Addiction in Emergency Medicine and Acute Care

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

In this episode, we discuss the fundamentals of treating opioid and alcohol use disorders with medication-assisted approaches. We review how to understand addiction as self-regulation with substances and how healthcare providers can leverage familiar medications alongside specialized treatments to help patients recover.We also discuss• Addiction fundamentally involves helping patients shift from self-regulating with substances to self-regulating without them• Distinguishing opioid dependence (physical brain chemistry changes) from opioid use disorder (psychological addiction)• Buprenorphine as a partial agonist that blocks other opioids, reduces cravings, and decreases overdose risk by 70%• Three FDA-approved medications for alcohol use disorder: disulfiram , naltrexone, and acamprosate• Off-label medications like gabapentin and topiramate can enhance alcohol use disorder treatment• Understanding the fentanyl crisis and emergence of counterfeit pills containing dangerous synthetic opioids• Addressing stigma through person-first language and recognizing addiction as a disorder of executive functioningTo contact Dr. Grover: ammadeeasy@fastmail.com

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 breaks down psychiatric medications and their role in addiction treatment, explaining how different medications work, when they're most appropriate, and which ones to avoid. He provides a practical overview based on his extensive experience treating patients with substance use disorders.• Psychiatric medications get developed through research on brain receptors and undergo rigorous testing before FDA approval• Medications often have "off-label" uses that weren't originally intended but provide benefits in certain situations• Antidepressants like SSRIs and SNRIs serve as the foundation for treating depression in people with addiction• Using non-addictive options like hydroxyzine, clonidine, and buspirone is crucial when treating anxiety in recovery• Trazodone and mirtazapine are preferred for sleep issues over benzodiazepines and "Z-drugs" that can create dependence• ADHD treatment requires careful consideration when patients have stimulant use disorder histories• Benzodiazepines should be avoided when possible as they paradoxically worsen anxiety over time• Medication selection should consider urgency of conditions, past medication responses, and potential side effects• Some psychiatric conditions may improve with therapy allowing medication reduction, while others require long-term treatmentThank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together we can make it happen. Remember, treating addiction saves lives.To contact Dr. Grover: ammadeeasy@fastmail.com

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

This episode provides a deep dive into the complexities of addiction medicine learned from seeing patients in my practice. Through real patient cases, I highlight the importance of tailored approaches to addiction that consider both the physiological and psychological aspects of recovery.We discuss• Insights into demographics of substance use in a rural setting • The effectiveness of dual medication therapies for alcohol use disorder • The link between trauma and substance use disorders • Emerging concerns surrounding kratom as a public health issue • The significance of managing co-occurring ADHD in addiction treatmentTo contact Dr. Grover: ammadeeasy@fastmail.com

This episode delves into the role of N-acetylcysteine (NAC) in treating cannabis use disorder, exploring scientific studies and their findings. Listeners will gain insights on the efficacy of NAC, its potential in addiction treatment, and practical considerations for use.• Overview of cannabis use disorder statistics and the need for treatment options • Explanation of N-acetylcysteine and its mechanism of action in addiction • Review of clinical trials evaluating NAC's effectiveness in reducing cannabis use Subscribe, share your thoughts, or leave a review!To contact Dr. Grover: ammadeeasy@fastmail.com

Trauma plays a pivotal role in the journey of addiction, with many individuals using substances as a means to cope with unresolved issues. Addressing PTSD is crucial for effective recovery, as understanding the link between trauma and addiction can empower individuals toward healing. In this episode we discuss:• Trauma and its historical context in PTSD understanding • Description of brain responses to trauma and the feedback loop • Big T and little t traumas and their cumulative effects • The connection between adverse childhood experiences (ACEs) and adult illnesses • The importance of a trauma-informed approach in treatment • Case studies illustrating the impact of trauma on addiction recovery • Recommendations for therapeutic interventions and medication optionsI reference a podcast episode at the beginning of the episode. Here's a link to that episodehttps://lemonadamedia.com/podcast/trauma-with-dr-gabor-mate/To contact Dr. Grover: ammadeeasy@fastmail.com

