How To Rebuild Your CNS While Detoxing & Recovering – Featuring Ken Starr, M.D. (Ep. 186)

Ken Starr, MD: Anytime you're detoxing or in recovery, you're rebuilding your central nervous system, or you're making it less kindling and less fryable. So anytime you can kind of stabilize and build on someone's nervous system, they really feel better, and things in their mood, and anxiety and cravings all improve. So my theory is that really just acting as mitochondrial fuel in a deficient state is probably what we're doing.

Ken Starr, MD: I was reading this really interesting article on NAD that came out the other day that, they think NAD levels are the main reason people get sick with COVID. If you have an NAD deficiency state, which you do if you are older, immunocompromised, obese, diabetic, that's who get super sick with COVID. It's those people.

Ken Starr, MD: So the scientists, and I can send you a link to that article, all speculate that NDA level is actually related to whether you're going to get sick from chronic disease or be more susceptible to infections.

Announcer: Thanks for tuning into the Elevation Recovery Podcast, your hub for addiction recovery strategies. Hosted by Chris Scott and Matt Finch.

Chris Scott: Welcome everyone to the Elevation Recovery Podcast. I'm Chris Scott, and today we have a guest who has actually been on the podcast before, twice before with Matt Finch, both times. It's actually an honor for me to talk with him. We've been on email chains together and I've heard all about him. His name is Dr. Ken Starr. He's a twice board certified addiction medicine doctor and an ER doctor.

Chris Scott: And he uses the biochemical restoration techniques that we talk about, a variety of them actually, customized for individual patients and also encourages people to kind of fuse that with the traditional model or alternative modalities that they find works best for them.

Chris Scott: So we're going to talk about that in the context of a little more alcohol addiction. This time in the past, he's talked with Matt a lot about opioids and anything else that comes up today. So Dr. Starr, thank you for being on the podcast.

Ken Starr, MD: Thanks Chris. Thanks for having me.

Chris Scott: Absolutely. So I know that you've been running your NAD+ clinic or I should say The Ken Starr MD Wellness Group, I believe it's called.

Ken Starr, MD: Right.

Chris Scott: And you've been helping people with all these modalities for like six or so years at this point, right?

Ken Starr, MD: Yeah. We started our program in 2011, so [inaudible 00:02:33] is 10 years now.

Chris Scott: Oh, almost 10 years. All right. We'll have to update the show notes from the last episode. Can you talk a little bit... This might be a refresher for anyone who's seen those prior episodes, but how you got into doing that kind of stuff in the first place.

Ken Starr, MD: Yeah, sure. Thanks Chris. So I am formally or certainly formally trained as an emergency physician and I've been practicing emergency medicine and I still do since around '97. Around 2011, 2010, my brother died of a heroin overdose, and at that point I really took just a look around about what services were around for substance abuse and recovery and where I was living there just really wasn't much, right?

Ken Starr, MD: You had the county program that was really drug offenders who had to be there, or you had private expensive rehabs on the beach, which California is known for. But there really wasn't anyone doing sort of outpatient, med management and outpatient detox. And I was real comfortable with that from my ER experience. And this is sort of when Suboxone, maybe was getting started, getting a little bit more common.

Ken Starr, MD: And we were certainly seeing a lot of that in the ER. So I basically thought, "Hmm, I'm going to start doing this". My best friend is an addiction psychiatrist, and we had spent a lot of time together and he's just like, "Hey Ken, you got to start doing this man". And he's like, "This is rewarding. It's fun. It's easy. You can get out of the ER eventually."

Ken Starr, MD: Anyway, so I basically rented a little office in a primary care doctor's office down the street. I kind of called them up and said, "Hey, can I rent your office space?" And he's like, "Yeah, sure." And at that point really, it was just opiates and Suboxone for MAT. And then we did a little bit of alcohol treatment. I say, we, it's me. I just did some alcohol withdrawal treatment. It was pretty ghetto.

Ken Starr, MD: I mean, it was me and a prescription pad and cross my fingers for the most part. Shortly after that, I teamed up with a lady living in town, who I just happened to meet coincidentally named Juliana Bankert, who is really a powerhouse. She's in recovery. She had a lot of experience as a counselor with groups and programming.

Ken Starr, MD: And we got together, then we actually started a program, where we rented a bigger space and then we started offering counseling in groups and individuals sort of therapy. It was about a few years into it, when I had a patient... I was doing mostly opiates I think. I had a patient who told me about this brain restoration therapy.

Ken Starr, MD: They said they were going to go to someplace in Louisiana and do the strip and they're going to get off opiates. And of course I'm thinking, "Whatever. Good luck." Right? "Whatever. I mean, they're going to sprinkle fairy dust on your head and you're going to be fine." So anyway, I followed up with that patient and they were like, "Oh yeah, it was great. I'm fine."

