Are you ready to transform your mental health and physical wellbeing? In this episode of Cracking Addiction, we dive deep into the powerful role of positivity, meaningful activity, and strong relationships in enhancing your life. If you've ever struggled with poor mental health or have been curious about how to improve your happiness, you're in the right place! Let's talk about how simple lifestyle changes, like adding those famous 10,000 steps and reducing leisure inactivity, can directly impact your well being. Keywords like "mental health" and "physical wellbeing" take center stage as we explore their intertwined connection. Ever wondered why "sitting is the new smoking"? You'll discover shocking insights that will make you rethink your daily habits. Alongside, we unravel the vicious cycle of alcohol consumption and its detrimental effects on mental health. But that's not all—we'll delve into Martin Seligman's PERMA model, showing you how positivity and engagement in meaningful activities can drastically change your life. This video isn't just informative; it's a roadmap to a healthier, happier you. 00:00:00 Introduction to Well Being and Poor Mental Health 00:00:30 Origins of the 10,000 Steps Concept 00:01:07 Relationship Between Steps and Mortality 00:01:50 The Harm of Leisure Time Inactivity 00:02:13 Sitting as the New Smoking 0 0:03:10 Harmful Alcohol Consumption and Mental Health 00:03:50 Alcohol Consumption Guidelines in Australia and Canada 00:04:05 The PERMA Model by Martin Seligman 00:05:03 Developing Positivity Through Deliberate Practices 00:06:05 Importance of Engagement in Meaningful Activities 00:07:23 Relationship Between Loneliness and Meta-Inflammation 00:08:53 Impact of Adverse Childhood Experiences on Well being 00:09:32 Benefits of High Well Being 00:10:09 Summary and Conclusion

Are you ready to dive deep into the multidimensional concept of well-being and discover actionable steps to enhance your life? In this episode of Cracking Addiction, I uncover the secrets to achieving ultimate well-being by examining the vital role of genetics and the impactful behaviours you can adopt today. From physical fitness and dieting strategies to the importance of social connections and lifestyle choices, you'll find out exactly how to boost your mental and physical health! Throughout this video, we explore the genetic influence on well-being, revealing that at least a third of our life satisfaction and wellness are inherited. You'll learn the significance of commuting physical activity, the power of a vegetable-rich diet, and the impact of abstaining from tobacco and alcohol. Each proven tip is designed to elevate your life, making this video a must-watch for anyone looking to improve their quality of life. 00:00:00 Introduction to Well Being 00:00:54 Definitions of Well Being 00:01:48 Genetic Influence on Well Being 00:02:58 Behavioural Determinants of Well Being 00:03:43 Activities Reducing Well Being 00:04:25 Alcohol Consumption and Well Being 00:04:53 Government Physical Activity Recommendations 00:05:34 Diet and Well Being 00:06:26 Tobacco and Well Being 00:07:07 Summary and Conclusion

Uncovering the Power of Ibogaine: A Game-Changer for Addiction Treatment [Psychedelic Medicine, Ibogaine, Addiction Recovery]

Are you ready to revolutionise your understanding of addiction treatment? In this eye-opening episode of Cracking Addiction, I sit down with the legendary Zappy Zapolin, founder of the Mind Army and renowned as the "psychedelic concierge to the stars." Together, we delve into the transformative world of psychedelic medicine, focusing specifically on the groundbreaking potential of ibogaine in addiction recovery.

🔥 Discover how ibogaine offers a radical shift in treating heroin addiction and other substance dependencies. Zappy takes us on a journey through the cultural and historical roots of this powerful African plant, used for centuries by the Bwiti people to connect with their ancestors. With current rising addiction crises and mental health issues, could ibogaine be the miracle we’ve been waiting for?

👀 Don't miss out on this riveting conversation that promises to challenge conventional wisdom. You'll learn why Zappy and his Mind Army are advocating fiercely for the decriminalization and legalization of naturally occurring psychedelics. Tune in to understand the profound benefits and the contentious debates surrounding their use.

💬 Be part of this transformative discussion! Like, share, comment, and subscribe to MedHeads to stay updated with the latest in addiction treatment breakthroughs!

📚 [Mind Army Official Website] https://mindarmy.org

#Ibogaine #PsychedelicMedicine #AddictionRecovery #MentalHealth #CrackingAddiction

This episode is perfect for you if you're committed to exploring cutting-edge treatments and alternative solutions to addiction.

