing stuff that we can’t even do here I mean they’re using medical heroin to taper people off and they’re using psychedelics and other countries and I mean just really innovative stuff that you know hopefully things will open up here in the future and we’ll we’ll be using other technologies that we don’t even have available yet
Cali Estes, PhD [05:53] I know it’s kind of interesting so I was on the Dr. Drew show in 2016 and Dr. Drew was abstinence abstinence apnis and I was pro marijuana. And he’s like, what do you mean pro marijuana? And I’m like, well, if somebody wants to come off a heroin with, you know, medical cannabis, why not? What’s the problem? Well, that’s not clean. That’s trading one drug for another. And now he’s pro marijuana. And I just thought it was the funniest thing because I’m like, you have to keep up with science. If something works and it works consistently, we as professionals and doctors should never say, don’t take that. We should say, if it’s working for you, take it, right? Let’s get you on something that makes you feel better to get you to transition where you need to be. And everybody’s like, well, you can’t do that. You can’t do clean needle programs. And I’m saying, well, why not? It’s a great idea. Somebody comes in, give them a clean needle. We’ve now dropped STDs. We’ve dropped HIV. We’ve dropped AIDS because we know they have a clean needle. We’ve cleaned up the ER. People say, everybody’s clogging up my ER. Well, if we offer this service, we’re not clogging up the ER. And if they overdose there, you’ve got Narcan. But even more importantly, while they’re sitting there, I can say, do you want to come off this? How about methadone? How about suboxone? How about coaching? How about marijuana? I can offer you services that maybe I couldn’t offer you because you didn’t come in to see me. And instead of saying, wow, this is an idea that may work. Everyone goes, oh my God, we can’t do that. Well, why not? What we’re doing currently is not working. So what about something else?
Dr. Mark Leeds [07:23] Oh, yeah, yeah, definitely. And so, yeah, I was reading your book. When did you write that book? Is really good. The seven keys that’s happened to the wealth inside you?
Cali Estes, PhD [07:30] That’s it. I wrote this, it took me about a year, and it was supposed to go out in October. And we kept pushing the date back because I had some other things I was working on. And then it finally launched two weeks ago. And it hit bestseller within, I don’t know, a couple hours. And then it hit international bestseller right behind it.
Dr. Mark Leeds [07:51] It’s really good practical information that people can use. That’s the kind of thing I want to share more with my patients. From the patients I’ve seen who are struggling with addiction, you know, mainly we deal with opiate addiction, heroin addiction, and what people imagine a heroin addict to be, you know, someone in a back alley shooting up with a needle is not what a real heroin addict is always like. I mean, they can be professionals, they can be doctors and lawyers, and they can be from all walks of life, you know, people that manage huge corporations. And they tend to be, you know, in my experience, people who struggle with addiction and who have the most difficulty overcoming it tend to be the people who have the greatest potential for success. And I feel like I should be motivating people more for that. Don’t just get clean, but do something really great with your life. I feel like maybe they need more motivation and coaching. What do you think about that?
Cali Estes, PhD [08:41] I don’t know if you saw this. My first book is I Married a Junkie. And it’s all about my husband turning to heroin while I was building my private practice working with clients. I’ve been doing this for 25 years. And he started using heroin. He’s a musician out of nowhere. And I started making this shift from therapy into coaching because I noticed as I did that, my patients and my clients benefited more from the coaching than from the therapy. Because with therapy, we’re always going backwards and rehashing stuff. And when I’m putting in real-time accountability and saying, okay, let’s get you sober. But now what? They all looked at me like, what do you mean now what? Now what? We don’t talk about the now what? We talk about getting sober and living day to day. And then we kind of just like drop them off. So I started coming up with ways to handle the now what, you know, how are you going to do the next phase of your life? And a lot of my professional clients said, you know what, I don’t think I want to be a doctor anymore. I’m not sure I want to be an attorney anymore, or I want to shift my practice from seeing this type of patient to that type of patient. So I said, well, let’s do it. Let’s create it. Because if you go to work and you’re not happy, you’re not going to stay sober. And if you wake up in the morning and you’re not happy with your wife and kids and you hate your life, you’re not going to stay sober. And that’s what prompted the second book. It was working with my clients on the now what? Where’s your purpose? Where’s your passion? Some of my clients live in lack. They’re always in fear of not having money, but they make a ton of money because they spend too much money and they don’t think about the, you know, saving for the future. And their theory is, well, just for today.
