Addiction Medicine Made Easy | Fighting back against addiction

Dr. Casey Grover reveals the vital role of psychiatric medications in addiction recovery. He discusses how medications are developed and approved, highlighting their off-label uses. Antidepressants and non-addictive options are emphasized for managing anxiety and sleep issues. The podcast also addresses careful medication selection for ADHD and the importance of avoiding benzodiazepines due to their worsening effects on anxiety. Grover advocates for personalized treatment strategies and integrating therapy for co-occurring disorders.

Kyle Santoro, a 19-year-old filmmaker, created the documentary "Fentanyl High" to explore teenage psychology behind substance abuse after witnessing overdoses at his high school. His film takes a peer-to-peer approach to addiction education, removing stigma and creating spaces for vulnerable conversations about why teens turn to substances.Kyle and Dr Grover discuss his experiences making the film and what he has learned through making it:• Kyle began the project after a classmate overdosed in a school bathroom and administrators never acknowledged the incident• Traditional school responses to substance use often involve punishment and shame rather than compassion and understanding• Several teens who participated in making the documentary achieved sobriety through the therapeutic process of sharing their stories• Film screenings serve as community events with resources, panel discussions, and free naloxone distribution• Schools often resist hosting screenings due to fear of being labeled as having a drug problem• The documentary has been screened across multiple states creating a "domino effect" of awareness in communities• Kyle raised $75,000 to produce the film through community sponsors and organizations• Prevention efforts need more youth representation to create effective messaging that resonates with teens• The film emphasizes the importance of parents maintaining open communication with their teenagersIf you want to learn more about Kyle's film, visit fentanylhigh.com.To contact Dr. Grover: ammadeeasy@fastmail.com

Tom Barnum, former Michigan State linebacker and NFL player, shares his remarkable journey from addiction to finding joy in sobriety through his team-based approach to recovery. He is the author of the book "Sobriety is a Team Sport"We discuss:• Addiction recovery requires admitting the problem is beyond personal control• Tom identifies the three paths for people with addiction: sobriety, jail, or death• AA meetings provide essential human connection that helps rewire the brain's dopamine system• Forced sobriety through court mandates or fear tactics rarely works long-term• Recovery groups create unique bonds between people who might otherwise never connect• Non-alcoholic beverages can be safely incorporated into recovery for some individuals• Even after decades of sobriety, addiction triggers can unexpectedly surface• Tom's recovery team includes his wife of 56 years, family, physicians, and former teammates• Social media has played a positive role in maintaining Tom's recovery connectionsFind Tom's book "Sobriety is a Team Sport" on Barnes & Noble or Amazon.To contact Dr. Grover: ammadeeasy@fastmail.com

Dr. Casey Grover interviews fellow addiction medicine physician Dr. Jason Giles to explore how addiction specialists approach treatment using long-acting injectable medications as tools for recovery.We discuss:• Dr. Giles shares his personal journey from anesthesiology to addiction medicine after developing his own dependency on fentanyl• Addiction as a disease of executive functioning that impairs decision-making ability• Recovery requires building new neural pathways - learning to manage emotions without substances• Long-acting injectable medications (Sublocade, Brixadi, Vivitrol) , and how these medications reduce cravings and provide protection while patients develop new coping skills• The process of stopping buprenorphine• Individualized tapering approaches help patients transition from daily medications to occasional use• Creating a safe environment where patients can be honest is essential for successful treatmentTo contact Dr. Grover - ammadeeasy@fastmail.com

Dr. Casey Grover shares his clinical experience treating Kratom Use Disorder through a detailed case presentation of a 38-year-old man who struggled to find medical professionals knowledgeable about kratom addiction.• Many healthcare providers lack knowledge about kratom, causing delays in patients receiving proper treatment• Kratom creates opioid dependence similar to traditional opioids, leading to withdrawal symptoms when stopping• The convenience of buying kratom at smoke shops contrasts sharply with the barriers of traditional medical care• Patients often use kratom to self-medicate underlying conditions like anxiety, ADHD, or pain• Effective treatment involves addressing opioid dependence with buprenorphine (or methadone) plus treating underlying conditions• Once dependent on opioids, patients must either use medications like Suboxone/methadone or endure withdrawal• Understanding the "feel something, take something" pattern is key to breaking the addiction cycle• Long-acting injectable buprenorphine (Sublocade) combined with as-needed oral doses proved effectiveTo contact Dr. Grover: ammadeeasy@fastmail.com

