High Truths on Drugs and Addiction – Details, episodes & analysis

Dr. Nora D. Volkow, M.D., is the longest residing Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health since 2003.

She is the world's go to person when it comes to the issue of drugs, and commonly known as the mother to the science demonstrating that drug addiction is a brain disorder. 

Dr. Volkow continues her tradition of starting the High Truths podcast season with reflections and hopes in the issue of drugs.

Hello and Welcome to Season 5 of  High Truths on Drugs and Addiction. What an honor and joy I have from hosting High Truths.  Each episode I have great discussions with fascinating and knowledge people who get me thinking and teach me something new. It is like the Talmudic saying in Ethics of our Fathers, Who is Wise, One who learns from every person. And you and I learn so much from our High Truths guest. Talmudically speaking - I guess that means we are all wise.

Can you believe that we already had 210 conversations with fascinating people? I love it. But more importantly, the conversations we have - lead to action, drug policies and solutions. 

Talk is great, but as the saying goes, Action speaks louder than words. Keeping with our High Truths tradition, this first episode of Season 5 will be just me sharing with you my monologue for the year.This is the one and only time of year where you hear just from me, and the rest of the season is dialogue with my guests. Here is what I want to cover with you today.

• First Reflections about this High Truths Podcast
• Then a state of the union on the drug data.
• And ending with hopes for our future with solutions and action.

So here I go...

56% of drivers involved in serious injury and fatal crashes tested positive for a least one drug.  I talked to Ari Briskman to get boots on the ground law enforcement perspective of drugged driving.

Sergeant Ari Briskman has served as a law enforcement officer since 2007. Ari is presently assigned full-time as the Commander of the Marine Unit for the Lake County Sheriff’s Office. Ari also serves the Sheriff’s Office as the Technical Crash Investigation Team Commander, the Auxiliary Deputy Unit Commander, and as a Public Information Officer.

Ari has dedicated much of his career to impaired driving enforcement and traffic safety. He is a certified Drug Recognition Expert, certified Drug Recognition Expert – Instructor, Standardized Field Sobriety Test Instructor, Seated Standardized Field Sobriety Test Instructor, and certified Crash Reconstruction Specialist. Ari has been recognized by courts in several counties in northern Illinois as an expert in the fields of alcohol and drug impairment. 

Ari has personally apprehended over 600 impaired vehicle and boat operators throughout his career, for which he has been recognized several times by Alliance Against Intoxicated Motorists and Mothers Against Drunk Driving. He has consulted with and assisted in the prosecution of hundreds of additional impaired driving cases throughout Illinois.

Ari has been contracted with various Illinois training units as an instructor to teach all the National Highway Traffic Safety Administration impaired driving enforcement courses, the National Association of State Boating Law Administrators boating under the influence courses, and his own original material. Ari serves as an adjunct instructor for the Homeland Security Training Institute at the College of DuPage teaching course material on drug impairment in the workplace. Ari is also a senior consultant for Dynamic Impairment, LLC, for whom he provides consultancy services to private businesses and court litigants on drug policies and impairment recognition. 

In addition to his law enforcement duties, Ari advocates for stronger impaired driving laws and protections for crash victims as a member of the Board of Directors of the Alliance Against Intoxicated Motorists. Ari also serves as a board member for the State of Illinois Impaired Driving Task Force and on the speaker’s bureau for the National Marijuana Initiative.

Ari holds a Bachelor of Science degree in Law Enforcement and Justice Administration and a Master of Arts degree in Public Safety Administration, both from Western Illinois University.

Death Diaries is what I call the  research I did with Dr. Jason Doctor. We reviewed data on every single person who died of an unintentional medical overdose and compared the drugs on autopsy to what was prescribed to the person. This list of medications were diaries that lead to death.  The research changed my life as a doctor and how I prescribe medications. Dr. Jason Doctor is an Associate Professor in the School of Pharmacy and Faculty at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California. His research program centers on decision-making in healthcare. Dr. Doctor specializes in applying behavioral economic methods within health and medicine and current leads a multi-site federally-funded multi-site cluster randomized clinical trial that evaluates behavioral economic approaches to improve physician adherence to comparatively effective treatments.  In other federally-funded research, Dr. Doctor has developed Bayesian decision algorithms to identify errors in blood panels to improve patient diagnosis. He also maintains a research program in understanding preferences for health from a behavioral economic perspective. He has extended the quality-adjusted life year (QALY) preference model to accommodate preference for helping others in medical need (social preferences) and has developed mathematical representations in QALY calculations that accommodate cognitive limitations people have in abiding by rational principles in decision making. JAMA Letter: Effect of Prescriber Notification of Patient's Fatal Overdose on Opioid Prescribing

Is it time to talk about Pre-Addiction? We have pre-diabetes and pre-glaucoma, diagnosis intended to prompt early treatment in order to prevent worse disease.  Should we be diagnosing and treating Pre-Addiction? Thomas McLellan, Ph.D. has been a career researcher in addiction treatment and policy for 40 years, working primarily at the University of Pennsylvania and at the Treatment Research Institute (TRI) which founded and served as CEO for 25 years.

From 2000-2009 he was Editor-in-Chief of the Journal of Substance Abuse Treatment.  From 2009 to 2011, he was Deputy Director of the White House Office of National Drug Control Policy (ONDCP) where he formulated President Obama’s National Drug Control Strategy and helped include addiction treatment into the Affordable Care Act.  In 2015-2016 he served as Senior Editor on the US Surgeon General’s Report, Facing Addiction.

