Addiction Medicine Made Easy | Fighting back against addiction

Whipped Cream With A Side Of Spinal Cord Damage

Mon, 11 May 2026 02:00:00 -0700

Nitrous oxide can look like a harmless party trick until you understand how fast it can flip into a medical emergency. We dig into whippets and laughing gas from an addiction medicine perspective, including why the high hits within seconds, why people keep reaching for “just one more,” and how the same drug can functionally mimic ketamine, benzodiazepines, and opioids in the brain. That mix helps explain both its legitimate role in minor procedures and why it can be so addictive outside the clinic.

We walk through what clinicians and families often miss: standard urine drug screens do not detect nitrous oxide, the detection window is short even with advanced lab testing, and the clearest red flag may be a profound vitamin B12 deficiency in someone who should not have it. From there, the conversation turns to the real stakes of B12 inactivation: spinal cord degeneration, myelopathy, peripheral neuropathy, gait instability, weakness, bladder dysfunction, cognitive changes, and the uncomfortable truth that we often cannot predict whether nerve damage will be permanent. We also cover immediate dangers while using, including hypoxia and sudden unconsciousness, traumatic falls, frostbite and cold burns from direct canister inhalation, pneumothorax and pneumomediastinum, arrhythmias especially when mixed with stimulants, mental health destabilization, increased blood clot risk, and serious pregnancy risks.

Because there is no proven medication-assisted treatment for nitrous cravings, we focus on what we can do: treat co-occurring anxiety, depression, and trauma, use CBT and group therapy, push hard on vitamin B12 replacement, and apply practical harm reduction when someone is not ready to quit. We close with a vivid patient case that shows how smoke shop access and relapse can spiral into hospitalization and disability, and how recovery is still possible with the right support.

If you find this helpful, subscribe, share the episode with someone who needs it, and leave a review so more people can find the show.

To contact Dr. Grover: ammadeeasy@fastmail.com

Goodbye Benzos, My Old Friend: Benzodiazepine Tapering Done Right

Mon, 04 May 2026 02:00:00 -0700

A benzodiazepine taper can feel like trying to land a plane in bad weather: the stakes are high, the instruments are imperfect, and speed is rarely your friend. We sit down with Dr. Rizzo to translate the ASAM benzodiazepine tapering guideline into real-world addiction medicine decisions, including what to do when a patient shows up on a very high dose of clonazepam and a sudden 50% cut has already happened.

We dig into the practical details clinicians and patients search for: how fast to reduce dose, why “5% to 10% every 2–4 weeks” is often a safer starting point, and when switching to a longer-acting benzodiazepine like diazepam helps or hurts. We also separate physical dependence from benzodiazepine use disorder so withdrawal is treated with seriousness rather than stigma, and we talk candidly about the access-to-care problem when long-term benzo patients can no longer find a prescriber.

We also cover special risks and settings: why older adults (65+) often need extra-slow tapers, why pregnancy requires careful coordination to avoid abrupt cessation, and when polysubstance use with opioids or alcohol should push care toward inpatient or residential support. Dr. Rizzo shares why phenobarbital can be useful in controlled detox settings, plus what actually improves success long term: CBT, treating underlying anxiety and insomnia with non-addictive medications, and building a plan patients can stick with.

If this helps, subscribe, share it with a colleague or family member, and leave a review so more people can find evidence-based guidance on benzodiazepine tapering and withdrawal.

ASAM Benzo Tapering Guideline: https://link.springer.com/article/10.1007/s11606-025-09499-2

To contact Dr. Grover: ammadeeasy@fastmail.com

What Happens in Residential Treatment: Inside The Place Rock Bottom Leads To

Mon, 27 Apr 2026 02:00:00 -0700

Residential treatment gets talked about like a single thing, but most people have no idea what they are walking into until they arrive. I sit down with Rachel Docekal, CEO of the Hanley Foundation in Florida, to open up the “black box” of residential addiction treatment and partial hospitalization (PHP), from how programs are structured to what patients actually do hour by hour.

We dig into what separates a quality rehab program from one that is all marketing. Rachel explains measurement based care, why repeat assessments like PHQ 9 and GAD 7 style tools matter, and how teams should adjust treatment based on data instead of vibes. We also address a hard topic: predatory rehab practices, including unethical pressure to relapse to meet ASAM criteria so insurance will pay again, and what ethical, patient centered care should look like instead.

Then we get practical. We talk length of stay, why discharge planning must start on day one, and how step down care, sober living, family involvement, and alumni support can make the difference between momentum and relapse. Rachel also walks through a real residential daily schedule including medical and psychiatric care, cohort based groups, nutrition and fitness, and why many programs restrict smartphones to improve engagement and outcomes.

If you want a clearer map for choosing a residential treatment center and building an aftercare plan that holds up in real life, press play. Subscribe, share this with someone who needs it, and leave a rating or review so more people can find the show.

To learn more about Rachel's program: https://hanleyfoundation.org/

To contact Dr. Grover: ammadeeasy@fastmail.com

Why Pushing A Loved One Harder to Get Sober Doesn't Help

Mon, 20 Apr 2026 02:00:00 -0700

Someone you love keeps drinking, using, or relapsing and you can feel your body tighten the moment you walk into the room. That tension makes sense, but it can also become part of the system that keeps addiction stuck. We sit down with therapist and family coach Jeff Jones, founder of The Family Recovery Solution and author of Rethinking Addiction, to unpack what actually helps families when a loved one is in active addiction or early recovery.

We get concrete with a classic scenario from the clinic: a middle-aged man with alcohol addiction and a spouse who loves him deeply but feels forced into constant pushing and correcting. Jeff explains why “help” can turn into pressure, how triangulation pulls doctors into the drama triangle, and how a simple 180-degree experiment plus journaling can reveal new options. We also talk boundaries as a way to create safety, calm the nervous system, and make better decisions, not as punishment or control.

Then we widen the lens to parenting teens and the added power dynamics families face, including why authoritative parenting (firm limits with connection) tends to work best. Jeff shares a powerful reframe from mediation: separate the addiction from the essence of your loved one, so you can hold consequences while staying anchored in love. We also cover structured family meetings, the idea that families move through the stages of change too, and why recovery is about building a life worth living, not only stopping a substance.

If this conversation helps, subscribe, share it with a family who needs it, and please leave a review so more people can find Addiction Medicine Made Easy.

To learn more about Jeff's work: https://www.thefamilyrecoverysolution.com/

To contact Dr. Grover: ammadeeasy@fastmail.com

An OB Addiction Specialist Explains Why Marijuana Is Not Benign In Pregnancy

Mon, 13 Apr 2026 02:00:00 -0700

THC isn’t the same drug it was 20 years ago, and pregnancy counseling hasn’t caught up. We sit down with Dr. Nazanin Amadieh, a board-certified OBGYN who also trained in addiction medicine, to map what today’s high-potency cannabis means for conception, the placenta, fetal development, and the newborn period. If you’ve heard “it’s legal” or “it’s just a plant” as proof of safety, this conversation offers a clearer, evidence-informed way to think about marijuana during pregnancy without stigma and without hand-waving.

We dig into the endocannabinoid system, why fetal receptors show up as early as five to six weeks, and how cannabis exposure may affect implantation, placenta formation, and early brain development. Then we get practical about the outcomes clinicians track: miscarriage risk signals, the stronger association with low birth weight or small for gestational age babies, and what NICU admission can mean for families. Because so much research is dated and modern THC concentrations can reach levels older studies never measured, we also talk openly about uncertainty and why “no proof of harm” is not the same as “safe.”

Nausea and vomiting gets its own spotlight, including the tricky overlap between hyperemesis gravidarum and cannabinoid hyperemesis syndrome, plus the hot shower clue that can point toward CHS. We also cover breastfeeding and THC in breast milk, what parents should watch for, and why postpartum relapse to cannabis is common when anxiety and overwhelm hit after the first few months. If you care about maternal health, prenatal care, addiction medicine, or harm reduction, you’ll leave with better questions and clearer next steps.

Subscribe, share this with someone who’s pregnant or caring for pregnant patients, and please leave a review so more people can find the show.

To contact Dr. Grover: ammadeeasy@fastmail.com

BIND: Benzodiazepine Induced Neurological Dysfunction

Mon, 06 Apr 2026 02:00:00 -0700

Benzodiazepines can feel like flipping a switch: panic quiets, sleep finally comes, your body unclenches. But what happens when that “off switch” starts rewiring the system you rely on to stay calm in the first place? Dr Andrew Rizzo joins me to dig into the biology behind chronic benzodiazepine use and why so many clinicians now recognize benzodiazepine-induced neurological dysfunction (BIND) as a real, patient-altering condition rather than a vague catch-all for “rebound anxiety.”

We walk through the GABA receptor in plain language, including why benzodiazepines act as positive allosteric modulators, how the brain chases homeostasis by downregulating inhibition and upregulating glutamate, and why tolerance is structural not moral. Then we connect the molecular story to the clinical reality: why abrupt benzo cessation can be life-threatening, how seizure risk emerges, what “kindling” means for repeat withdrawal attempts, and why a slow benzodiazepine taper often takes months, not weeks.

We also spend time on what patients and families actually need during recovery: validation, steady follow-up, and a plan that treats this like a fragile neurobiological injury. If you’re a clinician, a patient, or someone supporting a loved one, you’ll leave with clearer language, sharper warning signs, and a better mental model for why symptoms like photophobia, tinnitus, tremor, and cognitive fog can persist long after the last pill.

Subscribe, share this with someone who needs it, and leave a review with your biggest question about benzos and withdrawal.

To contact Dr. Grover: ammadeeasy@fastmail.com

Straight to the Shot: A New Way to Quit Fentanyl and Start Buprenorphine

Mon, 30 Mar 2026 02:00:00 -0700

Fentanyl changed the playbook for starting buprenorphine, and we’re tired of watching people suffer through days of withdrawal just to “earn” their first dose. So we break down a cleaner, faster on-ramp: direct-to-inject. Think of weekly Brixadi as an automatic microdose that builds buprenorphine levels over 24 hours, cuts out guesswork, and sets up a smooth handoff to a monthly injection that actually sticks.

We start by demystifying precipitated withdrawal with simple, memorable analogies—the “100 mph to 60 mph” shift explains why heroin-era inductions no longer work when fentanyl lingers like THC. From there, we map the current options: long waits with comfort meds, meticulous sublingual microdosing, short-acting opioid bridges, and why DTI often outperforms them in the real world. You’ll hear our step-by-step protocol for week one: when to keep using, when to stop, how to layer sublingual buprenorphine, and which comfort meds reliably blunt symptoms without fogging people out.

Then we get tactical. We compare Sublocade and Brixadi in plain English—needle size, injection sites, refrigeration, and the “tail” that can protect patients who miss appointments or face custody interruptions. We explain why some teams favor weekly Brixadi for the bridge and monthly Sublocade for its long half-life, while others choose monthly Brixadi for logistics and patient comfort. We also clear up a big myth: yes, you can supplement injectables with sublingual buprenorphine when needed.

What matters most is the outcome. DTI compresses complexity into a single, supported action and replaces fear with momentum. Patients report fewer false starts, less chaos, and a quicker path to cravings control and stability. For clinicians and outreach teams, it’s a protocol that works on the street and in clinic, with clear timing, meds, and contingencies that honor how people actually live.

If this helped you rethink induction in the fentanyl era, follow the show, share it with a colleague, and leave a quick review so more clinicians and families can find it. Treating addiction saves lives—let’s make the first step easier.

To contact Dr. Grover: ammadeeasy@fastmail.com

Addicted to Toxic Relationships: Trauma, Sex Work, and The Fight for Recovery

Mon, 23 Mar 2026 02:00:00 -0700

A lot of people think addiction begins with a bad decision. We start earlier—at the moments when consent was stolen, trust collapsed, and silence felt safer than speaking. Carly sits down with us to map the real terrain: childhood sexual assault, a near-rape behind a high school bonfire, military harassment that exploited rank, and the long slide from alcohol to meth, from oxy to heroin. The story is raw and specific, and it asks a bigger question we should all be wrestling with: what if addiction isn’t the disease, but the way we cope with the ones we don’t treat?

We walk through the culture of the OxyContin generation, the false safety of pills, and why heroin often follows when access dries up. Carly explains how meth’s euphoria and laser focus quieted a mind on fire, and why boundaries—not willpower—became the non‑negotiable tools of her recovery. We dig into homelessness, the dangerous logic of abusive relationships, and a nuanced view of sex work as both survival and, at times, chosen agency. It’s complicated on purpose; real lives are.

What stands out most is the timeline. She got clean from heroin years before she learned relationship sobriety. That difference matters to anyone supporting survivors or working in addiction medicine: cravings don’t exist in a vacuum, and trauma doesn’t disappear at discharge. We talk about “playing the tape forward,” spotting red flags early, and building safety that might look extreme to outsiders but keeps a survivor alive and growing.

If you care about trauma-informed recovery, sexual assault, military harassment, homelessness, sex work, and the real mechanics of healing, you’ll find honesty here you can use. Listen, share with someone who needs to hear it, and leave a review so others can find the show. Your feedback helps us keep having the hard conversations that save lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

What I Told a Room Full of High School Seniors About College Party Culture

Mon, 16 Mar 2026 02:00:00 -0700

I sat down with a room full of high school seniors to talk to them about party culture in college.

College freedom can be thrilling—and unforgiving. As an ER physician turned addiction specialist, I pull back the curtain on campus party culture with real stories, clear limits, and life-saving tactics to be used the first weekend of college. From Narcan basics and Good Samaritan protections to the truth about binge drinking, this conversation lays out what actually keeps college students safe when nights get loud and fast.

We start with the numbers: what high-risk drinking is, why “I can hold my liquor” isn’t a flex but a warning sign, and how body size and sex change BAC more than most people realize. Then we walk through the pressure cookers—Greek life hazing, pre-gaming, shotgunning beers, beer bongs, keg stands, and jungle juice—explaining why compressing 10 drinks into an hour is the exact scenario that leads to blackouts, injuries, and assaults. I teach simple, effective steps: eat first, alternate drinks with water, stick with sealed beverages you open yourself, and never leave your cup behind. We talk candidly about consent, spiked drinks, and why half of campus sexual assaults involve alcohol.

The episode also tackles cannabis in 2026: today’s THC is a different drug than what parents remember. We unpack potency, “greening out,” rising rates of cannabis-induced paranoia and psychosis, and how frequent use intersects with attention, grades, and graduation. Along the way, I share ER-tested guidance for handling alcohol poisoning—when to observe, when to call 911, and how to position someone safely—as well as how to spot early signs of alcohol addiction in college students and get help through campus health services.

If you’re a senior heading to college, a parent, or a mentor, this is a clear-eyed playbook for staying safe without sitting out. Subscribe, share this with a student you care about, and leave a quick review—it helps more people find practical, judgment-free advice when they need it most.

To contact Dr. Grover: ammadeeasy@fastmail.com

You Can Use Hypnosis to Drink Less Alcohol???

Mon, 09 Mar 2026 02:00:00 -0700

Hypnosis and moderation rarely share the same sentence—until you understand how your brain decides to drink. We sit down with Australian clinical hypnotherapist Georgia Foster to unpack a practical, science‑aligned approach to reducing alcohol that starts by changing state, not shaming behavior. Georgia explains why the amygdala’s fear and urgency often override the best intentions, how the inner critic fuels that cycle, and what it takes to bring the prefrontal cortex—the calm, planning center—back online when it matters.

You’ll hear how two common patterns show up in overdrinking. The perfectionist white‑knuckles through the week, then binges on relief because there are no references for slow, present drinking. The pleaser says yes to keep the peace, struggling to stay alcohol‑free in social settings. Georgia shows how hypnosis creates new “future references” by rehearsing success in the alpha‑theta window, the natural state between wake and sleep. By pairing imagined events with emotions like confidence, ease, and clarity, the brain encodes a different blueprint—so at a wedding, work dinner, or solo evening at home, choice feels obvious and safe.

We also dig into mindless home routines, the difference between emotional and habitual drinking, simple tactics like “drink one, water one,” and why many people discover they don’t even like what they were pouring once the inner critic quiets down. Georgia shares who responds fastest to hypnotherapy, when to seek additional support, and why building self‑esteem is central to long‑term change. Along the way, we talk about privacy, digital programs, and her goal to help one million people drink less by replacing shame with skill.

If this conversation resonates, follow the show, share it with a friend who could use a gentler path, and leave a quick review—your words help others find evidence‑informed help and start their own change.

To learn more about Georgia's work: https://shop.georgiafoster.com/

To contact Dr. Grover: ammadeeasy@fastmail.com

Understanding Addiction — For the People Who Love Someone Struggling

Mon, 02 Mar 2026 08:00:00 -0800

What if addiction isn’t a failure of willpower, but a failure of the brain systems that make willpower possible? In this episode Dr. Brenda Fann (who has been on the pod before) interviews me about addiction as we provide a clear, compassionate walk through what addiction really is, why it grips so hard, and how families can help without enabling. You’ll hear a physician’s lived experience of losing a spouse to alcohol use disorder, the science behind cravings and executive function, and the practical steps that move people from chaos toward stability.

We unpack the three C’s—cravings, compulsive use, and continued use despite harm—and translate them into everyday red flags partners and parents can actually spot. We explain how early exposure reshapes the adolescent brain, why withdrawal makes “just quit” dangerous advice, and what truly counts as a standard drink. From insomnia fueled drinking to masking trauma with stimulants, we explore how substances solve short‑term problems while creating long‑term damage—and how targeted treatment reverses that math.

Then we get tactical. Think of recovery as a three‑legged stool: medication to steady the biology, therapy to build skills and face trauma, and peer support to restore connection and motivation. For families, the parallel path matters: Al‑Anon or Nar‑Anon, counseling, and firm but fair boundaries. You’ll learn conversation starters that lower defenses (“Help me understand what you need from the alcohol”) and a simple rule for avoiding the “villain” role while still holding the line. We also break down the data on teens, vaping, and the myth that teaching kids to drink at home protects them—it doesn’t.

If you’re ready for a roadmap that blends medical insight with human kindness, this conversation delivers. Subscribe for more evidence‑based guidance, share this episode with someone who needs it, and leave a review so others can find real help faster.

To contact Dr. Grover: ammadeeasy@fastmail.com

Saving Lives: How To Recognize And Reverse An Opioid Overdose

Mon, 23 Feb 2026 02:00:00 -0800

In the case of an overdose, a person stops breathing long before most of us realize what is happening. That is why our mantra is simple and urgent: call 911 and give naloxone. We walk step by step through recognizing an opioid overdose, using nasal naloxone in under a minute, and staying safe while you help. You do not need a medical degree to save a life; you need a clear plan, Naloxone, and the courage to act when someone will not wake up.

We break down how opioids shut down the brain’s breathing center and why unresponsiveness plus poor breathing should trigger immediate action. You will learn the key visual cues, when pinpoint pupils help and when mixed drugs blur the picture, and why naloxone is still a smart move even if alcohol or other substances are involved. We also confront stigma head-on, separating withdrawal management from life-saving priorities, and share a powerful ER story where Naloxone rescued a patient from an overdose in minutes.

Fentanyl demands new habits. We explain why it often takes multiple naloxone sprays, debunk fears about casual skin contact, and outline a compact PPE kit—mask, eye protection, nitrile gloves—to protect against airborne powder or accidental transfer. We cover re-overdose risks when naloxone wears off, the critical role of EMS observation, and practical tips on storage, expiration, and keeping naloxone in your glove box or bag. Along the way, we highlight Good Samaritan protections that reduce fear of calling for help, so more people step forward when it counts.

If you care about harm reduction, community safety, and giving people a second chance, this guide is for you. Hit follow, share this episode with a friend who should carry naloxone, and leave a quick review so more people learn how to act when seconds matter.