Dr. Mark Leeds [10:12] Yeah. So people really need to set priorities and think about what they’re doing. And you talk in your book about people having limiting beliefs, not believing that they can do something.
Cali Estes, PhD [10:22] So I knew very early on that I didn’t fit the model of my parenting lifestyle. So my mother and my stepfather, when I wanted to go to college said, in our family, we don’t go to college. That’s not attainable. My dad, even though I made a lot of money, never finished high school. He went to real estate. When I said, I want to go to college, it was like, oh, we don’t do that. We don’t go to college. And I thought to myself, there has to be more. My mom said, what are your goals. And I’m like, well, I want to make a million dollars. And she went, we don’t have those resources. And I said, well, I want to have a house by the beach. I want to be at the beach. I can see the ocean. And she says, well, we don’t live there. We live here. You know, this is where we live. Okay. And I said, I want to go in and buy a new car off the car lot, like brand new. And she goes, well, we can’t really afford that. And I remember sitting there thinking, all I heard was we can’t, you don’t, you won’t. And I thought to myself, well, why not? And she He goes, because unfortunately you weren’t given those opportunities. And I thought, why can’t I have them? And I remember at 14 going, I’m going to smash that limiting belief and I’m going to become something. And I got such pushback from my family. It was like, well, you can’t go on TV. That’s a no, no. We don’t go on TV. And you can’t write that book because it talks about my family. The I Married a Junkie talks about my dad putting a gun to my head. And you can’t do that’s disgraceful. Why not? Because you can’t. But why can’t I? So when I work with my clients, I tell them, every one of your family is going to tell you can’t, you shouldn’t, you should not, you won’t. You have to question why. What about that stops you? And then I sat back and I realized, well, if I became successful, it made my family look less than successful. And I said, that’s okay. I can be more successful than you and still be the same person. It’s not going to change my personality. It’s just going to give me more resources to help more people. When I pitched it that way, my family went, okay, that makes sense. I had to reframe what I was doing so they understood it. And when I’m teaching my clients to defeat limiting belief system, everybody’s belief system is different. And a lot of times it’s negative because somebody tried something and failed, or they think you should fail because they don’t want to have to step up their game. But if you pitch it in a way they understand, then it makes more sense. So I said to my family, if I become successful, I can give back to my family and they can have more resources. And they went, well, that makes sense. So it was kind of like, whew, I got through and I teach my clients that because a lot of people gravitate towards the negative, especially in the news, especially now it’s, oh my goodness, this is so negative. I want to watch that. And they get stuck there. And then they spend three four five six seven days in the negative and can’t pull themselves out And then we see depression. We see anxiety. We see addiction and I’m sitting here going. Well, what do you want to do? Well, I want to attain this goal. Let’s do it Well, I can’t and then I hear all the I can’ts and I flip them and I say what if you could what if you could What if you could and they say well, I didn’t realize I could do that Why not? Let’s do it And then they do it and they see success and they’re excited Well, when they’re excited and they love life, they don’t want to use drugs because I tell them your drugs and alcohol are not your problem. They’re your solution to a problem. What’s your problem? And we get to the bottom underlying cause of I hate my life or I thought I couldn’t do that or I thought I wasn’t allowed to do that. And we flip that and they’re successful. They don’t want to get high or drunk.
Dr. Mark Leeds [13:50] There’s another book I’ve been reading about the underlying cause of addiction in most cases or maybe even all cases of people feeling feeling they’re helpless, you know, that they’re in a helpless situation. And usually, apparently, that goes back to childhood, you know, and then those same issues from childhood, come back in new situations where you feel helpless, that you just have no other way out other than to turn to drugs or alcohol as a solution. And in that book, the author is saying that you should try to catch, you need to catch that early to identify it. And I guess people have ways of hiding it from themselves that they don’t even realize that they’re at that point, you know, where maybe they get drunk or get high a week from now, and they’re already laying the groundwork for that, and they don’t even realize it. So, and now you have a background in therapy, so you understand it from the point of a doctor of psychology and as a coach.