Ken Starr, MD: They had no withdrawal, they had no pause, they were in recovery. They were doing great. I was like, "Wait now. Where did you go? What's it called?" So I did some research, made some calls, blah, blah, blah, went down, trained, again I've told this story, so I don't want to bore your listeners. But, I trained on this NAD, went to Springfield, Louisiana, which I'm sure you've heard about and saw what was going on.

Ken Starr, MD: It was just like, "Oh my God, this is amazing." Right. I'm seeing a whole room full of people detoxing who were feeling fine. I couldn't believe it. Because I had already been doing detox for years, and I just hadn't seen anything that effective. So I came back to California. I'm like, "This is the bomb, man. This is going to change the face of drug and alcohol recovery. Like how well this works and so forth."

Ken Starr, MD: So we started our NAD program here on the Central Coast of California around 2014, which really makes us one of probably the second longest running NAD program in the country now. And it's a big part of what we do. Now, we certainly do a lot of drug and alcohol treatment and detox without NAD. So we're not just an NAD program.

Ken Starr, MD: In fact, the vast majority of our patients don't do anything with NAD, right? We're still an accredited state licensed drug and alcohol treatment program. We do emphasize nutrition and supplements and we have a supplement line and we certainly focus on that. But we offer an NAD program in that. And just because of the cost and time, it's not in the cards for everybody, but when we do it, it's really worth it.

Ken Starr, MD: So that's our story. So we've kind of grown over the years. We're now probably the largest private outpatient drug and alcohol treatment in California. Or certainly between LA and San Francisco. We have probably, I don't know, probably 300 patients that we see regularly. And it's just a joy. It's a lot of fun. The patients are really a pleasure to work with and it's wonderful to see people get their lives back.

Ken Starr, MD: I still do ER, one or two days a week to pay the bills, but I enjoy it. We've got a wonderful office staff. We've got a great office. We're just real fortunate. So that's kind of a quick background of what we do. And then yeah, in that process, I did get board certified in addiction medicine and go through all sorts of the traditional channels. Right?

Chris Scott: Right. Yeah. Well, I think it takes a special kind of person to open your mind to things that you probably weren't familiarized with in medical school. I'm sure you didn't learn about NAD, and I know it's a relatively new treatment.

Ken Starr, MD: Well not even that Chris, but what we knew about addiction... I mean, I never had classes on addiction, right? I did medical school, I did residency, I've worked in major hospitals, I've worked in rural hospitals. I don't think I had one hour on a addiction. And it wasn't really until I got into the field and really opened my mind and talked to patients and read books, where I really learned about what really is addiction. Right?

Ken Starr, MD: So it's not something that most physicians have any working knowledge of. Not that they don't care, but they're just busy doing their thing. And it's just not their gig.

Chris Scott: Yeah. So about seven years ago I quit drinking. And before that, I think I had been open with one doctor who... And I don't remember, I probably... I don't know if I went to an urgent care clinic or if it was my... I didn't really have a good history of being consistent with primary care doctors, but a generalist, I suppose.

Chris Scott: I'd said, "I drink way too much, it's a problem". And he said, "Well, just quit". I said, "Okay. Do you have any recommendations?" He's like "Check out AA." And I said, "Is there anything else?" Because at the time, even I didn't want to go to AA for better or for worse. And I should say, I did utilize AA for several months in early recovery. I found it helpful, people were supportive. There are good things to be gotten from that, but at the time I wasn't ready to hear that.

Chris Scott: But I was thinking like, "Can you give me a pill?" At the time I wouldn't have cared if it was a medication or a nutrient. But he said, "No, there's really nothing else. That's it." And during that time you were already operating your program out in Calif- I wish he had said "Yes. Dr. Ken Starr in California has a clinic and they're doing cutting edge stuff."

Chris Scott: But it seems like, I haven't obviously been back to a doctor to talk about addiction in that period of time, but I would assume it's not that much better for the majority of people talking to their primary care doctors or whoever they go to see.

Ken Starr, MD: Yeah. We're just now getting to the point where primary care clinics in our community are now referring patients to us. But addiction medicine is a new specialty. So seven years ago, when you decided to get clean, there may not have been outpatient drug and alcohol specialists that do this, just like you'd see a cardiologist for heart problem, a urologist for a kidney problem.

Ken Starr, MD: I mean, now addiction medicine is a recognized board certification specialist. So I'm an addiction medicine specialist just like any other specialist. So it's new, it's new. And I think that it's great for people, but yeah, most of... I think there's just a new recognition of it. Right? And I don't think seven years ago that was there. Certainly not where I lived. There was no addiction medicine specialist. It was just you send them to rehab, right? "Go to AA or go into rehab." That's it.

