Podcasts about depakote

Attorney Kristina J. Anderson from Wallace Miller joined Jon Hansen on Let’s Get Legal to discuss her journey to the law firm. Kristina also talked to Jon about how Depakote exposure during pregnancy has been linked to autism and ADHD. For more information, visit www.wallacemiller.com or call 312-261-6193. Wallace Miller is currently accepting clients for […]

On this airing of Let’s Get Legal, Host Jon Hansen is joined by three guests to discuss the latest legal news. Segment 1: Trial Lawyer Michael Leonard of Leonard Trial Lawyers joins Jon Hansen to discuss the jury selection for Michael Madigan’s trial, how lawyers choose jurors for their case, and how much jurors are paid for […]

Welcome to our next mood stabilizer episode, today we will be discussing Valproic Acid! Other medication names you may encounter: Depakote DR, ER, and Depakene. --- Support this podcast: https://podcasters.spotify.com/pod/show/psychrounds/support

Hi guys, di episode kali ini gw bakal ceritain tentang apa yang terjadi di badan gw, mental gw, perasaan gw ketika gw mengkonsumsi obat penenang, jenisnya Alganax dan Depakote, saat ini sudah sekitar 13 tahun gw mengkonsumsi obat tersebut secara rutin, dan itu ternyata membuat gw bisa bertahan hidup sampai saat ini hehehe