Cali Estes, PhD [14:46] Yeah, both. I started off as a clinician, and then I went and got my PhD in clinical psychology, so I have all that background, but I also have the life coaching, and I like the life coaching style. It’s very action-based. It’s very in the moment and it’s very forward thinking. So when I get a client who wants to sit and complain and talk about when they dropped the ice cream cone, when they were five, and that’s why they are drug addict at 50, I stop and I go, okay, that’s great. But what are you going to do today to fix that? And it kind of takes them off guard because they say, well, wait a minute, I want to be over here and complain. And I’m like, no, no, no complaining. Let’s talk about action. So coaching is action. So in my sessions, they get five minutes to complain out of the hour. And I put my timer on and I say, for five minutes, you can complain about anything you want. I don’t care the weather, your wife, your kids, whatever. When that timer goes off, we’re in action. And they look at me and they’re like, okay, they love the first five minutes. And then when we’re in an action phase, they keep wanting to go backwards. And that’s the therapy component. And I’ll say to them, let’s process this, but we have to stay in action because if you don’t move forward, you’re just staying still. And that’s the coaching side.
Dr. Mark Leeds [15:54] You’re in Miami, right? Okay. Now also in Miami is another success coach and author, Grant Cardone. Are you familiar with him?
Cali Estes, PhD [16:04] Yeah. I was just at his 10X conference. Oh, he’s in Aventura. Yeah. I’m part of his little group.
Dr. Mark Leeds [16:11] Oh, that’s great. Yeah. And I know he talks about addiction in his books and how he overcame addiction. And he even, in one book I listened to recently, he says, you know, if you have a problem with addiction, Don’t go to a psychologist or psychiatrist or go to meetings. Talk to me because you don’t need to dwell on all that stuff. You need to move forward and be successful and turn your addiction into your obsession with success.
Cali Estes, PhD [16:34] You do, but there’s also a fine line in getting addicted to success and money. And I think he straddles that where money gives him that same rush that the cocaine did and the other drugs did. So when I’m working with my clients, I let them know an addict is an addict is an addict. You’re going to find something that’s going to get you out of bed in the morning. It has to be a healthy addiction. So Grant’s is a healthy addiction. Money and success is great, but that can become unhealthy if that’s your only obsession.
Dr. Mark Leeds [17:05] Yeah, I can see how his style might not appeal to everybody. And I think that there needs to be more out there for women. And it’s great that you’re doing this because women can obviously be as successful or more successful than any man in building a business and doing anything they want to do. And I think they need to hear it from someone they can relate to.
Cali Estes, PhD [17:22] It’s interesting you said that. So I went to his conference in Vegas. All of the speakers were male, except for his wife, Maria Forleo, who’s a very successful female, and then The Rock’s ex-wife. That’s it. Every other speaker was male. Most of the attendees were male. And when Eva, his wife, spoke, she said, Grant has 12,000 people for Grant Cardone conference. There’s the women’s section of that she runs. It only had 500 people. And she said, why is that? And she said, I’m the driving force behind him. He’s successful because I made him successful. And I stopped and I thought about that. And I said, she has a point. When you have a female that comes up that’s a strong female, people kind of shy away from that. And they say, wait a minute, it’s too aggressive or it’s too over the top or she’s too successful. So being female in this space was difficult. That’s what we face being a female in this space coming in this direction. But I’ve been able to train a lot of other women that have a softer, gentler style. Cause I’m very aggressive with my style. If you come to me, you’re going to achieve your goal. If you want to do it, we’re going to do it.
Dr. Mark Leeds [18:26] I love the story of the woman who founded Spanx. Yeah. She, you know, the thing about how she sold fax machines and, you know, and kind of really struggled to get the company going. It’s really a great story.
Cali Estes, PhD [18:39] It’s tough because in this, in any space, women are seen as less than we’re seen as, well, you’re not as good as this, or you’re not as good as that. Why is there such opposition and such anger? And it was just like, you can’t do what someone else is doing because you’re female. And I’m thinking to myself, that’s bizarre, but that’s how our culture is.