To contact Dr. Grover: ammadeeasy@fastmail.com

Wait… Weed Does That??? The Cannabis Side Effects Nobody Warned You About

Mon, 16 Feb 2026 02:00:00 -0800

The story we’ve been told about cannabis—safe, simple, and mostly benign—doesn’t match what we’re seeing at the bedside. Two ER-turned-addiction doctors pull back the curtain on how high-potency products can quietly undercut psychiatric meds, complicate procedural sedation, and nudge recovery off course even when everything else looks better. This isn’t a panic piece; it’s a practical guide to staying safer and getting more from treatment.

We start with psychiatry and a pattern that’s easy to miss: chronic cannabis use can upregulate ABC transporters along the gut, liver, and blood-brain barrier, pushing certain antipsychotics and mood meds out of cells faster and blunting their effect. What looks like “noncompliance” may be pharmacology. We talk through which agents lean on these transporters, which alternatives may perform better, and how to have a stigma-free conversation that protects trust while fixing the plan.

Then we roll into the procedure room. Heavy cannabis use can decrease sensitivity to propofol and other sedatives by altering GABA activity and endocannabinoid tone, often requiring higher doses and tighter monitoring. Add a lesser-known risk—post-propofol hypersalivation in frequent users—and disclosure becomes a safety tool. We share exactly what to tell anesthesia, what clinicians can prepare for, and how to keep airways protected without surprises.

Finally, we examine the “Cali sober” idea through data, not dogma. Large cohort studies link cannabis use to higher rates of alcohol recurrence and new substance use disorders over time, especially with potent concentrates. We cover why potency and pattern matter, how cannabis can dampen the gains of CBT, MI, and contingency management, and what a realistic harm reduction path looks like when abstinence isn’t the first stop. Throughout, we keep language careful—reported use, not admitted; return to use, not relapse—because words shape trust.

If you care for patients, care about someone in recovery, or care about your own health, this conversation offers a clear framework: ask better questions, match meds to biology, and align goals to protect progress. Subscribe, share with a colleague or friend, and leave a quick rating to help others find the show. What did you learn that changes your practice—or your plan—today?

Link to State by State Alternatives to California Sober: https://www.mcsweeneys.net/articles/local-alternatives-to-california-sober

To contact Dr. Grover: ammadeeasy@fastmail.com

Up All Night: How Drugs, Alcohol, and Recovery Disrupt Sleep—and How to Fix It

Mon, 09 Feb 2026 02:00:00 -0800

Sleep doesn’t break because you forgot how to close your eyes. It breaks when anxiety trains your brain to stay on guard, and when quick fixes like alcohol, cannabis, or OTC sleep aids sedate you without restoring you. We team up with Australian psychologist and author Helen Dugdale to unpack how insomnia forms, why 3 a.m. wakeups become a habit loop, and the practical, evidence‑based steps that rebuild real rest—especially for people in recovery.

Helen shares how anxiety sits at the core of most sleep problems and why the brain’s plasticity is our greatest ally. We dig into Cognitive Behavioral Therapy for Insomnia (CBT‑I) basics—aligning with circadian rhythm, setting simple pre‑bed routines, and replacing catastrophic thoughts with repeatable behaviors—and explore how Eye Movement Desensitization and Reprocessing (EMDR) calms trauma so sleep skills can finally land. Expect concrete tactics: caffeine cutoffs tied to bedtime, screen boundaries that don’t feel punitive, mantras that redirect attention, breathing and counting that occupy mental space, and progressive muscle relaxation you can run anywhere, even in a noisy room with the lights on.

We also address the realities people with addiction face: unstable housing, tight budgets, caregiving, and long days that drain executive function. You’ll hear how to build micro‑habits that fit into crowded lives—thirty seconds while the kettle boils, one minute before starting the car, seven minutes as “0.5% of your day.” We talk timelines for progress, what to do on rough days when HALT hits, and how to bounce back from relapse without shame. The throughline is hope: you are worth the effort, and repetition rewires nights. If you’re ready to trade quick fixes for deep, durable rest, this conversation gives you a blueprint you can start tonight.

Subscribe, share with a friend who needs better sleep, and leave a review with the one habit you’ll try first. Your feedback helps others find the show.

To learn more about Helen's work: https://australianbraincoaching.com.au

To contact Dr. Grover: ammadeeasy@fastmail.com

Could This Device Change the Future of Addiction Treatment???

Mon, 02 Feb 2026 02:00:00 -0800

What if opioid withdrawal could visibly ease in 20 minutes and cravings could drop to near zero within days? We sit down with Net Recovery CEO Joe Winston to unpack a wearable neuromodulation device, FDA-cleared for managing opioid withdrawal, that adapts to real-world drug trends and may restore a person’s ability to choose. Joe traces an unexpected journey from aerospace and AI to building a handheld system that translates complex waveform expertise into accessible care—and shares how rigorous trials and peer-reviewed data convinced skeptics.

We dive into how the device works: gel electrodes behind the ears deliver patterned stimulation that dynamically shifts based on daily assessments of opioid, sedative, and stimulant withdrawal. As supplies change—think xylazine-adulterated fentanyl or emerging veterinary sedatives—the team retools waveforms to meet the moment. The results are striking: measurable relief within an hour, average treatment of three to four days, and early evidence that many patients reduce use of opioids and psychostimulants for months post-treatment, even without medication. That renewed agency becomes the catalyst for aftercare, longer residential stays, and more consistent engagement.

Access and scale matter as much as science. We explore delivery in jails where Medicaid interruptions worsen withdrawal, residential programs, and new office-based addiction treatment designed for privacy and minimal life disruption. We also tackle safety and harm reduction—falling tolerance raises overdose risk if someone returns to old doses—and clarify patterns of lapse versus relapse observed in follow-ups. Beyond clinics, Joe lays out a bold public-health vision: statewide jail deployments measured against overdoses, all-cause mortality, and re-arrest. It’s a practical, humane plan to meet people where they are and move addiction care forward with data, transparency, and stories of real recovery.

If this conversation resonates, follow the show, share it with a colleague, and leave a quick rating. Your support helps more people find evidence-based paths out of addiction.

To Learn More about Net Recovery: https://www.netrecovery.net

One of the studies Joe referenced in our interview: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1510428/full

To contact Dr. Grover: ammadeeasy@fastmail.com

How Ketamine Treats Depression, Anxiety, And PTSD

Mon, 26 Jan 2026 02:00:00 -0800

Join us for this episode which is a fast, honest tour through what ketamine can actually do for mental health—without the hype. We sit down with addiction psychiatrist Dr. Mark Hrymoc to unpack where the evidence is strongest, who qualifies, and why IV ketamine often produces quicker relief than nasal esketamine when depression won’t budge. From treatment-resistant depression and acute suicidality to anxiety and PTSD, we dig into the protocols that matter: six-session inductions, customized maintenance, and practical strategies for measuring progress with tools like the PHQ-9.

We pull back the curtain on how ketamine works at the receptor level—NMDA antagonism, downstream dopamine effects, and BDNF-driven neuroplasticity—and explain why dissociation may help some patients but isn’t required for benefit. You’ll hear how we screen candidates, manage blood pressure, reduce nausea, and set up sessions with eye masks, ambient music, and a nurse at the bedside so the experience is safe, focused, and grounded. We also get real about addiction risk, clarifying the difference between recreational use and a carefully monitored medical protocol, and how stable recovery timelines factor into clinical decision-making.

For PTSD and anxiety, we explore pairing ketamine with psychotherapy and post-session integration to turn insights into change. We compare IV ketamine’s dosing flexibility with Spravato’s structured pathway, talk costs and coverage, and outline how to taper other meds only after sustained stability. Looking ahead, we spotlight promising research directions—from extending response with adjuncts to early signals for substance use disorders—and why interventional psychiatry is opening a much-needed chapter beyond traditional antidepressants. If you’ve wondered whether ketamine is a bridge or a destination, this conversation gives you a clear, practical map. Subscribe, share with a clinician friend, and leave a review to help others find evidence-based mental health care.

To contact Dr. Grover - ammadeasy@fastmail.com

Parents in Recovery: Navigating Sobriety While Raising a Family

Mon, 19 Jan 2026 02:00:00 -0800

Parenting can sharpen joy and stress at the same time—and for moms and dads in recovery, that edge can test every habit that keeps sobriety strong. We sit down with Sarah Benton, licensed counselor, addiction specialist, and author of Parents in Recovery, to unpack how families can protect recovery without sacrificing the warmth and wonder of raising kids. From morning routines to packed weekends to those birthday parties where wine shows up next to the cupcakes, we get practical about limits, language, and the lifestyle choices that prevent burnout.

Sarah explains why “recovery first” isn’t selfish—it’s the foundation that keeps everything else standing. We explore the high-functioning myth, where substances quietly enable overloaded schedules, and what happens when you remove the “checkout” at day’s end. Expect candid talk on right-sizing commitments, navigating the dip of post-acute withdrawal, and building a toolbox that actually works: therapy, meetings, peer support, and simple rituals for rest. We also dive into partner dynamics, from two parents in recovery to mixed households, and the education and respect that make those setups sustainable.

Prevention gets the spotlight too. Genetics raise the stakes, and delaying a teen’s first drink past 15 meaningfully lowers risk. We share how to start honest conversations by middle school, present family history without shame, and set boundaries around alcohol and cannabis in social spaces. You’ll hear real-world scripts, ways to model “social battery” limits at home, and strategies to swap FOMO for intention. By the end, you’ll have a clear map for turning recovery into a steady family culture—one that keeps parents connected and kids grounded.

If this conversation helped, follow the show, leave a quick review, and share it with someone who needs a practical, hopeful roadmap for parenting in recovery.

To learn more about Sarah's work:

www.bentonbhc.com

www.waterviewbh.com

To contact Dr. Grover:

ammmadeeasy@fastmail.com

Parallel Recovery: What If Helping Your Loved One With Addiction Begins With Healing You?

Mon, 12 Jan 2026 02:00:00 -0800

What if helping someone you love through addiction starts with healing yourself? That single shift reframes everything—your boundaries, your tone, your scripts, and the way your home holds stress. Dr. Casey Grover sits down with family coach and author Lisa Katona Smith to unpack Parallel Recovery, a values-driven approach that gives families actionable tools and a steady process for change without the burnout of fixing or the coldness of detachment.

Lisa shares how a personal crisis led her to blend educator skills, CRAFT principles, motivational interviewing, and trauma-informed strategies into a practical toolkit. We explore values and their shadow sides—how devotion without limits becomes resentment, and humor under pressure turns into sarcasm—and why clarity about who you want to be drives better boundaries. You’ll hear the “hamburger boundary” story, a low-stakes, high-impact example of retraining family dynamics; a phone-blocking repair script that turns punishment into invitation; and simple ways to separate the person from the behavior so conversations stay human.

We also look at the reality of nervous systems under stress and why sustainable change means concepts over checklists: consistent limits you can keep, language that calms, and agreements on how to raise concerns after treatment so families don’t slip back into super-sleuth mode. Lisa explains why families are the first and final connection in recovery and how parallel support—one guide for the family, one for the person—reduces conflict and opens the door to readiness. If you’ve felt stuck between carrot and stick, this conversation offers a third path: redesign the relationship so change has room to grow.

To learn more about Lisa and her work: https://lisakatonasmith.com/

To contact Dr. Grover: ammadeeasy@fastmail.com

How Cold Immersion, Breath Work, Yoga, And Meditation Can Build Lasting Sobriety

Mon, 05 Jan 2026 02:00:00 -0800

Cravings don’t wait for perfect conditions, so we need plans that work in real life. I sit down with coach Jason Lyle to unpack a grounded, nontraditional approach to addiction treatment that starts with the body and rewires the brain: cold water immersion, breath work, meditation, and yoga. This is recovery as nervous system training—practical tools that widen the gap between urge and action and put your prefrontal cortex back in the driver’s seat.

Jason shares his path from ministry through sex addiction and despair to a repeatable method that helps men regulate first, then choose. We break down the science in plain language: why ice baths create a safe, high‑intensity rehearsal for impulse control; how Wim Hof‑style breathing builds micro‑seconds of space during cravings; and how a five‑minute, no‑frills meditation practice teaches you to see thoughts and let them go. We also show where yoga fits in—not acrobatics, but simple positions that let the body signal the brain and release tension before it becomes a decision you regret.

Across the hour, we map a daily stack that takes 20–30 minutes and delivers fast results, plus what to expect at the two‑month plateau when the “new normal” feels unfamiliar. You’ll learn the three pillars Jason uses—honesty, curiosity, and self‑love—along with on‑demand regulation moves: a ten‑second breath reset, when to grab a cold shower, and why hard exercise can dump stress hormones when grounding isn’t enough. We also talk identity shifts, rewriting shame narratives with simple journaling and affirmations, and how small choices compound into a life you actually want to defend.

If you’re a clinician, coach, or anyone navigating addiction, this conversation offers concrete steps and clear language to share with patients and peers. Explore Jason’s resources at thesacredgrit.com and his Sacred Grit Podcast for guided practices. If this resonated, follow the show, leave a review, and share it with someone who could use a stronger toolkit for recovery. Your next calm breath might be the start of a different day.

To contact Dr. Grover: ammadeeasy@fastmail.com

Quaalude, Black Beauties, and More: A History of Misused Prescriptions

Mon, 29 Dec 2025 02:00:00 -0800

Vintage drug ads promised calm mornings, slimmer silhouettes, and instant relief from restless nights. We dig beneath the glossy slogans to unpack how Black Beauties, Quaaludes, Miltown, Barbiturates, and Purple Hearts shaped the path to today’s mediations—and what that history teaches us about safety, dependence, and withdrawal. With clear explanations of GABA, tolerance, and cross‑tapering, we connect old “uppers and downers” to modern clinical practice and the real risks people still face.

I share why amphetamines jumped from diet pills to productivity boosters, how tranquilizers won hearts and airwaves, and why barbiturates’ direct receptor action made them both effective and uniquely lethal. We explore the strange logic of combining a stimulant with a sedative in a single pill, the concept of the therapeutic index that flipped prescribing habits, and the cultural pressure—often aimed at women—that fueled demand for daily sedation. You’ll hear how benzos improved the safety margin, where they still go wrong, and how clinicians now use careful tapers, screen for polysubstance use, and apply harm‑reduction strategies to prevent overdose.

If you’ve ever wondered why some drugs vanished and others became standard, this deep dive brings context, clarity, and practical takeaways. You’ll walk away able to explain the difference between narrow and wide therapeutic indexes, why withdrawal from certain depressants is so dangerous, and how our field balances relief with risk. Subscribe, share with a colleague who treats anxiety or addiction, and leave a review with the one historical ad or insight that surprised you most.

To contact Dr. Grover: ammadeasy@fastmail.com

How to Build Emotional Resilience

Mon, 22 Dec 2025 02:00:00 -0800

Stress doesn’t wait for a convenient moment, so why should resilience training wait for a crisis? We sit down with Coach Kay, a PhD serving first responders, ER teams, and other high‑stress professionals, to unpack a practical roadmap for emotional resilience you can actually use. We connect the dots between addiction, overwhelm, and the brain’s survival circuitry, then break down simple steps to recruit the prefrontal cortex, label emotions accurately, and respond with intention instead of impulse.

You’ll hear a clear definition of emotional resilience as a learnable skill and a tour of the six domains that make it concrete: vision, composure, reasoning, health, tenacity, and collaboration. We talk through what a first session looks like, why early “small wins” build momentum, and how honest conversation itself shifts brain chemistry. For clinicians and caregivers, we address the bitter edge of burnout and PTSD and show how third‑person perspective and narrative reframing loosen long‑held patterns without minimizing the pain that created them. If you’re supporting people in recovery, you’ll get language to explain limbic activation, why substances become shortcuts, and how proactive habits restore choice.

This conversation is warm, candid, and grounded: practical journaling prompts, mindfulness tactics, and movement as medicine—whether that’s CrossFit or a neighborhood game of basketball. We make the case for teaching resilience to teens during key developmental windows while reminding everyone that it’s never too late to start. The thread throughout is agency: notice what you feel, understand why, and build rituals that help you act on your values when it counts.

If this resonates, follow the show, share it with a colleague who’s carrying too much, and leave a review with one resilience practice you’re trying this week. Your story might be the nudge someone else needs.

To learn more about Coach Kay's work: https://www.psyrescoaching.com/about

To contact Dr. Grover: ammadeeasy@fastmail.com

Wonderful Person, Horrible Disease: What It's Like Being Married To Someone With Addiction

Mon, 15 Dec 2025 02:00:00 -0800

A physician-mom sits across from us and tells the truth: she loved a good, kind man whose alcoholism, fueled by unhealed PTSD, dismantled their family one crisis at a time. From quiet home drinking to ER runs, withdrawal hallucinations, and an ICU ventilator, her story captures the clinical realities of alcohol use disorder and the human cost families carry in silence. She walks through safety plans for her kids, a neighbor’s garage that became a refuge, and a courthouse morning where getting a restraining order had to look “normal” so the children wouldn’t panic.

We dig into the mechanics of stigma—how judgment from colleagues, self-stigma as a physician, and the fear of losing a job keep people quiet. We talk person-first language, trauma-informed care, and the practical wisdom of respond, don’t react. She shares the hard boundary every caregiver eventually faces: sobriety can’t matter more to you than to the person using. Along the way, community shows up in surprising forms: a packed church, meals left at the door, volunteers finishing a half-built treehouse, hikes that reopen space to breathe, and faith that survives anger and doubt.

You’ll hear concrete takeaways for supporting loved ones with alcohol addiction: naming the disease without shaming the person, building child-first safety plans, seeking counseling that treats PTSD and substance use together, and finding support that fits your life when formal groups aren’t possible. Above all, you’ll hear hope—gritty, ordinary, persistent. If you’re carrying a similar weight, you are not alone. Listen, share this with someone who needs it, and leave a review to help more families find real support. Subscribe for more conversations that put compassion, science, and action at the center of addiction care.

How to Help Someone With Addiction Who Isn't Ready to Change

Mon, 08 Dec 2025 02:00:00 -0800

What if the fastest way to help a loved one stop using isn’t pushing harder but stepping out of the “villain” role? We sit down with master addiction counselor and YouTuber Amber Hollingsworth to unpack a practical, compassionate framework that actually moves people from resistance to readiness. Amber explains why policing, nagging, and ultimatums create the perfect distraction from change—and how strategic empathy, active listening, and credibility open the door to real motivation.

We break the recovery process into simple, workable steps: stop being the bad guy, build trust by reflecting the person’s perspective, and allow the bargaining phase—“only on weekends,” “just beer,” “no more pills”—to serve as useful data rather than defeat. You’ll hear how to accelerate learning without triggering defensiveness, why a 30-day trial of sobriety is a powerful reality check, and how to prepare resources so you can act quickly when the “I’m ready” moment arrives. We also dive into separate-counselor models that lower conflict, how to align change with a person’s values and strengths, and the role of humor and respect in keeping people engaged.

We don’t ignore medical realities. From treating insomnia, anxiety, and depression in early recovery to using long-acting buprenorphine injections for opioid use disorder, we explore low-barrier tools that improve safety and adherence—especially vital in the fentanyl era. The goal isn’t to force a path; it’s to create conditions where the next right step feels easier than the last wrong one.

If you’re a parent, partner, or clinician looking for strategies that work in the real world, this conversation offers concrete scripts, mindset shifts, and timing cues you can use today. Subscribe, share with someone who needs it, and leave a review with your biggest insight—what’s one change you’ll make in your next hard conversation?

To contact Dr. Grover: ammadeeasy@fastmail.com

A Principal’s Playbook For School Drug Prevention

Mon, 01 Dec 2025 02:00:00 -0800

The bell rings, the doors open, and the real work begins: keeping kids safe while the drug market slips into their phones and pockets. We sit down with Principal Leland Hansen to unpack the day-to-day reality of school-based prevention, from vape pens hidden in hoodies to Snapchat dealers who change handles as fast as administrators can warn parents. Leland lays out a candid, practical playbook that pairs firm boundaries with a health-first response, including a six-week on-campus program for first offenses that removes friction for families and actually gets used.

