Shows
Addiction Medicine Made Easy | Fighting back against addictionWhat I Found When I Went to a Smoke Shop and Bought Kratom...Curious about the mysterious herb that's causing a stir in both traditional medicine and recreational circles? Join Dr. Casey Grover as we uncover the fascinating details about kratom, a plant from Southeast Asia with unique stimulant and opioid-like properties. You'll learn about its historical uses for pain relief and energy, as well as its modern-day appeal for euphoria. We break down the science behind kratom, from opioid receptor agonism to COX-2 inhibition, and even explore how an overdose mirrors that of opioids. Dr. Grover shares insights from a visit to a local smoke shop, revealing how different s...
2024-09-0915 minAddiction Medicine Made Easy | Fighting back against addictionInside Addiction Medicine: What We've LearnedHave you ever wondered how early childhood traumas can shape our mental and physical health, leading to conditions like PTSD, anxiety, and addiction? Join us as Dr. Casey Grover and Dr. Reb Close unravel these complexities with compelling real-life examples from their extensive careers in addiction medicine and emergency care. Hear a poignant story that underscores the importance of understanding a patient's history and using empathetic, non-stigmatizing language. This discussion promises not just insights but practical tools for healthcare providers to foster trust and compassion in their practice.Discover how community support and harm reduction strategies are...
2024-08-2626 minAddiction Medicine Made Easy | Fighting back against addictionEffective Strategies for Talking to Your Kids About Drugs and Alcohol (Rebroadcast)Curious about how to effectively talk to your kids about the perils of drugs and alcohol? Join me, Dr. Casey Grover, as I share my personal experiences and practical strategies for starting these critical conversations. Reflecting on a talk I gave at a local school, I unravel the complexities of parenting in the face of substance use, emphasizing the importance of early and regular communication. Through heartfelt anecdotes, including one particular impactful story, we explore best practices for parenting and the necessity of understanding the underlying reasons for substance use among teens.Discover the transformative power of...
2024-08-1946 minAddiction Medicine Made Easy | Fighting back against addictionBuprenorphine's Role in Preventing Opioid Overdoses: A Closer LookDiscover the life-saving potential of buprenorphine in the fight against opioid overdoses with Dr. Casey Grover on the latest episode of Addiction Medicine Made Easy. We start with a poignant patient story that showcases the remarkable impact of addiction medicine using Topamax for alcohol use disorder. From there, we shift our focus to the powerful effects of buprenorphine in reducing fatal opioid overdoses, especially in the context of acute fentanyl exposures. Drawing on a pivotal 2020 study from the Journal of Substance Use and Addiction Treatment, we unpack the pharmacological magic behind buprenorphine’s ability to block full agonist opioids an...
2024-08-1219 minAddiction Medicine Made Easy | Fighting back against addiction80. High Stakes: The Hidden Heart Risks of Cannabis UseCan cannabis put your heart at risk? Join me, Dr. Casey Grover, as we unpack groundbreaking research that challenges the widespread perception of cannabis as a harmless, natural remedy. We'll kick off by discussing a revealing study from the Journal of Pain, which found that CBD products may be ineffective for pain relief and even potentially harmful. Then, we delve into a critical study from the Journal of the American Heart Association, shedding light on the alarming rise in cannabis use and cannabis use disorder, and the often-overlooked cardiovascular risks associated with it, such as syncope, stroke, and myocardial...
2024-07-2216 minAddiction Medicine Made Easy | Fighting back against addictionBonus - The Art of the Drug Deal (Rebroadcast)How does a drug deal work? How do people with addiction find out what their drugs are cut with? Can you ask your dealer if your drugs are cut with fentanyl? In this episode, Dr. Grover interviews Jeremy, who is a former injection drug user about what it's like buying drugs in the illicit market. This is a rebroadcast of Episode 64, with improved audio quality
2024-07-1536 minAddiction Medicine Made Easy | Fighting back against addiction79. Healing on the Streets: Treating Addiction with Street MedicineTraditional medicine involves going to the doctor. How is medicine different when we bring the doctor to you? Could we do a better job treating addiction if we brought the doctor to the patient? Better yet - for our unhoused patients - shouldn't we be bringing the doctor to the patient given all the barriers they face? In this episode Dr. Grover interviews Dominique McDowell, who is an experienced healthcare provider – who has worked in a variety of clinic settings – but has done great work with his team using street medicine to treat patients with substance use disorders.
