Addiction Medicine Made Easy | Fighting back against addiction

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

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.