Chris Scott: Right. Yeah. And that was the model that I'd used at least at first. And I did go to inpatient rehab, it was very expensive and there was zero talk about biochemical restoration or obviously NAD. Actually, the only talk there was, was we were encouraged by a counselor at one point to laugh at the idiots out there who thought that you could quote, cure alcoholism with vitamins.

Chris Scott: And along with everyone else, I was like, "ha ha ha. Isn't that funny?" Because we'd been brainwashed to think that the only way was 12-step. And again, I have to tread carefully because there are a lot of people who reach out to me for whom biochemical restoration is a missing link in their program, which they need to fix, but we don't want to throw the baby out with the bath water for people who do benefit from that.

Chris Scott: I think psycho-spiritual work can be profoundly important, but it does sometimes make my blood boil when people could be helped just with these missing links being filled in. And so that's what I've tried to do and I'm not a doctor, my audience knows. I used to work in finance. I had no [inaudible 00:12:19] I would ever be reading dozens, or hundreds of books and studies on this topic.

Chris Scott: I did it for myself and then I try to motivate people to educate themselves as well. But I'm very relieved when I see people who go become board certified in addiction medicine. Something I'll never do. And hopefully slowly start to change that paradigm. So I'd imagine that we might have some doctors in this audience. I'm actually always pleasantly surprised by how many doctors have signed up for my online course just to get some extra support.

Chris Scott: And I know it takes some putting ego aside for some people. They should know more about this stuff than I do, but it's a missing link in education for a lot of doctors. And then they email me and tell me how well they're doing later, but I think there's always an initial skepticism. So if there are doctors in our audience who are watching this, how might you in a nutshell if possible, explain the nature of the missing link of the biochemical repair, some of the strategies you use, maybe including NAD?

Chris Scott: But also, I know you do Myers Cocktails, B12 shots, you try to address ATP deficiency. There's a range of things customized program for people, but how does that all fit in? I know you started out with medication assisted treatment. What was it like to kind of obviously not leave that behind entirely, but start to embrace these new concepts?

Ken Starr, MD: Well, the nutritional aspects of recovery, which you're so well-versed in and I enjoy and I practice it and I believe in it. I think is an important part, but I think we need to like back the lens up because it was even more important is creating that environment and stewardship of, okay, accountability about honesty, about integrity and getting people connected into recovery community. Right? I think those are the big things.

Ken Starr, MD: Because I always tell patients, look at medication... I mean, once people are safely detoxed, let me back up, right? Once people are safely detoxed off alcohol and then we have a follow up visit and they've been sober for say a week or so, I usually say, "Medicines have a small role. There's prescriptions that we can use, like naltrexone or Gabapentin or Antabuse, and here's how they work. Not everybody needs this.

Ken Starr, MD: This is just a small role, and this is a good tool. If you want to try something like that, go ahead. But here are some other things that can help you decrease cravings and help you feel better and improve your energy and improve your memory and improve your mind and just help. And then I kind of go on to my list of, "Here are some basic nutrition, here are some supplements, here are some more aggressive things that you can do."

Ken Starr, MD: So the first thing is like, just get into a program of community and support and connection. Right? But speaking about nutrition. Yeah. I mean, look, alcohol causes a nutritional wasteland, right? You burn through all your NAD. Anybody can just google right now, images, alcohol metabolism. And you'll see that you used two molecules of NAD to metabolize one molecule of alcohol.

Ken Starr, MD: So if you're a drinker, you're NAD deficient. And doctors a long time ago in the '50s figured this out, right? And started supplementing people with NAD. And when you give those patients NAD, withdrawal goes away. I mean, they just feel so much better. Their skin glows. It's just unimaginable what you see. Cravings go down, their life comes back, their energy systems improve.

Ken Starr, MD: Because NAD, as we know now is involved in over 400 important reactions from sleep to immune system health, to aging, to tumor destruction. I mean, so many things are NAD dependent. And the big thing now is longevity, right? If anything, you google about NAD now is all longevity and Sinclair and anti-aging. But yeah. So we have found like... I take no credit for inventing any of this stuff. Right?

Ken Starr, MD: But we have found and believe that when we give these patients intense nutritional replenishment, IV, NAD, but Myers Cocktails, B vitamins, B complex, B12 Vitamin, Vitamin C, magnesium, the resiliency is just... I mean, they just feel so much better, so faster. Their recovery goes smoother. And of course, I'm not saying you do that in place of a recovery program, but when those patients... Patients who do these intense nutritional programs, absolutely feel better faster, recover faster and struggle less.

Chris Scott: Right. No, that's a great answer. I'd like to zoom in a little bit more on NAD.

Ken Starr, MD: Okay.

Chris Scott: Because the first time I'd heard of it was for anti-aging and I actually took it. I think I had taken it was either NMN or something else, I don't recall the-

Ken Starr, MD: NR. There's nicotinamide riboside.