2024-07-0742 min
Addiction Medicine Made Easy | Fighting back against addiction78. Managing Pain SafelyEpisode 78. Traditional teaching to medical students about pain management was to give Tylenol, then Advil, then opioids in ever increasing doses without any maximum dose! Turns out that wasn't quite right. In this episode, Dr. Grover and his colleague Dr. Reb Close share their expertise on best practices in pain management, including how to maximize non-opioid and opioid-sparing medication regimens.
2024-06-161h 00
Addiction Medicine Made Easy | Fighting back against addictionEpisode 77 - Using "Targeted" Naltrexone to Reduce Alcohol UseNaltrexone - a medication used to reduce alcohol consumption - is usually prescribed on a scheduled basis when treating alcohol use disorder. Could prescribing it to be taken only on drinking days work too?? In this episode Dr. Grover reviews a recent study on how "targeted" naltrexone can be used to reduce alcohol use.
2024-06-0316 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 76 - A Treatment That Reduces Meth Use by 86%!!!We all know that options to treat stimulant use disorder are limited. In this episode Dr. Grover interviews Dr. Michael Miller, an Addiction Medicine doctor in Indiana who has developed a novel approach to treating stimulant use disorder. In this interview, Dr. Miller describes his novel approach and his outstanding results (Spoiler Alert! - he is seeing an 86% reduction in methamphetamine use in his patients!!!)
2024-05-1345 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 75 - Opioid Use Disorder during PregnancyIn this episode we tackle opioid use disorder during pregnancy with OB-GYN Dr. Kenneth Spielvogel. Dr. Grover and Dr. Spielvogel discuss multiple topics including the use of methadone and buprenorphine during pregnancy, overdoses during pregnancy, fentanyl exposure during pregnancy, and breastfeeding while taking buprenorphine.
2024-05-011h 15
Addiction Medicine Made Easy | Fighting back against addictionBONUS EPISODE - Food, Eating Disorders, and Addictive FoodDr. Grover was asked to speak at a high school on the topic of food, nutrition, eating disorders, and how ultra processed food can be addictive. He recorded the lecture while giving it - so here it is as a bonus episode.
2024-04-2039 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 74 - How Does Counseling and Talk Therapy Help Patients with Addiction (Part 2)We tried to cover counseling and talk therapy as a part of treatment for addiction in a single episode - but it was too big of a topic! This episode is part 2 of Dr. Grover's interview with Andrew Finley, LMFT on the topic of counseling and talk therapy as a part of treatment for addiction.
2024-04-131h 22
Addiction Medicine Made Easy | Fighting back against addictionEpisode 73 - How to handle the polysubstance use patientOk...so you have a patient using nicotine, cannabis, alcohol, and methamphetamine. What substance should you focus on helping the patient stop first? Or should the patient stop everything at once? In this episode Dr. Grover interviews Addiction Medicine physician Dr. Lee Goldman on the topic of how to treat patients who use multiple substances.
2024-04-0148 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 72 - Cannabis Withdrawal RevisitedIn this episode, we take a second look at cannabis withdrawal. Dr. Grover covered this topic on a previous episode, but as cannabis use is very common, and many people don't realize that cannabis has a withdrawal syndrome - it needed another look. This episode is an up to date review of cannabis withdrawal, including options for treatment.
2024-03-1820 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 71 - How Does Counseling and Talk Therapy Help Patients with Addiction? (Part 1)How much do you know about talk therapy and counseling? How does it work? How does a therapist decide what to talk about? How does one define a successful therapy session? In this episode, Dr. Grover interviews Andrew Finley, LMFT, about how counseling and talk therapy work for patients with addiction. And since it's such a big topic, it will take several episodes to cover.