Understanding the teenage brain's vulnerability to addiction can help parents and educators guide youth more effectively. This episode explores the brain's development, early drug use risks, emotional impairment, and effective prevention strategies drawn from successful programs like Iceland's. Key points:• Teenage brains develop until around age 26, with the prefrontal cortex being critical for decision-making • Early substance use increases the risk of developing addiction • Social and emotional learning is impaired by drugs and alcohol • Nick Sheff's story highlights the long-term effects of early addiction • Dopamine plays a crucial role in pleasure, survival, and addiction risk • Teenagers have lower baseline dopamine levels, driving them to seek new experiences • Iceland's approach to reducing adolescent addiction focuses on positive activities and parental engagement • Organized activities are protective against addiction, creating positive environments for teens • Conclusion emphasizes the critical role of understanding and intervention in preventing addiction'To contact Dr. Grover: ammadeeasy@fastmail.com

Can personal stories of struggle and resilience reshape our understanding of addiction? The answer is YES! My patients teach me about addiction all the time!Join me, Dr. Casey Grover, as I share the powerful stories of three patients whose experiences challenge society's perceptions of addiction. Their journeys highlight the need for understanding over judgment and the vital role healthcare providers play in supporting those in need.  This episode is a heartfelt call to action. Byy raising awareness and extending support, we can improve addiction treatment and break the stigma surrounding this complex issue. Listen in and join a community committed to compassion, advocacy, and meaningful change.To contact Dr. Grover: ammadeeasy@fastmail.com

This podcast episode delves into the groundbreaking concept of dual brain psychology and its implications for understanding trauma and addiction. Dr. Fred Schiffer shares his insights on how different hemispheres of the brain process trauma and the methods developed to facilitate healing through dual brain dynamics.• Explanation of split brain studies and their significance • Distinction between the functions of each brain hemisphere • Insights on how trauma resides in different sides of the brain • Connection between cravings and brain hemisphere activity • The cumulative effect of trauma and its relation to addiction • Gender dynamics and patterns in trauma experiences • Therapeutic approaches using hemispheric stimulation • Call for clinicians and patients to explore dual brain psychologyTo contact Dr. Grover: ammmadeeasy@fastmail.com

This is an episode on addiction and trauma, with the author Rikki West as a guest. Rikki shares her powerful story of assault, addiction, and healing, and we discuss the deep connection between trauma and addiction. We had a fantastic conversation about personal struggles and the importance of community support, as well as finding the path to healing. We discuss:• Exploring the connection between trauma and addiction • Rikki's journey from childhood through addiction to recovery • Impact of familial addiction on personal development • The role of community and support groups in healing • Rikki's experience with therapy and emotional regulation • Navigating relationships and intimacy after trauma • The importance of sharing stories for healing and empowermentTo contact Dr. Grover: ammmadeeasy@fastmail.com 

In this episode, we are tackling stigma. Specifically stigma against patients by healthcare providers. Stigma against patients struggling with addiction is a significant barrier to effective healthcare treatment, leading to profound consequences, including increased harm and even death. The episode highlights the definition of stigma, its impacts on patient behavior, and actionable strategies to reduce it within the healthcare system. We discuss:• Definitions and types of stigma • The harmful effects of stigma on quality of life • The link between stigma and higher mortality rates • Patient responses to stigma in healthcare settings • Personal stories highlighting the real impact of stigma • Effective strategies for reducing stigma in healthcare • Importance of using person-first language and educational outreachTo contact Dr. Grover: ammadeeasy@fastmail.com

We're talking about Xylazine again. We haven't covered it on the podcast since 2022, and since it's becoming more common in the drug supply, it was time to discuss it again. Unlock the secrets to understanding one of today's most alarming substances misused in addiction – Xylazine, infamously dubbed the "Zombie Drug." Join me, Dr. Casey Grover, as I dive into the world of Xylazine, a veterinary medication with unintended and dangerous consequences when misused by humans. Discover the pharmacological effects of this alpha-2 agonist, closely related to medications like clonidine, and learn how it disrupts normal physiological functions, leading to slowed heart rate, low blood pressure, and sedation.In this episode, I unravel the complexities of Xylazine use, highlighting the dire risks of overdose and the challenges faced due to the absence of a human reversal agent. By sharing my 14 years of experience in the emergency department and my current role as a medical director in addiction treatment, I aim to provide crucial insights into how healthcare professionals can respond to Xylazine-related emergencies. This episode offers a comprehensive guide for anyone involved in the realm of addiction medicine, from healthcare providers to individuals battling addiction and their loved ones, emphasizing the importance of informed and compassionate care.To contact Dr. Grover: ammadeeasy@fastmail.com