The Frontier Psychiatrist's newsletter? It is what you are reading. It's a health-themed publication written by Owen Scott Muir, M.D. This is a brief detour from my recent series on medications, many of which have a critical slant. Those include Risperidone, Depakote, Geodon, Ambien, Prozac, Xanax, Klonopin, Lurasidone, Olanzapine, Zulranolone, Benzos, Caffeine, Semeglutide, Lamotrigine, Cocaine, Xylazine, Lithium, dextromethorphan/bupropion and Adderall, etc. I write this all by myself every day. Consider subscribing. (the paywall starts 5 weeks back, and there are 360something articles back there). It makes a horrible or awesome gift, depending on your friend circle. I also get paid more money by Amazon if my readers buy stuff now, like, for example, my favorite book about mental illness—or this tea I drink daily. I also encourage you to send me this coffee maker— or, more realistically, to anyone else.Today, I address what happens when schizophrenia is not treated, even if it is. It has high morbidity and mortality, a problem that medications address. Effectively. Not without costs, but the best data suggests treatment is better than no treatment for most people.I'm going to cut to the chase briefly, and if you or a family member want to read a great book on treatment with antipsychotic medicine, I'd recommend this one. Jeff Leiberman, M.D., has been …controversial… of late. However, there is no denying his role in understanding schizophrenia and its treatment, and his book on the topic is worth a read or listen, called a Malady of the Mind.Psychotic. We use the word commonly in chit-chat to denote something is bad. Unreasonable. Wrong. Deranged. Nothing is beguiling about the word. It is a thing to deny in oneself— “I am not psychotic!”Understanding PsychosisSome people don't get that luxury. Some people are honest-to-goodness psychotic. Most of us do not know what that means. Some of us do, and some smaller portions are blessed with the ability to spend time on both sides of that psychotic equation. I will define the term:Psychosis refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During an episode of psychosis, a person's thoughts and perceptions are disrupted and they may have difficulty recognizing what is real and what is not. The most common illness we associate with psychosis is schizophrenia. Psychosis can occur with depression, bipolar disorder, and other maladies. Depression and mania are mood states; we refer to these mixed with psychotic symptoms as affective disorders in psychiatry. A brief grammar note, brought to you by Grammarly, a tool I use and—sadly—am not paid to promote:Is affective just another word for effective? Are the two words similar and entangled in the way the verbs affect and effect are? No, affective is not just another word for effective. And affective and effective are not derived from the verbs affect and effect. They come from the nouns affect and effect.There is a difference in the literature—and in the lives of patients—when it comes to illnesses that have affective psychosis and non-affective psychosis. Much of the anti-psychiatry crowd focuses on affective disorders and argues about the side effects of those treatments. Less attention is paid to non-affective psychosis because It's not as compelling an argument. These are challenging illnesses either way and are associated with significant morbidity—impairments in life—and mortality—early death.