🚨 Important Update on Paracetamol in Australia! 🚨

Are you aware of the recent changes in paracetamol regulations and its implications for pain management? Whether you're a healthcare professional, student, or someone who frequently uses paracetamol, this must-see episode of "Cracking Addiction" is packed with crucial insights!

Join Dr. Ferghal Armstrong in our latest episode where he breaks down:

The various theories behind paracetamol's mechanism of action

A recent meta-analysis on paracetamol's effectiveness for different pain conditions

The liver toxicity risks associated with paracetamol and how to manage them effectively

Upcoming changes in paracetamol pack sizes and what they mean for you

Discover how the regulation changes, set to take effect on 1st February 2025, are aimed at reducing incidences of liver injury and death. Learn practical tips on safe paracetamol use and stay ahead of these regulatory updates.

Are you curious about what really causes addiction? In this eye-opening video, I dive deep into the complexities of addiction, examining the genetic vulnerability, environmental influences, and the significant role of trauma. You'll discover how substances like nicotine, heroin, and alcohol increase dopamine in the brain, making us crave them even when we don't necessarily enjoy them. Keyword alert: If you're fascinated by addiction, neuroscience, or mental health, this video is tailor-made for you!

Join me, Dr. Ferghal Armstrong, as we explore the intricate pathways and factors leading to addiction. You'll learn how genetic factors account for about 50% of addiction risk and why some substances hold higher addictive potential than others. We’ll delve into the environmental or exposure risk factors, such as family dynamics, school policies, and community environments, all of which play crucial roles in addiction. Most importantly, we'll discuss the often-overlooked impact of childhood trauma and how these early experiences can lead to risky behaviours and substance use later in life. Keyword lovers: Addiction causes, addiction genetics, addiction trauma—you don't want to miss this!

This video arms you with a better understanding of addiction so that we can approach those affected with empathy and compassion. You'll gain insights that can help illuminate why addiction is not just a personal failing but a multifaceted condition influenced by a range of factors.

Welcome to another insightful episode of Cracking Addiction, where we delve into the intricate connections between substance use and sleep architecture. I'm your host, Dr. Ferghal Armstrong, and joining me today is Dr. Richard Bradlow.

In this episode, we dive deep into understanding how various substances, particularly those that are misused, impact sleep quality and patterns. We will explore the challenging phenomenon of post-detox insomnia and its implications on relapse. Dr. Bradlow shares practical approaches to managing insomnia through lifestyle changes and short-term medication, highlighting the importance of addressing sleep issues in addiction recovery.

Additionally, we discuss the critical components of sleep architecture, including sleep latency, REM sleep, and slow wave sleep, and how different substances influence these parameters. From the negative impact of alcohol and cannabis on REM sleep to the importance of deep sleep in cognitive and physical restoration, this episode covers it all.

Join us as we unravel the complexities of sleep and addiction, and discover effective strategies to support those on the path to recovery.

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.

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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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.

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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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 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.

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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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 this episode of "Cracking Addiction," we dive deep into the concept of "resilience" and its critical role in addiction recovery. I'm Dr. Ferghal Armstrong, and joining me is the insightful Dr. Richard Bradlow. Together, we unravel the layers of how resilience can make or break the recovery process for individuals battling addiction.

Resilience in addiction recovery is more than just a buzzword; it's the lifeline that enables one to bounce back amidst life’s hardships. Dr. Richard Bradlow and I discuss how resilience helps manage both the impulsivity and compulsivity associated with substance use disorders. How can we bolster this resilience in recovery? By mastering small, achievable goals, creating positive habits, and saying 'no' to cravings, of course!

Are you or someone you know struggling with recovery? This episode is tailored for you. Tune in to discover practical tips, backed by real-life experiences and professional insights, to enhance your journey towards a substance-free life.

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.

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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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.

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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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. 

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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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

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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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.

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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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.

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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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.

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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Dr Ferghal Armstrong and Dr Richard Bradlow explore the significance of melatonin in sleep. Melatonin, a neurotransmitter produced by the pineal gland, plays a crucial role in helping you fall asleep. The discussion touches on various aspects of melatonin including its production, function, and how it can be optimised for better sleep. Ferghal and Richard also dive into the intricacies of sleep hygiene, shedding light on actionable steps that anyone can take to enhance their sleep quality.

