The Curbsiders Addiction Medicine Podcast

This episode explores complex questions around addiction treatment from our audience, including the off-label use of GLPs for SUDs, the nuances of naloxone, and managing high-dose methadone in hospital settings. Experts Drs. Shawn Cohen and Zina Huxley-Reicher, in addition to the co-hosts Drs. Carolyn Chan and Era Kryzhanovskaya share insights, resources, and practical tips for clinicians navigating these challenging scenarios.Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!Show Segments Intro, disclaimer Picks of the Week Off-Label GLP use Naloxone review Acute pain in patients with opioid use disorder (OUD) Care Coordination with opioid treatment programs (OTPs) New medications for pain; suzetrigine Perioperative pain management for patients with OUD Outro Credits Producer, Show Notes, Infographic: Era Kryzhanovskaya, MD Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD Reviewer: Kenny Morford, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Shawn Cohen, MD; Zina Huxley-Reicher, MD Production Partner: ACAAM The Curbsiders Addiction Medicine Podcast are proud to partner with The American College of Addiction Medicine (ACAAM) to bring you this mini-series. ACAAM’s membership has grown to include a strong and expanding community of addiction medicine specialists, fellows, and trainees dedicated to advancing the field. Membership provides access to a wide range of educational resources, professional development, and a national network of colleagues. Learn more about ACAAM Membership here. 

Familiarize yourself with the differences in mitragynine-derived compounds. Understand how to identify and manage kratom use disorder and withdrawal from mitragynine-derived compounds. We’re joined by Dr. Jonathan Tanawan (Profile).   Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!Credits Written and Produced, with  Show Notes, Infographic, and Cover Art by Zina Huxley-Reicher, MD  Hosts: Carolyn Chan, MD. MHS and Zina Huxley-Reicher, MD Reviewer: Kento Sonoda, MD, MPH Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jonathan Tanawan, MD Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Pharmacology of  kratom and other mitragynine-based compounds How to take a mitragynine-specific substance use history Defining a use disorder Withdrawal from kratom  Managing a use disorder with MOUD Legal landscape and regulation  Outro Sponsor: FreedGo to freed.ai and use code FREED50 for fifty dollars off your first month. Sponsor: FigsCurbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.  Sponsor: Continuing Education CompanyVisit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.

Maggie Lowenstein, an internist and addiction medicine specialist at UPenn who studies integrated addiction-primary care and inpatient consult models. She breaks down methadone dose confirmation and strategies when doses are missed. She explains the emergence of medetomidine in the drug supply, how it changes intoxication and withdrawal, and practical alpha-2 agonist treatments and discharge planning.

Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We’re joined by Ashish Thakrar, MD at the University of Pennsylvania. Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Symptoms of opioid withdrawal Medications for the management of opioid withdrawal Buprenorphine precipitated withdrawal Starting Buprenorphine: Experiences and Strategies  Titrating Methadone: Dosage and Adjuncts Adjunctive short-acting opioids Emerging Trends in Drug Supply: Xylazine and Medetomidine Outro Credits Producer, Show Notes: Zina Huxley-Reicher Infographics: Zina Huxley-Reicher MD and Zoya Surani Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD Reviewer: Payel Jhoom Roy, MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Ashish Thakrar, MD MHSP

In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using methamphetamines and/or living with methamphetamine use disorder. We explore the latest pharmacologic options, harm reduction strategies, contingency management, and innovative ideas for monitoring and supporting patients. Whether you’re in primary care or other subspecialty settings, this episode is packed with pearls for every clinician with our amazing guest, Dr. Phillip Coffin, Director of the Center on Substance Use and Health in the SFDPH. Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Four-tier approach to taking care of patients with methamphetamine use/use disorder Medications for treatment Psychosocial treatment Harm reduction New horizons in treatment  Outro Credits Producer/Script Writer/Show Notes: Era Kryzhanovskaya, MD Infographic and Cover Art: Zoya Surani Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD Reviewer: Sarah Leyde MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Dr. Phillip Coffin

Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We’re joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh). Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!Credits Producer, Show Notes, Infographics: Carolyn Chan MD, MHS Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD Reviewer: Payel Jhoom Roy MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jessica Merlin MD, PhD, MBA Sponsor: JournalFeedTry JournalFeed free for 7 days — and get 20% off your first year with code CURB25 at journalfeed.org/curb.Sponsor: FreedUsecode: CURB50 to get $50 off your first month when you subscribe at freed.aiSponsor: Mint MobileGet your summer savings and shop premium wireless plans at MINTMOBILE.com/CURB.