We get specific about what’s showing up now—tobacco and THC vapes far more than alcohol—why post-legalization supply is spilling into schools, and how educators investigate under strict limits that require reasonable suspicion. Leland shares the red flags he watches for, like sudden changes in demeanor and unlikely new friend pairings, and explains why middle school is the leverage point where beliefs are forming and choices stick. We compare big assemblies that grab attention with smaller class sessions that build trust and invite tough questions, and we talk about how students quietly use anonymous tip lines to help friends despite a “no snitching” culture.

Parents are crucial, but time-starved. We discuss ways to reach them—tabling at concerts and back-to-school nights, short videos and podcasts they can catch between chores, and direct guidance on home limits that reinforce school expectations. Partnerships matter: local nonprofits providing on-campus support, health educators updating staff on evolving devices, and police following up when adult sellers target kids. The throughline is simple and strong: clear rules, credible facts, and rapid support change outcomes.

If you care about safer schools, smarter prevention, and giving adolescents real choices, you’ll find tactics you can use tomorrow—whether you’re an educator, parent, or community partner. Subscribe, share with a colleague, and leave a review to help this podcast continue to grow. Your feedback helps us reach more schools and families.

To contact Dr. Grover: ammadeeasy@fastmail.com

Why Substance Use Looks Different After 65

Mon, 24 Nov 2025 02:00:00 -0800

The most dangerous phrase in senior health might be “I’ve always handled it fine.” We dive into how aging reshapes the risks of alcohol, benzodiazepines, opioids, nicotine, and today’s ultra‑potent cannabis—and why familiar habits can turn hazardous after 65. Drawing on frontline cases and recent research, we unpack the baby boomer lived experience, from “mother’s little helper” to daily cocktail hours in senior communities, then connect it to the biology of aging: slower metabolism, reduced kidney and liver function, impaired balance, and sharper sensitivity to side effects.

You’ll hear why DSM‑5 criteria still apply but require age‑aware interpretation, what “code cannabis” looks like in the ER when edibles or high‑THC products masquerade as stroke, and how subtle red flags—poor sleep, irritability, shakiness, forgetfulness, falls—signal a brewing problem. We get practical about safer detox for older adults, the reality of kindling with alcohol withdrawal, and the medication decisions that matter: when to taper sedatives, how to avoid dangerous interactions, and why nutrition and B‑vitamins can’t be an afterthought. Two real-world cases ground the lessons—titrating decades‑long benzodiazepine and Z‑drug use while reducing fall risk, and using naltrexone strategically for late‑onset alcohol use without tipping a patient into instability.

If you care for an older adult—or you are one—this conversation offers clear steps to lower risk and raise quality of life: rethink sleep meds, reduce alcohol use, check cannabis potency, simplify regimens, and choose therapy and support groups that fit your season of life. Subscribe, share this with a friend or colleague, and leave a review with your biggest takeaway so we can keep building smart, stigma‑free care for older adults.

To contact Dr. Grover: ammadeeasy@fastmail.com

A Bariatric Surgeon Schools Me On Food Addiction and Weight Loss Surgery

Mon, 17 Nov 2025 02:00:00 -0800

Food isn’t just fuel and obesity isn’t just willpower. We sat down with bariatric surgeon Dr. Mark Vierra to unpack what weight-loss surgery really changes, why genetics and hormones can overpower the best intentions, and how a careful program decides who needs a scalpel and who needs a different plan. From GLP‑1 surges and ghrelin drops to PYY’s “brake,” we walk through how surgery reshapes appetite signals and why even modest weight loss can dramatically improve diabetes and cardiovascular risk.

The conversation goes beyond the operating room. Dr. Vierra explains why five of six referrals don’t get surgery, how he and his partner analyze food diaries, depression, and daily constraints, and when medications like bupropion or GLP‑1s make more sense. We explore binge patterns, the messy reality of predicting who will do well after weight loss surgery, and the tough calls around patients who’ve been told their BMI is destiny when their labs and function say otherwise. The story shifts sharply when we talk alcohol: after gastric bypass, blood alcohol rises faster and stays higher, which raises the risk of alcohol use disorder over time. We share practical ways to screen motives for drinking, plan safeguards with families, and use craving meds thoughtfully.

What ties it all together is respect for biology and the person in front of us. Genetics like MC4R variants and syndromes such as Prader–Willi can drive lifelong hyperphagia; ultra‑processed foods and liquid calories amplify the problem; stigma keeps people from care. We push for a different bias—against soda and engineered foods, not against people—and for care that follows patients long after the incisions heal. If you want a grounded, humane guide to obesity treatment, this conversation delivers clarity without blame.

If this resonated, follow the show, share it with a friend, and leave a review so others can find it. Your support helps us keep building informed, stigma‑free conversations about health.

To contact Dr. Grover: ammadeeasy@fastmail.com

The Brain Science Behind Addiction

Mon, 10 Nov 2025 02:00:00 -0800

Your brain is ancient, but your world is not. We unpack how a hunter-gatherer reward system runs into modern dopamine superstimuli—engineered foods, infinite feeds, one-click buys, and potent drugs—and why that mismatch can spiral into addiction. Using clear language and vivid examples, we explain cravings, compulsion, and consequences through the lens of dopamine: how normal rewards help us survive, how substances hijack that circuitry, and how constant notifications keep the throttle stuck open.

We go deeper into the factors that raise or lower risk. Genetics account for roughly half of vulnerability and often determine a “drug of choice,” where one person feels sick from alcohol while another feels energized and social. Then we connect the dots between mental health and substance use. Depression, anxiety, ADHD, and PTSD frequently overlap with addiction, and treating one without the other rarely works. The ACEs research shows how chronic childhood stress reshapes the brain and the body, setting the stage for later disease. PTSD flips fight-or-flight on at the wrong time, and many people reach for alcohol or cannabis to blunt nightmares and panic, only to worsen the cycle.

Timing is pivotal. Teen brains run on lower baseline dopamine yet respond fiercely to novelty, making early use more rewarding and more dangerous. We share practical insights about delaying use, protecting brain development, and building real skills for stress, sleep, and conflict. A candid case study ties it together: a young adult mixing alcohol and cocaine, a missed PTSD diagnosis, and a turning point when care shifts to trauma therapy and targeted medications. The takeaway is hopeful and clear—when we treat the pain beneath the substance and rebuild healthy rewards, recovery becomes possible and durable.

If this conversation helped you see addiction more clearly, subscribe, share the episode with someone who needs it, and leave a review with your biggest takeaway. Your support helps more people find science-based care and hope.

To contact Dr. Grover: ammadeeasy@fastmail.com

Gas Station Heroin and the Loopholes Fueling “Legal Highs” In America

Mon, 03 Nov 2025 02:00:00 -0800

A brightly colored box at a smoke shop should not hit like an opioid, yet that’s the business model behind “gas station heroin.” We dive into how tianeptine—a foreign antidepressant with mu‑opioid activity—landed on American countertops as a “dietary supplement,” and why that mirrors a broader playbook: repackage potent psychoactives, exploit loopholes, pivot fast when bans arrive, and let consumers pay the price. Joined by Matthew Lowe, executive director of the Global Kratom Coalition, we trace the supply chain from warehouses to wallets and separate leaf kratom from the synthetic isolates hijacking its name.

We break down the risk gradient inside the kratom category: natural leaf with fiber and mixed pharmacology, concentrated extracts that raise potency, and seven‑hydroxymitragynine products that function like a novel opioid. Matthew explains why the FDA’s percentage‑based scheduling of 7‑OH is a smart, surgical fix that preserves traditional use while ejecting synthetic opioids from the “supplement” aisle. We also tackle hemp’s loophole economy—Delta‑8 and Delta‑10 THC derived from hemp yet delivering marijuana‑like effects with far less oversight—plus contamination, cross‑stocking, and the handful of distributors fueling multiple “legal high” trends at once.

Beyond policy, we talk people. When regulators finally pull a dangerous product, dependent users are often left stranded. We outline a practical path: better labeling that discloses opioid activity and dependence risk, age gates, potency caps, and targeted enforcement against unapproved drugs sold as supplements. Just as crucial, clinicians need straightforward guidance to assess what patients took, why they took it, and how to transition them to safer, evidence‑based care without stigma.

Curious how these products keep showing up, what “novel synthetic opioid” really means, and how we can protect choice where risk is low while acting decisively where harm is high? Press play, share this episode with a friend, and leave a review with the one reform you think would make the biggest difference. If this helped you learn something new, subscribe so you never miss an update.

To contact Dr. Grover: ammadeeasy@fastmail.com

What It’s Really Like To Practice Addiction Medicine

Mon, 27 Oct 2025 02:00:00 -0700

Have you ever wondered what it's like to practice Addiction Medicine? In this episode I speak about what we do in Addiction Medicine - both generally as well as how we do things in our practice on the Central Coast of California.

I share how our clinic treats substance use with low‑barrier access, kind care, peer support, and long‑acting injectables while partnering with therapists to address trauma and ADHD that often drive relapse.

I also review two cases that reveal how PTSD and undiagnosed ADHD change the treatment plan and the outcome.

Topics Discussed:

• What an addiction medicine visit includes
• Medications for alcohol and opioid use disorder
• The "three‑legged stool" of meds, therapy, and groups to treat addiction
• Levels of care and smooth transitions
• Dual diagnosis as the rule, not the exception
• Low‑barrier access through walk‑ins and telemedicine
• Person‑first language to reduce stigma
• Peer support as lived‑experience expertise
• Long‑acting injectables to boost adherence
• Mobile street medicine and carceral care partnerships

To contact Dr. Grover: ammadeeasy@fastmail.com

Busting Myths, Building Trust: Communicating with Patients

Mon, 20 Oct 2025 02:00:00 -0700

Dr. Casey Grover welcomes Dr. Sarah Nasir, an addiction medicine specialist, for an insightful conversation about effectively communicating with patients and addressing common myths in addiction treatment.

• Personal journeys into addiction medicine that transformed both doctors' understanding of substance use disorders
• The science behind medication-assisted treatment and why it's not "trading one addiction for another"
• How the body adapts to chronic opioid use through three key mechanisms: reducing natural chemicals, decreasing receptors, and increasing metabolism
• Why recovery takes time: "It's easier to break something than to fix it"
• The critical connection between trauma, PTSD, and addiction
• Integration of life coaching principles into addiction treatment
• Creating authentic connection as a cornerstone of effective recovery
• Addressing stigma around medications in recovery communities and sober living facilities
• The difference between dependence and addiction in patient education

If you're a healthcare provider treating patients with addiction, thank you for your life-saving work. For everyone else, thank you for taking time to learn about addiction – it's a fight we cannot win without awareness and action.

To contact Dr. Grover: ammadeeasy@fastmail.com

Dual Diagnosis: Why Treating One Without the Other Never Works

Mon, 13 Oct 2025 02:00:00 -0700

Mental health conditions and addiction are deeply intertwined, creating complex treatment challenges that require addressing both simultaneously. Dr. Mark Hrymoc, an addiction psychiatrist, shares insights on effectively treating dual diagnosis patients through parallel treatment plans that address both substance use and underlying mental health conditions.

• Dual diagnosis (co-occurring disorders) describes patients with both mental health conditions and substance use disorders
• Many patients use substances to self-medicate underlying mental health conditions rather than for euphoria
• 50-80% of patients with addiction also have PTSD or significant trauma histories
• SSRIs like Zoloft and Lexapro are first-line treatments for anxiety disorders including PTSD
• Prazosin is effective for PTSD-related nightmares
• Propranolol, clonidine, and gabapentin offer non-addictive options for anxiety management
• ADHD is a major risk factor for developing substance use disorders
• Non-stimulant options like Strattera, Qelbree, and Wellbutrin should be tried first for ADHD with comorbid addiction
• Insomnia treatment options include trazodone, mirtazapine, quetiapine, and newer DORA medications
• Ketamine therapy shows promise for treatment-resistant depression and suicidality

Remember, treating addiction saves lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

Weight Loss Surgery Doesn't Treat Food Addiction

Mon, 06 Oct 2025 02:00:00 -0700

Dr. Casey Grover shares his personal struggle with food addiction and binge eating while exploring the science behind why certain foods trigger addictive behaviors in the brain. He examines how the food industry deliberately engineers products to maximize pleasure and consumption through carefully calibrated combinations of sugar, fat, and salt.

• Food addiction involves an intense dopamine response to certain foods that varies between individuals based on genetic predisposition
• The food industry uses "bliss point" science to make products as addictive as possible
• Ultra-processed foods make up over half the average American diet despite increasing risks of various diseases
• Eating disorders (anorexia, bulimia, binge eating) are mental health conditions where food behaviors are merely the symptoms
• Treatment options include SSRIs, topiramate, naltrexone/bupropion combinations, and potentially GLP-1 medications
• Weight loss surgery fails to address the underlying mental health aspects of food addiction
• Dr. Grover's personal experience with naltrexone showed how it made previously pleasurable foods taste "flat"

If you found this episode helpful, please consider supporting Central Coast Overdose Prevention (https://ccodp.org/) and the work we do to treat addiction and prevent overdoses. Together we can improve how addiction is treated and save lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

Stigma 4: When Heroes Need Help

Mon, 29 Sep 2025 02:00:00 -0700

This episode is the fourth and final episode of a four part series on stigma.

This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.

First responders face unique mental health challenges due to the high-stress nature of their work, but stigma often prevents them from seeking help when they're struggling. Dr. Casey Grover, firefighter/paramedic Jesse, and firefighter/paremedic Evan discuss the psychological toll of being the ones who save lives, including PTSD, addiction, and the struggle with vulnerability.

We also hear from Dr. Reb Close, who worked as an Emergency Medicine physician for over 20 years.

• First responders naturally prioritize others over themselves, often neglecting self-care
• "Normalization of deviance" occurs when first responders gradually develop unhealthy coping mechanisms
• PTSD is a permanent brain change that many first responders experience but fear admitting
• Female first responders face additional challenges and scrutiny in male-dominated professions
• The pressure to appear perfect creates barriers to seeking help, even when struggling severely
• First responders often judge themselves more harshly than they judge others
• Addiction can develop as a way to self-medicate trauma and stress
• Recovery is possible when first responders become willing to be vulnerable and uncomfortable
• Those with established careers have the social capital to break stigma by sharing their experiences

If you're a first responder struggling with mental health or addiction issues, please know that help is available and seeking it early can prevent tremendous suffering. You are not alone, and recovery is possible.

To Contact Dr. Grover: ammadeeasy@fastmail.com

Stigma 3: Mom vs. Addiction - The battle she never signed up for

Mon, 22 Sep 2025 02:00:00 -0700

This episode is the third episode of a four part series on stigma.

In this episode, Wendy Solorio shares her raw, emotional journey as a mother supporting her daughter Gabrielle through addiction and into recovery, highlighting the often-overlooked impact on families and caregivers.

• First recognizing her daughter's addiction during high school while dealing with guilt and shame as a parent
• Reaching emotional breaking points while preparing for the worst possible outcomes
• Navigating the healthcare system and waiting for treatment beds during crisis moments
• Facing financial devastation with treatment costs of $40,000 and maxing out multiple credit cards
• Experiencing stigma from coworkers, friends, and even law enforcement
• Dealing with the trauma that remains even after 2.5 years of her daughter's sobriety
• Finding support through therapy, medication, and select family members
• Advocating for better education among first responders and healthcare providers
• Emphasizing the critical role of substance use navigators in emergency departments
• Offering advice to other parents: "Care for the caregiver, never stop self-educating, have tough conversations"

To contact Dr. Grover: ammadeeasy@fastmail.com

Stigma 2: Stigma Hurts, Compassion Heals

Mon, 15 Sep 2025 02:00:00 -0700

This episode is the second episode of a four part series on stigma.

In this episode, Gabrielle shares her powerful journey from fentanyl addiction to recovery, highlighting the unexpected moment of compassion from a correctional officer that changed everything. Her story reveals how respect and dignity can transform recovery outcomes, while exploring the deep impact of self-stigma and family support.

She shares her experience:

• Hitting rock bottom on Christmas Eve 2022 after stealing her mother's car during active fentanyl addiction
• Experiencing six overdoses, with each one bringing her closer to death
• Finding transformation through a year-long program at Teen Challenge
• Encountering a correctional officer who showed unexpected compassion and dignity
• Battling intense self-stigma despite having family who never gave up on her
• Receiving an ultimatum from her pregnant sister that became a powerful motivator
• Learning that recovery meant becoming a different person, not just the same person without drugs
• Moving from shame about her addiction to being open about her recovery journey
• Finding ways to help others by showing kindness and treating "humans like humans"
• Building a life she couldn't have imagined three years ago, working six days a week and helping with her sister's child

If you or someone you know is struggling with addiction, remember you don't have to do it alone. There are many avenues to recovery, and compassion can make all the difference.

To Contact Dr. Grover: ammadeeasy@fastmail.com

Stigma 1: The Other Side of Addiction - Finding Light After Darkness

Mon, 08 Sep 2025 02:00:00 -0700

This episode is the first episode of a four part series on stigma.

In this episode, Ana Alamo shares her powerful journey from addiction to recovery, revealing how her personal struggles now help her connect with clients as a peer support specialist.

• Born and raised in Salinas, Anna experienced childhood trauma at age five that shaped her early years
• She started using cannabis in middle school and developed a pattern of fighting and substance use
• Her use progressed to using pills including Norcos and Xanax from age 20-25
• Legal trouble became her wake-up call after being involved with fentanyl-laced pills that caused someone's death
• She now works as a peer support specialist and recently graduated with an Associate's degree in Addiction Studies
• She uses her lived experience to connect authentically with clients, especially teenage girls
• She does her best to balance accountability with compassion
• Family took approximately four years to fully trust her again
• Therapy helped her develop vulnerability and begin the ongoing process of self-forgiveness
• She plans to continue her education at CSUMB pursuing psychology

We discuss the stigma and judgement that she felt along the journey through her addiction

And we also discuss how she makes sure her clients with addiction don't feel judgment or stigma from her now that she is a peer support specialist

If you're struggling with addiction, know that recovery is possible. Ana's story shows how our darkest moments can become our greatest strengths in helping others.

To contact Dr. Grover: ammadeeasy@fastmail.com

Benzodiazepines - Pills That Sedate but Don't Rehabilitate

Mon, 01 Sep 2025 02:00:00 -0700

Dr. Casey Grover explores the challenging world of benzodiazepines, explaining why these commonly prescribed medications can create more problems than they solve for patients struggling with anxiety and other conditions.

• Benzodiazepines work like alcohol in pill form, enhancing the brain's natural "downer" chemical GABA
• Long-term use leads to tolerance, dependence, and potentially Benzodiazepine-Induced Neurological Dysfunction (BIND)
• The four most commonly prescribed benzos are diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax)
• Benzodiazepine withdrawal can cause seizures months after the last dose, making it particularly dangerous
• Unlike opioid addiction, there are no specialized medications to treat benzodiazepine addiction
• Tapering from benzodiazepines is extremely challenging, often taking months or years with patients experiencing severe rebound symptoms
• Modern medical understanding now recognizes benzos as inappropriate for long-term anxiety treatment
• Case studies demonstrate how patients prescribed benzos for anxiety often never learn proper coping skills and suffer increasingly worse symptoms

Thanks for listening and remember treating addiction saves lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

When your brain can't let go: Understanding the PTSD-addiction connection

Mon, 25 Aug 2025 02:00:00 -0700

This is a joint episode between the Addiction Medicine Made Easy Podcast and the Kratom Sobriety Podcast

Check out the Kratom Sobriety Podcast: https://kratomsobriety.com/

Trauma and addiction are deeply intertwined, with unresolved PTSD often driving substance use as people attempt to manage overwhelming emotions and physical sensations.