“Uncured of Worse”: 1937.As far back as 1937, authors noted the grim prospects in the long-term course of schizophrenia (in this context, I'm referring to largely “non-affective psychosis” —where the delusions or hallucinations are not tied to mood episodes):Of the 100 cases, 66% were uncured or worse after the lapse of 6-10 years, with persisting process symptoms or in a defective state after the course had run; 13% were improved, 4% were cured with defects, and 17% were completely cured. “The Prognosis is Poor”: 2010By 2010, with decades of more data, the conclusion was much the same—schizophrenia sucks, even compared to other admittedly bad illnesses:Our 26-year longitudinal study and other longitudinal studies confirm older views that outcome for schizophrenia, while showing some variation for different schizophrenia patients, is still significantly poorer than that for other psychiatric disorders.A large NIMH follow-up study with 2 to 10 years of time following patients from a first episode that required hospitalization demonstrated:The sample showed substantial functional impairment and levels of symptoms, with only about 20% of the sample demonstrating a good outcome…The “not-good” outcomes looked like this:78% of the sample suffered a relapse, 38% attempted suicide and 24% had episodes of major affective illness.Beyond Psychiatric Problems?We tend to focus on the role of bad psychiatric outcomes as psychiatrists. Still, the medical outcomes are similarly troubling, including high smoking rates, metabolic syndrome, heart disease, HIV, Hepatitis C, and other medical illnesses. Overall, this leads to an extremely disheartening finding: having schizophrenia is an illness that takes a tremendous toll on the individual and their family and leads to early death and disability at unacceptably high rates:Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased.Comparisons are useful, and if we look at HIV after the introduction of HAART (Highly Active Anti-Retroviral Therapy), we find:HIV-related mortality decreased from 6.5 to 1.3 per 100,000 population (80% decrease, p = 0.0115). New HIV diagnoses declined from 702 to 238 cases (66% decrease; p = 0.0004) with a consequent estimated decline in HIV incident cases from 632 to 368 cases per year (42% decrease; p = 0.0003).And if we compare that to schizophrenia, in the largest meta-analysis I could find, we find:The mortality risk for patients with schizophrenia was 1249 per 100 000 … (95% CI, 1029-1469)Psychosis is Bad Compared to Other Bad ThingsThe mortality from schizophrenia is 19,215% higher than from pre-HAART HIV infection and 96,076% higher than from HIV with HAART treatment. If you had to choose between HIV and schizophrenia, HIV is safer—with or without treatment.To make the point even more clearly, even having a car crash only has a 0.77% fatality rate, or 770/100,000.If you had to choose between a car crash and schizophrenia, the car crash is safer.Those outcomes are not good enough. Schizophrenia is impairing and dangerous to your life, especially if untreated. Other psychiatric illnesses are also. Psychiatric medications can modify this risk to your life in the right direction, even with those risks. Tapering them, as we saw in the RADAR trial (lead-authored by a critical psychiatrist, published in the Lancet just this week), doesn't make it better:At 2-year follow-up, a gradual, supported process of antipsychotic dose reduction had no effect on social functioning.And, further, made it worse:here were 93 serious adverse events in the reduction group affecting 49 individuals, mainly comprising admission for a mental health relapse, and 64 in the maintenance group, relating to 29 individuals.It includes twice as many deaths. In a research study, this is a huge deal. The way to look at this is the probability of relapsing is bad, and it's statistically more likely and with more than double likelihood if you were randomized to a taper protocol.Antipsychotic Medication Saves Lives. It has Burdens. These Choices are Difficult. We need to do better, but the haters are incorrect. We have done better than nothing, even with imperfect tools, even when examined by those who have an axe to grind with those very tools. Treatment of schizophrenia saves lives.Stay Humble,Faced with Suffering, and Carry On—Owen Scott Muir, M.D. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit thefrontierpsychiatrists.substack.com/subscribe