Cocaine toxicity - In this episode of Cracking Addiction, we discuss the metabolites of cocaine, the different organ systems affected by cocaine, and the harms associated with cocaine use. We discuss the harms of coingestion in particular of alcohol and cocaine and the toxic metabolite cocaethylene. We also discuss the common adulterants mixed in with cocaine and the harms that can be caused by these adulterants.

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Cocaine, Crack and Freebase -In this episode of Cracking Addiction we

explore cocaine, it's origins, the difference between powder cocaine and

crack and freebase and the effects of cocaine on various organ systems

and in pregnancy.

Cocaine is a stimulant drug that is made from the leaves of the coca plant. It is a powerful psychoactive substance that is commonly used for recreational purposes. When ingested, cocaine produces feelings of increased energy, alertness, and euphoria. It is also a potent anesthetic and can be used medically to numb tissues and decrease bleeding during surgery.

Crack is a form of cocaine that has been processed to create a rock crystal, which can be smoked. Crack cocaine is highly addictive and produces a strong, immediate high that lasts for only a few minutes. The high is followed by a crash that leaves the user feeling exhausted and depressed.

Freebase is another form of cocaine that has been processed to create a more pure, potent form of the drug. It is made by mixing cocaine with ammonia or sodium bicarbonate and heating the mixture to remove the hydrochloride salt, which makes the cocaine more soluble in water. This allows the drug to be smoked, producing an intense, short-lived high. Freebase cocaine is extremely potent and can be very dangerous due to the high risk of overdose.

It is important to note that all forms of cocaine are potentially harmful and can have serious short-term and long-term health effects. Regular use of cocaine can lead to addiction and can have detrimental effects on mental and physical health.

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Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in providing written reports in the field of addiction medicine. There are many agencies or entities that might request a formal opinion from an addiction medicine specialist. These include Vic Roads, insurance companies, AHPRA and the coroner’s court.

When writing reports for Vic roads one must bear in mind the private and commercial driving standards. Such reports usually are requested after a patient has tested positive for a prohibited substance, or because they have tested positive for a blood alcohol concentration in excess of the legal limit (0.05%). Reports may be requested by insurance companies regarding the suitability of ongoing high dose opioid prescribing, usually in the context of chronic pain. Court reports usually are requested in the context of alleged medical error or negligence.

Dr Frei’s advice to anyone considering writing a report is firstly to maintain impartiality, and secondly to be aware that the report will be scrutinised by all parties with a material interest in the matter at hand. For those starting out it is useful to bear in mind that language does not have to be literary, and that it is more important to be factually correct and fair in providing an opinion.

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Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in the care and management of clinicians who find themselves struggling with addictions.

Clinicians face significant stigma when dealing with their own illnesses, and even more so in the situation of mental illness and substance use disorder. An additional barrier to accessing treatment is the regulatory environment within which clinicians must access care. This includes the potential for mandatory reporting to AHPRA. For these reasons clinicians tend to present late for help. The good news is however that clinicians are more likely to make a recovery from addiction, in that they are, as Dr Frei states, “overrepresented in success stories”.

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In this episode of Cracking Addiction I speak with Associate Professor Suzanne Nielsen about the opioid epidemic and what we can do about it.

In the USA there seems to be more a problem with heroin whereas in Australia we are struggling with prescription opioid dependence. Even though a doctor may be prescribing your pain killers, it is still possible to become addicted to pain killers. The traditional treatments we have for opioid dependence in general include methadone and buprenorphine based opioid replacement therapy.

A recent addition to the family includes the Long -Acting Injectable Buprenorphine therapies, commonly referred to as “the Injection”. Patients who struggle with prescription opioid use disorder (which has been referred to as “pain killer addiction”) also benefit from opioid replacement therapy.

Suzanne’s research over the last ten years has proven that the same therapies that work for heroin dependency, also work for prescription opioid dependency.

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In episode 69 of Cracking Addiction we discuss the difference and similarities between general practice and Addiction Medicine. We discuss Addiction Medicine consultation liaison services in hospital, inpatient and community management options with regards to Addiction Medicine. Lastly we discuss the role general practitioners play in managing patients with substance use disorders within the community and the breadth of community presentations and continuity of care that they provide their patients.