2024-03-0455 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 70 - What drug is coming next in the illicit drug supply?Are you familiar with Bromazolam? Carfentanil? Isotonitazene? Flualprazolam? What do all these substances have in common? They are showing up in the illicit drug market, and we'll likely be seeing more of them in the future. Dr. Grover gives an update on what's coming next in the illicit drug supply
2024-02-2546 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 69 - Parent Education on How to Talk to Kids About Drugs and AlcoholDr. Grover was asked to speak at a high school to parents on how to talk to kids about drugs and alcohol - and this episode is a recording of that lecture. Dr. Grover reviews how to talk to kids about substance use in general, as well as how to talk to kids who are actively using substances. Pardon the raspy voice - Dr. Grover is getting over pneumonia :)
2024-02-1252 min
Addiction Medicine Made Easy | Fighting back against addictionFinally! A New Name!We finally came up with a new and better name for the podcast! Addiction in Emergency Medicine and Acute Care is now Addiction Medicine Made Easy. Dr. Grover shares his thoughts on the why behind the name change.
2024-02-0304 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 68 - Fentanyl-laced stimulantsWe all know that the illicit drug supply is full of contaminants, some more dangerous than others. I am seeing, in my practice, more of my patients who use stimulants test positive for fentanyl. In this episode, we review a study that analyzes specimens of meth and cocaine to see how often they are laced with fentanyl. Spoiler alert...it's pretty common :(
2024-01-2916 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 67 - Recreational Nitrous Oxide UseDo your patients use whippets? Have they ever mentioned that they use nitrous? Not quite sure what we're talking about? In this episode we look at recreational use of nitrous oxide, also known as laughing gas or whippets.
2024-01-1817 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 66 - Have you heard of Iso?Have you heard of the drug Iso? Is it isofentanyl? Or maybe it's isotonitazene? Or is it just fentanyl cut with who knows what? In this episode we discuss the drug being sold as "Iso" - and try to figure out what's in it.
2023-12-2614 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 65 – Can parents prevent alcohol use disorder by allowing teens to drink at home?Have you heard that giving teenagers alcohol in the home under parental supervision can teach them to use alcohol safely and reduce the risk of addiction to alcohol? Many parents believe this to be true. In this episode, we review the evidence in the literature to find out if this is true or not.
2023-12-0921 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 64 - The Art of the (Drug) DealHow does a drug deal work? How do people with addiction find out what their drugs are cut with? Can you ask your dealer if your drugs have fentanyl in them? In this episode Dr. Grover interviews Jeremy, who is a former injection drug user about what it's like buying drugs in the illicit market.
2023-11-2050 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 63 - Building trust with substance use patientsIn this episode we speak with Araceli, a Substance Use Navigator in California, about her work taking care of substance use patients in her Emergency Department. We talk about how to connect with patients with substance use - both in terms of building trust and how to work with patients who do not speak English as their first language.
2023-11-0347 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 62 - How P2P Meth changed everythingHave you heard of P2P methamphetamine? It has turned out to be a major destructive force in the world of addiction and in society in general. In this article we tell the story of how P2P meth came to be the dominant stimulant in the US, and how it has produced devastating mental health effects in those who use it.
2023-10-1921 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 61 - Have you heard of peer support? It's awesome!Have you heard of peer support? It's AWESOME! Such a huge help for patients with mental health conditions and substance use disorders. In this episode Dr. Grover provides an overview of peer support for the treatment of substance use, and we hear from Ceil - a woman in recovery who is providing peer support.