This episode explores the complexities surrounding kratom, featuring insights from Matthew Lowe of the Global Kratom Coalition (GKC). We discuss the dual nature of kratom, its benefits and risks, the importance of consumer education, and the ongoing push for industry regulation to protect users. We discuss• An overview of kratom's rising popularity and consumer demographics • The role of word-of-mouth and the internet in kratom discovery • Importance of accurate labeling and consumer education • Differences between kratom leaf, extracts, and synthetic products • Discussion on addiction potential and withdrawal symptoms • The Kratom Consumer Protection Acts and their significance • Ethical considerations within the kratom industry • Call for enhanced regulation and responsible marketing practicesTo contact Dr. Grover: ammadeeasy@fastmail.com

Evan Morgan, a dedicated fire captain from Central California, provides a raw and deeply personal account of his struggle with addiction, illustrating the harsh realities faced by healthcare professionals battling the stigma that comes with it. Once an ambitious student experimenting with drugs, Evan's journey spiraled into dependency on prescription painkillers after a workplace injury. His candid narrative reveals the devastating effects of addiction on his professional life and personal relationships, offering listeners a rare glimpse into the internal conflicts of a first responder caught between duty and dependency.Listeners will discover how Evan's life took a pivotal turn when an encounter with law enforcement acted as a much-needed wake-up call. The story unfolds to reveal the weight of maintaining a paramedic career while wrestling with a Dilaudid addiction and the unexpected relief that came with being honest about his struggles. With backing from his supportive fire department chiefs, Evan embarked on a rehabilitation journey at the International Association of Firefighters in Maryland, which ultimately led him to sobriety. Through his inspirational account, we explore the power of transparency and the surprising support system that can emerge when someone is brave enough to ask for help.Our episode underscores the critical need to shift perceptions around addiction in professional settings, with a focus on reducing stigma through empathy and understanding. Evan's experience exemplifies how sharing personal stories can foster compassion and break down prejudices in healthcare environments. By shedding light on the prevalent issues of substance abuse and PTSD among first responders, we aim to promote a culture of support and awareness, encouraging others to view addiction through a more compassionate lens. Join us as we commit to creating resources and raising awareness for addiction treatment, inspired by the bravery and resilience of those like Evan.

Join me, Dr. Casey Grover, on an eye-opening journey as we tackle the tough questions surrounding addiction medicine. We start by discovering why cannabis isn't the harmless plant many believe it to be, especially in the context of recovery. Drawing from a compelling study, we reveal how cannabis use in sober living environments may set the stage for relapse into alcohol and other drugs, challenging the notion that it can coexist with sobriety.But that's just the beginning. We next do a deep dive into dimethyltryptamine (DMT), a powerful hallucinogen stirring curiosity in addiction treatment circles. From its natural origins to its historical significance in traditional ayahuasca ceremonies, we explore DMT's unique effects and how they differ based on how it's taken. In our quest to understand hallucinogens in addiction treatment, we discuss hallucinogen use disorder. With no medication-assisted treatment available, we emphasize the need to address underlying mental health issues. As we finish the episode, we explore emerging research on the therapeutic possibilities of hallucinogens like psilocybin in the treatment of other substance use disorders.References: Madam Noire link: https://madamenoire.com/1331923/everything-you-need-to-know-about-ayahuasca/Addiction Medicine Textbook link: https://shop.lww.com/The-ASAM-Essentials-of-Addiction-Medicine/p/9781975107956To contact Dr. Grover: ammadeeasy@fastmail.com 