Chris Scott: You're right.

Ken Starr, MD: Nicotinamide riboside or our NMN, which is nicotinamide mononucleotide, both NAD precursors.

Chris Scott: Right. My dad takes NMN, he's 74 and does 500 plus pushups every day. He also incidentally cut out high sugar sodas and alcohol, about when I quit drinking. He lost 30 pounds and it's unclear how much is the NAD levels, but he's glowing. He looks better than he did when he retired 10 years ago. And so I love to see that, but I know it's also really helpful for people in early recovery

Chris Scott: Unfortunately, I didn't know about NAD. When I was in early recovery, I managed to use a variety of other nutrients, the magnesium, as you mentioned, some amino acids, some evidence-based herbs and fatty acids, Omega-3s to reduce inflammation. I wish I had known about NAD, but for someone who might've started on the other things, do you think it's necessary for them to start taking oral NAD? How should they decide whether or not to go to a clinic to get NAD infusions? Or do you think it's only necessary for some people?

Ken Starr, MD: There's different ways to administer NAD? There's IV NAD, which is what we're doing in like a 10-day brain restoration, detox, substance abuse recovery program. These are high doses of IV NAD. There is a nasal spray of NAD. There's transdermal patches of NAD, and now there's sublingual NAD. So those are all the NAD products.

Ken Starr, MD: Then, as you mentioned, there's precursors to NAD that you can take orally. So if you just take NAD orally, it just gets dissolve in the stomach. Nothing happens. So you really won't see any NAD products that you just swallow. But there are precursors. In other words, NAD is recycled through salvage pathways in your body and the precursors that make NAD, are NMN, nicotinamide mononucleotide, which is like what Sinclair takes.

Ken Starr, MD: It's not as accessible and available as another product called NR or nicotinamide riboside. So nicotinamide riboside and NMN are both precursors that go to NAD. It's been proven and shown that if you give somebody nicotinamide riboside NAD levels go up, they've measured this in humans. No question about it. And some of the NAD scientists like Brenner and Sinclair...

Ken Starr, MD: Brenner, by the way, is the guy who discovered nicotinamide riboside and is the mind behind ChromaDex, the only company that makes it. His argument is, you really only should take a precursor. If you take NAD, it's just degraded and metabolized to products that can be taken up into cells and use as NAD. And the example is, if you want healthy collagen on your skin, you don't take collagen powder and rub it on your face. You eat protein or eat collagen. Your body synthesizes healthy proteins, and then integrates that into tissues.

Ken Starr, MD: But a researcher named Ross Grant out of Australia, who's one of the leading scientists, he's not a treating doctor, he's a BEN scientist. He's proven that if you give IV NAD, it is upgraded. It is uploaded and increases NAD levels and is used by cells. So his theory is that there is a yet to be discovered transporter. So there's something bringing NAD across.

Ken Starr, MD: And I can tell you, when we give patients NAD, it works, they feel better, they feel different. I mean, maybe it's placebo. So, if somebody wants to take NAD for health, longevity, lifespan, wellness, they're fine taking a sublingual or a precursor product. I probably would just recommend nicotinamide riboside or NMN. I have not yet found pharmaceutical grade high quality NMN that is easily accessible and affordable. So I'm sure it's out there.

Ken Starr, MD: But nicotinamide riboside you can get that on Amazon. You can get that anywhere, All the nicotinamide riboside out there, no matter who it's labeled by, whether it's Tru Niagen or Thorne is all made by one company. Only one company makes the world supply of nicotinamide riboside, because they have the patent on it. I think that's a great product. I think it works. I think it's fine.

Ken Starr, MD: If you're trying to do NAD to detox of substances like alcohol, or really improve your recovery, you can start with a product like that. There's nothing wrong with it, but you might want to try IV NAD to see what the effect is. The only thing I'd say is that most people using NAD are say IV infusion clinics. Right?

Ken Starr, MD: In other words, they're not drug and alcohol treatment specialists at all. They're IV infusion clinics. Like, "Yeah, we do Vitamin C. We'll do Myers cocktail. We'll do banana bag, or this. Oh, and we learned about NAD and we're going to offer it because we can make money doing it." That's not the place that we'd go for a treatment program, because they don't know the complexities. Right?

Ken Starr, MD: If you give somebody a ranch, it doesn't make them a mechanic. Right? So they're not the place that I would go for more specialized care. But if you want to try IV NAD, why not? I mean, sure. You could probably go to a bigger city, go to infusion clinic and try NAD. I would make sure it's real NAD and not something... There's a lot of manufacturers now in that space, and I don't think they all have pure products.