Dr. Mark Leeds [18:58] You mentioned you specialize in helping people who have been victims of narcissism. And we did an episode on that scapegoat of the family who’s a victim of a narcissistic parent. And it was really interesting. And I think a lot of people could relate to that of, you know, maybe being the kid in the family who’s the overachiever, that person with high potential. Is that something you deal with a lot?
Cali Estes, PhD [19:21] I do. I generally end up working with the narcissist. So I generally work with the perpetrator. I’m able to get them to do some movement that other people can’t because I’ll challenge them as soon as I meet them. I do have some victims of narcissism. Victims of narcissism are usually in therapy for long periods of time. The narcissist, most people bow down to them. They’re afraid of them. They’re afraid of competition. They’re afraid of getting yelled at. They’re afraid of getting gaslit and I’m not. So when they get into that mode, they’ve called me every name in the book, the C word, the B word, the F word, I don’t care. I’ll just look at them and say, are you done? They’re intrigued by that. How is that happening? How is this pattern of behavior I have not working? And that’s when we start to delve into the pattern of behavior and we talk about, you know, what are you trying to achieve here? And in that process, the victim of their narcissism is usually getting help as well. So they’re starting to learn what to say and how to say it to the narcissist. So that’s my specialty.
Dr. Mark Leeds [20:23] Someone who is a victim of a narcissist, they could bring the parent or spouse or whoever to you to get some help.
Cali Estes, PhD [20:31] Oh, yeah. And then I can show them how to handle that person on the back end. They don’t realize they have so much power. They don’t think they have power. They don’t realize they’re in the driver’s seat. They think they’re in the back of the bus. And I say to them, you know, there’s certain things you can do and say that’ll change this whole thing around. So it’s interesting when you have that type of personality.
Dr. Mark Leeds [20:54] So where some people might recommend to someone who’s suffering with a narcissist, a lot of people would say just get away from them, you know.
Cali Estes, PhD [21:01] Yeah, and I always say this, even if you get away from them, you’re gonna pick the same type of person. There’s a reason you’re gravitating towards a narcissist and it has to do with childhood. It has to do with not feeling good enough and having low self-esteem because when you first meet the narcissist, if you go back to your first date, you’ll remember they told you were beautiful and smart and amazing and the best person they ever met. They’re gonna marry you and give you the world and you ate up all of that, right? They put the ring on your finger and it all went to hell. That’s a narcissist you’re going to repeat that pattern because something in you is not fulfilled your bucket is empty and because you have an empty bucket you’re relying on that narcissist to fill the bucket a narcissist love attention negative positive doesn’t matter they love attention right the more attention they have the better and you’re giving that to them you know you’re pleading with them not to leave because they’ll say to you I’m leaving I’m done you’re pleading not to leave and you’re telling them how amazing they are. And then you’re stuck in this cycle because they gave you the attention you needed at the beginning. And you have to learn how to fill that bucket. When that bucket’s full, you’re not gonna attract a narcissist. You’re gonna repel a narcissist. So I have to teach the victim how to fill the bucket and the narcissist on how to behave because they don’t know how to behave. They only know how to gaslight and be mean and be nasty because that’s what they’ve done their whole life to get where they are. They don’t know true success.