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In this episode of Cracking Addiction we discuss the class of drugs known as gabapentinoids, a group of GABA analogues. In this episode we discuss the clinical uses of gabapentinoids and also the increasing rates of prescription of gabapentinoids in recent years and the resultant harms associated with gabapentinoids including the risks of dependence/addiction as well as increased rates of overdose and polypharmacy harms.

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In episode 67 of Cracking Addiction we discuss the management of acute intoxication of MDMA and discuss the principles of both MDMA and stimulant withdrawal including supportive management options as well as the importance of psychosocial interventions in particular contingency management and CBT based interventions.

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In episode 66 of Cracking Addiction we discuss MDMA or ecstacy and discuss its analogues PMA and PMMA and discuss the pharmacokinetics of these drugs, the unique properties of MDMA as both an atypical amphetamine-type substance and its effects as an empathogen. We also discuss the usage as both a recreational drug but also the new and emerging evidence of the clinical effects and benefits of MDMA and its increased usage in medical practice. MDMA has many effects on the body and we discuss the effects of MDMA on the brain, heart and liver in particular as well as some of the side effects of MDMA.

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In this episode of Cracking Addiction we discuss the timeframe of GHB withdrawal, the severe and significant symptoms of GHB withdrawal and the potential life threatening sequelae of GHB withdrawal. We explore the approach to GHB withdrawal management including medications that can assist to manage these symptoms and the need to speak specialist help promptly given the potential for significant deterioration.

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In this episode of Cracking Addiction, I sit down with Jesse Ball to explore the profound journey of breaking free from addiction and embracing a fulfilling life in recovery. If you're looking for motivation and real-life insights on addiction, recovery, and maintaining sobriety, this video is just for you! Keywords: addiction, recovery, sobriety.

We dive deep into Jesse's personal experiences, from the pivotal moments that made recovery attractive to the ongoing practices that help him stay clean. You'll hear about the power of accountability, the journey through the twelve-step program, and how even salsa dancing can play a role in the path to a new life. Jesse’s story resonates with the struggles many face, and his tips on fitness, diet, and mental health are invaluable for anyone navigating their own recovery or supporting someone in theirs. Keywords: addiction, recovery, sobriety.

Trigger for Change: A realisation by the age of 25 that continuing to use drugs over a past breakup was no longer a valid reason.

Trauma and Substance Use: Emphasised the importance of not validating a victim mindset to avoid feeling disempowered and reinforcing the ability to change one's life.

Power and Accountability: Recognising powerlessness over addiction paradoxically empowers individuals to actively seek help and make lifestyle changes.

Sustaining Recovery: Success in early recovery involved following advice from experienced individuals in recovery, engaging in therapy, fitness, and building accountability through relationships and activities.

Maintaining Recovery: Continuously engaging in healthy habits such as regular exercise, meditation, and diet, while exploring new interests and remaining accountable to oneself and others.

In this episode of Cracking Addiction we discuss GHB and its analogs GBL and 1,4-butanediol and the differences between these drugs. We explore the clinical indications for GHB as well as the pharmacology and pharmacokinetics of this drug. We discuss the side effects of GHB and some of the symptoms of GHB withdrawal.

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In this episode of Cracking Addiction we speak to Professor Peg O'Connor, a professor of moral philosophy who is in recovery from alcohol use disorder and who addresses an audience much like herself: those in recovery who have struggled with the Christian-centric God at the heart of Alcoholics Anonymous. She brings our attention to a little-known fact: the term “higher power,” a touchstone in the twelve steps of Alcoholics Anonymous, was coined by William James, philosopher, psychologist, and intellectual giant of the early 20th century. 

In this book Professor O'Connor addresses concepts such as:

• Understanding the Concept of “Higher Power” at the Heart of the 12-Step Program 
• Why There Must Be Multiple Paths out of Addiction and No One is the Best or Right
• Why Needs in Recovery Change over Time
• Undertaking Spiritual Recovery in AA without a Religious Denomination

Professor O'Connor's book 'Higher and Friendly Powers: Transforming Addiction and Suffering' can be ordered from her website: https://pegoconnorauthor.com/ as well as Amazon, Barnes and Noble and Wildhouse Publications.

In this episode of Cracking

Addiction we discuss people who use drugs whilst in hospital and discuss

the ethics of treating people who use drugs, harm reduction measures

that can assist with patient engagement, the stigma and marginalisation

people who use drugs experience and the evidence and ethics around

behaviour contracts.