Learning outcomes from this episode include understanding the pineal gland's role in melatonin production and the significance of melatonin in the sleep-wake cycle. Richard explains that melatonin is not just any neurotransmitter but a pivotal player in beginning the sleep process. You'll learn why blue light suppresses melatonin production and why it’s crucial to limit your exposure to screens before bedtime. You'll also discover why the body's natural rhythms dictate that sleep hygiene actually starts in the morning, highlighting the importance of light exposure and physical activity.

Key points raised include the ineffectiveness of exogenous melatonin in improving sleep quality, often proving to be more of a placebo than a reliable solution. Ferghal and Richard discuss the importance of natural light exposure, particularly in the morning, to help suppress melatonin and kickstart the day. They also touch on the benefits of morning exercise and even cold showers to optimise wakefulness.

### Learning Outcomes

1. **Understanding Pineal Gland and Melatonin:**

The pineal gland’s role in melatonin production is essential for sleep. Melatonin, a neurotransmitter, is key in initiating sleep but does not keep you asleep. Richard elaborates that melatonin production is sensitive to light exposure, particularly blue light, which can suppress its release, making it harder to fall asleep. Therefore, taking steps to manage light exposure, especially in the evening, can significantly impact your ability to sleep.

2. **Ineffectiveness of Exogenous Melatonin:**

Exogenous melatonin does not significantly improve sleep; often, it is no more effective than a placebo. Ferghal highlights the variability in melatonin products, especially those purchased online, and questions their reliability. This revelation underscores the importance of turning to prescribed melatonin when necessary for accurate dosing. The discussion serves as a cautionary tale about the limited benefits and potential risks of self-medicating with melatonin.

3. **Role of Natural Light Exposure:**

Light exposure, particularly in the morning, is crucial in maintaining your body's circadian rhythm. Ferghal stresses the importance of getting outside and absorbing natural light to suppress melatonin and signal your body that it's time to wake up. Even on cloudy days, the light outdoors significantly surpasses indoor lighting in intensity. This practice can prepare your body for a more restful night by maintaining a healthy sleep-wake cycle.

4. **Importance of Physical Exercise:**

Engaging in physical activity is another vital component of sleep hygiene. Richard explains that exercise, especially when done in the morning, not only benefits your overall health but also helps maintain a healthy sleep-wake cycle. While some traditionally advise against exercising close to bedtime, studies show it does not necessarily affect sleep quality. Including exercise in your daily routine, even late in the day, can support better sleep habits.

### Actionable Takeaways

1. **Managing Light Exposure:**

Begin your sleep hygiene routine in the morning by exposing yourself to natural light. Avoid screens with blue light at least one to two hours before bedtime to prevent melatonin...

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.

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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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.

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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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. 

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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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.

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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

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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.

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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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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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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.

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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.

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I sit down with the inspiring Jesse Ball as we dive deep into the concept of spirituality and authenticity in recovery. The enlightening conversation reveals how Jesse transformed his life by reconnecting with his true self and breaking free from the chains of addiction. This is your opportunity to understand the profound impact of spiritual awakening and authentic living on the road to recovery.

Throughout this episode, Jesse and I unpack the disconnection that fueled his addiction and explore his journey toward understanding and embracing his authentic self. Jesse shares the revolutionary moment of spiritual realization that altered his path and offers valuable insights on maintaining that authenticity in daily life. If you're seeking practical advice on personal growth, emotional vulnerability, and authentic connection, you're in the right place.

Jesse's story is a beacon of hope and a testament to the power of taking responsibility for one's own life. By embracing his vulnerabilities, overcoming self-loathing, and making recovery his full-time job, Jesse discovered unimaginable strength and clarity. You'll learn how to release old narratives, confront your rock bottom, and build a life where your internal and external selves align perfectly.

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.

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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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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

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.

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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

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 31 of Cracking Addiction we discuss the harm reduction interventions that we can implement for people who inject drugs to decrease the risks of morbidity and mortality.