Dr. Mark Leeds [22:25] Now, as far as coaching, you know these days there’s a lot of people out there who are coaches but in your case I mean not only are you a doctor of psychology you’ve you’ve had incredible success in business I mean you’ve built multi-million dollar businesses how did you go from like nothing to building a multi-million dollar business
Cali Estes, PhD [22:44] So my very first business was when I was 12 I decided to write a newspaper this is for the for the computer I wanted to write a newspaper and sell it to the neighborhood so I did. I had to handwrite it. I went around and interviewed people. And then I had my mom copy it and I went around and sold it and I made money. And I was like, oh, this is fun. So I’ve always been an entrepreneur. And then when I moved to Texas, I left Pennsylvania and I was sitting there one day and I was applying for jobs and I wasn’t getting any. And my friend was applying for jobs, not getting any. And this is around 2003. I looked at him and I said, let’s start a company. He goes, what do you want to start? And I’m like, well, we both know fitness. We both know coaching. Let’s do an in-home fitness company. Bam, we popped it up. Now remember, we’re in, we each have a one bedroom apartment. I had no furniture, didn’t have any money. So I flipped over my plastic bin that I had my clothes in and put up my, back then it was the big computer, like a big monitor with a big desktop. And I put that up and I sat down and we just started writing a website. We didn’t know how to build a website. We didn’t know how to market. Google SEO had just come out. So we started doing it. And within two days, we got our first sale in San Diego for a trainer. We didn’t even have a trainer. And I looked at my business partner. I’m like, oh my God, we got to hire trainers. So we started hiring trainers that our first year, we made a hundred thousand. Our second year, we made 300,000. Our third year, we made 4.1 million. So we figured out the formula of what works. And then bam, I’m an entrepreneur. I think I’ve worked maybe three years for somebody else my entire life. And I’m sitting there. I’m like, okay, this is a start. So that was my start. And then I went all right what’s next and he said what do you want to create I’m like let’s do a music company he looks at me he’s like you’re crazy let’s do it anyway so we started doing press and PR for musicians that’s how I met my husband and from there we said the economy wasn’t strong enough so I took a step back and I said I’m gonna go back into psychology because that’s what I really know it’s what I really love but I also like making money so I took a step back back into my industry and then went into private practice and said if I’m going to do this. I’m doing this high-end only. I’m going to come out the gate, kick it. And I did. And here we are. I’ve created the largest online school for addiction studies in the world. We’re in 25 countries. We’ve trained 10,000 people. Certain treatment centers have bought our programs and white labeled them, which is really cool. And certain states have hired us to be their SUD, OUD providers solely. So all we do is train their counselors and their coaches.
Dr. Mark Leeds [25:10] You’ve had so much success in this area. And a lot of these rehabs around the country are still against medication-assisted treatment. And you understand it. You’re in favor of it. You could really have a huge influence and make a big difference in the industry.
Cali Estes, PhD [25:22] When I sit down with the treatment centers, they say there’s no money in it. And I’m like, well, okay. But what if you had an aftercare program where you had doctors that were part of your facility that did the actual aftercare? Think about your success rate. You know you someone comes to your treatment center and they go home and they have access to a doctor and access to a coach and they’re on a maintenance program and they can call their coach they can call their doctor you’ve created more powerful people and their answer is always well we don’t get paid for that and we want them to come back they’re in this like merry-go-round let’s keep them sick so they come back and it’s kind of like well that’s not why we’re in business we don’t want to keep our people sick we want to get our people well
Dr. Mark Leeds [26:03] And they see patients as basically insurance cards to repeatedly bill over and over again.
Cali Estes, PhD [26:09] Yeah. I’ve noticed too, when you go in, a client goes in, say, using heroin or opiates and they come out, they won’t give them Suboxone, they won’t give them methadone, but they’ll give them Seroquel. They’ll give them Wellbutrin. They’ll give them Celexa. They’ll give them like four or five different pill bottles. And I’m thinking to myself, they’re not depressed. They’re not anxious. They don’t have ADD, but you’ve got all this crap you’re giving them. Why don’t you give them Suboxone? Because that’s what they need. They came in with presenting problem was a heroin problem, right? So we know their serotonin and dopamine is depleted. Why are we continually giving them stuff they don’t need? And when they fail going, well, they didn’t get it, put them back through again. There’s no success there. And when I questioned that, a lot of treatment centers just shoot me out the door because like, well, you know, we don’t talk about that.
Dr. Mark Leeds [26:54] And, you know, hopefully things will change for the better going forward.
Cali Estes, PhD [26:58] Yeah. I actually teamed up with a colleague and we created a supplement line and I wanted to show you this if you could you like this and share a DO this is all neurotransmitter base this is for heroin and it’s we’ve we’ve been doing this for two years it comes in different packets and it’s called Pro Recovery Rx and they get a morning a noon and a night packet and it’s all neurotransmitter stuff and the goal is that when they’re coming off suboxone or methadone they have something to make them feel better so we load it for 30 days so as they make that transition, when they get down to the two milligram mark and they’re all panicking, their serotonin and dopamine is already naturally high enough that when they step down off of that, they’re not freaking out and panicking. And we’ve had success with all of our clients for two years doing this stuff. So we finally brought it to market and we have one, one for alcohol, one for crack and cocaine, one for marijuana. And then we have four mental health ones coming out. We have one for depression, one for anxiety, one for ADHD, and one for failure to launch. Because that’s the new thing is we’re hearing these parents say, my kid won’t get out of bed. He’s smoking weed, playing games and won’t get out of bed. And we’re like, that’s low dopamine. Like that’s just, that’s the problem. Let’s fix the dopamine. And then we look at what they’re eating, which I’m sure you hear that all the time is I don’t feel good. And you ask what you had for breakfast and you hear Pop-Tarts and you’re like, well, Pop-Tarts are not a breakfast food. And that’s probably why you don’t feel good.
