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

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

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

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. 

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. 

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.

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 

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.

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. 

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. 

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. 

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. 

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. 

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

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.

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.

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. 

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. 

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. 

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. 

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".

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! 

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. 

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. 

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

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

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. 

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. 

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. 

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?

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. 

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. 

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. 

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?

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

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

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

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 

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

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

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

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

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.

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 

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

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 

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 

* 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/

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 

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.