Imagine battling substance addiction for decades, only to find your path to recovery through personal growth and self-awareness. In this heartfelt episode, I, Dr. Casey Grover, sit down with Paul Giovino, a Monterey resident who courageously shares his transformative journey from dependency to resilience. Paul's story is not just about overcoming addiction; it's about addressing the emotional roots of substance use and finding strength in building self-esteem. Together, we explore the significant hurdles he faced, from professional setbacks to health challenges, and the pivotal role of personal development activities in his recovery process.As we navigate the complexities of opioid addiction treatment, we uncover the challenges posed by substances like fentanyl and the groundbreaking impact of treatments such as buprenorphine. Our conversation sheds light on the societal stigma surrounding treatments like methadone, which can often hinder recovery efforts. Through personal anecdotes, we discuss how individual differences in brain chemistry influence responses to opioids, and the ongoing struggle to overcome self-shame and societal misconceptions. It's a deep dive into the science and personal stories behind addiction, shedding light on how these factors play into the recovery journey.Community support emerges as a key theme in our discussion, emphasizing how networks like Alcoholics Anonymous can be instrumental in maintaining sobriety. We highlight the importance of creating compassionate and stigma-free healthcare environments, and how education is crucial in transforming addiction treatment. By sharing Paul's inspirational story, we underscore the life-saving impact of early access to addiction care and the power of a supportive community in fostering resilience and self-awareness. Join us for an episode that reminds us of the profound truth: treating addiction saves lives.To contact Dr. Grover: ammadeeasy@fastmail.com

Discover the transformative potential of ADHD medications in addiction treatment as we bring you a captivating discussion with Dr. Justin Mohatt, a renowned child and adolescent psychiatrist. Dr. Mohatt joins us to unravel the complexities of using ADHD medications to combat stimulant addiction, shedding light on how these drugs can make a difference. We'll explore a myriad of medications, including guanfacine, clonidine, and atomoxetine, and discuss their respective roles in addressing adult ADHD and substance use disorders. Learn the importance of a meticulous diagnostic process to distinguish ADHD from other mental health conditions like depression and anxiety, ensuring a tailored approach to treatment.We navigate the nuanced landscape of ADHD in adults with a history of substance use, emphasizing the critical role of family insights to inform diagnoses beyond self-reports. The conversation underscores the careful application of stimulants for ADHD, even in those with stimulant use disorders, while presenting Vyvanse as a potentially safer choice. Non-stimulant medications like atomoxetine receive special attention for their dual role in treating ADHD and co-occurring anxiety, offering a glimpse into strategies for managing side effects and insurance hurdles. Hear how non-addictive alternatives could provide solutions for patients who haven't found success with traditional medications.As we delve deeper into co-occurring ADHD and trauma, Dr. Mohatt discusses the potential benefits of alpha agonists and other non-stimulant options in treating complex cases involving PTSD and substance use disorders. Together, Dr. Mohatt and I affirm the importance of addressing ADHD within addiction treatment to foster recovery and improve cognitive function, offering a beacon of hope for those navigating these intertwined challenges.To contact Dr. Grover: ammadeeasy@fastmail.com 

This is a bonus episode. I was asked to speak at several schools in the area around where I work about drugs and alcohol - both to students and to parents. I wanted to make the education as impactful and real as possible. So I focused on the substances that are most likely to affect our youth and their families - alcohol, cannabis, nicotine/vaping, and fentanyl. To help make my presentation as real as possible, I actually went to a liquor store, a tobacco shop, and a cannabis dispensary to look at how these products are sold and marketed - and how to interpret the labels on them. Whether you are a student, a parent, or just a person concerned about substance use, I know you will learn something from this lecture. If you're looking to start a conversation with your loved one about drug and alcohol use, this lecture will help educate you on the current state of addiction, and give you information on how to start that conversation about drugs and alcohol.To contact Dr. Grover: ammadeeasy@fastmail.com 

Ever wondered if a plant could be both a herbal remedy and a controversial subject in addiction medicine? Join us as we uncover the multifaceted nature of Kratom with Dr. Sonia Del Tredici and Dr. John Keenan from the Addiction Medicine Journal Club podcast for a journal club style episode on Kratom. Together, we explore Kratom's historical uses for pain relief and fatigue management and its growing popularity as an aid in opioid withdrawal. This episode promises to give you a thorough understanding of its pharmacological effects, including interactions with opioid receptors and anti-inflammatory benefits.Our conversation shifts to the intriguing trends in Kratom usage across the United States. We dissect three recent studies on Kratom, highlighting Kratom's allure as a perceived safer option for managing anxiety, depression, and pain. Despite its benefits, we don't shy away from discussing its potential for addiction and the demographic reach of its users. This episode challenges listeners to consider whether the overlap between Kratom users and those with other substance use disorders is surprising or expected, urging healthcare providers to adopt open-ended dialogues to address patient needs effectively.In a deep dive into Kratom Use Disorder, our discussion includes a fascinating case series study examining the use of buprenorphine for treatment. We highlight the study's findings on withdrawal management and Kratom metabolite reduction, exploring the effectiveness of buprenorphine in stabilizing patients. With a significant portion of patients remaining in follow-up care, we ponder the subjective effects of using Kratom alongside buprenorphine. Tune in to grasp the complexities of Kratom use and the importance of education and ongoing research, as we prepare for an upcoming interview with an industry professional to continue this enlightening series.Our episode reviews three studies on Kratom to facilitate our discussion. Here are those studies:Smith KE, Dunn KE, Rogers JM, Grundmann O, McCurdy CR, Garcia-Romeu A, Schriefer D, Swogger MT, Epstein DH. Kratom use as more than a "self-treatment". Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694.  Hill K, Grundmann O, Smith KE, Stanciu CN. Prevalence of Kratom Use Disorder Among Kratom Consumers. J Addict Med. 2024 May-Jun 01;18(3):306-312. Broyan, V. R., Brar, J. K., Allgaier, Student, T., & Allgaier, J. T. (2022). Long-term buprenorphine treatment for kratom use disorder: A case series. Substance Abuse, 43(1), 763–766. To contact Dr. Grover: ammadeeasy@fastmail.com