2023-10-0552 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 60 - How to actually help patients with Cannabinoid Hyperemesis SyndromeHow often have you seen a patient you think has cannabinoid hyperemesis syndrome - and when you tell them you think they need to stop using cannabis they tell you..."it's not the weed". In this episode we review what patients with suspected cannabinoid hyperemesis syndrome think about the condition and how you can help them to stop using cannabis
2023-09-2618 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 59 - Why Substance Use Navigators are awesome!If you don't have a Substance Use Navigator (SUN) at your hospital, you need one! They are awesome! In this episode Dr. Grover speaks with Austin, a Substance Use Navigator, who shares his experience taking care of patients with substance use. Spoiler alert! Substance Use Navigators do incredible work!
2023-09-1437 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 58 - How to Use Naloxone like a ProNaloxone saves lives! In this episode, Addiction Medicine and Emergency Medicine physician Dr. Reb Close joins Dr. Grover to discuss naloxone - how to use it, how to get it into the hands of patients, and how to distribute it in the community.
2023-08-3035 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 57 - Have you heard of Phenibut?Have you heard of Phenibut? Did you know that it can be bought online as an unregulated supplement and yet regular use causes dependence? Any idea how to manage Phenibut withdrawal? In this episode we review the literature on Phenibut, including Phenibut toxicity and withdrawal.
2023-08-2417 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 56 - When you prescribe an opioid, who else besides your patient might have an overdose?In this episode we review the risk of having opioids in the home. As in – when you prescribe an opioid to a patient – what is the risk to the other people and family members in that patient’s home?
2023-07-2419 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 55 - Can you use baclofen to treat alcohol use disorder?Have you heard about using baclofen for alcohol use disorder? Does it work? How do you dose it? What are the contraindications? In this episode we do an evidence based review of the use of baclofen to treat alcohol use disorder
2023-07-1128 min
Addiction Medicine: Beyond the AbstractMeet New JAM Editor-in-Chief, David A. Fiellin, MD, FASAMMeet JAM Editor-in-Chief, David A. Fiellin, MD, FASAM
Dr. Fiellin is an internist, board certified in addiction medicine. He is professor of Medicine and Emergency Medicine at Yale School of Medicine, and Public Health at Yale School of Public Health; vice chief of Faculty Affairs for the Department of Internal Medicine’s Section of General Internal Medicine; and serves as the inaugural director of the Program in Addiction Medicine at Yale.
Dr. Fiellin has focused his scholarly work on improving access to and the quality of substance use prevention and treatment, especially in gen...
2023-07-1014 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 54 - Do you know enough about urine drug screens to use them effectively?So...how much do you know about urine drug screens? Can selegiline cause a false + for meth? Can quinolones cause a false + for opioids? Can putting visine in urine cause a false negative? What should you do if you think you've gotten a false positive result on a urine drug screen. In this episode - we tackle all these questions and more
2023-06-2727 min
Addiction Medicine Made Easy | Fighting back against addictionBONUS EPISODE - A little inspirationA really quick bonus episode! Dr. Grover shares a poem written about addiction that reminds us why treating patients with substance use disorders matters so much.
2023-06-1504 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 53 - Is the buprenorphine you prescribe going to end up on the street?Have you ever been worried that when you prescribe a controlled substance that your patient might sell it on the street or to a friend? Of course you have. What about when you prescribe buprenorphine? In this episode we review the topic of buprenorphine diversion - how common is it, and what actually happens when patients use diverted buprenorphine?
2023-06-0122 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 52 - Talking to kids about drug useIn this episode Dr. Casey Grover and child psychiatrist Dr. Susan Swick discuss the topic of talking to kids about drug use. They discuss how health care providers can connect with kids who are using substances, how to work with the parents of a child who is using substances, and when parents should start discussing substance use with their kids before substance use starts.
2023-05-1658 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 51 - What's it like having a family history of addiction?Have you ever wondered what it's like growing up with parents who have addiction? Have you ever talked to patients about what it's like parenting while in recovery? How often have you seen one generation with addiction lead to the next generation having addiction too? In this episode Dr. Grover interviews a colleague who discusses her strong family history of addiction, her own addiction, and how she is raising her kids in a healthy drug/alcohol free home.
