Dopey 550: The Anesthesiologist Who Shot Adrenaline and Fentanyl, Dr. Jason Giles, Hitler, Freud, Halsted, Addiction Recovery

This Week on Dopey! We are joined by Oro Recovery Medical Director - Dr. Jason Giles! We also read old comments and hear from a few dopes in the dopey nation. Then Dave interviews Dr.  Giles—twice board-certified in addiction medicine (via ABAM then ABPM), previously board-certified in anesthesiology and pain medicine, and a recovering opioid addict. He grew up in Santa Monica with a severely alcoholic father, fell into the second-wave ska/mod scene (Vespa, sharkskin suits, amphetamines), dropped out of high school, then clawed his way through community college to Berkeley, volunteering at the Berkeley Free Clinic and falling in love with medicine.

He explains anesthesia’s demands (no pain, no memory; muscle relaxants; airway control), the human connection of pediatric anesthesia, and the hope-work of pain management. In 1999, curiosity and stress led him to divert fentanyl: he edited paper records, carried a 2 mL syringe for a month, then IV-used with sterile technique. After a six-week gap he used again, convincing himself he could “handle it.” Use escalated to daily “after work,” leaving him in daytime withdrawal. The department chair paged him about missing fentanyl; instead of punishment, he offered help and a path into California’s 5-year diversion program (treatment, meetings, testing). Giles detoxed cold turkey, went to AA (first meeting mostly doctors), found he wasn’t unique, and built long-term sobriety (nearly 26 years by his telling), learning service and vulnerability through treatment feedback groups.

With sobriety he finished residency, married, had a son, worked in cardiac anesthesia and pain, and then moved into addiction treatment (Malibu), where his science and lived experience met the work. He and Dave range widely: purpose/mission as a recovery engine; Bill W., boomerangs and ants; truth-serum myths; Halsted (cocaine→heroin), Freud letters, Hitler’s amphetamines/opioids (book Blitzed), kratom (mixed withdrawal profiles), benzos vs. opiates (benzo withdrawal = fear), intraoperative awareness & memory, Suboxone vs. abstinence (cast/training-wheels framing), fentanyl’s dominance (counterfeit pills; heroin now rare), and whether fentanyl appears in non-opioid street drugs (he says he’s seen it). ALL THAT AND MUCH MORE ON A BRAND NEW EPISODE OF THAT GOD OLD DOPEY SHOW!

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