Addiction Medicine Made Easy | Fighting back against addiction

Ana Alamo, a peer support specialist and recent graduate in Addiction Studies, shares her transformative journey from addiction to recovery. She discusses her early struggles with substance use, including a wake-up call after legal troubles related to fentanyl-laced pills. Ana emphasizes the importance of empathy and connection, particularly for teenage girls she supports. The conversation explores the stigma surrounding addiction, the balance of accountability and compassion, and the ongoing journey of self-forgiveness and resilience in recovery.

Dr. Casey Grover explores the challenging world of benzodiazepines, explaining why these commonly prescribed medications can create more problems than they solve for patients struggling with anxiety and other conditions.• Benzodiazepines work like alcohol in pill form, enhancing the brain's natural "downer" chemical GABA• Long-term use leads to tolerance, dependence, and potentially Benzodiazepine-Induced Neurological Dysfunction (BIND)• The four most commonly prescribed benzos are diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax)• Benzodiazepine withdrawal can cause seizures months after the last dose, making it particularly dangerous• Unlike opioid addiction, there are no specialized medications to treat benzodiazepine addiction• Tapering from benzodiazepines is extremely challenging, often taking months or years with patients experiencing severe rebound symptoms• Modern medical understanding now recognizes benzos as inappropriate for long-term anxiety treatment• Case studies demonstrate how patients prescribed benzos for anxiety often never learn proper coping skills and suffer increasingly worse symptomsThanks for listening and remember treating addiction saves lives.To contact Dr. Grover: ammadeeasy@fastmail.com

This is a joint episode between the Addiction Medicine Made Easy Podcast and the Kratom Sobriety PodcastCheck out the Kratom Sobriety Podcast: https://kratomsobriety.com/Trauma and addiction are deeply intertwined, with unresolved PTSD often driving substance use as people attempt to manage overwhelming emotions and physical sensations.• Understanding PTSD beyond combat veterans—recognizing both "big T" traumas and accumulated "little t" stressors• Dr. Grover shares his personal journey with PTSD from emergency medicine and the stigma he faced• The Adverse Childhood Experiences (ACE) scale reveals how early trauma predicts addiction risk• Multiple diagnoses often overlap—ADHD, PTSD, and addiction create complex treatment challenges• Medication options for PTSD include prazosin for nightmares, propranolol for triggering, antidepressants, and more• Innovative treatments like stellate ganglion blocks can reduce physiological reactivity from trauma• Trauma-informed care requires providers to create safety and understand the person beyond their addiction• Breaking stigma requires vulnerability—sharing our stories helps others recognize they're not aloneVisit mdcalc.com to check out the Adverse Childhood Experiences score, and listen to the Last Day podcast episode with Dr. Gabor Maté for more insights on trauma and addiction.To contact Dr. Grover: ammadeeasy@fastmail.com

We discuss practical strategies for staying up-to-date with addiction medicine research in this collaborative episode between Addiction Medicine Made Easy and the Addiction Medicine Journal Club podcast.• Featuring a four-person roundtable with Dr. Casey Grover, Dr. John Keenan, Dr. Sonia Del Tredici, and Thomas Bannard• Understanding why evidence-based medicine matters in addiction care• Incorporating lived experience into addiction education and combating stigma• Developing personalized approaches to staying current with medical literature• Various learning strategies from reading journals to podcasts to collaborative discussions• Finding your motivation for continuing education in addiction medicine• Strategies for making learning "stick" through teaching and knowledge application• Making knowledge "count twice" by developing resources from what you learn• The value of consistent, sustainable learning processes over ambitious but unrealistic goalsTo contact the Addiction Medicine Journal Club Podcast: addictionmedicinejournalclub@gmail.com  To contact Dr. Grover: ammadeeasy@fastmail.com 

Mark MacNichol, a playwright and charity director, shares how his therapeutic approach called Anonymous Drama helps people in recovery and the justice system process trauma and develop emotional wellbeing by viewing their inner thoughts as characters in a play.• Anonymous Drama is not traditional theater but uses dramatic techniques for therapeutic purposes• The program helps participants identify characters in their life story, such as the protagonist, the inner critic, and the inner mentor• Anonymity protocol allows people to explore trauma through fictional characters without revealing personal experiences• Participants learn to recognize the difference between their negative inner critic and their positive inner mentor• Over 5,000 people have participated in Anonymous Drama programs, primarily in justice and recovery settings• The method works by helping people "rewrite their scripts" and develop healthier relationships with themselves• Mark developed this approach after his own experiences with family addiction and losing his brother to heroin overdose• Programs are available through an app for individuals or through group sessions• Financial assistance is available for those who cannot afford the subscription feeTo learn more about Mark's work: https://www.markmacnicol.com/To contact Dr. Grover: ammadeeasy@fastmail.com