Level up your treatment for people with alcohol use disorder. Learn about medication options beyond the first line, when they’re appropriate and not, and how to work with your patients to set goals that fit them. We’re joined by Dr Stephen Holt (Yale University School of Medicine)Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and  completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | Free CME!Credits Written, produced, show notes, cover art and infographics by: Shawn Cohen MD  Hosts: Carolyn Chan, MD. MHS, Shawn Cohen MD, and Paul Williams MD Reviewer: Kento Sonoda MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest:  Stephen Holt MD Sponsor: Pretty LitterGo to Prettylitter.com/curb to save twenty percent on your first order and get a free cat toy. Sponsor: QuinceGo to Quince.com/curb for 365-day returns, plus free shipping on your order. Sponsor: American College of Physicians IncInternal Medicine Board Review Courses and offered in the Greater Chicago area May 13-17 and, new for 2025,  Philadelphia, July 14-18. • Enter code COURSECS25 toSave $75 dollars when registering for the Philadelphia course by 6/1.  Registration is open now at acponline.org Sponsor: EzresusListeners of the Curbsiders get access to a 2-month free trial, letting them use 100% of the features of the app. Go to .ezresus.com/curbsiders and use promo code Curbsiders

Join Dr. Pam Ling, a UCSF expert on vaping cessation, and Dr. Maya Vijayaraghavan, who specializes in vaping health implications, as they explore the intricate world of e-cigarettes. They discuss how to effectively communicate with patients about vaping and whether e-cigarettes can aid in quitting traditional cigarettes. The conversation also addresses the development of nicotine use disorders, resources for cessation, and the importance of personalized treatment plans. Tune in for invaluable insights into vaping and addiction medicine!

In this discussion, Dr. Al Garcia-Romeu, a prominent researcher at the Johns Hopkins Center for Psychedelic and Consciousness Research, sheds light on the transformative potential of hallucinogens. He delves into their mechanisms of action, focusing on psilocybin and its role in treating addiction and mental health disorders. Risks of unregulated use and the intricacies of psychedelic-assisted therapy are explored, alongside the legal landscape affecting these substances. The conversation emphasizes informed patient communication and the importance of ongoing research in this emerging field.

Maximize your treatment of alcohol-associated liver disease. Learn how to evaluate liver disease in patients with alcohol use disorder (AUD), choose AUD medications that are safe and effective, and identify patients who may be eligible for early liver transplantation. We’re joined by Dr. Lamia Haque, @lykhaque (Yale School of Medicine). We are thrilled to produce Season 3 with support and partnership from The American College of Academic Addiction Medicine (ACAAM)!Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | [email protected] | Free CME!Show Segments Intro, disclaimer, guest bio 0:00  Guest one-liner 3:10 Case from Kashlak 6:30 Epidemiology of alcohol-associated liver disease (ALD) 7:40 How does alcohol affect the liver? 11:11 Spectrum of ALD 13:10 Risk factors for ALD 16:13 Evaluating for ALD 19:35 When to refer to hepatology 33:08 Medications for AUD in patients with ALD 37:00 Monitoring liver tests for naltrexone 44:27 Optimizing treatment for patients who continue drinking 47:18 ALD and liver transplantation 50:45 Post-transplant care 1:00:15 Take-home points 1:02:30 Outro 1:04:56 Credits Writer and Producer: Kenneth Morford, MD Show Notes: Kenneth Morford, MD Infographic and Cover Art: Natalie Stahl, MD, MPH Hosts: Carolyn Chan, MD. MHS and Kenneth Morford, MD Reviewer: Sarah Leyde, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Lamia Haque, MD, MPH