Addiction Medicine Made Easy | Fighting back against addiction

Casey Grover, MD, FACEP, FASAM
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Mar 30, 2022 • 25min

Episode 24 - How to handle buprenorphine in the perioperative setting

Ok. So you've induced your patient with opiate use disorder successfully on to buprenorphine. Nice work! But what happens if they need surgery? Should they still get treated with full agonist opioids after surgery? Will full agonist opioids even work given buprenorphine's pharmacology? In this episode we dig into how to handle pain control and medication management for patients with buprenorphine in the preoperative setting. 
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Mar 15, 2022 • 29min

Episode 23 - How much do you know about Vaping?

Sure...you ask your patients if they vape, but how much do you know about the world of vaping? Are they using a cigalike, a vape pen, or a JUUL? And are they using standard cartridges or have they bought a custom vape juice? What types of vape juice are most associated with EVALI? In this episode we review vaping - the history of the industry, the health effects, and the societal trends. 
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Mar 11, 2022 • 37min

Episode 22 - Illicit Fentanyl

In this episode we take a very deep dive into the topic of illicit fentanyl. We review the history of the opiate epidemic in the United States that has led us to our current time where 100,000 Americans have died of a drug overdose in the past year. And more importantly, we discuss what we as healthcare providers can do to fight back against this crisis of illicit fentanyl (and worse) in our drug supply causing so many fatal overdoses. 
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Feb 25, 2022 • 27min

Episode 21 - What's the deal with phenobarbital for alcohol withdrawal?

When was the last time you used phenobarbital for alcohol withdrawal? How familiar are you with how to dose it and when to give it? It turns out that phenobarbital is as effective as benzodiazepines for alcohol withdrawal, and might be a medication that you want to consider using in your practice for alcohol withdrawal. In this episode we dive into the topic of phenobarbital for alcohol withdrawal and try to figure out what's the best way to use phenobarbital when treating patients with alcohol withdrawal.
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Feb 12, 2022 • 11min

Episode 20 – A patient story. Getting “well” with opiate use disorder

What does it mean to be well? In this episode we dig into the perspective of a person living with an opiate use disorder. Dr. Grover reads a piece on opiate addiction that he wrote with a patient who has lived experience with an opiate use disorder. The original article can be found here https://www.kevinmd.com/blog/2017/03/mean-well-ask-opiate-addict.html 
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Feb 3, 2022 • 25min

Episode 19 - The Patient on Methadone for Opiate Use Disorder

Has this ever happened to you at 11 pm on a Saturday Night..."Hey doc, I'm on 85 mg of methadone and I missed my daily dose yesterday. Can you give me a dose?" In Episode 19 we discuss methadone, how methadone is regulated, and what to do when a patient on methadone for OUD presents to the ED asking for a missed dose or needs inpatient admission.
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Jan 19, 2022 • 22min

Episode 18 - What is Post Acute Withdrawal Syndrome?

In this episode, we review Post Acute Withdrawal Syndrome (PAWS). Haven't heard of it? You're not alone. It's a common, yet understudied syndrome experienced by people in early recovery. Unfortunately the data is limited, but Dr. Grover summarizes the best information we have on PAWS including pathophysiology, naming, symptoms, and treatment. 
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Jan 3, 2022 • 23min

Episode 17 - Buprenorphine precipitated opiate withdrawal

Buprenorphine precipitated opiate withdrawal is the worst! Patients feel awful, and we as healthcare providers feel awful for making them feel awful. In this episode we review the literature on and discuss some local expert opinion on buprenorphine precipitated opiate withdrawal, including the best way to treat it if it happens. 
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Dec 7, 2021 • 33min

Episode 16 - How stigma hurts patients and what we can do about it

How much do you know about stigma? Would you believe experiencing stigma can shorten a person's lifespan by 12 years? In this episode we review stigma - what it is, how it affects patients with stigmatizing conditions, and how to reduce how much stigma there is in health care. Dr. Grover just did a Grand Rounds presentation on Stigma - and this episode is a rapid review of all the material covered in the Grand Rounds presentation. 
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Dec 3, 2021 • 20min

Episode 15.5 - Lit Review - Using High Dose Buprenorphine in the Emergency Department

In this episode we do a review of a recent paper on the safety and efficacy of using high dose (up to 32 mg) buprenorphine in the emergency department. The title of the article is "High Dose Buprenorphine in the Emergency Department for Treatment of Opioid Use Disorder" by Dr. Andrew Herring and his colleagues. 

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