I'm thrilled to welcome Amity Cooper to the Addiction Medicine Made Easy Podcast! Amity is a mental health professional specializing in equine therapy, to share her unique perspective on the pivotal role of mental health in achieving and maintaining sobriety. Together, we explore the intersection of mental health and addiction recovery, delving into therapies that support individuals on their journey to a fulfilling sober life. Amity's insights provide insight at how equine therapy and holistic approaches can transform the recovery process, offering hope and healing to those in need.Our discussion then turns to the concept of personal transformation during recovery, focusing on the importance of establishing a guiding "North Star." We highlight strategies like polyvagal therapy and self-awareness practices as essential tools for managing co-occurring mental health and addiction disorders. Finally, we delve into the therapeutic benefits of equine therapy, where horses act as co-partners in therapy, promoting mindfulness and emotional expression. Discover how this innovative approach can empower individuals to redefine their futures, fostering emotional healing and self-awareness in the process.At the beginning of the episode we look at how early cannabis use can impact academic performance. We discuss the findings of a compelling study published in JAMA Pediatrics. We'll explore how adolescent cannabis use is linked to lower grades and increased dropout rates, setting the stage for a deeper understanding of the long-term effects of substance use. This episode promises to equip listeners with crucial insights into how these early choices can alter life's trajectory, emphasizing the importance of informed decision-making for young people.Amity's website: https://amitycooper.com/To reach Dr. Grover: ammadeeasy@fastmail.com 

Join us for a riveting discussion with Chris Terzakos, an insightful author and life coach, who shares his compelling journey from the gritty streets of New York City to finding solace in fitness. Chris opens up about witnessing the widespread impact of drugs like cocaine and LSD in his neighborhood and how he turned to exercise as his lifeline. Discover how the pursuit of a natural high through fitness provided a therapeutic escape, laying the foundation for Chris's message about the healing power of exercise in addiction recovery. Chris discusses how addiction has affected his life, including his experience when his best friend developed addiction. Chris candidly discusses his own struggles with anabolic steroids and the path to sobriety. He offers insights into overcoming addiction, emphasizing the role of empathy and support in helping loved ones navigate their journeys. This episode covers a wide range of topics from people who have transformed their lives through fitness, challenging the stigma surrounding addiction terminology, and highlighting how addiction affects friends and family. 

Have you ever considered the emotional journey of siblings when they discover a loved one's trauma? This episode invites you to explore this often-overlooked perspective with our special guest, Keeper Catran-Whitney, the author of "Helplessness: What Happens To Brothers When We Learn Our Sisters Have Been Molested By Our Parents?." Keeper opens up about the personal journey of grappling with childhood trauma, poverty, and the complex layers of emotions that arise when a brother learns of his sister's abuse. His story sheds light on the shadows often cast by societal norms, where male vulnerability is frequently stifled.We navigate through the intricate links between trauma and addiction, unpacking how these experiences shape one's path to healing. Keeper eloquently shares the emotional turmoil of disbelief, guilt, and anger, painting a vivid picture of the internal battles faced by siblings who are often left without a voice. The episode underscores the critical lack of support for brothers and the societal taboos that keep them silent. We also reflect on Keeper's personal confrontation with family issues and his journey towards finding happiness and healing through forgiveness and empathy.Our conversation doesn't shy away from the raw, unfiltered realities of confronting trauma. Keeper reveals how writing became his therapeutic outlet, allowing him to process and express his vulnerability when professional help was unattainable. He emphasizes the transformative power of storytelling and the necessity of addressing unresolved family issues. Join us as we discuss the ongoing journey of healing, the importance of supportive communities, and the courageous steps towards self-compassion and emotional honesty.