Ken Starr, MD: But yeah. I think it's fine, and I think it's very helpful. And honestly, even though we're a specialty drug and alcohol program, Chris, probably most of our patients who are coming in and doing NAD are not doing it for substance abuse indication. They're doing it for wellness, clarity, their head space is clear.

Ken Starr, MD: We have a group of like transcendental meditation women that come in and do NAD just because it gets them into a higher place. We have people who do NAD for nerve pain, for depression. It seems to be very effective for nerve conditions, like say regional pain syndrome, fibromyalgia. NAD is really a foundational substrate for nerve cell mitochondria.

Ken Starr, MD: So any central nervous system condition that is not great, you could try NAD and see if it helps. It's like putting super unleaded in the tank. I mean, if your engine's broken, it's not going to start running, but it can sure help things run better. So yeah. NAD is great. It's a wonderful supplement. It's role in drug and alcohol really is amazing. I mean, what it does is nothing short of miraculous.

Ken Starr, MD: I have patients who are continuous relapsers, who've been in a lot of programs and they do attend the NAD program and they've never felt or done better. It seems to really result in some significant improvements that are hard to achieve other ways. And that's on top of traditional recovery programs.

Chris Scott: I know it was a little bit mysterious maybe as recently as a few years ago, about what exactly is going on in the brain. Are we resetting neural pathways? Is it just the deficiency in this base compound that's used for so many other biological processes? Do we have any more light on what exactly is going on with NAD for addiction recovery?

Ken Starr, MD: No, not really. I mean, the molecular biology would suggest that it has to do with... I think it's ribose d-phosphorylation. In other words, we need to develop a tolerance to a substance like alcohol, right? You develop a tolerance to it. There's the molecular mechanism where I think these ribosome molecules are phosphorylated and that some molecular biology of sort of what tolerance is.

Ken Starr, MD: And NAD, I guess, does something where these... And I'm not a molecular biologist, I don't pretend to be. But when I've tried to talk to them about it, apparently NAD has a role in the phosphorylation pathways that seem to eliminate or really minimize... I shouldn't say eliminate. Really minimize withdrawal and accelerate post-acute withdrawal.

Ken Starr, MD: So certainly in an NAD deficiency state like alcohol... I mean, I love it when people come in and do NAD for an alcohol use disorder, alcohol recovery, compared to people who are doing NAD say for opiate recovery or NAD for benzo recovery. Because I know the alcohol recovery patients, they're going to get blown away, I mean, every one of them blown away.

Ken Starr, MD: I know they're going to have an amazing response. I know they're going to feel great. So I love it when this patient show up. Benzos, I hope they feel better, and sometimes they do. Sometimes helpful, but I really try to under promise and over-deliver.

Ken Starr, MD: So you're asking what's the molecular biology? I don't think it resets, I think that's more like why we use ketamine with NAD, we can go into that. But ketamine has more of a nerve reset principle. NAD just seems to really act as this amazing foundation for nervous system support. And anytime you're detoxing or in recovery, you're rebuilding your central nervous system, or you're making it less kindling and less fryable.

Ken Starr, MD: So anytime you can kind of stabilize and build on someone's nervous system, they really feel better, and things in their mood, and anxiety and cravings all improve. So my theory is that really just acting as mitochondrial fuel in a deficient state is probably what we're doing.

Ken Starr, MD: I was reading this really interesting article on NAD that came out the other day that, they think NAD levels are the main reason people get sick with COVID. If you have an NAD deficiency state, which you do if you are older, immunocompromised, obese, diabetic, that's who get super sick with COVID. It's those people.

Ken Starr, MD: So the scientists, and I can send you a link to that article, all speculate that NDA level is actually related to whether you're going to get sick from chronic disease or be more susceptible to infections. So anyway, NAD is just [crosstalk 00:28:18]. Yeah, it's blowing up. So-

Chris Scott: I've heard a lot about the connection potentially between Vitamin D3 deficiency and COVID, and it would be odd if there was only one natural compound that was involved with it.

Ken Starr, MD: Right. Yeah. I've been taking vitamin D since that whole thing started and I think there's some good science behind that. So I can't give you an exact mechanism. I'm just going to throw out Ribose phosphorylation. If you're a molecular biologist, you can call bullshit on that, and that's fine. But if you're just a normal guy, you're like, "Yeah, that sounds good."

Chris Scott: I can't call bullshit on it. I've just noticed recently I can get the gist of studies and I couldn't make much sense of not being trained as a doctor or a molecular biologist. I still couldn't come up with a conclusive picture of what's going on with this NAD thing. But I will say that I've had several private coaching clients who have done NAD treatment, all for alcohol recovery, obviously.