2023-05-0540 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 50 - A Recovery Story, Part 2In this episode Dr. Grover does a follow up interview with Aiden, a young man in recovery. Aiden shares more of his recovery story, including how music keeps him focused on recovery, what it was like to be incarcerated, how being incarcerated has affected his recovery, how he deals with regret looking back on his time with active addiction, and what his goals are for the future.
2023-04-271h 04
Addiction Medicine Made Easy | Fighting back against addictionEpisode 49 - Buprenorphine vs FentanylAs we've discussed many times on this podcast there is a lot of concern - from both patients and medical providers - that patients with opioid use disorder using fentanyl will have an increased risk of precipitated opioid withdrawal when they start buprenorphine. And finally, we have a study looking directly at this topic!! In this episode we review a recent paper from JAMA Network Open that looks at the rate of precipitated opioid withdrawal during buprenorphine inductions in patients with opioid use disorder using fentanyl.
2023-04-1918 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 48 - A Recovery StoryIn this episode Dr. Grover interviews Aiden, a young man in recovery. Aiden shares his story of how his addiction developed, what it's like living with addiction, how his recovery started, and what life is like as a young man in recovery.
2023-04-0643 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 47 - What is Kratom?How much do you know about Kratom? Who takes it and why? How does Kratom withdrawal present and how do you treat it? And what do you do in the case of a Kratom overdose? In this episode we do an evidence based review on Kratom to answer all of these questions and more.
2023-03-2222 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 46 - Treating Alcohol Use Disorder with TopiramateHave you had a patient ask you about using Topiramate to treat their alcohol use disorder? Or maybe you've heard a colleague talk about it, but don't know much about it? In this episode we review the use of the medication topiramate in treating alcohol use disorder. Spoiler alert! This may be practice changing!
2023-03-1025 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 45 - Cannabinoid Hyperemesis SyndromeHow often do you see patients who regularly use cannabis who get recurrent abdominal pain, nausea, and vomiting? It seems like this comes up at least every other shift in the Emergency Department. In this episode we review all aspects of Cannabinoid Hyperemesis Syndrome, from pathophysiology, to diagnosis, to treatment.
2023-02-2726 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 44 - What is the risk of fentanyl exposure to first responders and what do we do about it?Have you heard reports of first responders having overdoses on fentanyl after just touching it? Do you actually know how well fentanyl is absorbed through the skin? What PPE should first responders use if they know they are going to be exposed to fentanyl? In this episode we do a mega deep dive to find out what is the risk of fentanyl exposure to first responders and what can we do to mitigate that risk?
2023-02-1039 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 43 - Cannabis Toxicity and "Greening Out"How familiar are you with cannabis toxicity? Do you know the symptoms of a cannabis overdose? If your patient told you that she "greened out" last night, would you know what she was talking about? In this episode we do an evidence-based review of cannabis toxicity, including what it means to "green out"
2023-01-1924 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 42 - Delirium TremensPink Elephants anyone? In this episode we review Delirium Tremens, also know as alcohol withdrawal delirium. It's not too common, but it makes people impressively sick when it develops. Listen in for an evidence based review of the diagnosis and treatment of delirium tremens.
2023-01-0622 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 41 - How does microdosing buprenorphine work?Have you heard about microdosing buprenorphine? Have your patients asked you if it's an option for them? In this episode we do a deep dive on the topic of microdosing buprenorphine...including how it might be the best option for patients using illicit fentanyl to start bupe without experiencing precipitated withdrawal.
2022-12-2829 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 40 - What the heck is Xylazine and how do you treat a Xylazine overdose?Have you heard of Xylazine? I sure don't remember it from pharmacology in medical school. It turns out Xylazine is a veterinary medicine that is being increasingly cut into the illicit drug supply in the US. Why is it being cut into drugs, what does it do, and how is a Xylazine overdose treated? We cover everything you need to know about Xylazine in this episode.