Unlock the complexities of Kratom, a substance both fascinating and misunderstood, as we promise to enrich your understanding with insights from Dr. Sonya Del Tredici and Dr. John Keenan of the Addiction Medicine Journal Club. Join us as we explore Kratom's dual identity as a stimulant and opioid-like substance, its traditional roots, and the reasons behind its rise in popularity. Despite its widespread use, many see Kratom as an herbal supplement rather than a drug, leading to an awareness gap among healthcare professionals. We stress the importance of recognizing Kratom's impact in the field of addiction medicine and why it's crucial for medical practitioners to inquire about its use in patient assessments.Peel back the layers of Kratom withdrawal, which shares parallels with opioid withdrawal, but with unique mood-related symptoms like anxiety and insomnia. Through enlightening patient anecdotes and clinical observations, we uncover the personal motivations driving individuals to Kratom, whether it's for anxiety relief or as a stepping stone from other opioid treatments. The varied experiences highlight the need for a nuanced approach to understanding withdrawal and the complex reasons behind Kratom usage, emphasizing the importance of patient-centered care that addresses both physical and emotional well-being.As we shift our focus to the broader implications of natural substance use, we traverse the cultural and health landscape of Kratom and cannabis. The potential role of Kratom in harm reduction strategies for opioid users is a key topic, alongside its legal advantages and challenges due to its unregulated nature. With a promise of future evidence-based exploration, our collaborative episode the Addiction Medicine Journal Club pledges to shed light on these critical issues, advocating for better regulation, open communication, and long-term patient relationships.

What if the root of America's deadly opioid crisis lies in a single pharmaceutical company's marketing strategy? Dr. Casey Grover takes you on a compelling journey through the origins and evolution of this epidemic. From Purdue Pharma's aggressive promotion of OxyContin to the alarming rise of synthetic opioids like fentanyl, we dissect how tolerance and dependence perpetuate the cycle of addiction. You'll also gain historical insights into heroin's early marketing by Bayer Pharmaceuticals as a "non-addictive" remedy, and hear personal stories that underscore the human cost of opioid dependence.We then shift our focus to the emergence of novel and perilous synthetic drugs that are infiltrating our communities. Discover why carrying Narcan has become essential and learn about the life-saving potential of deregulating buprenorphine. Dr. Grover also highlights the tragic story of Paul, whose life and artwork poignantly reflect the struggles of addiction. Paul's legacy serves as a stark reminder of the importance of effective treatment and education in combating this crisis. Tune in for an essential discussion on the urgent changes needed to address opioid use and overdoses in the United States.

Can CBD truly provide effective pain relief, or is it just another overhyped remedy? Join us in this eye-opening episode of Addiction Medicine Made Easy, where Dr. Casey Grover critically examines the realities behind cannabidiol (CBD) usage for pain management. We start the episode with inspiring encounters, including a discussion of the work of musician Matt Butler, who uses his songs to shine a light on addiction in prisons and jails. Dr. Grover also shares his heartfelt recommendation of Stephanie Wittels Wachs' book, "Everything is Wonderful and Horrible," which offers a raw perspective on coping with the loss of a loved one to overdose.As we journey deeper, we unpack a 2024 article from the Journal of Pain by Andrew Moore, which scrutinizes the effectiveness, cost, and potential harms of CBD products. Our discussion highlights the widespread use of CBD, yet flags significant issues like product purity and labeling discrepancies. The episode dives into CBD's dual roles—both as Epidiolex for seizure disorders and as a non-pharmaceutical pain relief option. Despite its popularity, current research shows mixed results on CBD's efficacy for pain relief. Furthermore, hidden risks such as the presence of THC, sedation, and hepatotoxicity are explored. This episode underscores the necessity for ongoing research and thoughtful consideration when using CBD, especially in the context of addiction treatment. Don't miss out on this thorough examination of CBD's complexities and what they mean for pain management and addiction medicine.