Chris Scott: And their stories were amazing. One of them had been drinking like a liter of vodka, she worked from home, every day for God knows how many years. And went and did this clinic, and on the third day, I think it's like a 10 day treatment. I'm not sure where she went. At the time, if I had known about you, I would have referred her to you. But I think on the third day she went to go have lunch, and the only place she could do it was a bar. And she left the bar, and thought to herself, "Wow, that's weird. It never even occurred to me that they were serving alcohol in there."

Chris Scott: And I was like, "Whoa." This was a woman who had trouble driving past street malls that might have liquor stores in them. And she had lunch in a bar on the third day and was just focused on her lunch and then left. I mean, that's the kind of epiphany I had, like two years alcohol free, where I would go to like a wedding and then I would leave and I'd be like, "Oh, there are people drinking there. That's weird."

Chris Scott: But it took me that long, you know if she could get anywhere near there in a couple of days, it's amazing. I might show up to your clinic seven years late just to see if there's anything I can do for me. I'm sure I would. I mean, I'm pretty optimized, but I'm always trying to get to the next level. And NAD infusions are really interesting to me.

Ken Starr, MD: There's actually, and not to plug any specific pathway or program. There's actually an NAD clinic in Georgia.

Chris Scott: I've heard of that, yeah. But I know there is one that's in Louisiana, that's the one where you went to, right? Or you had studied it?

Ken Starr, MD: Oh, that's where you go to train. But there's a guy who actually knows what he's doing, He is on an NAD board with me. And I'll put it in the show notes. I'll send it to you.

Chris Scott: Excellent.

Ken Starr, MD: We get a lot of calls and emails like, "Hey, do you know anyone doing NAD where I live and blank?" And usually it's like, "No." There's a couple of co-op programs in California. There's a program in Oregon. There's a program in Washington. There's a program in Georgia. There's one in Florida, but we get a ton of calls from like the Northeast, like, New York. And I don't know of anyone up there doing NAD. Not to say there's not an infusion clinic that offers NAD, but are there addiction and drug and alcohol specialist using NAD?

Chris Scott: Right.

Ken Starr, MD: I don't know the answer to that.

Chris Scott: Okay. Besides NAD, have you noticed that any supplements in particular tend to help people with alcohol addiction recovery?

Ken Starr, MD: Yeah, for sure. First of all, I always recommend, B complex. I always recommend B complex and not one single B-vitamin because in nature, I don't think they're in solidarity like that. I mean, or in isolation like that. So I always recommend generous B-vitamins at least orally they're cheap, they're effective. I always double them up. I've taught people they should have yellow pee all day. As you know, the gastric absorption of those is very poor. You're not absorbing, but a small percentage probably, maybe even single digits when you take something like that early.

Ken Starr, MD: So I like multivitamin, but specifically a B complex. There's a supplement called... We call it Essential Recovery Support, and it really is actually just decreases carb cravings. And that has like five HTP DLPA tyrosine and glutamine in it. And then of course, sometimes we use just pure glutamine, right? We call it immediate craving control, and that's just glutamine, amino acid powder. They just put in your mouth and it decreases cravings.

Ken Starr, MD: I think anything that you do to improve gut health is good. So, probiotics or prebiotics or testing your gut through like some program called like Onegevity, make sure you fix your small... Your gut health, whether it's that CIBA or that super important. I think vitamin D supplementation's super important. I think magnesium, it can be really helpful. Those were kind of the basics for me, and we'll use those in higher doses IV. So we'll give IV vitamin C mag and B vitamins in real high doses more frequently. Maybe even a couple of times a week.

Ken Starr, MD: And we'll also do that in the NAD program, because if we get an alcohol patient who comes in, if they don't have the nutrient foundation, NAD sometimes will make them worse. So we'll have to give them IV thymine and B vitamins to make sure that they... Because NAD is going to rev up their sort of nutritional... It's going to start building up and doing a lot of recovery. And it needs other products to do that. So, I've kind of found that if we give some of the B vitamins and other minerals before we do NAD, it even works better.

Chris Scott: Well, because they're burning more energy when they have the NAD, right? I mean, that's just a theory, it kind of makes sense. If you don't have the other raw materials for biological processes that are in-

Ken Starr, MD: Great.

Chris Scott: ... it might be tough.

Ken Starr, MD: I think there's a rule. We don't really do it, but I think Omegas, and fatty acids are super important for brain health. And I think that if people are detoxing, I stop their statin. A lot of times people are on statins. I stop their statins because I want their fatty acids to build up a little bit, their cholesterol to build up a little bit for their brain health.

Chris Scott: All right. I know standards have become at least somewhat controversial. A lot of people who are more holistically minded are not quite sure if they even have a role in medicine anymore. And that's not a, I think I'm well versed in, I think my mom had taken statins for a while and I think the whole thing around cholesterol or the narrative around that might be shifting, I don't know.

