The Curbsiders Internal Medicine Podcast #497 Methamphetamine Use Disorder: Tailoring and Ramping up Management with Dr. Phillip Coffin
46 snips
Sep 8, 2025 Dr. Phillip Coffin, Director of the Center on Substance Use and Health, discusses the evolving landscape of treating methamphetamine use disorder. He highlights a patient-centered four-step management approach, innovative medications, and the crucial role of harm reduction strategies. The conversation intertwines personal anecdotes with insights into assessing patient exposure and the importance of customized treatment plans. Listeners gain practical knowledge on integrating psychosocial therapies and the latest advancements in addiction medicine.
AI Snips
Chapters
Transcript
Episode notes
Humanizing Personal Hobbies
- Phillip described personal hobbies like kite surfing and costume events, showing humanizing details outside medicine.
- These anecdotes framed him as a clinician who balances intense clinical work with creative and adventurous pursuits.
Start By Asking Why They Use
- Ask patients first about the benefits they get from methamphetamine to understand its functional role in their life.
- Assess cumulative exposure and binge patterns because harms relate to long-term dose and runs rather than single overdoses.
Long-Term Use Without Disorder Example
- Phillip shared a patient who used meth daily for decades but only had dental decay as a criterion, so he did not meet use-disorder thresholds.
- That case shows the difference between problematic use and formal use disorder and why screening matters.