• Understanding PTSD beyond combat veterans—recognizing both "big T" traumas and accumulated "little t" stressors
• Dr. Grover shares his personal journey with PTSD from emergency medicine and the stigma he faced
• The Adverse Childhood Experiences (ACE) scale reveals how early trauma predicts addiction risk
• Multiple diagnoses often overlap—ADHD, PTSD, and addiction create complex treatment challenges
• Medication options for PTSD include prazosin for nightmares, propranolol for triggering, antidepressants, and more
• Innovative treatments like stellate ganglion blocks can reduce physiological reactivity from trauma
• Trauma-informed care requires providers to create safety and understand the person beyond their addiction
• Breaking stigma requires vulnerability—sharing our stories helps others recognize they're not alone

Visit mdcalc.com to check out the Adverse Childhood Experiences score, and listen to the Last Day podcast episode with Dr. Gabor Maté for more insights on trauma and addiction.

To contact Dr. Grover: ammadeeasy@fastmail.com

Medical Literature Matters: How Addiction Professionals Keep Learning

Mon, 18 Aug 2025 02:00:00 -0700

We discuss practical strategies for staying up-to-date with addiction medicine research in this collaborative episode between Addiction Medicine Made Easy and the Addiction Medicine Journal Club podcast.

• Featuring a four-person roundtable with Dr. Casey Grover, Dr. John Keenan, Dr. Sonia Del Tredici, and Thomas Bannard
• Understanding why evidence-based medicine matters in addiction care
• Incorporating lived experience into addiction education and combating stigma
• Developing personalized approaches to staying current with medical literature
• Various learning strategies from reading journals to podcasts to collaborative discussions
• Finding your motivation for continuing education in addiction medicine
• Strategies for making learning "stick" through teaching and knowledge application
• Making knowledge "count twice" by developing resources from what you learn
• The value of consistent, sustainable learning processes over ambitious but unrealistic goals

To contact the Addiction Medicine Journal Club Podcast: addictionmedicinejournalclub@gmail.com

To contact Dr. Grover: ammadeeasy@fastmail.com

Meet Your Inner Mentor (Your Inner Critic Already Knows You) - Anonymous Drama Therapy

Mon, 11 Aug 2025 02:00:00 -0700

Mark MacNichol, a playwright and charity director, shares how his therapeutic approach called Anonymous Drama helps people in recovery and the justice system process trauma and develop emotional wellbeing by viewing their inner thoughts as characters in a play.

• Anonymous Drama is not traditional theater but uses dramatic techniques for therapeutic purposes
• The program helps participants identify characters in their life story, such as the protagonist, the inner critic, and the inner mentor
• Anonymity protocol allows people to explore trauma through fictional characters without revealing personal experiences
• Participants learn to recognize the difference between their negative inner critic and their positive inner mentor
• Over 5,000 people have participated in Anonymous Drama programs, primarily in justice and recovery settings
• The method works by helping people "rewrite their scripts" and develop healthier relationships with themselves
• Mark developed this approach after his own experiences with family addiction and losing his brother to heroin overdose
• Programs are available through an app for individuals or through group sessions
• Financial assistance is available for those who cannot afford the subscription fee

To learn more about Mark's work: https://www.markmacnicol.com/

To contact Dr. Grover: ammadeeasy@fastmail.com

Breaking Barriers: Creating Patient-Friendly Addiction Treatment

Mon, 04 Aug 2025 02:00:00 -0700

Dr. Amy Swift, Deputy Chief Medical Officer and addiction psychiatrist, shares insights on creating healthcare systems that better serve patients with addiction through reduced stigma, trauma-informed approaches, and greater accessibility. She brings a unique perspective as someone who oversees medical care while remaining deeply connected to patients' experiences, emphasizing the need to understand addiction as a brain disease rather than a moral failing.

• Psychiatry and addiction have historically been separated, with mental health providers often telling patients to "get sober first"
• Understanding executive functioning challenges in addiction helps create more flexible, accommodating healthcare systems
• Stigma against addiction is pervasive in healthcare and actively prevents people from seeking life-saving treatment
• Person-first language and creating welcoming environments are crucial steps in reducing stigma
• Virtually all patients with addiction have experienced trauma, requiring trauma-informed approaches to treatment
• Different trauma responses can drive different patterns of substance use – numbness often leads to stimulant use while hyperarousal leads to depressant use
• Family involvement and education are essential components of effective addiction treatment
• Youth education and prevention efforts are critical, particularly around cannabis and newer substances perceived as harmless
• Healthcare leaders must recognize addiction as a brain disease requiring the same compassion and quality of care as other medical conditions

If you're interested in improving addiction care in your healthcare system or community, focus on reducing stigma, implementing trauma-informed approaches, and creating flexible systems that accommodate the unique challenges faced by those with addiction.

To contact Dr. Grover: ammadeeasy@fastmail.com

How To Use Naloxone Like a Pro with Dr. Reb Close (Rebroadcast)

Mon, 28 Jul 2025 02:00:00 -0700

Addiction medicine specialists Dr. Casey Grover and Dr. Reb Close share essential information about using naloxone (Narcan) to save lives during opioid overdoses. They discuss how naloxone administration differs between hospital settings and community response, emphasizing that having this medication readily available is crucial in today's world of fentanyl-contaminated street drugs.

• Naloxone should be as normalized and common as fire extinguishers in homes and workplaces
• In medical settings, naloxone can be carefully titrated to prevent precipitating severe withdrawal
• In community settings, the protocol is simple: administer nasal naloxone, call 911, wait for help
• Only 4% of naloxone prescriptions are actually picked up at pharmacies, making direct distribution essential
• Almost all street drugs now contain fentanyl, placing anyone who uses illicit substances at risk of opioid overdose
• Effective community training includes brief videos, hands-on demonstrations, and normalizing the medication
• Emerging substances in the drug supply (xylazine, synthetic benzos) make naloxone even more important
• Framing naloxone as a tool to help others rather than oneself can overcome stigma-based resistance

If you want to conduct a naloxone training in your community and need resources like videos, slide decks, or handouts, please email Dr. Grover.

Together we can ensure everyone has the knowledge and tools to prevent overdose deaths.

To contact Dr. Grover: ammadeeasy@fastmail.com

Ketamine: The Good, The Bad, and The Ugly

Mon, 21 Jul 2025 02:00:00 -0700

Dr. Casey Grover explores the complexities of ketamine, examining its medical benefits, potential for addiction, and growing presence in both therapeutic and recreational settings.

• Originally developed as a dissociative anesthetic for surgery that doesn't suppress breathing
• Now recognized for treating treatment-resistant depression, PTSD, and suicidal ideation
• Can reduce suicidal thoughts as quickly as 90 minutes after administration
• Also effective for severe pain, alcohol withdrawal, and certain emergency situations
• Recreational use has increased dramatically with seizures up 350% between 2017-2022
• Creates a trance-like "K-hole" state that users seek for altered perception and relaxation
• Long-term use can cause "ketamine bladder" – potentially requiring surgical intervention
• No FDA-approved medications exist specifically for treating ketamine addiction
• For-profit ketamine clinics often charge $500-1,250 per treatment without comprehensive care
• Matthew Perry's death highlights the dangers of ketamine misuse, even under medical supervision
• Most patients with addiction histories should approach ketamine therapy with extreme caution

Thank you for tuning in to the Addiction Medicine Made Easy Podcast. Together we can improve how addiction is treated and save lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

When Mental Health Meets Primary Care: Transforming Addiction Treatment

Mon, 14 Jul 2025 02:00:00 -0700

In this episode, Dr. Casey Grover explores how integrating behavioral health and addiction services into primary care settings can transform healthcare delivery and dramatically improve access to treatment. Dr. Grover speaks to psychologists Patti Robinson and Jeff Reiter about their work creating integrated primary care practices and clinics.

• Healthcare in the US is siloed, forcing patients to navigate separate systems for physical health, mental health, and addiction
• Mental health specialization creates artificial barriers when generalist counselors could help many addiction patients
• Integrated care places behavioral health providers in primary care settings with same-day, brief (15-30 min) appointments
• Primary care doctors welcome the support while mental health providers need retraining to adapt to the flexible model
• Physical clinic design matters—providers should be within 15-20 feet of each other for true integration
• "Pathways" can be created for specific populations like those with opioid use disorder
• Patients overwhelmingly appreciate the convenience and comprehensive approach of integrated care

Visit speaktoyourdoctor.com for resources to share with your medical provider about implementing integrated behavioral health services.

To contact Dr. Grover: ammadeeasy@fastmail.com

Treating Opioid Withdrawal—With the Ear???

Mon, 07 Jul 2025 02:00:00 -0700

Discover how stimulating specific points on the ear can dramatically reduce opioid withdrawal symptoms through an FDA-approved device called the ST Genesis. Shelley Halligan, President of Speranza Therapeutics, explains the science behind percutaneous nerve field stimulation and its remarkable effects on patients struggling with addiction.

• The device works by targeting cranial nerves in the ear to activate the parasympathetic nervous system
• Small electrical pulses delivered continuously for five days can significantly reduce withdrawal symptoms
• Clinical applications include shortening the waiting period before starting Suboxone treatment
• The technology may help prevent precipitated withdrawal, a major barrier to recovery
• Patient case studies show dramatic symptom reduction within minutes of application
• Preliminary evidence suggests effectiveness for alcohol and other substance withdrawals
• Research is underway to develop a 10-day version specifically for fentanyl withdrawal
• The device empowers patients by giving them more control over their treatment timeline
• Implementation in emergency settings could transform overdose follow-up care
• Healthcare providers can receive free training to incorporate this technology into practice

Visit speranzatherapeutics.com to learn more about the ST Genesis device and provider training opportunities.

To contact Dr. Grover: ammadeasy@fastmail.com

A Deep Dive into Urine Drug Testing

Mon, 30 Jun 2025 02:00:00 -0700

Urine drug testing provides critical insights for addiction treatment, helping clinicians understand what substances patients are actually using and how the drug supply is rapidly changing. Matthew Rutledge, founder of MD Labs, shares his expertise on testing methodologies, detection capabilities, and emerging trends in substance use.

• Different drug test types include basic immunoassay cups (similar to pregnancy tests), which detect drug shapes but can have false positives/negatives
• Liquid and Gas chromatography with mass spectrometry provides highly accurate substance identification down to nanogram levels
• Developing tests for novel substances takes 2-4 months, requiring standards and validation across hundreds of specimens
• Poppy seed muffins can genuinely cause positive opiate tests depending on seed source and patient body mass
• Unexpected test results require clinical judgment—some exposures may occur through contamination, intimate contact, or environmental exposure
• Integration of pain and addiction medicine allows better co-management of patients with both conditions
• Emerging threats include nitazine opioids, exotic benzodiazepines, and tianeptine ("gas station heroin")
• Test adulteration methods (vinegar, bleach, dilution) can be detected through validity testing for oxidants, creatinine levels, and specific gravity

To contact Dr. Grover: ammadeeasy@fastmail.com

The High Functioning Patient with Addiction

Mon, 23 Jun 2025 02:00:00 -0700

Today we speak with Dr. Samantha Harte about her experience living as a high-functioning person with addiction and how perfection masks internal struggles. She shares her journey from overdosing on cocaine as she was accepted into her doctoral program to becoming an author and recovery coach helping others find authentic healing.

• High-functioning addiction often hides behind external success and achievements
• Control and perfectionism become secondary addictions that receive cultural reinforcement
• Traditional recovery approaches can face resistance from high-achievers who struggle to admit powerlessness
• Dr. Harte discusses writing her book "Breaking the Circuit" after losing her sister to overdose
• Trauma-informed recovery approaches help address the underlying childhood experiences driving perfectionism
• Self-compassion and making amends to yourself are crucial parts of healing for perfectionists
• Both Dr. Harte and Dr. Grover share personal experiences of maintaining outward success while struggling internally
• Physical healing and spiritual healing are interconnected in authentic recovery

If something Dr. Harte shared resonates with you, please reach out. Dr. Samantha Harte, responds to her own DMs. Connect with her, book a free discovery call, and don't ignore the call if something pierces you – she's here to wake you up and light your soul on fire.

To contact Dr. Grover: ammadeeasy@fastmail.com

Breaking the Ice: Treating Methamphetamine Use Disorder

Mon, 16 Jun 2025 02:00:00 -0700

Dr. Casey Grover explores the history, neuroscience, and treatment approaches for methamphetamine use disorder, highlighting how methamphetamine releases more dopamine than any other known substance.

• Methamphetamine was widely used during World War II by German, Japanese, and Allied forces to enhance performance
• Modern meth production shifted from ephedra to P2P method, creating cheaper, more potent meth with worse psychiatric effects
• Meth causes dopamine release up to 1,400 ng/dL of dopamine compared to cocaine (400), sex (200), and food (150), severely damaging reward centers
• Many methamphetamine users have undiagnosed ADHD and are inadvertently self-medicating
• Effective medications include bupropion, topiramate, atomoxetine, viloxazine, guanfacine, and mirtazapine
• Contingency management (reward-based incentives) shows significant efficacy for methamphetamine addiction treatment
• Combination therapies using bupropion with naltrexone show promise for reducing meth use
• Treating underlying mental health conditions and providing housing/social support remains essential for recovery

To contact Dr. Grover: ammadeeasy@fastmail.com

What Every Doctor Should Know About Addiction: Buprenorphine, Naltrexone, and More

Mon, 09 Jun 2025 02:00:00 -0700

In this episode, we discuss the fundamentals of treating opioid and alcohol use disorders with medication-assisted approaches. We review how to understand addiction as self-regulation with substances and how healthcare providers can leverage familiar medications alongside specialized treatments to help patients recover.

We also discuss

• Addiction fundamentally involves helping patients shift from self-regulating with substances to self-regulating without them
• Distinguishing opioid dependence (physical brain chemistry changes) from opioid use disorder (psychological addiction)
• Buprenorphine as a partial agonist that blocks other opioids, reduces cravings, and decreases overdose risk by 70%
• Three FDA-approved medications for alcohol use disorder: disulfiram , naltrexone, and acamprosate
• Off-label medications like gabapentin and topiramate can enhance alcohol use disorder treatment
• Understanding the fentanyl crisis and emergence of counterfeit pills containing dangerous synthetic opioids
• Addressing stigma through person-first language and recognizing addiction as a disorder of executive functioning

To contact Dr. Grover: ammadeeasy@fastmail.com

What I Learned About Addiction from Matt Butler’s Prison Concerts

Mon, 02 Jun 2025 02:00:00 -0700

This episode is an interview with Matt Butler, a singer-songwriter who has performed in jails and prisons across America for a decade. He shares how music creates transformative spaces for healing in correctional environments.

• Matt's musical journey began after writing songs for a documentary about recovery high schools
• Music penetrates emotional defenses faster than conventional approaches, allowing inmates to be vulnerable
• Songs like "Good Friday" and "Time to Be a Man" directly speak to experiences of addiction and incarceration
• Hypervigilance in prison environments makes trauma processing nearly impossible
• Music temporarily changes the atmosphere, allowing emotional expression typically suppressed for survival
• Trauma and addiction form a vicious cycle that's particularly difficult to break while incarcerated
• Reentry challenges include practical barriers like employment, housing, and basic skills deficits
• Many successful recovery stories involve people transforming their past struggles into purpose by helping others
• Creating spaces where people feel safe and accepted is essential for healing from addiction and trauma

Please check out Matt's album Reckless Son, the one-man show he performs in correctional facilities across the country.

To contact Dr. Grover: ammadeeasy@fastmail.com

An Overview of Psychiatric Medication (and How They Can Help Patients with Addiction)

Mon, 26 May 2025 02:00:00 -0700

Dr. Casey Grover breaks down psychiatric medications and their role in addiction treatment, explaining how different medications work, when they're most appropriate, and which ones to avoid. He provides a practical overview based on his extensive experience treating patients with substance use disorders.

• Psychiatric medications get developed through research on brain receptors and undergo rigorous testing before FDA approval
• Medications often have "off-label" uses that weren't originally intended but provide benefits in certain situations
• Antidepressants like SSRIs and SNRIs serve as the foundation for treating depression in people with addiction
• Using non-addictive options like hydroxyzine, clonidine, and buspirone is crucial when treating anxiety in recovery
• Trazodone and mirtazapine are preferred for sleep issues over benzodiazepines and "Z-drugs" that can create dependence
• ADHD treatment requires careful consideration when patients have stimulant use disorder histories
• Benzodiazepines should be avoided when possible as they paradoxically worsen anxiety over time
• Medication selection should consider urgency of conditions, past medication responses, and potential side effects
• Some psychiatric conditions may improve with therapy allowing medication reduction, while others require long-term treatment

Thank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together we can make it happen. Remember, treating addiction saves lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

Fentanyl High: A Teen Filmmaker's Fight Against the Opioid Crisis

Mon, 19 May 2025 02:00:00 -0700

Kyle Santoro, a 19-year-old filmmaker, created the documentary "Fentanyl High" to explore teenage psychology behind substance abuse after witnessing overdoses at his high school. His film takes a peer-to-peer approach to addiction education, removing stigma and creating spaces for vulnerable conversations about why teens turn to substances.

Kyle and Dr Grover discuss his experiences making the film and what he has learned through making it:

• Kyle began the project after a classmate overdosed in a school bathroom and administrators never acknowledged the incident
• Traditional school responses to substance use often involve punishment and shame rather than compassion and understanding
• Several teens who participated in making the documentary achieved sobriety through the therapeutic process of sharing their stories
• Film screenings serve as community events with resources, panel discussions, and free naloxone distribution
• Schools often resist hosting screenings due to fear of being labeled as having a drug problem
• The documentary has been screened across multiple states creating a "domino effect" of awareness in communities
• Kyle raised $75,000 to produce the film through community sponsors and organizations
• Prevention efforts need more youth representation to create effective messaging that resonates with teens
• The film emphasizes the importance of parents maintaining open communication with their teenagers

If you want to learn more about Kyle's film, visit fentanylhigh.com.

To contact Dr. Grover: ammadeeasy@fastmail.com

Sobriety is a Team Sport

Mon, 12 May 2025 02:00:00 -0700

Tom Barnum, former Michigan State linebacker and NFL player, shares his remarkable journey from addiction to finding joy in sobriety through his team-based approach to recovery.

He is the author of the book "Sobriety is a Team Sport"

We discuss:
• Addiction recovery requires admitting the problem is beyond personal control
• Tom identifies the three paths for people with addiction: sobriety, jail, or death
• AA meetings provide essential human connection that helps rewire the brain's dopamine system
• Forced sobriety through court mandates or fear tactics rarely works long-term
• Recovery groups create unique bonds between people who might otherwise never connect
• Non-alcoholic beverages can be safely incorporated into recovery for some individuals
• Even after decades of sobriety, addiction triggers can unexpectedly surface
• Tom's recovery team includes his wife of 56 years, family, physicians, and former teammates
• Social media has played a positive role in maintaining Tom's recovery connections

Find Tom's book "Sobriety is a Team Sport" on Barnes & Noble or Amazon.

To contact Dr. Grover: ammadeeasy@fastmail.com

These Shots Save Lives - Using Long Acting Injectable Meds for Addiction

Mon, 05 May 2025 02:00:00 -0700

Dr. Casey Grover interviews fellow addiction medicine physician Dr. Jason Giles to explore how addiction specialists approach treatment using long-acting injectable medications as tools for recovery.

