Addiction Medicine Made Easy | Fighting back against addiction

Dr. Mark Vierra, a seasoned bariatric surgeon, dives into the complexities of food addiction and the biology of obesity. He explains how weight-loss surgery alters hormones affecting appetite and improves metabolic health. Vierra shares insights on why many referrals don't lead to surgery and emphasizes understanding individual patient challenges. The conversation also addresses the increased risk of alcohol use disorder post-surgery and the importance of screening motives for drinking. A respectful approach to each patient's biology and story is at the heart of his practice.

Delve into the ancient brain's wiring and how it collides with modern dopamine traps like social media and processed foods. Discover the significant roles of genetics and childhood trauma in addiction vulnerability. Learn how mental health issues intertwine with substance use, amplifying the challenge of recovery. The discussion illuminates why teen brains are particularly at risk and offers practical tips for navigating stress without substances. A real-life case study showcases the complexities of diagnosis and the importance of addressing trauma in addiction treatment.

A brightly colored box at a smoke shop should not hit like an opioid, yet that’s the business model behind “gas station heroin.” We dive into how tianeptine—a foreign antidepressant with mu‑opioid activity—landed on American countertops as a “dietary supplement,” and why that mirrors a broader playbook: repackage potent psychoactives, exploit loopholes, pivot fast when bans arrive, and let consumers pay the price. Joined by Matthew Lowe, executive director of the Global Kratom Coalition, we trace the supply chain from warehouses to wallets and separate leaf kratom from the synthetic isolates hijacking its name.We break down the risk gradient inside the kratom category: natural leaf with fiber and mixed pharmacology, concentrated extracts that raise potency, and seven‑hydroxymitragynine products that function like a novel opioid. Matthew explains why the FDA’s percentage‑based scheduling of 7‑OH is a smart, surgical fix that preserves traditional use while ejecting synthetic opioids from the “supplement” aisle. We also tackle hemp’s loophole economy—Delta‑8 and Delta‑10 THC derived from hemp yet delivering marijuana‑like effects with far less oversight—plus contamination, cross‑stocking, and the handful of distributors fueling multiple “legal high” trends at once.Beyond policy, we talk people. When regulators finally pull a dangerous product, dependent users are often left stranded. We outline a practical path: better labeling that discloses opioid activity and dependence risk, age gates, potency caps, and targeted enforcement against unapproved drugs sold as supplements. Just as crucial, clinicians need straightforward guidance to assess what patients took, why they took it, and how to transition them to safer, evidence‑based care without stigma.Curious how these products keep showing up, what “novel synthetic opioid” really means, and how we can protect choice where risk is low while acting decisively where harm is high? Press play, share this episode with a friend, and leave a review with the one reform you think would make the biggest difference. If this helped you learn something new, subscribe so you never miss an update.To contact Dr. Grover: ammadeeasy@fastmail.com

Discover the unique world of Addiction Medicine, where compassion meets clinical care. The discussion reveals how treatments focus not only on substance use but also on underlying issues like PTSD and ADHD. Learn about low-barrier access via walk-ins and telemedicine, enhancing patient engagement through peer support, and the vital integration of medication with therapy. Real-life cases illustrate the importance of dual diagnosis and tailored treatment plans. Join in to understand how kindness, respect, and stigma reduction shape effective addiction care.

Dr. Casey Grover welcomes Dr. Sarah Nasir, an addiction medicine specialist, for an insightful conversation about effectively communicating with patients and addressing common myths in addiction treatment.• Personal journeys into addiction medicine that transformed both doctors' understanding of substance use disorders• The science behind medication-assisted treatment and why it's not "trading one addiction for another"• How the body adapts to chronic opioid use through three key mechanisms: reducing natural chemicals, decreasing receptors, and increasing metabolism• Why recovery takes time: "It's easier to break something than to fix it"• The critical connection between trauma, PTSD, and addiction• Integration of life coaching principles into addiction treatment• Creating authentic connection as a cornerstone of effective recovery• Addressing stigma around medications in recovery communities and sober living facilities• The difference between dependence and addiction in patient educationIf you're a healthcare provider treating patients with addiction, thank you for your life-saving work. For everyone else, thank you for taking time to learn about addiction – it's a fight we cannot win without awareness and action.To contact Dr. Grover: ammadeeasy@fastmail.com

Mental health conditions and addiction are deeply intertwined, creating complex treatment challenges that require addressing both simultaneously. Dr. Mark Hrymoc, an addiction psychiatrist, shares insights on effectively treating dual diagnosis patients through parallel treatment plans that address both substance use and underlying mental health conditions.• Dual diagnosis (co-occurring disorders) describes patients with both mental health conditions and substance use disorders• Many patients use substances to self-medicate underlying mental health conditions rather than for euphoria• 50-80% of patients with addiction also have PTSD or significant trauma histories• SSRIs like Zoloft and Lexapro are first-line treatments for anxiety disorders including PTSD• Prazosin is effective for PTSD-related nightmares• Propranolol, clonidine, and gabapentin offer non-addictive options for anxiety management• ADHD is a major risk factor for developing substance use disorders• Non-stimulant options like Strattera, Qelbree, and Wellbutrin should be tried first for ADHD with comorbid addiction• Insomnia treatment options include trazodone, mirtazapine, quetiapine, and newer DORA medications• Ketamine therapy shows promise for treatment-resistant depression and suicidalityRemember, treating addiction saves lives.To contact Dr. Grover: ammadeeasy@fastmail.com