In his career he has published over 550 articles and chapters on addiction research and was awarded over 150 NIH research grants.  He has been among the top ten most cited researchers in the addiction field for 15 years.

Dr. McLellan is the recipient of several distinguished awards including the Lifetime Achievement Awards of the American, Italian, Australian, Egyptian and British Societies of Addiction Medicine; the Robert Wood Johnson Innovator Award; Distinguished Contribution to Addiction Medicine from the American Public Health Association, the American Medical Association; and jointly from the National Institutes of Drug Abuse and Alcoholism and Alcohol Abuse.

He currently serves on the boards of Indivior LLC (makers of Suboxone) and Recover Together; and lives with his wife Kerry in Sarasota Florida.

Pre-Addiction - A Missing Concept for Treating Substance Use Disorder, Aug 2022

This is a reverse podcast. Typically I am interviewing my guests. In this special episode, I am  interviewed by Dr John Bibb on my path to the White House and addiction medicine. I talked about my young years as an emergency physician, having a family, along with failed and successful projects from opioid prescription epidemic to our national drug crisis.

What is the best approach for preventing youth with substance use disorder? Learn from Dr. Sid Puri who reaches kids with SUD in LA County. "Prevention begins at birth or before." "It's the end of casual drug use" - because of fentanyl

Dr. Siddarth Puri

Dr. Puri is the Associate Medical Director of Prevention at the division of Substance Abuse Prevention and Control (SAPC) at the Los Angeles Department of Public Health and an attending on the addiction consult service at Los Angeles County-USC Hospital. He completed his medical education at UC Davis and his adult psychiatric residency and both his child and adolescent, and addiction psychiatry fellowships at the UCLA Semel Institute for Neuroscience and Human Behavior.

How does a retired bald DEA agent reach children about making the right choices when it comes to drugs?

Rockwell Herron

Developed “I Choose My Future” a drug prevention presentation for kids.  Since 2007 he delivered over 820 presentations in 15 countries to 165,000 kids ages 12 to 22.

Rocky know about drugs from his service as a DEA Special Agent from 1990 to 202. He is the Alcohol and Other Drug Ambassador for San Diego County Office of Education from 2021.

https://www.rockyherron.com

Dr. Lynn Silver talks to High Truths about the history of marijuana legalization and best practices for policies that protect public health. Lynn Silver, MD, MPH, FAAP

Pediatrician, public health researcher and advocate, Silver is Senior Advisor at the Public Health Institute (PHI) and Clinical Professor at University of California San Francisco. She directs PHI’s Prevention Policy Group, including Getting it Right from the Start, a project of PHI founded in 2017 to support adoption of cannabis policies to better protect youth, public health and equity. Silver is an expert on the use of policy and law to prevent chronic disease, its risk factors and inequitable impact, including unhealthy diet, tobacco, and physical inactivity.  She is an NIH supported researcher evaluating chronic disease prevention policy and cannabis regulatory policy. Silver was Assistant Health Commissioner of New York City under Mayor Bloomberg, where she led groundbreaking policy initiatives including the nation’s first trans-fat ban, calorie labeling law, and the National Salt Reduction Initiative. In California, she served as county health officer in Sonoma County, and has contributed to the passage of the first successful U.S. soda taxes in the Bay Area and many local cannabis laws. She serves on the CA Advisory Group for the Proposition 64 cannabis tax revenue, the Board of the Center for Science in the Public Interest and chairs the CA Alliance for Prevention Funding which fights for health equity investments. Silver was previously Visiting Scholar of International Health at the Karolinska Institute, Dean and Associate Professor at University of Brasilia’s School of Health Sciences,  and taught at Brazil’s National School of Public Health. She has worked widely on health policy as a researcher, educator, government official, consultant and advocate. She has served as consultant to the World Health Organization/Pan American Health Organization, the Federal Reserve Bank of San Francisco, the World Bank, the Low Income Investment Fund, hospitals and foundations. She received her MD and MPH degrees and pediatric training from the Johns Hopkins University. Silver has published widely and was honored to be the recipient of the 2011 Wavemaker Award of the Campaign for Public Health.

  SB1097, Cannabis Right to Know Act - Torpedoed by Cannabis Industry Power  

A recent publication in JAMA Pediatrics shows that mental health burdens are associated with prenatal cannabis exposure that persists from childhood to early adolescence. These are results from the Longitudinal ABCD (Adolescent Brain Cognitive Development) study.

David Baranger, PhD

I am a Neuroscientist and Postdoc at Washington University in St. Louis. My primary interest is in understanding how neurodevelopment mediates the effects of genetics and stress on the emergence of psychopathology, particularly substance use and depressive disorders. My research also includes work identifying replicable and reliable neural correlates of psychopathology, as well as work studying factors that influence the measurement of common neuroimaging metrics.

As a postdoc I have worked with Dr. Arpana Agrawal, Dr. Anna Manelis, and Dr. Erika Forbes. This work has focused on studying the reliability of neuroimaging measures of reward, identifying novel structural (cortical myelin) correlates of depression, and studying the association of depression with the neurodevelopment of reward function. My current work seeks to understand how genomic risk for substance use and depression influences neurodevelopment and the emergence of psychopathology in developing samples. 

I completed my PhD in Neuroscience at Washington University in St Louis, where I worked with Dr. Ryan Bogdan and Dr. Deanna Barch. My dissertation was on the use of neural biomarkers to disentangle the causes and downstream consequences of alcohol use.

Outside of work you can find me playing with my cats, rock climbing, backpacking, and at indie/electronic shows.