Ken Starr, MD: Yeah. My view on that is, if you've had a primary event, like you've had a heart attack, you've had a stroke. I think there's some pretty good evidence that the statin drugs can prevent subsequent events. But if you're healthy, they don't prevent anything. That's my opinion, they don't prevent anything I think they have a lot of side effects. So if you're just thinking it's going to prevent a heart attack or prevent a stroke, I think they have more problems than they're worth. So I take a lot of patients off of statins, honestly.

Chris Scott: Interesting. So we've talked a lot about biochemical restoration, but you also encourage people to heal as whole people. Matt and I like to talk about the biochemical, psychological, social, spiritual model of addiction treatment. Is that something you would like to talk to people about their diet, their exercise, and their spirituality or those having a sense of purpose, do you find those are important too?

Ken Starr, MD: Oh, absolutely. I'm always emphasizing number one, you have to get good restorative sleep. Right? So, so many of my drinkers feel like they have to drink to go to sleep because it makes them tired. But of course, when they learn that they're not getting that restorative deep level of sleep, what are they doing? Now they're accelerating, they're aging, they're accelerating cellular destruction. They're accelerating abnormal brain pathways by not being fully rested.

Ken Starr, MD: So sleep is exercise, you got to get them exercising. Even if they're just doing 20 air squats and five pushups. I mean, you've got to start getting some daily exercise or going for a walk. I tell them, look at... I put on a podcast, preferably yours, put on a podcast. Do you have a dog? Oh, that dog needs to be walked. Go out for 45 minutes and just walk fast. Just do it and just get some fresh air, get some sunlight.

Ken Starr, MD: I mean, I got to get them exercising. I've got to get them off processed foods. You got to meet people where they are. Sometimes that's a little much, but try to clean up their diet, try to get them exercising, try to get normal sleep, wake cycles, get them in a program and encourage some of these nutritional supplements. It's all part of it. It all makes it better. I mean, you can get into some, you know... I published something on YouTube about part of the healing your central nervous system, is learning to calm your central nervous system. So I put out something on like Wim Hof breathing in cold water.

Ken Starr, MD: Because I think that's pretty powerful. And I found a lot of people being like, "Oh my God, hell yeah, this is phenomenal. I just detoxed and tapered off benzos. And I did Wim Hof breathing in cold water. And I'm fine. This is minimal. I feel great." You can't start throwing that stuff out to somebody who's not even getting off the couch, but yeah, you've got to have an exercise program and fortunately, there's so many great resources on that now. I can't remember what it's called, have you seen those two brothers in recovery on YouTube that are really fitness oriented.

Chris Scott: I'm horrible with names, [crosstalk 00:38:35].

Ken Starr, MD: Oh, okay. Anyway, there's some great YouTube resources I refer people to. And so yeah, it's not just like go to a 12 step meeting. It's not just stop drinking. You've got to have a program of recovery. If this was easy, it would be easy. I wouldn't have a job, right? If this was, you could just stop drinking.

Chris Scott: And I wouldn't have a podcast.

Ken Starr, MD: You wouldn't have a podcast. So people need a plan. They need some training, they need a new skill set. They need new coping mechanisms. They need new tools in the toolbox. When people are drinking, it really comes down to, they started drinking because it was the best solution they had at the time for the stresses and the trauma they had at the time. So, just like any maladaptive behavior, it's a great short term solution, it's a terrible long term solution.

Ken Starr, MD: So, we can talk about nutrition. We could talk about exercise. We could talk about how great the supplements are, but these patients need to understand why they're chemically coping, what they're avoiding, teach them how to deal with these new raw emotions. What did they say the best part of being sober is now you get to deal with these raw emotions and problems, and then the worst part of being sober, is now you have to deal with these raw emotions and problems so that, you just can't be avoided.

Ken Starr, MD: So, that's why I think you need programming, we need counseling, we need new tools in the toolbox. And yes, we can absolutely get people feeling better faster with appropriate nutrition and supplements. But again, it's just one part of this whole solution, right? They need inspiration. Like Matt does such a good job with inspiring people and giving them a plan and giving them coaching. I don't ever tell people, I just need to go to AA. But you need a plan, and if AA works for you, wonderful, great. Do your 90 meetings in 90 days.

Ken Starr, MD: But if that just triggers you and it's not effective for you, then let's come up with something else. Let's do smart recovery. Let's do individual counseling. Some of the best people in our community are not licensed therapists. They're just recovery coaches and there are life coaches who have found recovery on their own. So, I don't know where I'm going with that. I would just say, yeah, it's just a huge constellation of continuous self-improvement.

Chris Scott: Absolutely. And that alcohol recovery centered life coaching is essentially what I've done for several years now. Matt Finch has done a great job with some people who were found full recovery as a coach, I saw along with coach Tana, coach Vianna. And I know Matt is a certified substance abuse counselor who spent a lot of time doing that. Coach Tana is certified in Biochemical Restoration coaching and Vianna is certified in the psychology of eating and also addictive disorders as well.