My favorite opening line of an academic article (this week) follows:Mental illnesses are prevalent, cause great suffering, and are burdensome to society.Welcome to the Frontier Psychiatrists. It's a newsletter that I write all by myself. I'm doing a series on medications, largely (but not entirely) in psychiatry. I'm a child and adult psychiatrist, and I still see patients. I've also been a patient since I was 16 years old. Please consider subscribing and sharing widely.The first antipsychotic introduced after clozapine would be a big deal—especially if it didn't cause life-threatening side effects. Risperidone was first developed by the Johnson & Johnson subsidiary Janssen-Cilag between 1988 and 1992 and was first approved by the FDA in 1994. It's one of the very few drugs with data for bipolar disorder that I, personally, have never been prescribed.Risperidone—Risperdal as a trade name—was ready to be a huge hit.It was presented as very atypical—this was the post-clozapine branding of choice. The “second generation” label was added years later. I have a confession to make. After residency, when the attending doctors told me, as a trainee, what to prescribe, I never prescribed risperidone ever again. I think this compound—and paliperidone, the metabolite— still has an important role in managing schizophrenia and bipolar disorder. There are more formulations of long-acting injectable risperidone and related compounds than I can remember. I think those are going to be useful drugs for a long time. Oral risperidone? Nope.Clozapine was an exciting drug. No horrible motor side effects? (Plausibly) More effective? It was better than every drug that came before. It had this pesky adverse effect that could lead to death called agranulocytosis, which I addressed in my first research paper in 2011. We needed more drugs that were this atypical!We—the field of psychiatry, at least— needed things that were not gonna kill you abruptly, in a terrifying manner, like clozapine had the rare potential to do. But we didn't want more of the same old antipsychotics. After Psychiatry got a taste of not having to explain permanent tardive dyskinesia as a likely side effect of antipsychotic medication, we wanted to keep doing that. Editors note: It is still a side effect of all non-clozapine antipsychotics, and we should never have let our guard down.Risperidone was the first antipsychotic that came to market after clozapine rocked the world of psychiatry by being better. Risperidone is similar, and they even use the accidental branding of clozapine— “atypical”—for this medication. The Food and Drug Administration (FDA)-approved indications for oral risperidone (tablets, oral solution, and M-TABs) include the treatment of:* schizophrenia (in adults and children aged 13 and up), * bipolar I acute manic or mixed episodes as monotherapy (in adults and children aged 10 and up), * bipolar I acute manic or mixed episodes adjunctive with lithium or valproate (in adults)* autism-associated irritability (in children aged 5 and up). Also, the long-acting risperidone injection has been approved for the use of schizophrenia and maintenance of bipolar disorder (as monotherapy or adjunctive to valproate or lithium) in adults.The “mechanism of action” of all of the drugs that have efficacy in psychosis was presumed to be dopamine D2 receptor blockade, a mechanism shared with all of the prior medication from Thorazine (chlorpromazine) through Haldol (haloperidol). The assumption—which clozapine disproved—was motor side effects were required for the drug's efficacy in psychosis. This primacy of the D2 blockade as a mechanism of action has since been disproven. This is the mechanism that leads to gynecomastia, leading to a bevy of lawsuits from men who developed breasts. It also causes related side effects like galactorrhea—breast milk from breasts that can be on men or women who are not nursing— and erectile dysfunction. Dopamine—it does a lot of work in the brain, not just pleasure.This motor side effect profile was not true with clozapine. It had various additional receptors, particularly in the serotonergic family (5HT-2a, for example), and alpha-adrenergic, histaminic, and other receptor sites throughout the brain. This broad profile of different receptors explains the wide range of side effects. But more importantly, these are complex, “messy,” and hard-to-predict outcomes given the complexity of the brain. The complex pharmacology allowed psychiatrists like me to think—hard!—about which particular witches brew of receptors we would choose to tickle (agonize) or antagonize. It's very satisfying. I also suspect this is a story we tell ourselves that is not as closely moored to truth as we'd like. We enjoy thinking about science-ish stuff. Receptor binding profiles are seductive— because they are knowable. Our patient's heart, hope, dreams, and heartbreak? Less so.The most important feature of risperidone today—and its 1st order metabolite, paliperidone—is that is deliverable as pills, rapid-acting dissolvable tablets, and long-acting injectable formulations, lasting between 2 weeks and 6 months between doses. A psychiatric treatment that isn't an oral once-daily pill? One you have to take twice a year? Medicine that is intended for people who often—like many—feel conflicted about taking a daily pill? That is a big enough deal. That is a real innovation— it considers human frailty, ambivalence, and common failures of mind. Not because it's a magic drug. Rather, long-acting medicine that doesn't make crippling relapse easy —thanks to good design— is exactly the kind of medicine that works. My second research effort was on the acceptability of such medicines in youth. It's responsible for my presence at the academic conference where I met my now wife.Oral medicines were popular because they were easy to sell. Novel medicines and technologies will be easy to take. The story of my fascination with the risks and benefits of these medicines doesn't end there, though.I still research these medicines and their adverse effects— funded by NIMH— for identifying Tardive Dyskinesia with Machine Learning and closed-loop Internet of Things physical medication compliance tech with my team at iRxReminder and colleagues at Videra. We are enrolling in a study at Fermata in New York and other sites. Thanks for reading.This article is another in my series about one drug or another. Prior installments include Depakote, Geodon, Ambien, Prozac, Xanax, Klonopin, Lurasidone, Olanzapine, Zulranolone, Benzos, Caffeine, Semeglutide, Lamotrigine, Cocaine, Xylazine, Lithium, dextromethorphan/bupropion and Adderall, etc.Sponsored Content!One way of supporting this publication is buying stuff from Amazon, like a nifty box from Apogee that I used to record the voice-over: the BOOM. In fairness, it's just the A/D. I am also using the API 512c mic pre, plugged into an AnaMod 660 500 series compressor, nestled in a reliable RND R6 Lunchbox, and all of that plugs into the Boom into my Mac. It's a Microtech Geffel mic. Most of the audio post-processing is done with Izotope RX 10. I get money if you purchase any of these things— not a trivial amount since they upped my affiliate rewards.In case anyone was wondering if I was an audio nerd… This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit thefrontierpsychiatrists.substack.com/subscribe