We discuss:

• Dr. Giles shares his personal journey from anesthesiology to addiction medicine after developing his own dependency on fentanyl
• Addiction as a disease of executive functioning that impairs decision-making ability
• Recovery requires building new neural pathways - learning to manage emotions without substances
• Long-acting injectable medications (Sublocade, Brixadi, Vivitrol) , and how these medications reduce cravings and provide protection while patients develop new coping skills
• The process of stopping buprenorphine
• Individualized tapering approaches help patients transition from daily medications to occasional use
• Creating a safe environment where patients can be honest is essential for successful treatment

To contact Dr. Grover - ammadeeasy@fastmail.com

How One of My Patients Quit Kratom

Mon, 28 Apr 2025 02:00:00 -0700

Dr. Casey Grover shares his clinical experience treating Kratom Use Disorder through a detailed case presentation of a 38-year-old man who struggled to find medical professionals knowledgeable about kratom addiction.

• Many healthcare providers lack knowledge about kratom, causing delays in patients receiving proper treatment
• Kratom creates opioid dependence similar to traditional opioids, leading to withdrawal symptoms when stopping
• The convenience of buying kratom at smoke shops contrasts sharply with the barriers of traditional medical care
• Patients often use kratom to self-medicate underlying conditions like anxiety, ADHD, or pain
• Effective treatment involves addressing opioid dependence with buprenorphine (or methadone) plus treating underlying conditions
• Once dependent on opioids, patients must either use medications like Suboxone/methadone or endure withdrawal
• Understanding the "feel something, take something" pattern is key to breaking the addiction cycle
• Long-acting injectable buprenorphine (Sublocade) combined with as-needed oral doses proved effective

To contact Dr. Grover: ammadeeasy@fastmail.com

Hot Showers and Horror Stories: Scromiting and Cannabinoid Hyperemesis Syndrome

Mon, 21 Apr 2025 02:00:00 -0700

Cannabinoid Hyperemesis Syndrome (CHS), also known as "scromiting," is a debilitating condition characterized by severe nausea, vomiting, and abdominal pain that affects heavy cannabis users. Dr. Casey Grover explains this increasingly common syndrome caused by high-potency cannabis products, which paradoxically improves with hot showers and proves challenging to treat with conventional medications.

• First identified in 2009 and named "scromiting" to reflect the combined screaming and vomiting patients experience
• Cannabis potency has increased dramatically from 1% THC in the 1970s to 25-30% THC in today's products
• Patients experience cyclical episodes of diffuse abdominal pain, nausea, and vomiting lasting 24-48 hours
• Compulsive hot bathing is a hallmark symptom, with patients focusing hot water on their abdomen for relief
• Standard anti-nausea medications like Zofran don't work well; psychiatric medications like Haldol often provide better relief
• Many patients question the diagnosis because cannabis is thought to help nausea rather than cause it
• Treatment requires cannabis cessation, though symptoms may persist for months after quitting
• Multiple theories explain CHS, including nerve hypersensitivity and paradoxical stress responses from high-dose THC

To contact Dr. Grover: ammadeeasy@fastmail.com

Can You Overdose on Cannabis? The Answer is Yes (Update from 2023)

Mon, 14 Apr 2025 02:00:00 -0700

The cannabis available today is dramatically stronger than what existed in previous decades, with THC levels climbing from 1% in 1970 to 25-30% in 2025, creating serious risks particularly for young people who don't understand appropriate dosing. Dr. Grover shares how cannabis has been deliberately bred for higher potency and how new extraction techniques have created products with astronomical THC levels, leading to dangerous situations like young people consuming 60 times a reasonable dose.

• Cannabis potency has increased from 1% THC in 1970 to 25-30% THC today through selective breeding
• Modern extraction techniques allow THC to be added back into products, creating concentrations as high as 45% and above
• A recreational dose of THC is between 2.5-15mg, but products often contain hundreds or thousands of milligrams
• "Greening out" or cannabis toxicity causes symptoms like confusion, vomiting, decreased consciousness, and anxiety
• Children are especially vulnerable to cannabis toxicity due to smaller body size
• Most cannabis toxicity cases resolve within 24 hours with supportive care
• Prevention requires understanding appropriate dosing and using cannabis judiciously

To contact Dr. Grover: ammadeeasy@fastmail.com

Trauma Therapy Explained with Dr. Jessica Cooper

Mon, 07 Apr 2025 02:00:00 -0700

Trauma is a crucial aspect of addiction treatment, often serving as the underlying cause for substance use. In this illuminating interview with trauma therapist Dr. Jessica Cooper, we explore the mechanics of trauma therapy and how it helps people heal from devastating experiences.

• Breaking down trauma therapy into three essential phases: establishing safety, processing memories, and reconnection/integration
• Understanding how childhood trauma creates patterns that can lead to re-traumatization in adulthood
• Exploring the "fawn" trauma response (people-pleasing) alongside the better-known fight/flight/freeze responses
• Examining the differences in approach between single-incident trauma vs. complex, repeated trauma
• Creating a trauma timeline with "stones" (traumatic events) and "flowers" (protective factors)
• Processing traumatic memories through multiple perspectives: factual, sensory, emotional, and belief-based
• Recognizing signs of healing while understanding recovery is non-linear
• Using creative expression as a powerful tool in trauma recovery
• Developing a collaborative approach to trauma treatment

To contact Dr. Grover: ammadeeasy@fastmail.com

Laughing Gas Addiction Isn't Funny (Update from 2024)

Mon, 31 Mar 2025 02:00:00 -0700

Exploring the growing problem of recreational nitrous oxide use and its serious medical complications, including paralysis and permanent nerve damage. I share personal patient cases and investigate how this addictive substance is readily available in smoke shops and even on Amazon with minimal warning labels.

• Multiple patients experiencing serious neurological complications from recreational nitrous oxide use
• Personal investigation revealing easy access to nitrous oxide on Amazon marketed for whipped cream making
• How nitrous oxide depletes vitamin B12, leading to potential spinal cord and peripheral nerve damage
• Examination of labeling issues with commercial nitrous oxide products
• Comprehensive overview of nitrous oxide's history, effects, and recreational use patterns
• Medical complications including acute risks (seizures, cardiac issues) and chronic effects (neurological damage)
• Treatment approaches focusing on vitamin B12 supplementation and addiction therapies
• Growing prevalence of nitrous oxide use, especially among young people

Remember that treating addiction saves lives. If you or someone you know is struggling with substance use, please reach out for professional help.

To contact Dr. Grover: ammmadeeasy@fastmail.com

Saving Two Lives: How I Manage Opioid Addiction During Pregnancy

Mon, 24 Mar 2025 02:00:00 -0700

Join me, Dr. Casey Grover, as I provide a comprehensive guide to treating opioid use disorder during pregnancy, examining evidence-based approaches that protect both mother and baby through critical periods of care. The statistics are sobering - opioid use disorder in pregnancy has more than doubled in recent years, with overdoses now a leading cause of pregnancy-associated death.

• Two major medical societies (ACOG and ASAM) recommend treating with methadone or buprenorphine rather than attempting medication-free withdrawal
• Buprenorphine shows slight advantages over methadone for pregnancy outcomes, but the best choice is whichever medication keeps the mother sober
• Neonatal abstinence syndrome occurs when babies experience withdrawal after birth, but can often be managed with supportive care rather than medication
• Medication dosages often need adjustment during pregnancy as increased blood volume dilutes medication concentration
• Breastfeeding is compatible with both methadone and buprenorphine treatment
• The postpartum period brings unique challenges that increase relapse risk, requiring enhanced support for new mothers
• Two patient cases illustrate both successful treatment and the challenges of maintaining recovery while parenting a newborn

Visit centralcoastoverdoseprevention.org to learn more about preventing overdose deaths in your community.

To contact Dr. Grover: ammadeeasy@fastmail.com

Lessons Learned From the Front Lines of Addiction Medicine

Mon, 17 Mar 2025 02:00:00 -0700

This episode provides a deep dive into the complexities of addiction medicine learned from seeing patients in my practice. Through real patient cases, I highlight the importance of tailored approaches to addiction that consider both the physiological and psychological aspects of recovery.

We discuss
• Insights into demographics of substance use in a rural setting
• The effectiveness of dual medication therapies for alcohol use disorder
• The link between trauma and substance use disorders
• Emerging concerns surrounding kratom as a public health issue
• The significance of managing co-occurring ADHD in addiction treatment

To contact Dr. Grover: ammadeeasy@fastmail.com

Could N-Acetylcysteine Be the Key to Beating Cannabis Use Disorder?

Mon, 10 Mar 2025 02:00:00 -0700

This episode delves into the role of N-acetylcysteine (NAC) in treating cannabis use disorder, exploring scientific studies and their findings. Listeners will gain insights on the efficacy of NAC, its potential in addiction treatment, and practical considerations for use.

• Overview of cannabis use disorder statistics and the need for treatment options
• Explanation of N-acetylcysteine and its mechanism of action in addiction
• Review of clinical trials evaluating NAC's effectiveness in reducing cannabis use

Subscribe, share your thoughts, or leave a review!

To contact Dr. Grover: ammadeeasy@fastmail.com

How I've Come to Understand PTSD In My Practice

Mon, 03 Mar 2025 02:00:00 -0800

Trauma plays a pivotal role in the journey of addiction, with many individuals using substances as a means to cope with unresolved issues. Addressing PTSD is crucial for effective recovery, as understanding the link between trauma and addiction can empower individuals toward healing.

In this episode we discuss:
• Trauma and its historical context in PTSD understanding
• Description of brain responses to trauma and the feedback loop
• Big T and little t traumas and their cumulative effects
• The connection between adverse childhood experiences (ACEs) and adult illnesses
• The importance of a trauma-informed approach in treatment
• Case studies illustrating the impact of trauma on addiction recovery
• Recommendations for therapeutic interventions and medication options

I reference a podcast episode at the beginning of the episode. Here's a link to that episode

https://lemonadamedia.com/podcast/trauma-with-dr-gabor-mate/

To contact Dr. Grover: ammadeeasy@fastmail.com

Why the Teenage Brain is Wired for Addiction

Mon, 24 Feb 2025 02:00:00 -0800

Understanding the teenage brain’s vulnerability to addiction can help parents and educators guide youth more effectively. This episode explores the brain's development, early drug use risks, emotional impairment, and effective prevention strategies drawn from successful programs like Iceland's.

Key points:
• Teenage brains develop until around age 26, with the prefrontal cortex being critical for decision-making
• Early substance use increases the risk of developing addiction
• Social and emotional learning is impaired by drugs and alcohol
• Nick Sheff's story highlights the long-term effects of early addiction
• Dopamine plays a crucial role in pleasure, survival, and addiction risk
• Teenagers have lower baseline dopamine levels, driving them to seek new experiences
• Iceland's approach to reducing adolescent addiction focuses on positive activities and parental engagement
• Organized activities are protective against addiction, creating positive environments for teens
• Conclusion emphasizes the critical role of understanding and intervention in preventing addiction'

To contact Dr. Grover: ammadeeasy@fastmail.com

Stories From My Patients That Teach Me About Addiction

Mon, 17 Feb 2025 02:00:00 -0800

Can personal stories of struggle and resilience reshape our understanding of addiction? The answer is YES! My patients teach me about addiction all the time!

Join me, Dr. Casey Grover, as I share the powerful stories of three patients whose experiences challenge society’s perceptions of addiction. Their journeys highlight the need for understanding over judgment and the vital role healthcare providers play in supporting those in need.

This episode is a heartfelt call to action. Byy raising awareness and extending support, we can improve addiction treatment and break the stigma surrounding this complex issue. Listen in and join a community committed to compassion, advocacy, and meaningful change.

To contact Dr. Grover: ammadeeasy@fastmail.com

Understanding Trauma: How I Found Out that My Brain Stores Trauma on the Left Side

Mon, 10 Feb 2025 02:00:00 -0800

This podcast episode delves into the groundbreaking concept of dual brain psychology and its implications for understanding trauma and addiction. Dr. Fred Schiffer shares his insights on how different hemispheres of the brain process trauma and the methods developed to facilitate healing through dual brain dynamics.

• Explanation of split brain studies and their significance
• Distinction between the functions of each brain hemisphere
• Insights on how trauma resides in different sides of the brain
• Connection between cravings and brain hemisphere activity
• The cumulative effect of trauma and its relation to addiction
• Gender dynamics and patterns in trauma experiences
• Therapeutic approaches using hemispheric stimulation
• Call for clinicians and patients to explore dual brain psychology

To contact Dr. Grover: ammmadeeasy@fastmail.com

Assault, Addiction, and Healing from Trauma

Mon, 03 Feb 2025 02:00:00 -0800

This is an episode on addiction and trauma, with the author Rikki West as a guest.

Rikki shares her powerful story of assault, addiction, and healing, and we discuss the deep connection between trauma and addiction. We had a fantastic conversation about personal struggles and the importance of community support, as well as finding the path to healing.

We discuss:

• Exploring the connection between trauma and addiction
• Rikki's journey from childhood through addiction to recovery
• Impact of familial addiction on personal development
• The role of community and support groups in healing
• Rikki's experience with therapy and emotional regulation
• Navigating relationships and intimacy after trauma
• The importance of sharing stories for healing and empowerment

To contact Dr. Grover: ammmadeeasy@fastmail.com

Stigma Kills Patients. How We Can Fight Back.

Mon, 20 Jan 2025 02:00:00 -0800

In this episode, we are tackling stigma. Specifically stigma against patients by healthcare providers.

Stigma against patients struggling with addiction is a significant barrier to effective healthcare treatment, leading to profound consequences, including increased harm and even death. The episode highlights the definition of stigma, its impacts on patient behavior, and actionable strategies to reduce it within the healthcare system.

We discuss:
• Definitions and types of stigma
• The harmful effects of stigma on quality of life
• The link between stigma and higher mortality rates
• Patient responses to stigma in healthcare settings
• Personal stories highlighting the real impact of stigma
• Effective strategies for reducing stigma in healthcare
• Importance of using person-first language and educational outreach

To contact Dr. Grover: ammadeeasy@fastmail.com

Xylazine - The "Zombie Drug"

Mon, 13 Jan 2025 02:00:00 -0800

We're talking about Xylazine again. We haven't covered it on the podcast since 2022, and since it's becoming more common in the drug supply, it was time to discuss it again.

Unlock the secrets to understanding one of today's most alarming substances misused in addiction – Xylazine, infamously dubbed the "Zombie Drug." Join me, Dr. Casey Grover, as I dive into the world of Xylazine, a veterinary medication with unintended and dangerous consequences when misused by humans. Discover the pharmacological effects of this alpha-2 agonist, closely related to medications like clonidine, and learn how it disrupts normal physiological functions, leading to slowed heart rate, low blood pressure, and sedation.

In this episode, I unravel the complexities of Xylazine use, highlighting the dire risks of overdose and the challenges faced due to the absence of a human reversal agent. By sharing my 14 years of experience in the emergency department and my current role as a medical director in addiction treatment, I aim to provide crucial insights into how healthcare professionals can respond to Xylazine-related emergencies. This episode offers a comprehensive guide for anyone involved in the realm of addiction medicine, from healthcare providers to individuals battling addiction and their loved ones, emphasizing the importance of informed and compassionate care.

To contact Dr. Grover: ammadeeasy@fastmail.com

Kratom: What Someone Who Uses it (and Loves it) Thinks About it

Mon, 06 Jan 2025 02:00:00 -0800

This episode explores the complexities surrounding kratom, featuring insights from Matthew Lowe of the Global Kratom Coalition (GKC). We discuss the dual nature of kratom, its benefits and risks, the importance of consumer education, and the ongoing push for industry regulation to protect users.

We discuss
• An overview of kratom's rising popularity and consumer demographics
• The role of word-of-mouth and the internet in kratom discovery
• Importance of accurate labeling and consumer education
• Differences between kratom leaf, extracts, and synthetic products
• Discussion on addiction potential and withdrawal symptoms
• The Kratom Consumer Protection Acts and their significance
• Ethical considerations within the kratom industry
• Call for enhanced regulation and responsible marketing practices

To contact Dr. Grover: ammadeeasy@fastmail.com

How A Firefighter Went from Injecting Opioids to Sobriety and Fighting Stigma

Mon, 23 Dec 2024 02:00:00 -0800

Evan Morgan, a dedicated fire captain from Central California, provides a raw and deeply personal account of his struggle with addiction, illustrating the harsh realities faced by healthcare professionals battling the stigma that comes with it. Once an ambitious student experimenting with drugs, Evan’s journey spiraled into dependency on prescription painkillers after a workplace injury. His candid narrative reveals the devastating effects of addiction on his professional life and personal relationships, offering listeners a rare glimpse into the internal conflicts of a first responder caught between duty and dependency.

Listeners will discover how Evan's life took a pivotal turn when an encounter with law enforcement acted as a much-needed wake-up call. The story unfolds to reveal the weight of maintaining a paramedic career while wrestling with a Dilaudid addiction and the unexpected relief that came with being honest about his struggles. With backing from his supportive fire department chiefs, Evan embarked on a rehabilitation journey at the International Association of Firefighters in Maryland, which ultimately led him to sobriety. Through his inspirational account, we explore the power of transparency and the surprising support system that can emerge when someone is brave enough to ask for help.

Our episode underscores the critical need to shift perceptions around addiction in professional settings, with a focus on reducing stigma through empathy and understanding. Evan's experience exemplifies how sharing personal stories can foster compassion and break down prejudices in healthcare environments. By shedding light on the prevalent issues of substance abuse and PTSD among first responders, we aim to promote a culture of support and awareness, encouraging others to view addiction through a more compassionate lens. Join us as we commit to creating resources and raising awareness for addiction treatment, inspired by the bravery and resilience of those like Evan.

What I Learned When I Went Down The DMT Rabbit Hole

Mon, 16 Dec 2024 02:00:00 -0800

Join me, Dr. Casey Grover, on an eye-opening journey as we tackle the tough questions surrounding addiction medicine.

We start by discovering why cannabis isn't the harmless plant many believe it to be, especially in the context of recovery. Drawing from a compelling study, we reveal how cannabis use in sober living environments may set the stage for relapse into alcohol and other drugs, challenging the notion that it can coexist with sobriety.

But that's just the beginning. We next do a deep dive into dimethyltryptamine (DMT), a powerful hallucinogen stirring curiosity in addiction treatment circles. From its natural origins to its historical significance in traditional ayahuasca ceremonies, we explore DMT's unique effects and how they differ based on how it's taken.

In our quest to understand hallucinogens in addiction treatment, we discuss hallucinogen use disorder. With no medication-assisted treatment available, we emphasize the need to address underlying mental health issues. As we finish the episode, we explore emerging research on the therapeutic possibilities of hallucinogens like psilocybin in the treatment of other substance use disorders.

References:

Madam Noire link: https://madamenoire.com/1331923/everything-you-need-to-know-about-ayahuasca/

Addiction Medicine Textbook link: https://shop.lww.com/The-ASAM-Essentials-of-Addiction-Medicine/p/9781975107956

To contact Dr. Grover: ammadeeasy@fastmail.com

How My Friend Paul Got Sober, Slipped Up, and Got Sober Again

Mon, 09 Dec 2024 02:00:00 -0800

Imagine battling substance addiction for decades, only to find your path to recovery through personal growth and self-awareness. In this heartfelt episode, I, Dr. Casey Grover, sit down with Paul Giovino, a Monterey resident who courageously shares his transformative journey from dependency to resilience. Paul's story is not just about overcoming addiction; it's about addressing the emotional roots of substance use and finding strength in building self-esteem. Together, we explore the significant hurdles he faced, from professional setbacks to health challenges, and the pivotal role of personal development activities in his recovery process.

As we navigate the complexities of opioid addiction treatment, we uncover the challenges posed by substances like fentanyl and the groundbreaking impact of treatments such as buprenorphine. Our conversation sheds light on the societal stigma surrounding treatments like methadone, which can often hinder recovery efforts. Through personal anecdotes, we discuss how individual differences in brain chemistry influence responses to opioids, and the ongoing struggle to overcome self-shame and societal misconceptions. It's a deep dive into the science and personal stories behind addiction, shedding light on how these factors play into the recovery journey.