Dr. Mark Leeds [28:23] That’s a great idea because people don’t realize that it’s neurotransmitter depletion is why they don’t feel good after they crash from using drugs. I remember hearing an addiction expert lecturing at one of the conferences and he said, you can only squeeze so much serotonin out of a neuron before you can’t get any more out of it.
Cali Estes, PhD [28:37] Yep, absolutely. And then we don’t fix that. Abstinence doesn’t fix that. They say, okay, don’t do drugs. Here you go. And it’s like, well, wait a minute. How are you going to fix the brain? The brain has to heal. And they say, oh, well, it’ll heal over time. Whoa. Who wants to feel like crap for six months while their brain is starting to repair? What if you had, I mean, we have the science, we have the tools, we have the things out there to help people feel better now. But we’re in such an antiquated system that everyone is like, well, you know, the book from 1939 tells us we shouldn’t take that stuff. Well, it’s not 1939 anymore. It’s 100 years later, we have more tools, let’s use them. Why are we stuck in this, let’s not use the tools thing. And I can’t figure that out.
Dr. Mark Leeds [29:18] I like to tell people a story I read, there was a book called Overcoming Opioid Addiction by Dr. Adam Bisaga. He tells a story in the book, Bill W., the founder of AA, had a meeting with the doctor who founded the methadone maintenance program. And he went to me and he said, you know, methadone works so well for heroin addicts. Can you come up with a drug like this that works for alcoholism? Because if people could get medical treatment and they could focus on working their steps. So even the founder of AA was in favor of that. And now things have completely changed, you know, and I know AA doesn’t have a thing about medication. It’s a per group. You know, there’s people in AA that don’t believe in it. The founder believed in medication, but then you go to NA, Narcotics Anonymous, and they’re officially against methadone and officially against Suboxone. And that’s a big problem, you know, that people can’t go to those meetings and feel comfortable if they’re on medical treatment.
Cali Estes, PhD [30:03] Well, that’s why I created the recovery coaching training. People want to go to meetings. They want to be connected. They want to feel part of, and they want to talk. But once you go, you’re judged, right? If you have a drug problem, you go to AA, they don’t like you because you’re not an alcoholic. Well, alcohol is a drug. There’s like this stigma of, well, you don’t do alcohol, so you don’t belong, or you’re a junkie, so you don’t belong. And they go to NA and they say, okay, here I am. I’m on method. Oh my goodness. You’re using drugs. You know, meanwhile, they’re sucking down caffeine. They’re smoking on a cigarette outside, chain smoking, and they’re eating enough sugar to kill a small tribe in Africa going, you can’t have this, but I can have this. So I’ve always questioned that. I’ve always said, if you’re, sugar’s, you know, one of the biggest drugs on the planet. If you’re sucking down Snickers bars and Skittles telling him he can’t be on methadone, do you realize you’re doing a drug? And then they say, oh, well, that’s not going to make me steal stuff. And I’m like, well, suboxone and methadone isn’t going to make them steal stuff either. You know, it’s this, I can have it, but you can’t concept. And I think all of that needs to change.
Dr. Mark Leeds [31:04] And on top of that, if someone is in one of these programs and they take methadone or suboxone for pain, you know, if it’s prescribed off label for pain, then they’re consider clean in the program? Because they’re saying, you know, if it’s for pain, it’s none of our business. If it’s for addiction, then we don’t consider you clean.
Cali Estes, PhD [31:20] So this is, and this is where the problem that I have is because according to what they’re preaching is they’re not supposed to be judging anybody else, right? That’s a huge component. So why are they judging who comes in the front door? Because you have people that have two hours clean coming to a meeting, trying to get clean and that’s okay. You have somebody that smells of alcohol, if it’s detoxing and that’s okay, but it’s not okay for you to be on methadone.