Updates from the 2023 International Bipolar Conference: Avoid valproate (Depakote) in women of childbearing age; who to blame when patients are noncompliant; and functioning trumps symptom reduction.CME: Take the CME Post-Test for this EpisodePublished On: 08/28/2023Duration: 12 minutes, 20 secondsChris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

This is the 26th podcast episode for the Psychiatric Medication Podcast Series. Series Description: Current literature indicates that podcasts can be an effective educational format to reach health professionals across the continuum of medical education, addressing a myriad of topics pertinent to providers. This episode serves as an overview of Valproic Acid/Depakote. This podcast season is the second released by East Carolina University's Office of Continuing Medical Education and may be beneficial for physicians, residents, fellows, nurse practitioners, physician assistants, and nurses. This podcast season is comprised of approximately 30 episodes, each focusing on different psychiatric medications for the non-psychiatric provider. Those tuning into the podcast's second season will receive a primer on the "bread and butter" behavioral health medications for primary care: antidepressants, antipsychotics, and mood stabilizers. Episodes will be released weekly on Wednesdays.Irene Pastis, MD & Daniel Majarwitz, MD

Consumer Voice has long been concerned with the use of antipsychotics and other drugs in long-term care, as they are too often used as chemical restraints in place of providing adequate care. In this episode, Consumer Voice Executive Director, Lori Smetanka, is joined by award-winning writer/director Susie Singer Carter and former federal prosecutor Rick Mountcastle to discuss their upcoming documentary, No Country for Old People. Susie and Rick are collaborating on the film to promote conversations about the improper treatment and poor conditions many individuals in long-term care endure and spur action to address these failures in care. The documentary was inspired by Susie's mother and the ordeal she experienced in what was advertised as a five-star long-term care residence in Los Angeles. Without Susie's consent, her mother was given Depakote, a medication that was not approved for the treatment of dementia-related agitation. When she eventually came off the drug, which had a black-box warning, Susie noticed her mother's personality return to a limited degree, but her quality of life significantly worsened, and she would never walk again. As was true for many with family members in long-term care, the COVID-19 pandemic drew the curtain on what was really going on, even in reputable facilities. Susie connected with Rick, who led the investigation and charges against Depakote's manufacturer, Abbott Laboratories. Rick is also known for his prosecution of Purdue Pharma and its top executives for the false marketing of oxycontin and their contribution to the opioid crisis in America, as featured in the miniseries Dopesick. After they spoke, Susie realized that the use of chemical restraints in long-term care – as well as harmful neglect of residents – were systemic issues nationwide, not limited to her mother's facility in California. The two teamed up to co-produce the documentary, united in their sense of urgency to make this story heard. Consumer Voice agrees that a culture change is necessary to hold these facilities – many of which receive public funds – accountable for how they treat their residents. No Country for Old People is in development, but Susie and Rick intend to make the film available to as many people as possible. To learn more about the documentary or to donate to its production, please visit act.theconsumervoice.org/documentary.

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Divalproex Trade Name Depakote Indication Seizures, manic episodes, prevention of headache Action Increases the level of GABA (inhibitory neurotransmitter) in CNS Therapeutic Class Anticonvulsant, vascular headache suppressants Pharmacologic Class None Nursing Considerations • May cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis • Increases risk for bleeding with Warfarin • Use caution with MAOIs • Monitor liver function tests

Last week we talked about why you often feel hungry and some ways you can feel more satisfied. And we briefly mentioned that one of the reasons you always feel hungry is that you're taking a medication that increases your appetite.  Today I want to focus on those medications that can cause weight gain and what you can do about it. It's important to remember that certain medications may cause weight gain as a side effect. But remember that not everyone taking certain medications will have the same issues. Some antidepressants and antipsychotics are more likely to cause weight gain than others. For example, a selective serotonin reuptake inhibitor (SSRI) like Paxil is expected to cause weight gain more than Zoloft or Prozac. Also, tricyclic antidepressants (TCAs) like amitriptyline and nortriptyline and medications like Remeron and Lithium cause weight gain.  It's difficult to determine precisely how much weight a person could potentially gain with each of these medications as the amount of weight people gain seems to vary between studies.  If you're experiencing weight gain with your antidepressant or antipsychotic medication, make sure to discuss your concerns with your healthcare provider. Never stop taking your medication without talking to your provider first. Diabetes medications like insulin, glipizide, and Actos can also cause weight gain. This is because these medications cause your body to absorb more sugar from your blood. This extra sugar is then stored as fat. As a result, people on these diabetes medications typically gain 5 lbs to 10 lbs of weight. Steroids like prednisone used to help lower inflammation, can also cause weight gain. However, this weight gain is typically seen when the medication is used for long periods. The good news is most people who use prednisone typically use the medication for a short time, so weight gain shouldn't be an issue.  It's also important to know that weight gain isn't an issue with topical steroid use (e.g., creams or ointments), nose sprays, or eye drops. Typically weight gain is seen when people use steroids for certain inflammatory conditions (e.g., rheumatoid arthritis, cancer patients, lupus).  The medication causes weight gain by increasing your appetite, changing how the body processes sugar and fat, and causing fluid retention. Seizure medications like gabapentin, Lyrica, and Depakote can also cause weight gain. It's unclear why this happens, but it may be due to increased appetite.  Antihistamines used to treat allergy symptoms can also cause weight gain. Medications like  Benadryl and hydroxyzine are thought to make you hungrier and tired, making you less active and gaining weight. What can I do to manage weight gain from medications? Several things to help manage weight gain caused by medications involve healthy lifestyle changes. You can start by following a healthy diet and regular exercise. Your healthcare provider may also suggest switching you to an alternative medication or lower dose of your current medication to see if this helps with your weight gain. What about semaglutide? Let's say you've followed a healthy diet and regularly exercised. And you've talked to your healthcare provider about switching medications or lowering your dose, but you continue to keep the weight on. When these lifestyle changes (diet and exercise) aren't enough to lose the weight you desire, weight-loss medications like semaglutide may be helpful.  Semaglutide can help suppress your appetite and food intake.  Thanks again for listening to The Peptide Podcast, we love having you as part of our community. You can find out more information about semaglutide on our previous podcasts. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! Pro Tips We're huge advocates of using daily collagen peptide supplements in your routine to help with skin, nail, bone, and joint health. But what do you know about peptides for health and wellness? Giving yourself a peptide injection can be scary or confusing. But we've got you covered. Check out 6 tips to make peptide injections easier. 