Chris Scott: Ironically, I'm the least certified of everyone, I have no letters after my name. I don't pretend for my career, but I am passionate about this. And I find that when people approach this, it's like an open-ended adventure, not just like a series of steps that need to be done, and then that's not a shot at AA. But I just mean it's not like, "All right, first do this, this and that." No, no, it needs to be an all encompassing spiritual journey. As much as I hate the word journey, I don't have a better one.

Ken Starr, MD: Coming as.

Chris Scott: You're becoming as, you're forging a new identity that hopefully retains the best parts of who you've always been. But you add on these layers of growth and it was Tony Robbins, one of my favorite authors for early recovery would always say happiness is growth. And I found that recovery is growth as well. And at some point, the recovery stops becoming about alcohol. And for me at a certain point in my life stopped becoming about recovery.

Chris Scott: And as much as it stopped becoming about the absence of alcohol and it started becoming about the plethora of new things that I would rather devote my energy towards, and alcohol just fell off the priority list. So a lot of people can get there, but it takes work in the biochemical realm for sure, especially in early recovery, but I mean lifestyle optimization and biochemical optimization are still primary focuses of my life to this day. I probably took about, I don't know, eight or nine supplements this morning. They're all targeted towards my own needs at this point, immunity being one of them with the ongoing pandemic.

Chris Scott: But also, mental acuity. I notice that my sleep wasn't great for the last two weeks. How can I tweak this? Maybe I'll take some glycine before bed. Maybe I'll try this herb, this Chinese tonic herb that Matt showed me a few weeks ago. People don't need to obsess over it to the level I do. I find it fun, but I found that people who do make it a passion to try to figure out the puzzle of their lives, biochemistry included, but also psychology, social lives and, spirituality tend to do much better as time goes on and things start to feel more manageable and the whole thing can really be fun.

Chris Scott: So I know we've talked for, I think around 45 minutes at this point, I feel like you and I could talk for hours and definitely, I'd like to have you back on for another episode at some point. But I wanted to make sure that you give people information on where they can find you and your supplement company as well.

Ken Starr, MD: Yeah. Thanks Chris. Well, my supplement shop is called getcleansupplements.com. And I started that a couple of years ago with get clean supplements. Clean being these are all supplements designed for substance abuse, addiction recovery, but also cleaning because they're simple, high quality products. So it's called getcleansupplements.com.

Ken Starr, MD: My website is just kenstarrmd.com, with two Rs, kenstarrmd.com. And we have a YouTube channel that where we try to put out useful information when things come out. We have a little blog that we try to do of course. Social media is not my forte. I kind of gave up on it. So don't look for me on Twitter, Instagram. I do have an account, but I don't know. It's sucks. I can't do it.

Chris Scott: I'm in and out of Instagram. I can tell everyone I'm coming back, if I haven't already, by the time you-

Ken Starr, MD: You know it's pretty embarrassing. My son has an Instagram account for Subarus. I put a plug in there for him because he likes Subarus. He has 11,000 followers.

Chris Scott: I might need to follow him too.

Ken Starr, MD: Yeah, I know. And I actually have hired a social media company to do blogs and I would get like six likes or like four engagement. Like it wasn't going anywhere. It's like, "Why am I doing this? No one cares." Anyway, I think it's kind of important for what we do, but I don't know. I haven't figured it out. Anyway, we do at getcleansupplements.com is where we actually sell, sublingual NAD, and nasal spray NAD, which are by far the biggest products that we sell. And we have some basic things.

Ken Starr, MD: I mean, it's not everything for everybody, but it's essential recovery support. It's immediate craving control, NAD products. There's a product called Serve-U, which is really good for just mental focus and helps with NAPA syndrome. And then the website it just kind of lists what our services are. And I think our YouTube channel's really where we can answer questions, make videos, talk about MAT, talk about medications, why we use them, how we use them. We have a lot on NAD, ketamine and so forth. So, yeah.

Chris Scott: Excellent.

Ken Starr, MD: Great.

Chris Scott: And I believe we have a coupon code, 444, I think is the code. Anyone can go to the show notes on elevationrecovery.com and find this particular episode with Dr. Ken Starr and you'll find the code. Matt and I will make sure to put it in the show notes as well.

Ken Starr, MD: Yeah, right. 444 is the coupon code, right? For you guys.

Chris Scott: Awesome.

Ken Starr, MD: 10% off.

Chris Scott: Excellent. Well, Dr. Ken Starr, thank you so much for being on the show. It's been a pleasure.

Ken Starr, MD: Yeah. Thanks for having me. It's been a lot of fun.