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Kamini an Ayurvedic opiate-Kamini or Kamini Vidrawan Ras is an Ayurvedic medicine containing opiates as well as some heavy metals. It is a medicine marketed for a variety of indications ranging from premature ejaculation and impotence to increased stamina. There is increased recognition and awareness of patients presenting to specialist Addiction Medicine services with opioid dependence secondary to Kamini Vidrawan Ras often requiring treatment with opioid substitution therapy.

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In this episode of Cracking Addiction we discuss the timeframe and symptoms of benzodiazepine withdrawal, how to stabilise a patient on benzodiazepines and weaning and tapering of benzodiazepines within a community setting. We also discuss and highlight the importance of psychosocial support and lifestyle interventions in managing benzodiazepine dependence and withdrawal.

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In this episode  of Cracking Addiction we discuss the effects of chronic

benzodiazepine usage and the mechanisms of which tolerance and

dependence to benzodiazepines develops and discuss the time course in

which these syndromes can occur as well as discuss the diagnostic

criteria for a benzodiazepine use disorder.

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In episode 58 of Cracking Addiction we discuss the pharmacology of benzodiazepines and their interaction with the GABA-A receptor, the different types of benzodiazepines and their different half lives and effects, discuss how to calculator benzodiazepine dose equivalence, the increased risks of benzodiazepine overdose when compared with other medications especially with opioid medications and the pharmacokinetics and metabolism of benzodiazepines.

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In today's episode of Cracking Addiction we are joined by Dr Sam Manger the President of the Australasian Society of Lifestyle Medicine and host of the GP Show podcast who discusses lifestyle interventions in substance use disorders. Lifestyle interventions can be safe and efficacious interventions and there is a growing evidence base for certain lifestyle interventions in some substance use disorders.

For further information on lifestyle interventions in substance use disorders please read our journal article on this topic at: https://www1.racgp.org.au/ajgp/2022/august/lifestyle-interventions-for-substance-use-disorder

The GP Show podcast and other lifestyle medicine resources: https://thegpshow.com

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In this episode of Cracking Addiction we discuss relapse prevention strategies with regards to methamphetamine use and discuss harm reduction strategies, how to avoid a lapse becoming a relapse, the Matrix Model, motivational intervention and contingency management.

We also discuss the importance of peer support programs in aiding people on their path to recovery from substance use disorder and discuss the evidence surrounding pharmacotherapy interventions for methamphetamine use disorder.

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In this Episode of Cracking Addiction we discuss the three phases of methamphetamine withdrawal, strategies to manage the methamphetamine withdrawal including possible medication options and the ongoing psychosocial support required to support patients during methamphetamine withdrawal.

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Are you curious about how alcohol really affects your heart health? In this eye-opening episode of "Cracking Addiction," Dr. Richard Bradlow and Dr. Ferghal Armstrong dive deep into the science behind alcohol consumption and its impacts on diseases like high blood pressure and heart disease. This video is packed with insights that you won't want to miss!

Alcohol and heart health are two critical subjects that often spark extensive debates. In today's discussion, we'll explore the common questions that many people have about alcohol and its relationship with high blood pressure and heart disease. We'll debunk myths, reveal surprising facts, and help you understand the intricate balance between potential benefits and significant risks.

We start with the famous debate on whether alcohol, especially red wine, can benefit your heart. While resveratrol in wine does have some health benefits, I explain how the harmful effects of excessive alcohol consumption far outweigh these perks. Dr. Bradlow and I cover topics like alcoholic cardiomyopathy, thiamine deficiency, and the dangerous path toward cirrhosis and other liver issues. Understanding these mechanisms will give you a clearer picture of what too much alcohol can do to your body, especially your heart.

In this episode of Cracking Addiction we mainly speak about

methamphetamines but also amphetamines and discuss the amphetamine class

of drugs and their physiological effects, the different types of

methamphetamines, symptoms of intoxication with amphetamines, side

effects of methamphetamine and amphetamines including the various organ

systems they impact and in particular the potential psychological and

psychiatric harms and focus on drug induced psychosis. 