Episode 80. Learn about lifestyle modifications and medications used to prevent headaches and treat them. Notes about tension headaches:  Medications: Tylenol, Advil, Motrin, or Aspirin. Read the label and talk to your doctor first! Ask your doctor about prophylactic therapy (amitriptyline). Notes about migraine headaches: Medications: Tylenol, Advil, Motrin, Excedrin, Aspirin. Read the label and talk to your doctor first! Ask your doctor about triptans and prophylactic therapy like Topamax, Depakote, beta-blockers, calcium channel blockers, and tricyclic antidepressants. Other options: Botox (Onabotulinum toxin A), monoclonal antibodies (erenumab, galcanezumab, fremanezumab), acupuncture, therapy, and biofeedback Editing Service and One-on-One Consultation for Pre-Med and Medical Students (CV, personal statement, applications): ⁠https://www.fiverr.com/firstlinepod⁠  Visit First Line's website and blog: ⁠https://poddcaststudios.wixsite.com/firstlinepodcast⁠ For a discount off your TrueLearn subscription use link: ⁠https://truelearn.referralrock.com/l/firstline/⁠ and code: firstline Instagram: @firstlinepodcast Facebook: ⁠www.facebook.com/firstlinepodcast⁠ Email: firstlinepodcast@yahoo.com Content on First Line is for educational and informational purposes only, not as medical advice. Views expressed are my own and do not represent any organizations I am associated with.

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/DivalproexDepakoteNursingConsiderations    Generic Name Divalproex Trade Name Depakote Indication Seizures, manic episodes, prevention of headache Action Increases the level of GABA (inhibitory neurotransmitter) in CNS Therapeutic Class Anticonvulsant, vascular headache suppressants Pharmacologic Class None Nursing Considerations • May cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis • Increases risk for bleeding with Warfarin • Use caution with MAOIs • Monitor liver function tests

Katie and Mandy talk with their friend Jess about her mental health journey, from panic attacks to being diagnosed with Bipolar II, and her experience weaning off medication in hopes of becoming a mother. She highlights where God showed up and how her faith grew along the way. 

Rick Mountcastle served as a federal prosecutor for more than 32 years, first at the Department of Justice and later at the U.S. Attorney's Office for the Western District of Virginia. As a senior trial attorney in DOJ's Criminal Tax Enforcement Section, he prosecuted criminal tax cases throughout the United States.  In 1993, Rick was awarded DOJ's highest honor, the Attorney General's Award for the Trial of Litigation, for his work as the lead prosecutor in the trial and conviction of a Russian organized crime leader and his associates for a multi-million dollar motor fuel excise tax scheme, United States v. Balagula, et al., in the Eastern District of New York.  While at the U.S. Attorney's Office from 1995 through 2018, Rick served in numerous roles, including as  a criminal division Assistant United States Attorney (AUSA), a civil division AUSA, the chief of the civil division, the First Assistant U.S. Attorney, the Principal Deputy U.S. Attorney, and the interim U.S. Attorney. He was the lead prosecutor on several high-profile health care fraud cases, including the first Purdue Pharma prosecution (featured in the Hulu series “Dopesick"), the criminal and civil false claims prosecution of Abbott Laboratories for the fraudulent marketing of the anti-epileptic Depakote, and the Universal Health Services, Inc. False Claims Act litigation.  Rick previously served four years as an active duty Army JAG officer and 24 years as a National Guard and Army Reserve JAG officer.