Dr. Amy Swift, Deputy Chief Medical Officer and addiction psychiatrist, shares insights on creating healthcare systems that better serve patients with addiction through reduced stigma, trauma-informed approaches, and greater accessibility. She brings a unique perspective as someone who oversees medical care while remaining deeply connected to patients' experiences, emphasizing the need to understand addiction as a brain disease rather than a moral failing.• Psychiatry and addiction have historically been separated, with mental health providers often telling patients to "get sober first"• Understanding executive functioning challenges in addiction helps create more flexible, accommodating healthcare systems• Stigma against addiction is pervasive in healthcare and actively prevents people from seeking life-saving treatment• Person-first language and creating welcoming environments are crucial steps in reducing stigma• Virtually all patients with addiction have experienced trauma, requiring trauma-informed approaches to treatment• Different trauma responses can drive different patterns of substance use – numbness often leads to stimulant use while hyperarousal leads to depressant use• Family involvement and education are essential components of effective addiction treatment• Youth education and prevention efforts are critical, particularly around cannabis and newer substances perceived as harmless• Healthcare leaders must recognize addiction as a brain disease requiring the same compassion and quality of care as other medical conditionsIf you're interested in improving addiction care in your healthcare system or community, focus on reducing stigma, implementing trauma-informed approaches, and creating flexible systems that accommodate the unique challenges faced by those with addiction.To contact Dr. Grover: ammadeeasy@fastmail.com

Join Dr. Reb Close, an emergency medicine physician and addiction medicine specialist, as he shares critical insights on using naloxone to combat the opioid crisis. He emphasizes the importance of making naloxone as ubiquitous as fire extinguishers in our communities. Discussions cover the stark differences in naloxone usage between medical settings and the streets, as well as strategies to destigmatize its use. With over 90% of street drugs now containing fentanyl, the urgency for community training and quick response in overdose situations is more crucial than ever.

Explore the dual nature of ketamine, balancing its medical benefits for conditions like treatment-resistant depression against the risks of misuse. Discover how ketamine can quickly reduce suicidal thoughts, but also hear about the alarming rise in recreational use and its dangerous side effects, including severe addiction issues. Learn about the phenomenon of the 'K-hole' and the real health concerns tied to long-term use. With no FDA-approved treatments for ketamine addiction, caution is essential, especially for those with a history of substance abuse.

In this episode, Dr. Casey Grover explores how integrating behavioral health and addiction services into primary care settings can transform healthcare delivery and dramatically improve access to treatment. Dr. Grover speaks to psychologists Patti Robinson and Jeff Reiter about their work creating integrated primary care practices and clinics. • Healthcare in the US is siloed, forcing patients to navigate separate systems for physical health, mental health, and addiction• Mental health specialization creates artificial barriers when generalist counselors could help many addiction patients• Integrated care places behavioral health providers in primary care settings with same-day, brief (15-30 min) appointments• Primary care doctors welcome the support while mental health providers need retraining to adapt to the flexible model• Physical clinic design matters—providers should be within 15-20 feet of each other for true integration• "Pathways" can be created for specific populations like those with opioid use disorder• Patients overwhelmingly appreciate the convenience and comprehensive approach of integrated careVisit speaktoyourdoctor.com for resources to share with your medical provider about implementing integrated behavioral health services.To contact Dr. Grover: ammadeeasy@fastmail.com

Discover how stimulating specific points on the ear can dramatically reduce opioid withdrawal symptoms through an FDA-approved device called the ST Genesis. Shelley Halligan, President of Speranza Therapeutics, explains the science behind percutaneous nerve field stimulation and its remarkable effects on patients struggling with addiction.• The device works by targeting cranial nerves in the ear to activate the parasympathetic nervous system• Small electrical pulses delivered continuously for five days can significantly reduce withdrawal symptoms• Clinical applications include shortening the waiting period before starting Suboxone treatment• The technology may help prevent precipitated withdrawal, a major barrier to recovery• Patient case studies show dramatic symptom reduction within minutes of application• Preliminary evidence suggests effectiveness for alcohol and other substance withdrawals• Research is underway to develop a 10-day version specifically for fentanyl withdrawal• The device empowers patients by giving them more control over their treatment timeline• Implementation in emergency settings could transform overdose follow-up care• Healthcare providers can receive free training to incorporate this technology into practiceVisit speranzatherapeutics.com to learn more about the ST Genesis device and provider training opportunities.To contact Dr. Grover: ammadeasy@fastmail.com