Community support emerges as a key theme in our discussion, emphasizing how networks like Alcoholics Anonymous can be instrumental in maintaining sobriety. We highlight the importance of creating compassionate and stigma-free healthcare environments, and how education is crucial in transforming addiction treatment. By sharing Paul's inspirational story, we underscore the life-saving impact of early access to addiction care and the power of a supportive community in fostering resilience and self-awareness. Join us for an episode that reminds us of the profound truth: treating addiction saves lives.

To contact Dr. Grover: ammadeeasy@fastmail.com

A Child Psychiatrist Schools Me on ADHD Meds in the Treatment of Addiction

Mon, 02 Dec 2024 02:00:00 -0800

Discover the transformative potential of ADHD medications in addiction treatment as we bring you a captivating discussion with Dr. Justin Mohatt, a renowned child and adolescent psychiatrist. Dr. Mohatt joins us to unravel the complexities of using ADHD medications to combat stimulant addiction, shedding light on how these drugs can make a difference. We'll explore a myriad of medications, including guanfacine, clonidine, and atomoxetine, and discuss their respective roles in addressing adult ADHD and substance use disorders. Learn the importance of a meticulous diagnostic process to distinguish ADHD from other mental health conditions like depression and anxiety, ensuring a tailored approach to treatment.

We navigate the nuanced landscape of ADHD in adults with a history of substance use, emphasizing the critical role of family insights to inform diagnoses beyond self-reports. The conversation underscores the careful application of stimulants for ADHD, even in those with stimulant use disorders, while presenting Vyvanse as a potentially safer choice. Non-stimulant medications like atomoxetine receive special attention for their dual role in treating ADHD and co-occurring anxiety, offering a glimpse into strategies for managing side effects and insurance hurdles. Hear how non-addictive alternatives could provide solutions for patients who haven't found success with traditional medications.

As we delve deeper into co-occurring ADHD and trauma, Dr. Mohatt discusses the potential benefits of alpha agonists and other non-stimulant options in treating complex cases involving PTSD and substance use disorders. Together, Dr. Mohatt and I affirm the importance of addressing ADHD within addiction treatment to foster recovery and improve cognitive function, offering a beacon of hope for those navigating these intertwined challenges.

To contact Dr. Grover: ammadeeasy@fastmail.com

What I Say to High Schoolers When I Teach About Addiction

Mon, 25 Nov 2024 02:00:00 -0800

This is a bonus episode. I was asked to speak at several schools in the area around where I work about drugs and alcohol - both to students and to parents.

I wanted to make the education as impactful and real as possible. So I focused on the substances that are most likely to affect our youth and their families - alcohol, cannabis, nicotine/vaping, and fentanyl.

To help make my presentation as real as possible, I actually went to a liquor store, a tobacco shop, and a cannabis dispensary to look at how these products are sold and marketed - and how to interpret the labels on them.

Whether you are a student, a parent, or just a person concerned about substance use, I know you will learn something from this lecture. If you're looking to start a conversation with your loved one about drug and alcohol use, this lecture will help educate you on the current state of addiction, and give you information on how to start that conversation about drugs and alcohol.

To contact Dr. Grover: ammadeeasy@fastmail.com

The Science on Kratom: Kratom Journal Club (Bonus with CME)

Mon, 18 Nov 2024 02:00:00 -0800

* Link to get CME at the bottom of the show notes *

Ever wondered if a plant could be both a herbal remedy and a controversial subject in addiction medicine? Join us as we uncover the multifaceted nature of Kratom with Dr. Sonia Del Tredici and Dr. John Keenan from the Addiction Medicine Journal Club podcast for a journal club style episode on Kratom. Together, we explore Kratom's historical uses for pain relief and fatigue management and its growing popularity as an aid in opioid withdrawal. This episode promises to give you a thorough understanding of its pharmacological effects, including interactions with opioid receptors and anti-inflammatory benefits.

Our conversation shifts to the intriguing trends in Kratom usage across the United States. We dissect three recent studies on Kratom, highlighting Kratom's allure as a perceived safer option for managing anxiety, depression, and pain. Despite its benefits, we don't shy away from discussing its potential for addiction and the demographic reach of its users. This episode challenges listeners to consider whether the overlap between Kratom users and those with other substance use disorders is surprising or expected, urging healthcare providers to adopt open-ended dialogues to address patient needs effectively.

In a deep dive into Kratom Use Disorder, our discussion includes a fascinating case series study examining the use of buprenorphine for treatment. We highlight the study's findings on withdrawal management and Kratom metabolite reduction, exploring the effectiveness of buprenorphine in stabilizing patients. With a significant portion of patients remaining in follow-up care, we ponder the subjective effects of using Kratom alongside buprenorphine. Tune in to grasp the complexities of Kratom use and the importance of education and ongoing research, as we prepare for an upcoming interview with an industry professional to continue this enlightening series.

Our episode reviews three studies on Kratom to facilitate our discussion. Here are those studies:

Smith KE, Dunn KE, Rogers JM, Grundmann O, McCurdy CR, Garcia-Romeu A, Schriefer D, Swogger MT, Epstein DH. Kratom use as more than a "self-treatment". Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694.

Hill K, Grundmann O, Smith KE, Stanciu CN. Prevalence of Kratom Use Disorder Among Kratom Consumers. J Addict Med. 2024 May-Jun 01;18(3):306-312.

Broyan, V. R., Brar, J. K., Allgaier, Student, T., & Allgaier, J. T. (2022). Long-term buprenorphine treatment for kratom use disorder: A case series. Substance Abuse, 43(1), 763–766.

To contact Dr. Grover: ammadeeasy@fastmail.com

Follow this link to get CME for this episode:

https://micaresed.org/courses/podcast-addiction-medicine-journal-club/

What I Learned When I Talked About Addiction with a Licensed Therapist

Tue, 12 Nov 2024 02:00:00 -0800

I'm thrilled to welcome Amity Cooper to the Addiction Medicine Made Easy Podcast! Amity is a mental health professional specializing in equine therapy, to share her unique perspective on the pivotal role of mental health in achieving and maintaining sobriety. Together, we explore the intersection of mental health and addiction recovery, delving into therapies that support individuals on their journey to a fulfilling sober life. Amity's insights provide insight at how equine therapy and holistic approaches can transform the recovery process, offering hope and healing to those in need.

Our discussion then turns to the concept of personal transformation during recovery, focusing on the importance of establishing a guiding "North Star." We highlight strategies like polyvagal therapy and self-awareness practices as essential tools for managing co-occurring mental health and addiction disorders. Finally, we delve into the therapeutic benefits of equine therapy, where horses act as co-partners in therapy, promoting mindfulness and emotional expression. Discover how this innovative approach can empower individuals to redefine their futures, fostering emotional healing and self-awareness in the process.

At the beginning of the episode we look at how early cannabis use can impact academic performance. We discuss the findings of a compelling study published in JAMA Pediatrics. We'll explore how adolescent cannabis use is linked to lower grades and increased dropout rates, setting the stage for a deeper understanding of the long-term effects of substance use. This episode promises to equip listeners with crucial insights into how these early choices can alter life's trajectory, emphasizing the importance of informed decision-making for young people.

Amity's website: https://amitycooper.com/

To reach Dr. Grover: ammadeeasy@fastmail.com

Unraveling Addiction: A Story of Fitness, Healing, Strength, and Steroids

Mon, 04 Nov 2024 02:00:00 -0800

Join us for a riveting discussion with Chris Terzakos, an insightful author and life coach, who shares his compelling journey from the gritty streets of New York City to finding solace in fitness. Chris opens up about witnessing the widespread impact of drugs like cocaine and LSD in his neighborhood and how he turned to exercise as his lifeline. Discover how the pursuit of a natural high through fitness provided a therapeutic escape, laying the foundation for Chris's message about the healing power of exercise in addiction recovery. Chris discusses how addiction has affected his life, including his experience when his best friend developed addiction.

Chris candidly discusses his own struggles with anabolic steroids and the path to sobriety. He offers insights into overcoming addiction, emphasizing the role of empathy and support in helping loved ones navigate their journeys.

This episode covers a wide range of topics from people who have transformed their lives through fitness, challenging the stigma surrounding addiction terminology, and highlighting how addiction affects friends and family.

Unmasking Trauma: A Brother's Journey Through Pain, Addiction, and Healing

Wed, 30 Oct 2024 02:00:00 -0700

Have you ever considered the emotional journey of siblings when they discover a loved one's trauma? This episode invites you to explore this often-overlooked perspective with our special guest, Keeper Catran-Whitney, the author of "Helplessness: What Happens To Brothers When We Learn Our Sisters Have Been Molested By Our Parents?." Keeper opens up about the personal journey of grappling with childhood trauma, poverty, and the complex layers of emotions that arise when a brother learns of his sister's abuse. His story sheds light on the shadows often cast by societal norms, where male vulnerability is frequently stifled.

We navigate through the intricate links between trauma and addiction, unpacking how these experiences shape one's path to healing. Keeper eloquently shares the emotional turmoil of disbelief, guilt, and anger, painting a vivid picture of the internal battles faced by siblings who are often left without a voice. The episode underscores the critical lack of support for brothers and the societal taboos that keep them silent. We also reflect on Keeper's personal confrontation with family issues and his journey towards finding happiness and healing through forgiveness and empathy.

Our conversation doesn't shy away from the raw, unfiltered realities of confronting trauma. Keeper reveals how writing became his therapeutic outlet, allowing him to process and express his vulnerability when professional help was unattainable. He emphasizes the transformative power of storytelling and the necessity of addressing unresolved family issues. Join us as we discuss the ongoing journey of healing, the importance of supportive communities, and the courageous steps towards self-compassion and emotional honesty.

Kratom and the US Opioid Crisis: A Help or a Harm?

Mon, 14 Oct 2024 02:00:00 -0700

Unlock the complexities of Kratom, a substance both fascinating and misunderstood, as we promise to enrich your understanding with insights from Dr. Sonya Del Tredici and Dr. John Keenan of the Addiction Medicine Journal Club. Join us as we explore Kratom's dual identity as a stimulant and opioid-like substance, its traditional roots, and the reasons behind its rise in popularity. Despite its widespread use, many see Kratom as an herbal supplement rather than a drug, leading to an awareness gap among healthcare professionals. We stress the importance of recognizing Kratom's impact in the field of addiction medicine and why it’s crucial for medical practitioners to inquire about its use in patient assessments.

Peel back the layers of Kratom withdrawal, which shares parallels with opioid withdrawal, but with unique mood-related symptoms like anxiety and insomnia. Through enlightening patient anecdotes and clinical observations, we uncover the personal motivations driving individuals to Kratom, whether it's for anxiety relief or as a stepping stone from other opioid treatments. The varied experiences highlight the need for a nuanced approach to understanding withdrawal and the complex reasons behind Kratom usage, emphasizing the importance of patient-centered care that addresses both physical and emotional well-being.

As we shift our focus to the broader implications of natural substance use, we traverse the cultural and health landscape of Kratom and cannabis. The potential role of Kratom in harm reduction strategies for opioid users is a key topic, alongside its legal advantages and challenges due to its unregulated nature. With a promise of future evidence-based exploration, our collaborative episode the Addiction Medicine Journal Club pledges to shed light on these critical issues, advocating for better regulation, open communication, and long-term patient relationships.

Unveiling the Opioid Epidemic: From Big Pharma to Synthetic Threats (Bonus)

Mon, 07 Oct 2024 02:00:00 -0700

What if the root of America’s deadly opioid crisis lies in a single pharmaceutical company’s marketing strategy? Dr. Casey Grover takes you on a compelling journey through the origins and evolution of this epidemic. From Purdue Pharma's aggressive promotion of OxyContin to the alarming rise of synthetic opioids like fentanyl, we dissect how tolerance and dependence perpetuate the cycle of addiction. You'll also gain historical insights into heroin's early marketing by Bayer Pharmaceuticals as a "non-addictive" remedy, and hear personal stories that underscore the human cost of opioid dependence.

We then shift our focus to the emergence of novel and perilous synthetic drugs that are infiltrating our communities. Discover why carrying Narcan has become essential and learn about the life-saving potential of deregulating buprenorphine. Dr. Grover also highlights the tragic story of Paul, whose life and artwork poignantly reflect the struggles of addiction. Paul's legacy serves as a stark reminder of the importance of effective treatment and education in combating this crisis. Tune in for an essential discussion on the urgent changes needed to address opioid use and overdoses in the United States.

Debunking CBD: Does it Really Help with Pain or is it Overhyped?

Mon, 30 Sep 2024 02:00:00 -0700

Can CBD truly provide effective pain relief, or is it just another overhyped remedy? Join us in this eye-opening episode of Addiction Medicine Made Easy, where Dr. Casey Grover critically examines the realities behind cannabidiol (CBD) usage for pain management. We start the episode with inspiring encounters, including a discussion of the work of musician Matt Butler, who uses his songs to shine a light on addiction in prisons and jails. Dr. Grover also shares his heartfelt recommendation of Stephanie Wittels Wachs' book, "Everything is Wonderful and Horrible," which offers a raw perspective on coping with the loss of a loved one to overdose.

As we journey deeper, we unpack a 2024 article from the Journal of Pain by Andrew Moore, which scrutinizes the effectiveness, cost, and potential harms of CBD products. Our discussion highlights the widespread use of CBD, yet flags significant issues like product purity and labeling discrepancies. The episode dives into CBD's dual roles—both as Epidiolex for seizure disorders and as a non-pharmaceutical pain relief option. Despite its popularity, current research shows mixed results on CBD's efficacy for pain relief. Furthermore, hidden risks such as the presence of THC, sedation, and hepatotoxicity are explored. This episode underscores the necessity for ongoing research and thoughtful consideration when using CBD, especially in the context of addiction treatment. Don't miss out on this thorough examination of CBD's complexities and what they mean for pain management and addiction medicine.

Unmasking Addiction: Debunking Myths, Understanding Risks, and the Power of Narcan (Bonus)

Mon, 23 Sep 2024 02:00:00 -0700

Can smart people really be immune to addiction? On this special bonus episode of the Addiction Medicine Made Easy podcast, Dr. Casey Grover uncovers the truths behind common myths about addiction, drugs, and overdoses. Designed for students from grades 6 through 12, this episode is both engaging and educational, challenging misconceptions such as the addictive potential of cannabis and the dangers of merely touching fentanyl. You'll gain a deeper understanding of how addiction affects decision-making in the brain, making complex medical science both accessible and compelling.

Additionally, we shed light on how a meal can influence alcohol absorption and reduce intoxication risks. Plus, hear a real-life ER story that underscores the life-saving power of Narcan, a medication that can reverse opioid overdoses in minutes. Dr. Grover also highlights the staggering statistics surrounding addiction in America, driving home the importance of carrying Narcan in schools and public spaces. This episode is not only informative but also a call to action to help save lives by better understanding and treating addiction.

What I Found When I Went to a Smoke Shop and Bought Kratom...

Mon, 09 Sep 2024 02:00:00 -0700

Curious about the mysterious herb that's causing a stir in both traditional medicine and recreational circles? Join Dr. Casey Grover as we uncover the fascinating details about kratom, a plant from Southeast Asia with unique stimulant and opioid-like properties. You'll learn about its historical uses for pain relief and energy, as well as its modern-day appeal for euphoria. We break down the science behind kratom, from opioid receptor agonism to COX-2 inhibition, and even explore how an overdose mirrors that of opioids.

Dr. Grover shares insights from a visit to a local smoke shop, revealing how different strains—green, white, and red vein—are marketed and sold, each promising effects like relaxation, energy, and mood enhancement. However, the lack of consumer information about risks such as dependence and withdrawal will leave you questioning just how safe this herb really is.

Dr. Grover also challenges the regulatory frameworks surrounding kratom, juxtaposing it against well-known supplements like St. John's wort and echinacea. You'll discover the startling gaps in labeling and disclosure, particularly concerning its opioid nature and potential for tolerance and dependence. We also dive into why patients might be hesitant to discuss their kratom use with healthcare providers, shedding light on the stigma and misconceptions that contribute to this silence. This episode underscores the urgent need for better regulations and transparent labeling to ensure consumer safety. Thank you for tuning in and prioritizing your health and well-being with us.

Inside Addiction Medicine: What We've Learned

Mon, 26 Aug 2024 02:00:00 -0700

Have you ever wondered how early childhood traumas can shape our mental and physical health, leading to conditions like PTSD, anxiety, and addiction? Join us as Dr. Casey Grover and Dr. Reb Close unravel these complexities with compelling real-life examples from their extensive careers in addiction medicine and emergency care. Hear a poignant story that underscores the importance of understanding a patient's history and using empathetic, non-stigmatizing language. This discussion promises not just insights but practical tools for healthcare providers to foster trust and compassion in their practice.

Discover how community support and harm reduction strategies are pivotal in battling addiction. We highlight the necessity of Narcan, drawing parallels with everyday safety items such as fire extinguishers and seatbelts. Listen to inspiring stories of community initiatives like fitness programs for recovery and essential item distribution, demonstrating how these efforts build trust and support recovery. Dr. Grover and Dr. Close shed light on the success of these programs, emphasizing the human connection and practical assistance in reducing harm.

Finally, we delve into the critical topic of safe and effective pain management, focusing on the use of buprenorphine. Dr. Close shares a real-life scenario of collaborating with a surgeon to manage a patient's post-operative pain using buprenorphine, highlighting the importance of interdisciplinary communication and mutual understanding in patient care. This episode is packed with invaluable insights and compassionate approaches, aiming to equip healthcare providers and anyone interested in addiction medicine with the knowledge to make a significant difference in the lives of those struggling with addiction.

Effective Strategies for Talking to Your Kids About Drugs and Alcohol (Rebroadcast)

Mon, 19 Aug 2024 02:00:00 -0700

Curious about how to effectively talk to your kids about the perils of drugs and alcohol? Join me, Dr. Casey Grover, as I share my personal experiences and practical strategies for starting these critical conversations. Reflecting on a talk I gave at a local school, I unravel the complexities of parenting in the face of substance use, emphasizing the importance of early and regular communication. Through heartfelt anecdotes, including one particular impactful story, we explore best practices for parenting and the necessity of understanding the underlying reasons for substance use among teens.

Discover the transformative power of family and community in preventing addiction. We highlight the significance of strong parental bonds, family meals, and knowing your child's friends and whereabouts. From the success story of Iceland’s national strategy to local initiatives like CrossFit classes and the Reps for Recovery gym, learn how community connections can act as a robust shield against addiction. We also delve into the mental health aspects and the role of resilience and coping strategies in addiction prevention, offering insights into building a supportive environment for your children.

Unearth powerful strategies for recognizing and addressing signs of substance use and managing challenging conversations about addiction. We discuss the warning signs parents should watch for and the risk factors that might lead teens to substance use. Explore approaches for externalizing the problem, using news stories as conversation starters, and engaging young people as experts. Finally, we shine a light on community-based drug prevention organizations and their vital role in combating overdose deaths among young people.

Buprenorphine's Role in Preventing Opioid Overdoses: A Closer Look

Mon, 12 Aug 2024 02:00:00 -0700

Discover the life-saving potential of buprenorphine in the fight against opioid overdoses with Dr. Casey Grover on the latest episode of Addiction Medicine Made Easy. We start with a poignant patient story that showcases the remarkable impact of addiction medicine using Topamax for alcohol use disorder. From there, we shift our focus to the powerful effects of buprenorphine in reducing fatal opioid overdoses, especially in the context of acute fentanyl exposures. Drawing on a pivotal 2020 study from the Journal of Substance Use and Addiction Treatment, we unpack the pharmacological magic behind buprenorphine’s ability to block full agonist opioids and explore its potential to protect during the fentanyl crisis.

Effective communication with patients about buprenorphine is key, and Dr. Grover emphasizes the importance of this in reducing overdose risks. Reflecting on his own practice, he shares how he now approaches conversations about the medication, underlining that while buprenorphine substantially lowers the risk of fatal overdoses, it doesn’t offer complete protection, particularly if not taken regularly. Tune in for actionable advice and insightful discussions designed to elevate your approach to addiction medicine.