Can smart people really be immune to addiction? On this special bonus episode of the Addiction Medicine Made Easy podcast, Dr. Casey Grover uncovers the truths behind common myths about addiction, drugs, and overdoses. Designed for students from grades 6 through 12, this episode is both engaging and educational, challenging misconceptions such as the addictive potential of cannabis and the dangers of merely touching fentanyl. You'll gain a deeper understanding of how addiction affects decision-making in the brain, making complex medical science both accessible and compelling.Additionally, we shed light on how a meal can influence alcohol absorption and reduce intoxication risks. Plus, hear a real-life ER story that underscores the life-saving power of Narcan, a medication that can reverse opioid overdoses in minutes. Dr. Grover also highlights the staggering statistics surrounding addiction in America, driving home the importance of carrying Narcan in schools and public spaces. This episode is not only informative but also a call to action to help save lives by better understanding and treating addiction.

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 strains—green, white, and red vein—are marketed and sold, each promising effects like relaxation, energy, and mood enhancement. However, the lack of consumer information about risks such as dependence and withdrawal will leave you questioning just how safe this herb really is.Dr. Grover also challenges the regulatory frameworks surrounding kratom, juxtaposing it against well-known supplements like St. John's wort and echinacea. You'll discover the startling gaps in labeling and disclosure, particularly concerning its opioid nature and potential for tolerance and dependence. We also dive into why patients might be hesitant to discuss their kratom use with healthcare providers, shedding light on the stigma and misconceptions that contribute to this silence. This episode underscores the urgent need for better regulations and transparent labeling to ensure consumer safety. Thank you for tuning in and prioritizing your health and well-being with us.

Have 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 pivotal in battling addiction. We highlight the necessity of Narcan, drawing parallels with everyday safety items such as fire extinguishers and seatbelts. Listen to inspiring stories of community initiatives like fitness programs for recovery and essential item distribution, demonstrating how these efforts build trust and support recovery. Dr. Grover and Dr. Close shed light on the success of these programs, emphasizing the human connection and practical assistance in reducing harm.Finally, we delve into the critical topic of safe and effective pain management, focusing on the use of buprenorphine. Dr. Close shares a real-life scenario of collaborating with a surgeon to manage a patient's post-operative pain using buprenorphine, highlighting the importance of interdisciplinary communication and mutual understanding in patient care. This episode is packed with invaluable insights and compassionate approaches, aiming to equip healthcare providers and anyone interested in addiction medicine with the knowledge to make a significant difference in the lives of those struggling with addiction.

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 family and community in preventing addiction. We highlight the significance of strong parental bonds, family meals, and knowing your child's friends and whereabouts. From the success story of Iceland's national strategy to local initiatives like CrossFit classes and the Reps for Recovery gym, learn how community connections can act as a robust shield against addiction. We also delve into the mental health aspects and the role of resilience and coping strategies in addiction prevention, offering insights into building a supportive environment for your children.Unearth powerful strategies for recognizing and addressing signs of substance use and managing challenging conversations about addiction. We discuss the warning signs parents should watch for and the risk factors that might lead teens to substance use. Explore approaches for externalizing the problem, using news stories as conversation starters, and engaging young people as experts. Finally, we shine a light on community-based drug prevention organizations and their vital role in combating overdose deaths among young people. 

Discover 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 and explore its potential to protect during the fentanyl crisis.Effective communication with patients about buprenorphine is key, and Dr. Grover emphasizes the importance of this in reducing overdose risks. Reflecting on his own practice, he shares how he now approaches conversations about the medication, underlining that while buprenorphine substantially lowers the risk of fatal overdoses, it doesn't offer complete protection, particularly if not taken regularly. Tune in for actionable advice and insightful discussions designed to elevate your approach to addiction medicine.

Can 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 infarction.In this episode, we'll explore the association between cannabis use and cardiovascular disease, presenting it as a likely independent risk factor. You'll discover why it's crucial to counsel patients, especially those already at risk for heart disease, about the potential dangers of cannabis use. This conversation emphasizes the vital role healthcare professionals play in treating substance use disorders and ultimately saving lives. Tune in to equip yourself with the knowledge needed to provide better care and protect your patients' hearts. 

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

Traditional 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.

Episode 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.

Naltrexone - 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.

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!!!)

In 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.

Dr. 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.

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.

Ok...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.

In 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.