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In this episode of Cracking Addiction we are privileged to have Steven

McDonald who discusses his lived experience with addiction and his path

towards recovery. Steven speaks openly and honestly about his past

history and his experiences. Steven has written a book 'Thanks for

Letting Me Share' which is a book of 368 quotes that have helped him

along his journey. The book is available on Amazon https://www.amazon.com/dp/B09BCG67JK/ and Facebook https://www.facebook.com/Thanks-for-Letting-Me-Share-book-102078078856382

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In this episode of Cracking Addiction we discuss cannabis hyperemesis

syndrome, the various theories surrounding the pathophysiology of

cannabis hyperemesis, treatment of cannabis hyperemesis syndrome,

diagnostic criteria for cannabis hyperemesis syndrome and discuss the

other potential differential diagnoses of cyclic vomiting symptoms and

how cannabis hyperemesis syndrome is often a diagnosis of exclusion.

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In this episode of Cracking Addiction we discuss the variety within the

class of synthetic cannabinoids, symptoms of synthetic cannabis

intoxications, side effects and complication of synthetic cannabis usage

and specific considerations in withdrawal management.

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In the latest episode of Cracking Addiction we discuss the symptoms of

cannabis withdrawal syndrome and the duration that can be expected for

these symptoms, the common reasons that people use cannabis and how to

manage these symptoms post cannabis withdrawal, the pharmacological

management options for cannabis withdrawal which is largely symptomatic

management and also the the common clinical scenarios of comorbid

dependency with cannabis and other substances such as tobacco and

caffeine and the need to often manage withdrawal of other substances

whilst managing cannabis withdrawal.

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In this episode of Cracking Addiction we discuss the symptoms of

cannabis use disorder and cannabis intoxication, the different

preparations of cannabis and the THC contents of these various

preparations, the harms associated with cannabis use, the harms of

cannabis when compared with tobacco and alcohol usage, the risk factors

for developing cannabis use disorder, how to identify a person with

cannabis use disorder, the social determinants impacting substance use

and the classifications systems for cannabis use disorder mainly DSM 5

and ICD 11.

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In this episode of Cracking Addiction we discuss cannabidiol (CBD) and

discuss the clinical effects of CBD, how CBD acts on the cannabinoid

receptors, the clinical indications for CBD products, the potential

areas where CBD may have the most clinical benefit and discuss the lack

of psychoactive properties of CBD. We also discuss the risks associated

with CBD and how to counsel patients on these risks. Finally we discuss

the potential future role of CBD in the management of chronic pain and

people on high dose opioids and also in the treatment of cannabis use

disorder.

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In this episode of Cracking Addiction we discuss delta 9

tetrahydrocannabinol (THC) and how it interacts with the cannabinoid

receptors and how this interaction with the receptors causes its effects

on the body. We also explore the clinical effects of THC, side effects

of THC and the clinical indications for THC products.

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In this episode of Cracking Addiction we discuss the endocannabinoid

system, the different types of endocannabinoid receptors CB1 and CB2,

the location of the different receptors, the endogenous ligands of

cannabinoid receptors and their synthesis and breakdown and briefly

touch on the two best known cannabinoids THC and cannabidiol. 

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In this episode of Cracking Addiction, Scot Aitken and Dr Ferghal Armstrong chat about Johan Hari’s book, Chasing The Scream. We explore some of themes of the book including the motivations that underpin the war on drugs, the economic factors that affect the war on drugs and the role of decriminalization of drug use.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Mastering Opioid Risk Management:

Practical Tips & Life-Saving Strategies with Dr. Ferghal Armstrong

Are you concerned about the risks associated with opioids? Want to understand practical strategies for opioid risk management? This is the video just for you! Join me, Dr. Ferghal Armstrong, and Dr. Richard Bradlow as we delve deep into the intricacies of managing opioid toxicity, dependency, and safety.

In this episode of Cracking Addiction, we tackle the pressing [keywords "opioid risk management"] head-on. We discuss why it's crucial to manage the risks of opioids and share actionable techniques that you can incorporate into your medical practice immediately. Our conversation covers everything from assessing the right reasons for prescribing opioids, establishing clearly defined functional goals, to the benefits of opioid rotation and utilising naloxone nasal spray (Nixoid).

If you want to stay ahead in your practice and ensure patient safety, make sure not to miss this episode! We also highlight the importance of having an "exit strategy" for opioid prescriptions and discuss harm minimisation strategies for high doses. This video is packed with valuable insights and expert advice.