80. High Stakes: The Hidden Heart Risks of Cannabis Use

Mon, 22 Jul 2024 02:00:00 -0700

Can cannabis put your heart at risk? Join me, Dr. Casey Grover, as we unpack groundbreaking research that challenges the widespread perception of cannabis as a harmless, natural remedy. We'll kick off by discussing a revealing study from the Journal of Pain, which found that CBD products may be ineffective for pain relief and even potentially harmful. Then, we delve into a critical study from the Journal of the American Heart Association, shedding light on the alarming rise in cannabis use and cannabis use disorder, and the often-overlooked cardiovascular risks associated with it, such as syncope, stroke, and myocardial infarction.

In this episode, we'll explore the association between cannabis use and cardiovascular disease, presenting it as a likely independent risk factor. You'll discover why it's crucial to counsel patients, especially those already at risk for heart disease, about the potential dangers of cannabis use. This conversation emphasizes the vital role healthcare professionals play in treating substance use disorders and ultimately saving lives. Tune in to equip yourself with the knowledge needed to provide better care and protect your patients' hearts.

Bonus - The Art of the Drug Deal (Rebroadcast)

Mon, 15 Jul 2024 02:00:00 -0700

How does a drug deal work? How do people with addiction find out what their drugs are cut with? Can you ask your dealer if your drugs are cut with fentanyl? In this episode, Dr. Grover interviews Jeremy, who is a former injection drug user about what it's like buying drugs in the illicit market.

This is a rebroadcast of Episode 64, with improved audio quality

79. Healing on the Streets: Treating Addiction with Street Medicine

Sun, 07 Jul 2024 07:00:00 -0700

Traditional medicine involves going to the doctor. How is medicine different when we bring the doctor to you? Could we do a better job treating addiction if we brought the doctor to the patient? Better yet - for our unhoused patients - shouldn't we be bringing the doctor to the patient given all the barriers they face? In this episode Dr. Grover interviews Dominique McDowell, who is an experienced healthcare provider – who has worked in a variety of clinic settings – but has done great work with his team using street medicine to treat patients with substance use disorders.

78. Managing Pain Safely

Sun, 16 Jun 2024 00:51:39 -0700

Episode 78. Traditional teaching to medical students about pain management was to give Tylenol, then Advil, then opioids in ever increasing doses without any maximum dose! Turns out that wasn't quite right. In this episode, Dr. Grover and his colleague Dr. Reb Close share their expertise on best practices in pain management, including how to maximize non-opioid and opioid-sparing medication regimens.

Episode 77 - Using "Targeted" Naltrexone to Reduce Alcohol Use

Sun, 02 Jun 2024 17:41:57 -0700

Naltrexone - a medication used to reduce alcohol consumption - is usually prescribed on a scheduled basis when treating alcohol use disorder. Could prescribing it to be taken only on drinking days work too?? In this episode Dr. Grover reviews a recent study on how "targeted" naltrexone can be used to reduce alcohol use.

Episode 76 - A Treatment That Reduces Meth Use by 86%!!!

Mon, 13 May 2024 07:37:46 -0700

We all know that options to treat stimulant use disorder are limited. In this episode Dr. Grover interviews Dr. Michael Miller, an Addiction Medicine doctor in Indiana who has developed a novel approach to treating stimulant use disorder. In this interview, Dr. Miller describes his novel approach and his outstanding results (Spoiler Alert! - he is seeing an 86% reduction in methamphetamine use in his patients!!!)

Episode 75 - Opioid Use Disorder during Pregnancy

Wed, 01 May 2024 04:48:19 -0700

In this episode we tackle opioid use disorder during pregnancy with OB-GYN Dr. Kenneth Spielvogel. Dr. Grover and Dr. Spielvogel discuss multiple topics including the use of methadone and buprenorphine during pregnancy, overdoses during pregnancy, fentanyl exposure during pregnancy, and breastfeeding while taking buprenorphine.

BONUS EPISODE - Food, Eating Disorders, and Addictive Food

Sat, 20 Apr 2024 08:40:34 -0700

Dr. Grover was asked to speak at a high school on the topic of food, nutrition, eating disorders, and how ultra processed food can be addictive. He recorded the lecture while giving it - so here it is as a bonus episode.

Episode 74 - How Does Counseling and Talk Therapy Help Patients with Addiction (Part 2)

Sat, 13 Apr 2024 14:25:50 -0700

We tried to cover counseling and talk therapy as a part of treatment for addiction in a single episode - but it was too big of a topic! This episode is part 2 of Dr. Grover's interview with Andrew Finley, LMFT on the topic of counseling and talk therapy as a part of treatment for addiction.

Episode 73 - How to handle the polysubstance use patient

Mon, 01 Apr 2024 13:12:54 -0700

Ok...so you have a patient using nicotine, cannabis, alcohol, and methamphetamine. What substance should you focus on helping the patient stop first? Or should the patient stop everything at once? In this episode Dr. Grover interviews Addiction Medicine physician Dr. Lee Goldman on the topic of how to treat patients who use multiple substances.

Episode 72 - Cannabis Withdrawal Revisited

Mon, 18 Mar 2024 07:04:26 -0700

In this episode, we take a second look at cannabis withdrawal. Dr. Grover covered this topic on a previous episode, but as cannabis use is very common, and many people don't realize that cannabis has a withdrawal syndrome - it needed another look. This episode is an up to date review of cannabis withdrawal, including options for treatment.

Episode 71 - How Does Counseling and Talk Therapy Help Patients with Addiction? (Part 1)

Mon, 04 Mar 2024 10:43:48 -0800

How much do you know about talk therapy and counseling? How does it work? How does a therapist decide what to talk about? How does one define a successful therapy session? In this episode, Dr. Grover interviews Andrew Finley, LMFT, about how counseling and talk therapy work for patients with addiction. And since it's such a big topic, it will take several episodes to cover.

Episode 70 - What drug is coming next in the illicit drug supply?

Sat, 24 Feb 2024 21:42:46 -0800

Are you familiar with Bromazolam? Carfentanil? Isotonitazene? Flualprazolam? What do all these substances have in common? They are showing up in the illicit drug market, and we'll likely be seeing more of them in the future. Dr. Grover gives an update on what's coming next in the illicit drug supply

Episode 69 - Parent Education on How to Talk to Kids About Drugs and Alcohol

Mon, 12 Feb 2024 10:37:20 -0800

Dr. Grover was asked to speak at a high school to parents on how to talk to kids about drugs and alcohol - and this episode is a recording of that lecture. Dr. Grover reviews how to talk to kids about substance use in general, as well as how to talk to kids who are actively using substances. Pardon the raspy voice - Dr. Grover is getting over pneumonia :)

Finally! A New Name!

Fri, 02 Feb 2024 19:23:37 -0800

We finally came up with a new and better name for the podcast! Addiction in Emergency Medicine and Acute Care is now Addiction Medicine Made Easy. Dr. Grover shares his thoughts on the why behind the name change.

Episode 68 - Fentanyl-laced stimulants

Sun, 28 Jan 2024 17:59:50 -0800

We all know that the illicit drug supply is full of contaminants, some more dangerous than others. I am seeing, in my practice, more of my patients who use stimulants test positive for fentanyl. In this episode, we review a study that analyzes specimens of meth and cocaine to see how often they are laced with fentanyl. Spoiler alert...it's pretty common :(

Episode 67 - Recreational Nitrous Oxide Use

Wed, 17 Jan 2024 21:47:44 -0800

Do your patients use whippets? Have they ever mentioned that they use nitrous? Not quite sure what we're talking about? In this episode we look at recreational use of nitrous oxide, also known as laughing gas or whippets.

Episode 66 - Have you heard of Iso?

Tue, 26 Dec 2023 08:12:09 -0800

Have you heard of the drug Iso? Is it isofentanyl? Or maybe it's isotonitazene? Or is it just fentanyl cut with who knows what? In this episode we discuss the drug being sold as "Iso" - and try to figure out what's in it.

Episode 65 – Can parents prevent alcohol use disorder by allowing teens to drink at home?

Sat, 09 Dec 2023 10:49:29 -0800

Have you heard that giving teenagers alcohol in the home under parental supervision can teach them to use alcohol safely and reduce the risk of addiction to alcohol? Many parents believe this to be true. In this episode, we review the evidence in the literature to find out if this is true or not.

Episode 64 - The Art of the (Drug) Deal

Mon, 20 Nov 2023 07:44:57 -0800

How does a drug deal work? How do people with addiction find out what their drugs are cut with? Can you ask your dealer if your drugs have fentanyl in them? In this episode Dr. Grover interviews Jeremy, who is a former injection drug user about what it's like buying drugs in the illicit market.

Episode 63 - Building trust with substance use patients

Fri, 03 Nov 2023 11:16:54 -0700

In this episode we speak with Araceli, a Substance Use Navigator in California, about her work taking care of substance use patients in her Emergency Department. We talk about how to connect with patients with substance use - both in terms of building trust and how to work with patients who do not speak English as their first language.

Episode 62 - How P2P Meth changed everything

Thu, 19 Oct 2023 10:31:35 -0700

Have you heard of P2P methamphetamine? It has turned out to be a major destructive force in the world of addiction and in society in general. In this article we tell the story of how P2P meth came to be the dominant stimulant in the US, and how it has produced devastating mental health effects in those who use it.

Episode 61 - Have you heard of peer support? It's awesome!

Wed, 04 Oct 2023 19:01:21 -0700

Have you heard of peer support? It's AWESOME! Such a huge help for patients with mental health conditions and substance use disorders. In this episode Dr. Grover provides an overview of peer support for the treatment of substance use, and we hear from Ceil - a woman in recovery who is providing peer support.

Episode 60 - How to actually help patients with Cannabinoid Hyperemesis Syndrome

Mon, 25 Sep 2023 21:24:43 -0700

How often have you seen a patient you think has cannabinoid hyperemesis syndrome - and when you tell them you think they need to stop using cannabis they tell you..."it's not the weed". In this episode we review what patients with suspected cannabinoid hyperemesis syndrome think about the condition and how you can help them to stop using cannabis

Episode 59 - Why Substance Use Navigators are awesome!

Wed, 13 Sep 2023 21:35:02 -0700

If you don't have a Substance Use Navigator (SUN) at your hospital, you need one! They are awesome! In this episode Dr. Grover speaks with Austin, a Substance Use Navigator, who shares his experience taking care of patients with substance use. Spoiler alert! Substance Use Navigators do incredible work!

Episode 58 - How to Use Naloxone like a Pro

Wed, 30 Aug 2023 09:29:38 -0700

Naloxone saves lives! In this episode, Addiction Medicine and Emergency Medicine physician Dr. Reb Close joins Dr. Grover to discuss naloxone - how to use it, how to get it into the hands of patients, and how to distribute it in the community.

Episode 57 - Have you heard of Phenibut?

Thu, 24 Aug 2023 09:06:49 -0700

Have you heard of Phenibut? Did you know that it can be bought online as an unregulated supplement and yet regular use causes dependence? Any idea how to manage Phenibut withdrawal? In this episode we review the literature on Phenibut, including Phenibut toxicity and withdrawal.

Episode 56 - When you prescribe an opioid, who else besides your patient might have an overdose?

Mon, 24 Jul 2023 05:17:13 -0700

In this episode we review the risk of having opioids in the home. As in – when you prescribe an opioid to a patient – what is the risk to the other people and family members in that patient’s home?

Episode 55 - Can you use baclofen to treat alcohol use disorder?

Mon, 10 Jul 2023 19:44:41 -0700

Have you heard about using baclofen for alcohol use disorder? Does it work? How do you dose it? What are the contraindications? In this episode we do an evidence based review of the use of baclofen to treat alcohol use disorder

Episode 54 - Do you know enough about urine drug screens to use them effectively?

Mon, 26 Jun 2023 21:21:22 -0700

So...how much do you know about urine drug screens? Can selegiline cause a false + for meth? Can quinolones cause a false + for opioids? Can putting visine in urine cause a false negative? What should you do if you think you've gotten a false positive result on a urine drug screen. In this episode - we tackle all these questions and more

BONUS EPISODE - A little inspiration

Wed, 14 Jun 2023 19:51:50 -0700

A really quick bonus episode! Dr. Grover shares a poem written about addiction that reminds us why treating patients with substance use disorders matters so much.

Episode 53 - Is the buprenorphine you prescribe going to end up on the street?

Thu, 01 Jun 2023 06:08:56 -0700

Have you ever been worried that when you prescribe a controlled substance that your patient might sell it on the street or to a friend? Of course you have. What about when you prescribe buprenorphine? In this episode we review the topic of buprenorphine diversion - how common is it, and what actually happens when patients use diverted buprenorphine?

Episode 52 - Talking to kids about drug use

Mon, 15 May 2023 16:46:32 -0700

In this episode Dr. Casey Grover and child psychiatrist Dr. Susan Swick discuss the topic of talking to kids about drug use. They discuss how health care providers can connect with kids who are using substances, how to work with the parents of a child who is using substances, and when parents should start discussing substance use with their kids before substance use starts.

Episode 51 - What's it like having a family history of addiction?

Thu, 04 May 2023 18:52:19 -0700

Have you ever wondered what it's like growing up with parents who have addiction? Have you ever talked to patients about what it's like parenting while in recovery? How often have you seen one generation with addiction lead to the next generation having addiction too? In this episode Dr. Grover interviews a colleague who discusses her strong family history of addiction, her own addiction, and how she is raising her kids in a healthy drug/alcohol free home.

Episode 50 - A Recovery Story, Part 2

Wed, 26 Apr 2023 19:39:46 -0700

In this episode Dr. Grover does a follow up interview with Aiden, a young man in recovery. Aiden shares more of his recovery story, including how music keeps him focused on recovery, what it was like to be incarcerated, how being incarcerated has affected his recovery, how he deals with regret looking back on his time with active addiction, and what his goals are for the future.

Episode 49 - Buprenorphine vs Fentanyl

Wed, 19 Apr 2023 11:38:52 -0700

As we've discussed many times on this podcast there is a lot of concern - from both patients and medical providers - that patients with opioid use disorder using fentanyl will have an increased risk of precipitated opioid withdrawal when they start buprenorphine. And finally, we have a study looking directly at this topic!! In this episode we review a recent paper from JAMA Network Open that looks at the rate of precipitated opioid withdrawal during buprenorphine inductions in patients with opioid use disorder using fentanyl.

Episode 48 - A Recovery Story

Wed, 05 Apr 2023 18:45:55 -0700

In this episode Dr. Grover interviews Aiden, a young man in recovery. Aiden shares his story of how his addiction developed, what it's like living with addiction, how his recovery started, and what life is like as a young man in recovery.

Episode 47 - What is Kratom?

Wed, 22 Mar 2023 08:11:03 -0700

How much do you know about Kratom? Who takes it and why? How does Kratom withdrawal present and how do you treat it? And what do you do in the case of a Kratom overdose? In this episode we do an evidence based review on Kratom to answer all of these questions and more.

Episode 46 - Treating Alcohol Use Disorder with Topiramate

Thu, 09 Mar 2023 18:25:23 -0800

Have you had a patient ask you about using Topiramate to treat their alcohol use disorder? Or maybe you've heard a colleague talk about it, but don't know much about it? In this episode we review the use of the medication topiramate in treating alcohol use disorder. Spoiler alert! This may be practice changing!

Episode 45 - Cannabinoid Hyperemesis Syndrome

Mon, 27 Feb 2023 06:34:54 -0800

How often do you see patients who regularly use cannabis who get recurrent abdominal pain, nausea, and vomiting? It seems like this comes up at least every other shift in the Emergency Department. In this episode we review all aspects of Cannabinoid Hyperemesis Syndrome, from pathophysiology, to diagnosis, to treatment.

Episode 44 - What is the risk of fentanyl exposure to first responders and what do we do about it?

Fri, 10 Feb 2023 14:43:48 -0800

Have you heard reports of first responders having overdoses on fentanyl after just touching it? Do you actually know how well fentanyl is absorbed through the skin? What PPE should first responders use if they know they are going to be exposed to fentanyl? In this episode we do a mega deep dive to find out what is the risk of fentanyl exposure to first responders and what can we do to mitigate that risk?

Episode 43 - Cannabis Toxicity and "Greening Out"

Thu, 19 Jan 2023 11:06:12 -0800

How familiar are you with cannabis toxicity? Do you know the symptoms of a cannabis overdose? If your patient told you that she "greened out" last night, would you know what she was talking about? In this episode we do an evidence-based review of cannabis toxicity, including what it means to "green out"

Episode 42 - Delirium Tremens

Fri, 06 Jan 2023 08:51:37 -0800

Pink Elephants anyone? In this episode we review Delirium Tremens, also know as alcohol withdrawal delirium. It's not too common, but it makes people impressively sick when it develops. Listen in for an evidence based review of the diagnosis and treatment of delirium tremens.

Episode 41 - How does microdosing buprenorphine work?

Wed, 28 Dec 2022 11:03:27 -0800

Have you heard about microdosing buprenorphine? Have your patients asked you if it's an option for them? In this episode we do a deep dive on the topic of microdosing buprenorphine...including how it might be the best option for patients using illicit fentanyl to start bupe without experiencing precipitated withdrawal.

Episode 40 - What the heck is Xylazine and how do you treat a Xylazine overdose?

Thu, 01 Dec 2022 17:37:10 -0800

Have you heard of Xylazine? I sure don't remember it from pharmacology in medical school. It turns out Xylazine is a veterinary medicine that is being increasingly cut into the illicit drug supply in the US. Why is it being cut into drugs, what does it do, and how is a Xylazine overdose treated? We cover everything you need to know about Xylazine in this episode.

Episode 39 - Are you confused by all the different formulations of buprenorphine? Me too

Thu, 17 Nov 2022 16:39:04 -0800

Have you found all the different formulations of buprenorphine confusing? What is Zubsolv and how is it different from regular sublingual buprenorphine? And what about Belbuca? Or BuTrans? When can you use injectable Buprenex? What about Sublocade? In this episode we do a deep dive into all the different formulations of buprenorphine, including what they are used for and how to dose them. We also discuss how challenging it can be to convert between different formulations.

BONUS EPISODE - A plea to treat Alcohol Use Disorder as well as we do Opiate Use Disorder

Mon, 07 Nov 2022 16:13:48 -0800

Another bonus episode! I was asked to give a lecture on medications for alcohol use disorder to some of my colleagues in my area. We have made such incredible improvements in how we treat opiate use disorder with medication...it's time to do the same with alcohol use disorder. So...in this lecture I tried to convince my colleagues that we need to start routinely treating patients with alcohol use disorder with medication for alcohol use disorder. Take a listen...hopefully I can convince you too.

Episode 38 - Could you be eligible to be board certified in Addiction Medicine?

Mon, 31 Oct 2022 18:13:13 -0700

We need more Addiction Medicine physicians, both here in the United States and all over the world. In the United States, board certification in Addiction Medicine is supervised by the American Board of Preventative Medicine (ABPM). In this episode we review the process for how to obtain board certification in Addiction Medicine in the US. It turns out that the ABPM has a practice pathway that allows for board certification in Addiction Medicine without having to do a fellowship for those who already are doing addiction medicine in their current practice. Could you be eligible to apply for board certification in Addiction Medicine? Listen in and find out!

Episode 37 - Stimulant Withdrawal

Thu, 13 Oct 2022 07:04:39 -0700

I don't know about you but I was taught stimulants didn't have a withdrawal syndrome, and yet many of my patients - after a post methamphetamine crash - will complain of being in withdrawal. So...how much do you know about stimulant withdrawal? In this episode we review stimulant withdrawal - how to diagnose it, how to treat it, and how it feels to patients.