Dr. Casey Grover shares his personal struggle with food addiction and binge eating while exploring the science behind why certain foods trigger addictive behaviors in the brain. He examines how the food industry deliberately engineers products to maximize pleasure and consumption through carefully calibrated combinations of sugar, fat, and salt.• Food addiction involves an intense dopamine response to certain foods that varies between individuals based on genetic predisposition• The food industry uses "bliss point" science to make products as addictive as possible• Ultra-processed foods make up over half the average American diet despite increasing risks of various diseases• Eating disorders (anorexia, bulimia, binge eating) are mental health conditions where food behaviors are merely the symptoms• Treatment options include SSRIs, topiramate, naltrexone/bupropion combinations, and potentially GLP-1 medications• Weight loss surgery fails to address the underlying mental health aspects of food addiction• Dr. Grover's personal experience with naltrexone showed how it made previously pleasurable foods taste "flat"If you found this episode helpful, please consider supporting Central Coast Overdose Prevention (https://ccodp.org/) and the work we do to treat addiction and prevent overdoses. Together we can improve how addiction is treated and save lives.To contact Dr. Grover: ammadeeasy@fastmail.com

This episode is the fourth and final episode of a four part series on stigma.This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.First responders face unique mental health challenges due to the high-stress nature of their work, but stigma often prevents them from seeking help when they're struggling. Dr. Casey Grover, firefighter/paramedic Jesse, and firefighter/paremedic Evan discuss the psychological toll of being the ones who save lives, including PTSD, addiction, and the struggle with vulnerability.We also hear from Dr. Reb Close, who worked as an Emergency Medicine physician for over 20 years.• First responders naturally prioritize others over themselves, often neglecting self-care• "Normalization of deviance" occurs when first responders gradually develop unhealthy coping mechanisms• PTSD is a permanent brain change that many first responders experience but fear admitting• Female first responders face additional challenges and scrutiny in male-dominated professions• The pressure to appear perfect creates barriers to seeking help, even when struggling severely• First responders often judge themselves more harshly than they judge others• Addiction can develop as a way to self-medicate trauma and stress• Recovery is possible when first responders become willing to be vulnerable and uncomfortable• Those with established careers have the social capital to break stigma by sharing their experiencesIf you're a first responder struggling with mental health or addiction issues, please know that help is available and seeking it early can prevent tremendous suffering. You are not alone, and recovery is possible.To Contact Dr. Grover: ammadeeasy@fastmail.com

This episode is the third episode of a four part series on stigma.This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.In this episode, Wendy Solorio shares her raw, emotional journey as a mother supporting her daughter Gabrielle through addiction and into recovery, highlighting the often-overlooked impact on families and caregivers.• First recognizing her daughter's addiction during high school while dealing with guilt and shame as a parent• Reaching emotional breaking points while preparing for the worst possible outcomes• Navigating the healthcare system and waiting for treatment beds during crisis moments• Facing financial devastation with treatment costs of $40,000 and maxing out multiple credit cards• Experiencing stigma from coworkers, friends, and even law enforcement• Dealing with the trauma that remains even after 2.5 years of her daughter's sobriety• Finding support through therapy, medication, and select family members• Advocating for better education among first responders and healthcare providers• Emphasizing the critical role of substance use navigators in emergency departments• Offering advice to other parents: "Care for the caregiver, never stop self-educating, have tough conversations"To contact Dr. Grover: ammadeeasy@fastmail.com

This episode is the second episode of a four part series on stigma.This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.In this episode, Gabrielle shares her powerful journey from fentanyl addiction to recovery, highlighting the unexpected moment of compassion from a correctional officer that changed everything. Her story reveals how respect and dignity can transform recovery outcomes, while exploring the deep impact of self-stigma and family support.She shares her experience:• Hitting rock bottom on Christmas Eve 2022 after stealing her mother's car during active fentanyl addiction• Experiencing six overdoses, with each one bringing her closer to death• Finding transformation through a year-long program at Teen Challenge• Encountering a correctional officer who showed unexpected compassion and dignity• Battling intense self-stigma despite having family who never gave up on her• Receiving an ultimatum from her pregnant sister that became a powerful motivator• Learning that recovery meant becoming a different person, not just the same person without drugs• Moving from shame about her addiction to being open about her recovery journey• Finding ways to help others by showing kindness and treating "humans like humans"• Building a life she couldn't have imagined three years ago, working six days a week and helping with her sister's childIf you or someone you know is struggling with addiction, remember you don't have to do it alone. There are many avenues to recovery, and compassion can make all the difference.To Contact Dr. Grover: ammadeeasy@fastmail.com