Addiction Medicine Made Easy | Fighting back against addiction

Urine drug testing provides critical insights for addiction treatment, helping clinicians understand what substances patients are actually using and how the drug supply is rapidly changing. Matthew Rutledge, founder of MD Labs, shares his expertise on testing methodologies, detection capabilities, and emerging trends in substance use.• Different drug test types include basic immunoassay cups (similar to pregnancy tests), which detect drug shapes but can have false positives/negatives• Liquid and Gas chromatography with mass spectrometry provides highly accurate substance identification down to nanogram levels• Developing tests for novel substances takes 2-4 months, requiring standards and validation across hundreds of specimens• Poppy seed muffins can genuinely cause positive opiate tests depending on seed source and patient body mass• Unexpected test results require clinical judgment—some exposures may occur through contamination, intimate contact, or environmental exposure• Integration of pain and addiction medicine allows better co-management of patients with both conditions• Emerging threats include nitazine opioids, exotic benzodiazepines, and tianeptine ("gas station heroin")• Test adulteration methods (vinegar, bleach, dilution) can be detected through validity testing for oxidants, creatinine levels, and specific gravityTo contact Dr. Grover: ammadeeasy@fastmail.com

Today we speak with Dr. Samantha Harte about her experience living as a high-functioning person with addiction and how perfection masks internal struggles. She shares her journey from overdosing on cocaine as she was accepted into her doctoral program to becoming an author and recovery coach helping others find authentic healing.• High-functioning addiction often hides behind external success and achievements• Control and perfectionism become secondary addictions that receive cultural reinforcement• Traditional recovery approaches can face resistance from high-achievers who struggle to admit powerlessness• Dr. Harte discusses writing her book "Breaking the Circuit" after losing her sister to overdose• Trauma-informed recovery approaches help address the underlying childhood experiences driving perfectionism• Self-compassion and making amends to yourself are crucial parts of healing for perfectionists• Both Dr. Harte and Dr. Grover share personal experiences of maintaining outward success while struggling internally• Physical healing and spiritual healing are interconnected in authentic recoveryIf something Dr. Harte shared resonates with you, please reach out. Dr. Samantha Harte, responds to her own DMs. Connect with her, book a free discovery call, and don't ignore the call if something pierces you – she's here to wake you up and light your soul on fire.To contact Dr. Grover: ammadeeasy@fastmail.com

Dr. Casey Grover explores the history, neuroscience, and treatment approaches for methamphetamine use disorder, highlighting how methamphetamine releases more dopamine than any other known substance.• Methamphetamine was widely used during World War II by German, Japanese, and Allied forces to enhance performance• Modern meth production shifted from ephedra to P2P method, creating cheaper, more potent meth with worse psychiatric effects• Meth causes dopamine release up to 1,400 ng/dL of dopamine compared to cocaine (400), sex (200), and food (150), severely damaging reward centers• Many methamphetamine users have undiagnosed ADHD and are inadvertently self-medicating• Effective medications include bupropion, topiramate, atomoxetine, viloxazine, guanfacine, and mirtazapine• Contingency management (reward-based incentives) shows significant efficacy for methamphetamine addiction treatment• Combination therapies using bupropion with naltrexone show promise for reducing meth use• Treating underlying mental health conditions and providing housing/social support remains essential for recoveryTo contact Dr. Grover: ammadeeasy@fastmail.com

The discussion delves into treating opioid and alcohol use disorders through medication-assisted approaches. It emphasizes addiction as a challenge of self-regulation, distinguishing between dependence and disorder. Key medications like buprenorphine are highlighted for their effectiveness in reducing cravings and overdose risk. The podcast also tackles the fentanyl crisis and encourages the use of person-first language to combat stigma, promoting a more compassionate understanding of addiction. Off-label medications for alcohol treatment are discussed, offering further insights into comprehensive care.

This episode is an interview with Matt Butler, a singer-songwriter who has performed in jails and prisons across America for a decade. He shares how music creates transformative spaces for healing in correctional environments.• Matt's musical journey began after writing songs for a documentary about recovery high schools• Music penetrates emotional defenses faster than conventional approaches, allowing inmates to be vulnerable• Songs like "Good Friday" and "Time to Be a Man" directly speak to experiences of addiction and incarceration• Hypervigilance in prison environments makes trauma processing nearly impossible• Music temporarily changes the atmosphere, allowing emotional expression typically suppressed for survival• Trauma and addiction form a vicious cycle that's particularly difficult to break while incarcerated• Reentry challenges include practical barriers like employment, housing, and basic skills deficits• Many successful recovery stories involve people transforming their past struggles into purpose by helping others• Creating spaces where people feel safe and accepted is essential for healing from addiction and traumaPlease check out Matt's album Reckless Son, the one-man show he performs in correctional facilities across the country.To contact Dr. Grover: ammadeeasy@fastmail.com

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