2022-12-0224 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 39 - Are you confused by all the different formulations of buprenorphine? Me tooHave you found all the different formulations of buprenorphine confusing? What is Zubsolv and how is it different from regular sublingual buprenorphine? And what about Belbuca? Or BuTrans? When can you use injectable Buprenex? What about Sublocade? In this episode we do a deep dive into all the different formulations of buprenorphine, including what they are used for and how to dose them. We also discuss how challenging it can be to convert between different formulations.
2022-11-1827 min
Addiction Medicine Made Easy | Fighting back against addictionBONUS EPISODE - A plea to treat Alcohol Use Disorder as well as we do Opiate Use DisorderAnother bonus episode! I was asked to give a lecture on medications for alcohol use disorder to some of my colleagues in my area. We have made such incredible improvements in how we treat opiate use disorder with medication...it's time to do the same with alcohol use disorder. So...in this lecture I tried to convince my colleagues that we need to start routinely treating patients with alcohol use disorder with medication for alcohol use disorder. Take a listen...hopefully I can convince you too.
2022-11-0818 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 38 - Could you be eligible to be board certified in Addiction Medicine?We need more Addiction Medicine physicians, both here in the United States and all over the world. In the United States, board certification in Addiction Medicine is supervised by the American Board of Preventative Medicine (ABPM). In this episode we review the process for how to obtain board certification in Addiction Medicine in the US. It turns out that the ABPM has a practice pathway that allows for board certification in Addiction Medicine without having to do a fellowship for those who already are doing addiction medicine in their current practice. Could you be eligible to apply for board...
2022-11-0110 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 37 - Stimulant WithdrawalI don't know about you but I was taught stimulants didn't have a withdrawal syndrome, and yet many of my patients - after a post methamphetamine crash - will complain of being in withdrawal. So...how much do you know about stimulant withdrawal? In this episode we review stimulant withdrawal - how to diagnose it, how to treat it, and how it feels to patients.
2022-10-1318 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 36 - What labs can you use to assess alcohol use? (follow up to Episode #27)A follow up to Episode #27 on labs and alcohol use disorder. So you're at work and you have a patient who you're pretty convinced has an alcohol use disorder, but you're not sure which test you should order to assess their alcohol use. LFTs? Carbohydrate deficient transferrin? Ethyl glucuronide? Phosphatidylethanol? In this episode we take another look at lab tests that can help you with your assessment of patients who use alcohol...including some lab tests that you probably have never heard of (but might find useful)
2022-09-3023 min
Addiction Medicine Made Easy | Fighting back against addictionBONUS EPISODE - The Non-Opioid Management of Renal ColicA bonus episode! This isn't really on the topic of addiction...but it does involve opioid sparing and alternative to opioid treatment protocols (and avoiding a new start of opioids may prevent someone from developing opioid dependence or opioid use disorder). I put together a lecture on the non-opioid management of renal colic a few months back. I thought the topic was really useful, so I presented it to the docs that I work with where I practice as a part of our monthly physician education. I literally just recorded my presentation with my iPad while I w...
2022-09-1318 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 35 - Hallucinogen IntoxicationHow much do you know about hallucinogens? Do you know the differences between LSD, psilocybin, and MDMA? In this episode we review hallucinogens as a general class of drugs, specific hallucinogenic drugs, and how to manage the acutely intoxicated in the ED and acute care setting.
2022-09-0824 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 34 - An Overview of Methamphetamine Use DisorderGiven how prevalent methamphetamine use is, this topic is WAY overdue. In this episode we take a broad look at methamphetamine use disorder - how methamphetamine affects the brain, the clinical features of methamphetamine use disorder, and how to treat methamphetamine use disorder.
2022-08-2522 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 33 - Methamphetamine PsychosisYou just had a patient arrive via ambulance on an involuntary hold who is clearly psychotic. As the paramedics are giving report, you hear that the patient was found using methamphetamine on scene. So...is this schizophrenia? Or is it meth psychosis? Can you tell the difference? In this episode, we do a deep dive into methamphetamine psychosis, to review the clinical features, prognosis, risk factors, and treatment - including a discussion of the differences between primary psychotic disorders and methamphetamine induced psychosis.