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In this episode of Cracking Addiction we are again joined by Dr Colin Mendelsohn to discuss the controversies around vaping including the risks around vaping, the thoughts of vaping being a gateway to smoking cigarettes, the risks of EVALI, the role of 'Big Tobacco' in vaping, looking at the evidence around vaping and challenging some of the latest reviews around vaping

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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https://www.meducate.com.au/blog

About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In part 2 of 3 episodes. In this episode of Cracking Addiction we are again joined by Dr Colin Mendelsohn to discuss the different types of vaping products on the market, the different types of nicotine e-liquids available, how to source vaping products, how to prescribe nicotine and how to vape safely.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

https://www.meducate.com.au/blog

About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In this 1st of three episodes of Cracking Addiction we are joined by Dr Colin Mendelsohn to discuss the harms of tobacco usage, what vaping is and how vaping can be useful to aid smoking cessation, the myths and benefits surrounding nicotine and the efficacy of vaping in smoking cessation. Nicotine vaping is surrounded in mystery with a lot of myths and misinformation abounding and in this episode we try and dispel some of this misinformation.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction we discuss tobacco use in

pregnancy and the those with mental health disorders and the evidence

around smoking cessation in these special population groups.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction we discuss various smoking cessation interventions including behavioural interventions, nicotine replacement therapy, varenicline, bupropion and nortriptyline to aid patients in stopping smoking.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

https://www.meducate.com.au/blog

About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction we discuss the harms associated with tobacco use, the health benefits of tobacco cessation, briefly discuss smoking cessation interventions and highlight the importance of brief interventions in eliciting behaviour change.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

https://www.meducate.com.au/blog

About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In Episode 38 of Cracking Addiction we summarise the previous episodes regarding opioid use disorder and discuss a framework on the safe management of patients with opioid use disorder.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

https://www.meducate.com.au/blog

About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 37 of Cracking Addiction we discuss in detail some of the social comorbidities associated with substance use disorders and what to screen for, be aware of and some management strategies to tackle these social comorbidities.

Social isolation and alienation are some of the unfortunate hallmarks of substance use disorder. Some of the biggest social harms that occur to the patient are the harms that can occur with increased rates of unemployment, homelessness, broken relationships and social isolation. Loneliness appears to be a significant product and by-product of substance use disorder and can lead to worsening outcomes.

Some of the social harms to society include the role of acquisitive crime to fund drug usage in some circumstances, increased rates of violence and domestic violence in particular as well as potential risks of child endangerment and child welfare concerns. It is important that we focus on safety with the above concerns, and that in the case of domestic violence and child abuse that medical practitioners are aware of their mandatory reporting requirements and also how to support women and children in particular who are at risk of violence or other harms and which supports and services one can refer them to.

The role of incarceration in the management of substance use disorder is controversial. History has provided numerous examples of where prohibition of drugs was ineffective and incarceration for substance use disorder (which is a medical condition) does not appear to be effective in reducing drug usage or it’s associated harms. Effective treatment of substance use disorder and consideration of decriminalisation of drugs and managing patients through diversion and rehabilitation programs would likely be of more benefit for the individual and society as a whole. Furthermore, by marginalising people with substance use disorder and treating people like criminals and incarcerating people we risk alienating and further stigmatising people. From a governmental perspective this could include less people participating in the workforce and a loss of tax revenue, the costs of incarcerating people and the costs of the criminal justice system to process people through this system.

In summary there are significant social comorbidities associated with substance use disorder. Treating people with substance use disorders holistically, understanding the potential struggles which they might encounter and providing appropriate assistance might help decrease the social harms associated with substance use disorder for both the individual but society as a whole.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 36 of Cracking Addiction we discuss in detail some of the physical comorbidities associated with substance use disorders and what to screen for, be aware of and some management techniques.

People with substance use disorders often deal with many medical and physical issues that can impact both their quality of life but also increase the risks of morbidity and mortality. There are a number of medical and physical conditions that could be discussed but for the sake brevity this blog post will detail the following:

• Chronic pain

• Tobacco use

• Infectious diseases

• Chronic NSAID toxicity

Chronic pain

Chronic pain alters brain’s stress and reward systems and increases the risk for developing an opioid use disorder. It is thought that up to 30% of chronic pain patients misuse prescription opioids and this is becoming an increasingly problematic matter within society. Recent data and statistics reveal that prescription drug deaths in Victoria now exceed the road toll. The treatment and management of chronic non-cancer related pain is now moving away from a medication centred approach and indeed chronic opioid medication usage are associated with long-term harms within this group including increased risks of opioid induced hyperalgaesia, osteoporosis and hypothalamic pituitary gonadal axis dysfunction. The management of chronic non-cancer related pain now increasingly centres around active pain management strategies, physical therapy, allied health input and rehabilitation activities.