Episode 36 - What labs can you use to assess alcohol use? (follow up to Episode #27)

Thu, 29 Sep 2022 19:23:51 -0700

A follow up to Episode #27 on labs and alcohol use disorder. So you're at work and you have a patient who you're pretty convinced has an alcohol use disorder, but you're not sure which test you should order to assess their alcohol use. LFTs? Carbohydrate deficient transferrin? Ethyl glucuronide? Phosphatidylethanol? In this episode we take another look at lab tests that can help you with your assessment of patients who use alcohol...including some lab tests that you probably have never heard of (but might find useful)

BONUS EPISODE - The Non-Opioid Management of Renal Colic

Tue, 13 Sep 2022 06:29:02 -0700

A bonus episode! This isn't really on the topic of addiction...but it does involve opioid sparing and alternative to opioid treatment protocols (and avoiding a new start of opioids may prevent someone from developing opioid dependence or opioid use disorder).

I put together a lecture on the non-opioid management of renal colic a few months back. I thought the topic was really useful, so I presented it to the docs that I work with where I practice as a part of our monthly physician education. I literally just recorded my presentation with my iPad while I was giving the lecture to my group (thus the lousy audio...my apologies). In any case - I hope you find this lecture helpful. I review non opioid pain management of renal colic in detail, including NSAIDs, lidocaine infusions, antispasmodics, and tamsulosin.

Episode 35 - Hallucinogen Intoxication

Wed, 07 Sep 2022 21:11:12 -0700

How much do you know about hallucinogens? Do you know the differences between LSD, psilocybin, and MDMA? In this episode we review hallucinogens as a general class of drugs, specific hallucinogenic drugs, and how to manage the acutely intoxicated in the ED and acute care setting.

Episode 34 - An Overview of Methamphetamine Use Disorder

Thu, 25 Aug 2022 13:32:21 -0700

Given how prevalent methamphetamine use is, this topic is WAY overdue. In this episode we take a broad look at methamphetamine use disorder - how methamphetamine affects the brain, the clinical features of methamphetamine use disorder, and how to treat methamphetamine use disorder.

Episode 33 - Methamphetamine Psychosis

Mon, 08 Aug 2022 18:19:29 -0700

You just had a patient arrive via ambulance on an involuntary hold who is clearly psychotic. As the paramedics are giving report, you hear that the patient was found using methamphetamine on scene. So...is this schizophrenia? Or is it meth psychosis? Can you tell the difference? In this episode, we do a deep dive into methamphetamine psychosis, to review the clinical features, prognosis, risk factors, and treatment - including a discussion of the differences between primary psychotic disorders and methamphetamine induced psychosis.

Episode 32 - The "Drug-Seeking" Patient and why it's time to retire the term "Drug-Seeking"

Tue, 26 Jul 2022 14:20:33 -0700

This episode is on the topic of the label "drug-seeking" that is often given to patients. Dr. Grover reviews a clinical case and reviews a perspective piece written on this topic. How would you handle a patient in pain who has an allergy to multiple medications, is refusing non-opioid options, and is asking for morphine? Is it addiction? Severe pain? Or is the patient in withdrawal? In this episode we delve into the complex and nuanced topic of the so-called "Drug-Seeking" patient.

Episode 31 - How do mutual support groups and 12 step programs like Alcoholics Anonymous work?

Sun, 10 Jul 2022 17:22:26 -0700

You've probably heard patients talking about going to AA (Alcoholics Anonymous), but how much do you actually know about what AA does? In this episode we review mutual support groups and 12 step programs (such as AA) - what they are and how they work.

Episode 30 - Buprenorphine After Naloxone Rescue

Mon, 27 Jun 2022 21:33:14 -0700

We all know that buprenorphine is an effective medication to treat opiate withdrawal, yet most of us only use buprenorphine to treat opiate withdrawal from abstinence from opioids. It turns out that buprenorphine can also treat the opiate withdrawal that patients experience when they are given naloxone after an opioid overdose. In this episode we review the literature on using buprenorphine after naloxone rescue, and how to actually do it in your practice. We also take on a few other topics around this issue, including whether or not naloxone can be given electively to induce withdrawal to facilitate a rapid buprenorphine induction.

Episode 29 - Drinking Alcohol + Naltrexone = Cure for Alcohol Use Disorder

Sat, 04 Jun 2022 14:31:42 -0700

Wait, what??? Drinking Alcohol + Naltrexone = Cure for Alcohol Use Disorder??? In this episode we do a detailed review of a different way to use naltrexone for alcohol use disorder, which is to continue drinking while using naltrexone. This method is often referred to as the Sinclair Method, and may be effective in up to 80% of patients to reduce alcohol consumption or stop drinking entirely. This episode is based on the book "The Cure for Alcoholism" by Roy Eskapa, PhD

Episode 28 - Cannabis Induced Psychosis

Wed, 25 May 2022 09:04:34 -0700

Have you ever had this case in your ED? A patient purchases a cannabis edible candy bar or pastry. She or he eats a small amount and waits 30-60 minutes. Feeling nothing, the patient proceeds to eat the whole bar and then comes to the ED via ambulance or with a friend about an hour later completely panicked and hallucinating.

In this episode we dig in to Cannabis Induced Psychosis - why it happens, how THC content contributes to the development of psychosis, how common it may be, and how to treat it.

Episode 27 - Can you diagnose an alcohol use disorder based on lab tests?

Fri, 06 May 2022 18:30:07 -0700

We all have had this scenario...a patient comes to the ED or is getting admitted for a medical complaint...and you notice a few findings on their lab tests that make you wonder if they have an alcohol use disorder. An elevated MCV. An elevated AST. Have you ever asked yourself - how accurate are these tests are detecting and diagnosing an alcohol use disorder? Or on the flip side - how often do we see a patient presents to the ED requesting help with alcohol after years of heavy drinking and has essentially normal labs? In this episode we dig into the limited literature on this topic and try to answer the question - how accurate are lab tests in determining if a person is consuming alcohol, and if so how much?

Episode 26 - Can Bupropion and Naltrexone help treat methamphetamine use disorder?

Fri, 29 Apr 2022 08:31:45 -0700

Methamphetamine use disorder...we see it every day in the Emergency Department, and yet it feels like we have nothing to offer as far as treatment. Could there be some hope that we finally have some medications for methamphetamine use disorder? In this episode we review a recent study on the use of Bupropion and Naltrexone for the treatment of methamphetamine use disorder.

Episode 25 - What is kindling in alcohol withdrawal?

Fri, 15 Apr 2022 16:04:58 -0700

Have you heard of the kindling phenomenon? Have you ever wondered why alcohol withdrawal seems to get worse the longer people drink? In this episode we review kindling in alcohol withdrawal - what it is, why it happens, and why it matters clinically.

Episode 24 - How to handle buprenorphine in the perioperative setting

Wed, 30 Mar 2022 12:45:08 -0700

Ok. So you've induced your patient with opiate use disorder successfully on to buprenorphine. Nice work! But what happens if they need surgery? Should they still get treated with full agonist opioids after surgery? Will full agonist opioids even work given buprenorphine's pharmacology? In this episode we dig into how to handle pain control and medication management for patients with buprenorphine in the preoperative setting.

Episode 23 - How much do you know about Vaping?

Mon, 14 Mar 2022 19:27:42 -0700

Sure...you ask your patients if they vape, but how much do you know about the world of vaping? Are they using a cigalike, a vape pen, or a JUUL? And are they using standard cartridges or have they bought a custom vape juice? What types of vape juice are most associated with EVALI? In this episode we review vaping - the history of the industry, the health effects, and the societal trends.

Episode 22 - Illicit Fentanyl

Thu, 10 Mar 2022 17:21:44 -0800

In this episode we take a very deep dive into the topic of illicit fentanyl. We review the history of the opiate epidemic in the United States that has led us to our current time where 100,000 Americans have died of a drug overdose in the past year. And more importantly, we discuss what we as healthcare providers can do to fight back against this crisis of illicit fentanyl (and worse) in our drug supply causing so many fatal overdoses.

Episode 21 - What's the deal with phenobarbital for alcohol withdrawal?

Thu, 24 Feb 2022 23:16:16 -0800

When was the last time you used phenobarbital for alcohol withdrawal? How familiar are you with how to dose it and when to give it? It turns out that phenobarbital is as effective as benzodiazepines for alcohol withdrawal, and might be a medication that you want to consider using in your practice for alcohol withdrawal. In this episode we dive into the topic of phenobarbital for alcohol withdrawal and try to figure out what's the best way to use phenobarbital when treating patients with alcohol withdrawal.

Episode 20 – A patient story. Getting “well” with opiate use disorder

Sat, 12 Feb 2022 07:07:59 -0800

What does it mean to be well? In this episode we dig into the perspective of a person living with an opiate use disorder. Dr. Grover reads a piece on opiate addiction that he wrote with a patient who has lived experience with an opiate use disorder. The original article can be found here https://www.kevinmd.com/blog/2017/03/mean-well-ask-opiate-addict.html

Episode 19 - The Patient on Methadone for Opiate Use Disorder

Thu, 03 Feb 2022 08:37:38 -0800

Has this ever happened to you at 11 pm on a Saturday Night..."Hey doc, I'm on 85 mg of methadone and I missed my daily dose yesterday. Can you give me a dose?" In Episode 19 we discuss methadone, how methadone is regulated, and what to do when a patient on methadone for OUD presents to the ED asking for a missed dose or needs inpatient admission.

Episode 18 - What is Post Acute Withdrawal Syndrome?

Wed, 19 Jan 2022 12:20:56 -0800

In this episode, we review Post Acute Withdrawal Syndrome (PAWS). Haven't heard of it? You're not alone. It's a common, yet understudied syndrome experienced by people in early recovery. Unfortunately the data is limited, but Dr. Grover summarizes the best information we have on PAWS including pathophysiology, naming, symptoms, and treatment.

Episode 17 - Buprenorphine precipitated opiate withdrawal

Mon, 03 Jan 2022 12:08:27 -0800

Buprenorphine precipitated opiate withdrawal is the worst! Patients feel awful, and we as healthcare providers feel awful for making them feel awful. In this episode we review the literature on and discuss some local expert opinion on buprenorphine precipitated opiate withdrawal, including the best way to treat it if it happens.

Episode 16 - How stigma hurts patients and what we can do about it

Mon, 06 Dec 2021 16:52:28 -0800

How much do you know about stigma? Would you believe experiencing stigma can shorten a person's lifespan by 12 years? In this episode we review stigma - what it is, how it affects patients with stigmatizing conditions, and how to reduce how much stigma there is in health care. Dr. Grover just did a Grand Rounds presentation on Stigma - and this episode is a rapid review of all the material covered in the Grand Rounds presentation.

Episode 15.5 - Lit Review - Using High Dose Buprenorphine in the Emergency Department

Fri, 03 Dec 2021 12:37:59 -0800

In this episode we do a review of a recent paper on the safety and efficacy of using high dose (up to 32 mg) buprenorphine in the emergency department. The title of the article is "High Dose Buprenorphine in the Emergency Department for Treatment of Opioid Use Disorder" by Dr. Andrew Herring and his colleagues.

Episode 15 - An Overview of Alcohol Withdrawal

Sat, 20 Nov 2021 08:05:52 -0800

This episode has been on the to-do list for quite a while. In Episode 15, Dr. Grover tackles the huge topic of alcohol withdrawal - from definitions, to pathophysiology, to diagnosis, to management.

Episode 14: Cannabis Dispensaries - Who works there and what do they tell patients about cannabis?

Mon, 08 Nov 2021 14:24:28 -0800

Have you had patients ask you about information on cannabis that they received from a cannabis dispensary? Perhaps they have been told that they need a certain THC:CBD ratio to treat their condition. How good is that information? In this episode we’re going to be talking about Cannabis Dispensaries. Most specifically, who works there, what do they tell people about cannabis, and how good is the information that they give out.

Episode 13 - Alcoholic Ketoacidosis

Tue, 26 Oct 2021 06:35:29 -0700

How much do you remember from your training on alcoholic ketoacidosis? Do you remember which IV fluids need to be given? In Episode 13, we review the topic of alcoholic ketoacidosis - from a brief history of the condition, to pathophysiology, to making the diagnosis, and how to treat it.

Episode 12 - Medications to prevent relapses on alcohol and reduce alcohol intake (aka Medications for Alcohol Use Disorder)

Sun, 17 Oct 2021 18:20:28 -0700

In this episode Dr. Grover tackles medications for alcohol use disorder. These are medications to prevent a relapse on alcohol and to reduce the desire for drinking. You may not have used these medications much in your practice, but after listening to this episode hopefully you'll start using them. Episode 12 reviews two papers on medications for alcohol use disorder, reviewing their indications, dosing, side effects, efficacy, contraindications, and cost.

Episode 11 - Adulterants in street drugs: Does anyone actually know what's in the drugs they use??

Sun, 26 Sep 2021 14:15:28 -0700

Do you have any idea what is truly in the street drugs your patients are buying and using? No? Turns out your patients probably don't either. And worse yet, your hospital doesn't have ready access to testing to find out. Is that really heroin your patient is using or is it quinine?

In this episode we review a few papers on how street drugs are cut and adulterated. From quinidine, to acetaminophen, to baking soda, to levamisole - you'll be amazed what ends up in our street drug supply.

Episode 10 - Gabapentin as a treatment for Cannabis Dependence and Withdrawal

Wed, 08 Sep 2021 11:41:23 -0700

Finally! A medication option for the treatment of Cannabis Dependence and Cannabis Withdrawal. Dr. Grover shares a case from his practice in the Emergency Department and does a deep dive into the literature supporting gabapentin as a treatment for Cannabis Dependence and Cannabis Withdrawal.

Episode 9 - Harm Reduction and how using it in your practice improves your patient care

Tue, 24 Aug 2021 10:05:34 -0700

On this episode we'll be covering the topic of harm reduction. Most people know a little bit about it, but in this episode we dive deep into harm reduction, and why it is extremely important for patients with an active substance use disorder. Dr. Grover reviews a brief history of harm reduction, how it helps people get into long term recovery, key concepts of harm reduction, how to incorporate it into your practice, and why it can be controversial - including a discussion of syringe exchange programs.

Episode 8.5 - Lit Review - What is the 1 year mortality for patients after an ED visit for a non-fatal opioid overdose?

Mon, 09 Aug 2021 21:12:16 -0700

We all know how devastating opioid overdose deaths are in the United States and around the world. However we don't know as much about non-fatal opioid overdoses, including how likely they are to lead to fatal opioid overdoses. In this episode we review the 2020 Annals of Emergency Medicine paper "One Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose".

Episode 8 - The Neurobiology of the "Addict Brain" (aka why addiction makes people do crazy things)

Sun, 25 Jul 2021 11:08:00 -0700

Have you ever taken care of a patient with a substance use disorder and wondered "what made you think THAT was a good idea??!?!". In Episode 8 - we go through the neurobiology of how substance use affects the brain and how disordered brain function in patients with substance use disorder leads to erratic behavior and an inability to weigh the risks and benefits when making decisions about substance use. Spoiler alert - it's all about dopamine!

Episode 7 - Carisoprodol (Soma) Abuse and Withdrawal

Mon, 12 Jul 2021 21:40:27 -0700

Dr. Grover reviews 2 papers on carisoprodol - looking at abuse of, dependence on, and withdrawal from carisoprodol. From Brave New World to treating carisoprodol dependence with a taper, this episode is a deep dive into the sparse literature on the topic of carisoprodol - aka Soma.

Episode 6.5 - Lit Review - How Iceland Got Teens to Say No to Drugs

Mon, 05 Jul 2021 21:13:17 -0700

If you've ever wondered how we can prevent our youth from developing substance use disorders, Iceland already figured this out in the 1990s. Iceland dropped alcohol use in teens by 90% between 1998 and 2016. How did they do it? We review a magazine article that covers this incredibly effective effort in Iceland to reduce substance use in teens, and how Iceland accomplished it.

Episode 6 - How to assess the severity of a substance use disorder

Tue, 22 Jun 2021 21:43:35 -0700

Do you know how to determine if an alcohol use disorder is mild, moderate, or severe? Does your patient who is using cocaine have a mild cocaine use disorder, a moderate cocaine use disorder, or a severe cocaine use disorder? In this episode we walk through the DSM-V criteria for substance use disorder and how to assess if your patient has a mild, moderate, or severe substance use disorder

Episode 5 - Medications for Smoking Cessation 101

Tue, 08 Jun 2021 21:25:13 -0700

How familiar are you with pharmacotherapy for smoking cessation? Turns out medications for smoking cessation are relatively simple, and easy to prescribe. Dr. Grover gives a concise review of medications for smoking cessation. Considering that cigarette smoking causes about 1 out of every 5 deaths in America - we as acute care providers can make a big different for our patients by helping them quit smoking with medications.

Episode 4.5 - Lit Review - What are patients thinking about after an opioid overdose?

Wed, 02 Jun 2021 15:42:19 -0700

Have you ever sat down with someone after an opioid overdose? Ever wondered what people are worried about after they have an overdose and end up in an Emergency Department? In this episode, we review this paper from Academic Emergency Medicine in 2021: "A qualitative study of Emergency Department patients who survived an opioid overdose: Perspectives on treatment and unmet needs." The authors interviewed patients in the ED after an opioid overdose to hear their perspectives. You'll may be surprised by what patients identify as the most important issues after an overdose.

Episode 4 - How to handle benzodiazepine dependence

Tue, 25 May 2021 22:48:09 -0700

Benzodiazepines are often mis-managed by physicians. Benzodiazepine dependence develops within weeks of use, with 50% of people using them for > 1 month becoming dependent. 5% of patients with new benzodiazepine prescriptions will continue to use it after 8 years. So what do we do with these patients in the acute care setting when they want to taper off of them? Dr. Grover provides an evidence-based overview of benzodiazepine dependence, how to start people on benzodiazepine tapers, and what to do with patients that are on extremely high doses of benzodiazepines.

Episode 3 - What is Cannabis Withdrawal Syndrome?

Sat, 22 May 2021 18:05:55 -0700

How much do you know about Cannabis Withdrawal Syndrome? I didn't know anything until I researched and recorded this episode. Turns out it's way more common than you think, and may be the cause of your patients' worsening anxiety and depression. This episode is an evidence based review of Cannabis Withdrawal Syndrome: What is it? How common is it? And what symptoms does it present with?

Episode 2 - Buprenorphine Basics

Mon, 17 May 2021 22:50:18 -0700

Taking on a huge topic in Emergency Medicine and Acute Care - Buprenorphine! A medication that saves lives but can be very intimidating when you first start using it due to how it works in the body. Dr. Casey Grover breaks down the basics so that you can be ready to use buprenorphine successfully on your next shift.

Episode 1.5 - Lit Review - Will this hospitalized patient develop severe alcohol withdrawal?

Mon, 10 May 2021 00:24:28 -0700

A review of the paper by Evan Wood et al in JAMA 2018: "Will this hospitalized patient develop severe alcohol withdrawal"

We discuss a brief overview of alcohol withdrawal, and what a JAMA Rational Clinical Examination Systematic Review says on which hospitalized patients will develop severe alcohol withdrawal. We also talk about trying to predict which patients who present to the hospital in alcohol withdrawal will go on to develop severe alcohol withdrawal vs mild or moderate withdrawal.

Episode 1 - Why Care About Addiction?

Mon, 03 May 2021 22:29:48 -0700

How big of a problem is substance use? Is substance use a problem for patients in the acute care setting? Is treatment for substance use effective in the acute care setting, particularly the Emergency Department?

Dr. Casey Grover provides an evidence-based overview of why we should - as healthcare providers - all care about substance use disorders.

Episode 0 - Introduction

Mon, 03 May 2021 22:21:18 -0700

An introduction to the Addiction in Emergency Medicine and Acute Care Podcast

Who am I? Why does this topic matter? How is this podcast going to work?