Dr. Mark Leeds [31:45] They can sit in the meeting, but they’re expected not to do service. They can’t get involved. Really, they can’t share in the meeting. So they’re expected to sit there quietly as if they’re still high and just listen.
Cali Estes, PhD [31:56] See, that doesn’t work for me. That to me is like, we’re hurting our population instead of helping them right there. Because anybody that comes to me, and I do a lot of harm reduction. So they’ll come to me and they’ll say, okay, I’m drinking a six pack a day and I want to go to five beers instead of six. Okay, I’ll help you. I’m not going to turn you away. That’s a goal. Coaching says you have to have a goal. You have a goal. Let’s do it. And then maybe let’s go to four and let’s go to three and let’s go to two and let’s go to one and then maintain. Sure. Let’s try it. Maybe it’ll work. Maybe it won’t. But if you have somebody who’s into these steps and into that lifestyle, they say you can’t do that. Well, why not? We can’t. It says right here that you’re not a true alcoholic. And I got into a big debate with somebody over this. What is a true alcoholic? What does that mean? If you’re a true alcoholic, you can’t maintain. And I said, well, let me put it to you this way. Everybody has a drug of choice, right? So a heroin addict whose drug of choice is heroin can never have a glass of wine with dinner ever again, or they’re still using. And he said, yes. I said, that to me is stupid. And he goes, what? And I said, because that’s not their drug of choice. They’re not going to overdose on wine if heroin is their thing. I said, and vice versa. I was a diet pill addict. I’m a food addict first, diet pill second. So uppers are my thing. I can go out and have a glass of wine. I could sit there for four hours and have a conversation and my wine glass doesn’t disappear because I don’t like to be down. I like to fly. That’s not my drug of choice. Does that mean that I can’t, I’m not clean? And he goes, oh, you’re not clean. And I said, but you’re eating a Snickers bar and sugar is the biggest drug on the planet. Then you’re not clean. And we got in this big debate and it was interesting because it’s like, it’s so close minded to me for somebody to say, you’re not clean if you don’t do X. Well, instead of saying, how can I help you? Instead of judging people, let’s start saying, how can I help you? And where do you want to be? You know, if getting on methadone for the rest of your life is what you need to do, then do it. If it’s what you need to do, do it. Get to where you need to go so you feel better. Instead of saying, you can’t do that. Well, why not? Because you said, well, who are you? And we say that, who are you? You’re telling someone else how to do something. You’re nobody, you know? And I think a lot of these meetings, a lot of these things where people get up and say, well, you know, I’m going to do this and I’m going to do that. You need to do it this way and only this way. That’s not right. You know, you’re not helping somebody. You’re hurting somebody.
Dr. Mark Leeds [34:18] Dr. Cali, just tell me, how can people find your books and find your website and your products? And where can people go to learn more about you?
Cali Estes, PhD [34:24] Okay, so my books are on Amazon. You can go to amazon.com. My website is theaddictionscoach.com or caliestes.com. You can find the books there and the services. The supplement line is called Pro Recovery Rx, and you can find that at Pro Recovery Rx. It’s also on the other websites. And if you want to get trained as a student to learn coaching, we have 30 plus classes, including harm reduction. You can find us at theaddictions, plural, academy.com, or you can click on the addictions coach and click on training and you’ll find it there.
Dr. Mark Leeds [34:59] So someone can learn to be a coach from you.
Cali Estes, PhD [35:01] We train coaches. Yep. Recovery coaches. We do internet addiction, harm reduction, sex addiction, food addiction, nutrition, pretty much anything related to addiction we have. We have a failure to launch class. We have a mental health class. Anything you wanted to know to help other people, we can train you in.
Dr. Mark Leeds [35:18] Thank you for joining me today on the Rehab Podcast. This has really been an incredible conversation.
Cali Estes, PhD [35:23] Awesome. Well, thank you for having me.
Dr. Mark Leeds [35:27] Thank you for joining us today on The Rehab on the Mental Health News Radio Network. I hope that you have found this show to be interesting and useful. If so, please subscribe to The Rehab Podcast and share on social media. I appreciate your taking the time to listen to The Rehab. Thank you.