2022-08-0933 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 32 - The "Drug-Seeking" Patient and why it's time to retire the term "Drug-Seeking"This episode is on the topic of the label "drug-seeking" that is often given to patients. Dr. Grover reviews a clinical case and reviews a perspective piece written on this topic. How would you handle a patient in pain who has an allergy to multiple medications, is refusing non-opioid options, and is asking for morphine? Is it addiction? Severe pain? Or is the patient in withdrawal? In this episode we delve into the complex and nuanced topic of the so-called "Drug-Seeking" patient.
2022-07-2622 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 31 - How do mutual support groups and 12 step programs like Alcoholics Anonymous work?You've probably heard patients talking about going to AA (Alcoholics Anonymous), but how much do you actually know about what AA does? In this episode we review mutual support groups and 12 step programs (such as AA) - what they are and how they work.
2022-07-1126 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 30 - Buprenorphine After Naloxone RescueWe all know that buprenorphine is an effective medication to treat opiate withdrawal, yet most of us only use buprenorphine to treat opiate withdrawal from abstinence from opioids. It turns out that buprenorphine can also treat the opiate withdrawal that patients experience when they are given naloxone after an opioid overdose. In this episode we review the literature on using buprenorphine after naloxone rescue, and how to actually do it in your practice. We also take on a few other topics around this issue, including whether or not naloxone can be given electively to induce withdrawal to facilitate a...
2022-06-2829 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 29 - Drinking Alcohol + Naltrexone = Cure for Alcohol Use DisorderWait, what??? Drinking Alcohol + Naltrexone = Cure for Alcohol Use Disorder??? In this episode we do a detailed review of a different way to use naltrexone for alcohol use disorder, which is to continue drinking while using naltrexone. This method is often referred to as the Sinclair Method, and may be effective in up to 80% of patients to reduce alcohol consumption or stop drinking entirely. This episode is based on the book "The Cure for Alcoholism" by Roy Eskapa, PhD
2022-06-0422 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 28 - Cannabis Induced PsychosisHave you ever had this case in your ED? A patient purchases a cannabis edible candy bar or pastry. She or he eats a small amount and waits 30-60 minutes. Feeling nothing, the patient proceeds to eat the whole bar and then comes to the ED via ambulance or with a friend about an hour later completely panicked and hallucinating. In this episode we dig in to Cannabis Induced Psychosis - why it happens, how THC content contributes to the development of psychosis, how common it may be, and how to treat it.
2022-05-2521 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 27 - Can you diagnose an alcohol use disorder based on lab tests?We all have had this scenario...a patient comes to the ED or is getting admitted for a medical complaint...and you notice a few findings on their lab tests that make you wonder if they have an alcohol use disorder. An elevated MCV. An elevated AST. Have you ever asked yourself - how accurate are these tests are detecting and diagnosing an alcohol use disorder? Or on the flip side - how often do we see a patient presents to the ED requesting help with alcohol after years of heavy drinking and has essentially normal labs? In this...
2022-05-0726 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 26 - Can Bupropion and Naltrexone help treat methamphetamine use disorder?Methamphetamine use disorder...we see it every day in the Emergency Department, and yet it feels like we have nothing to offer as far as treatment. Could there be some hope that we finally have some medications for methamphetamine use disorder? In this episode we review a recent study on the use of Bupropion and Naltrexone for the treatment of methamphetamine use disorder.
2022-04-2919 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 25 - What is kindling in alcohol withdrawal?Have you heard of the kindling phenomenon? Have you ever wondered why alcohol withdrawal seems to get worse the longer people drink? In this episode we review kindling in alcohol withdrawal - what it is, why it happens, and why it matters clinically.
2022-04-1617 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 24 - How to handle buprenorphine in the perioperative settingOk. 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.
2022-03-3024 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 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.