Tobacco use

Many patients with substance use disorders smoke tobacco and broaching smoking and tobacco cessation is important to improving the overall health and wellbeing of the patient. Oftentimes it appears other drugs and substances take priority of tobacco usage but tobacco usage is also associated with significant harms to the patient. It is important to discuss the harms of smoking with patients with substance use disorders and offer smoking cessation interventions. Tobacco usage is responsible for the majority of lung cancer and approximately one-third of all cancer related deaths. Tobacco use is also directly responsible for: cardiovascular disease, reduced immunity, poor wound healing, age related macular degeneration and worsening chronic pain.

Infectious diseases

Patients with substance use disorder are at increased risk of some infectious diseases and it is important to screen people appropriately. In particular people who inject drugs and share needles or who engage in commercial sex work to pay for drugs require screening for blood borne viruses and the latter group in particular will require a thorough sexually transmitted infection screen. Blood borne virus screening includes screening for Hepatitis B, C and HIV and STI screening includes screening for chlamydia, gonorrhoea and syphilis in the first instance.

People who inject drugs are also at risk of skin infections and abscesses as a result of injecting drug use and skin examination should be carried out periodically to exclude thrombophlebitis in veins, cellulitis and one should always consider the risks of infective endocarditis in the appropriate clinical scenario. It is important to be thorough and systematic in our physical examination of our patients and when ordering tests so as not to miss an important medical diagnosis.

Chronic NSAID toxicity

Codeine misuse and dependency associated with chronic non-steroidal anti-inflammatory drug (NSAID) toxicity. NSAIDS can ulceration of the gastrointestinal tract which can lead to bleeding and even perforation of the gastrointestinal tract in severe circumstances. Chronic NSAIDs usage can lead to iron deficiency with or without anaemia due to bleeding from the gastrointestinal tract. Chronic NSAID usage can also lead to recurrent metabolic acidosis and also cause significant renal impairment and lead to NSAID nephropathy...

In episode 35 of Cracking Addiction we discuss in detail some of the psychiatric comorbidities associated with substance use disorders and what to screen for, be aware of and some management techniques.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Are you concerned about the dangers of benzodiazepines and opioids? Curious about how these medications impact individuals with substance use disorders? In this episode of Cracking Addiction, Dr. Ferghal Armstrong and Dr. Richard Bradlow tackle the pressing issues surrounding the prescription of benzodiazepines and opioids. This is essential viewing for anyone interested in the complex dynamics of medication management and opioid stewardship.

From the outset, we delve into the rising legal and ethical concerns GPs face when prescribing these medications. We discuss the escalated risks of co-prescribing benzodiazepines with other sedatives, including alcohol and opioids, which can be life-threatening. Our experts explain why saying no to persistent medication requests is difficult but sometimes necessary to uphold the principle of "primum non nocere" — do not harm.

What sets this episode apart is its insightful historical context. We explore tranquilizers from the first minor tranquilizer, Milltown, to the development of major tranquilizers alongside antipsychotics and antidepressants. Dr. Bradlow’s analysis is both rich and engaging, providing a broader understanding of how these medications evolved and why benzodiazepines, despite their therapeutic window, are fraught with dependency issues.

Discover the nuanced strategies for managing long-term benzodiazepine and opioid prescriptions, especially in cases involving chronic pain and opioid use disorder. Learn about the importance of clear communication and shared decision-making between doctors and patients, which is crucial for safe prescribing practices.

Feel empowered in your knowledge and join the conversation on how we can navigate these challenging waters responsibly. Whether you're a healthcare professional, educator, or someone affected by substance use disorders, this video provides the insights you need.

In episode 34 of Cracking Addiction we discuss how to manage some of the special circumstances in opioid substation therapy including OST in renal and hepatic impairment, managing polypharmacy complications with OST and managing acute pain whilst a patient is on OST.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 33 of Cracking Addiction we discuss how to manage some of the special circumstances in opioid substation therapy including vomiting of doses of OST, dealing with intoxicated patients, overdoses of OST and transitioning between Methadone and Suboxone and vice versa.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 32 of Cracking Addiction we discuss the harm reduction intervention of Naloxone and when to consider prescribing this medication, the benefits of take home naloxone and how it saves lives!

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au