Cannabinoid Hyperemesis Syndrome (CHS), also known as "scromiting," is a debilitating condition characterized by severe nausea, vomiting, and abdominal pain that affects heavy cannabis users. Dr. Casey Grover explains this increasingly common syndrome caused by high-potency cannabis products, which paradoxically improves with hot showers and proves challenging to treat with conventional medications.• First identified in 2009 and named "scromiting" to reflect the combined screaming and vomiting patients experience• Cannabis potency has increased dramatically from 1% THC in the 1970s to 25-30% THC in today's products• Patients experience cyclical episodes of diffuse abdominal pain, nausea, and vomiting lasting 24-48 hours• Compulsive hot bathing is a hallmark symptom, with patients focusing hot water on their abdomen for relief• Standard anti-nausea medications like Zofran don't work well; psychiatric medications like Haldol often provide better relief• Many patients question the diagnosis because cannabis is thought to help nausea rather than cause it• Treatment requires cannabis cessation, though symptoms may persist for months after quitting• Multiple theories explain CHS, including nerve hypersensitivity and paradoxical stress responses from high-dose THCTo contact Dr. Grover: ammadeeasy@fastmail.com

The cannabis available today is dramatically stronger than what existed in previous decades, with THC levels climbing from 1% in 1970 to 25-30% in 2025, creating serious risks particularly for young people who don't understand appropriate dosing. Dr. Grover shares how cannabis has been deliberately bred for higher potency and how new extraction techniques have created products with astronomical THC levels, leading to dangerous situations like young people consuming 60 times a reasonable dose.• Cannabis potency has increased from 1% THC in 1970 to 25-30% THC today through selective breeding• Modern extraction techniques allow THC to be added back into products, creating concentrations as high as 45% and above• A recreational dose of THC is between 2.5-15mg, but products often contain hundreds or thousands of milligrams• "Greening out" or cannabis toxicity causes symptoms like confusion, vomiting, decreased consciousness, and anxiety• Children are especially vulnerable to cannabis toxicity due to smaller body size• Most cannabis toxicity cases resolve within 24 hours with supportive care• Prevention requires understanding appropriate dosing and using cannabis judiciouslyTo contact Dr. Grover: ammadeeasy@fastmail.com

Trauma is a crucial aspect of addiction treatment, often serving as the underlying cause for substance use. In this illuminating interview with trauma therapist Dr. Jessica Cooper, we explore the mechanics of trauma therapy and how it helps people heal from devastating experiences.• Breaking down trauma therapy into three essential phases: establishing safety, processing memories, and reconnection/integration• Understanding how childhood trauma creates patterns that can lead to re-traumatization in adulthood• Exploring the "fawn" trauma response (people-pleasing) alongside the better-known fight/flight/freeze responses• Examining the differences in approach between single-incident trauma vs. complex, repeated trauma• Creating a trauma timeline with "stones" (traumatic events) and "flowers" (protective factors)• Processing traumatic memories through multiple perspectives: factual, sensory, emotional, and belief-based• Recognizing signs of healing while understanding recovery is non-linear• Using creative expression as a powerful tool in trauma recovery• Developing a collaborative approach to trauma treatmentTo contact Dr. Grover: ammadeeasy@fastmail.com

Exploring the growing problem of recreational nitrous oxide use and its serious medical complications, including paralysis and permanent nerve damage. I share personal patient cases and investigate how this addictive substance is readily available in smoke shops and even on Amazon with minimal warning labels.• Multiple patients experiencing serious neurological complications from recreational nitrous oxide use• Personal investigation revealing easy access to nitrous oxide on Amazon marketed for whipped cream making• How nitrous oxide depletes vitamin B12, leading to potential spinal cord and peripheral nerve damage• Examination of labeling issues with commercial nitrous oxide products• Comprehensive overview of nitrous oxide's history, effects, and recreational use patterns• Medical complications including acute risks (seizures, cardiac issues) and chronic effects (neurological damage)• Treatment approaches focusing on vitamin B12 supplementation and addiction therapies• Growing prevalence of nitrous oxide use, especially among young peopleRemember that treating addiction saves lives. If you or someone you know is struggling with substance use, please reach out for professional help.To contact Dr. Grover: ammmadeeasy@fastmail.com

Join me, Dr. Casey Grover, as I provide a comprehensive guide to treating opioid use disorder during pregnancy, examining evidence-based approaches that protect both mother and baby through critical periods of care. The statistics are sobering - opioid use disorder in pregnancy has more than doubled in recent years, with overdoses now a leading cause of pregnancy-associated death.• Two major medical societies (ACOG and ASAM) recommend treating with methadone or buprenorphine rather than attempting medication-free withdrawal• Buprenorphine shows slight advantages over methadone for pregnancy outcomes, but the best choice is whichever medication keeps the mother sober• Neonatal abstinence syndrome occurs when babies experience withdrawal after birth, but can often be managed with supportive care rather than medication• Medication dosages often need adjustment during pregnancy as increased blood volume dilutes medication concentration• Breastfeeding is compatible with both methadone and buprenorphine treatment• The postpartum period brings unique challenges that increase relapse risk, requiring enhanced support for new mothers• Two patient cases illustrate both successful treatment and the challenges of maintaining recovery while parenting a newbornVisit centralcoastoverdoseprevention.org to learn more about preventing overdose deaths in your community.To contact Dr. Grover: ammadeeasy@fastmail.com