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 30 of Cracking Addiction we discuss the different opioid receptors buprenorphine acts upon and the nature of these effects, the difference between agonists and antagonists, how to start a patient on Suboxone and how to monitor patients on Suboxone and adjust doses.

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 29 of Cracking Addiction we discuss Suboxone and talk about the components of Suboxone as well as the pharmacology and pharmacokinetics of Suboxone.

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

Recovery isn’t just about stopping substance use; it’s about transforming your life. This episode covers key points like the idea of “white knuckling” versus a more holistic approach to sobriety, and how hitting rock bottom can be a powerful catalyst for change. Jesse, a former addict turned lived experience peer worker, shares his own journey, revealing how finding your authentic self can turn recovery into an exciting, fulfilling process.

**Learning Outcomes:**

1. **Understanding the True Nature of Recovery:** It’s crucial to understand that recovery is far more than just abstaining from harmful substances. Jesse highlights that true recovery is about discovering and connecting with your authentic self. This shift in perspective can turn what seems like a daunting process into an attractive and fulfilling journey. By acknowledging that recovery involves reconnecting with your real self, you can focus on the long-term benefits rather than short-term sacrifices.

2. **Recovery vs. White Knuckling:** Jesse discusses the exhausting and often unsuccessful method known as "white knuckling"—relying solely on willpower to refrain from substance use. He outlines how this is not sustainable for those deeply entrenched in addiction. Instead, a structured recovery programme alongside community support can offer a more sustainable and fulfilling path to sobriety. Recognising this can help you align your recovery efforts more effectively and avoid the burnout associated with sheer willpower.

3. **The Role of Hitting Rock Bottom:** Ferghal and Jesse delve into the importance of hitting rock bottom as a catalyst for embracing recovery. Jesse explains how the sheer misery of his lowest point opened his eyes to the necessity of change. This realisation can act as a turning point, making the attractions of a clean, healthy life more apparent. This insight can be both a wake-up call and a motivator for those reluctant to embark on their recovery journey.

4. **The Concept of Self Care in Recovery:** One of the standout themes is the idea that recovery demands rigorous self-care. Jesse’s tale of prioritising diet, exercise, and mental wellness paints a vivid picture of how taking care of oneself daily is not a luxury but a necessity. This actionable takeaway can help you build a solid foundation for long-term sobriety by instilling habits that support both your physical and emotional well-being.

**Actionable Takeaways:**

1. **Engage with Recovery Communities:** Jesse highlights how seeing others with qualities he admired—patience, calmness, wisdom—made recovery appealing for him. This underscores the importance of surrounding yourself with supportive individuals who inspire you. Seek out local or online recovery support groups; these communities can be invaluable in offering the encouragement and motivation you need to stay on track.

2. **Explore New Hobbies and Interests:** Breaking free from the cycle of addiction often requires filling your life with new, healthy activities. Jesse mentions trying ultra running, hiking, and even yoga retreats to fulfil his need for excitement. Make a list of activities you’ve always wanted to try and commit to exploring at least one new interest a month. This approach not only keeps you engaged but also helps in building a new identity beyond addiction.

3. **Prioritise Self-care:** A recurring theme in this episode is the crucial role of self-care in recovery. Jesse’s disciplined routine, including meditation, yoga, and maintaining a balanced lifestyle, serves as a powerful model. Develop a daily self-care regimen that includes physical, mental, and emotional health practices. Prioritising self-care helps prevent relapse and promotes overall well-being.

4. **Shift Your Perspective on Fun:** One of the most profound insights Jesse shares is how his...

In episode 28 of Cracking Addiction we discuss our practical tips, advice and experience in managing patients on LAIB and share what we have learned.

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

Episode 27 of Cracking Addiction discusses the patient journey on LAIB and how to adequately deal with and manage adjusting doses of LAIB, commencing and ceasing LAIB and ensuring that patients are maintained on LAIB therapy

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

Cracking Addiction discusses Sublocade one of the LAIB preparations available and how to commence, maintain and manage any dose changes or complications associated with Sublocade.

Sublocade is a long acting injectable buprenorphine (LAIB) manufactured by Invidior that uses the “Atrigel” system to provide for a sustained and prolonged delivery of buprenorphine into the systemic circulation after subcutaneous injection.

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