2022-03-1528 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 22 - Illicit FentanylIn 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.
2022-03-1136 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 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.
2022-02-2527 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 20 – A patient story. Getting “well” with opiate use disorderWhat 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
2022-02-1211 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 19 - The Patient on Methadone for Opiate Use DisorderHas 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.
2022-02-0324 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 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.
2022-01-1921 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 17 - Buprenorphine precipitated opiate withdrawalBuprenorphine 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.
2022-01-0323 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 16 - How stigma hurts patients and what we can do about itHow 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.
2021-12-0732 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 15.5 - Lit Review - Using High Dose Buprenorphine in the Emergency DepartmentIn 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.
2021-12-0319 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 15 - An Overview of Alcohol WithdrawalThis episode has been on the to-do list for quite a while. In Episode 15, Dr. Grover tackles the huge topic of alcohol withdrawal - from definitions, to pathophysiology, to diagnosis, to management.
2021-11-2035 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 14: Cannabis Dispensaries - Who works there and what do they tell patients about cannabis?Have you had patients ask you about information on cannabis that they received from a cannabis dispensary? Perhaps they have been told that they need a certain THC:CBD ratio to treat their condition. How good is that information? In this episode we’re going to be talking about Cannabis Dispensaries. Most specifically, who works there, what do they tell people about cannabis, and how good is the information that they give out.
2021-11-0823 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 13 - Alcoholic KetoacidosisHow much do you remember from your training on alcoholic ketoacidosis? Do you remember which IV fluids need to be given? In Episode 13, we review the topic of alcoholic ketoacidosis - from a brief history of the condition, to pathophysiology, to making the diagnosis, and how to treat it.
2021-10-2618 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 12 - Medications to prevent relapses on alcohol and reduce alcohol intake (aka Medications for Alcohol Use Disorder)In this episode Dr. Grover tackles medications for alcohol use disorder. These are medications to prevent a relapse on alcohol and to reduce the desire for drinking. You may not have used these medications much in your practice, but after listening to this episode hopefully you'll start using them. Episode 12 reviews two papers on medications for alcohol use disorder, reviewing their indications, dosing, side effects, efficacy, contraindications, and cost.
2021-10-1825 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 11 - Adulterants in street drugs: Does anyone actually know what's in the drugs they use??Do you have any idea what is truly in the street drugs your patients are buying and using? No? Turns out your patients probably don't either. And worse yet, your hospital doesn't have ready access to testing to find out. Is that really heroin your patient is using or is it quinine?In this episode we review a few papers on how street drugs are cut and adulterated. From quinidine, to acetaminophen, to baking soda, to levamisole - you'll be amazed what ends up in our street drug supply.
2021-09-2621 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 10 - Gabapentin as a treatment for Cannabis Dependence and WithdrawalFinally! A medication option for the treatment of Cannabis Dependence and Cannabis Withdrawal. Dr. Grover shares a case from his practice in the Emergency Department and does a deep dive into the literature supporting gabapentin as a treatment for Cannabis Dependence and Cannabis Withdrawal.
2021-09-0823 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 9 - Harm Reduction and how using it in your practice improves your patient careOn this episode we'll be covering the topic of harm reduction. Most people know a little bit about it, but in this episode we dive deep into harm reduction, and why it is extremely important for patients with an active substance use disorder. Dr. Grover reviews a brief history of harm reduction, how it helps people get into long term recovery, key concepts of harm reduction, how to incorporate it into your practice, and why it can be controversial - including a discussion of syringe exchange programs.
2021-08-2421 min
Addiction Medicine Made Easy | Fighting back against addictionEpisode 8.5 - Lit Review - What is the 1 year mortality for patients after an ED visit for a non-fatal opioid overdose?We all know how devastating opioid overdose deaths are in the United States and around the world. However we don't know as much about non-fatal opioid overdoses, including how likely they are to lead to fatal opioid overdoses. In this episode we review the 2020 Annals of Emergency Medicine paper "One Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose".
2021-08-1015 min