Rick Mountcastle  is not only an Assistant Attorney General for the Commonwealth of Virginia and a Retired Federal Prosecutor, he is a bonafide hero.  Rick, along with his partner, Randy Ramseyer, led the investigation and prosecution of Purdue Pharma, as well as its CEO, General Counsel, and Chief Medical Officer, in an unprecedented case, that, at the inception of the opioid crisis, held the opioid manufacturer and its top executives criminally and civilly responsible for falsely marketing OxyContin.  This case was at the center of Beth Macy's best-selling book, "Dopesick," and the the riveting, IMPORTANT, Hulu miniseries  of the same name that  premiered in October 2021. Rick is beautifully  portrayed  by Peter Sarsgaard. I binged all eight episodes of "Dopesick" which was eyeopening and absolutely horrifying. Showrunner/Executive Producer, Danny Strong,  did an amazing job putting faces on the opioid crisis, as well as the crusaders who relentlessly pursued "Big Pharma".  (One being our guest, Rick Mountcastle.)I was already blown away by Rick and Randy's passionate pursuit in taking down Purdue Pharma, but I literally gasped out loud when it was revealed in the last episode that they were going to go after Abbott Laboratories for falsely marketing  Depаkote, a drug that is meant to treat epilepsy, and tаrgeting nursing homes to treat agitation associated with Alzheimer's and dementia.  Depakote is the drug responsible for rendering my otherwise healthy mother non ambulatory and incontinent in a matter of seven days.Rick led the investigation and prosecution of Abbott Labs which resulted in criminal and civil penalties totaling $1.5 Billion (at the time the largest pharmaceutical settlement involving a single drug in U.S. history).  I had to thank him.  I did and asked if he might share what he had learned while investigating Abbott. Turns out Abbott Labs are not the only pharma targeting the under-staffed and over-worked nursing homes. Listen or watch this episode and TAKE NOTES. And HUGE thanks  to my special guest co-host, Trish Humenansky-Laub , Founder of Comfort in Their Journey LLC, guiding: Alzheimer's

Disclaimer -  “All of the statements and comments in this podcast episode are Rick's personal views and opinions and are in no way related to his current position as an Assistant Attorney General."DOPESICK! / The Hulu Original Series out now features the investigation and prosecution of Purdue Pharma, its CEO, General Counsel, and Chief Medical Officer.Rick Mountcastle led that investigation and prosecution at the inception of the opioid crisis and he joined us on the show! This unprecedented case held an opioid manufacturer and its top executives criminally and civilly responsible for falsely marketing OxyContin.Rick also led the investigation and prosecution of Abbott Laboratories for its false marketing of the epilepsy drug, Depakote, resulting in criminal and civil penalties totaling $1.5 Billion (at the time the largest pharmaceutical settlement involving a single drug in U.S. history).Today, Rick is with the Virginia Attorney General's Office, currently working to address the opioid crisis by conducting parallel criminal-civil investigations of health care providers who prescribe controlled substances without legitimate medical purpose.Support the show

Rick Mountcastle is an Assistant Attorney General for the Commonwealth of Virginia and a Retired Federal Prosecutor.   Operating from a small, satellite U.S. Attorney's Office in Abingdon, Virginia, Rick led the investigation and prosecution of Purdue Pharma, as well as its CEO, General Counsel, and Chief Medical Officer, in an unprecedented case, that, at the inception of the opioid crisis, held an opioid manufacturer and its top executives criminally and civilly responsible for falsely marketing OxyContin. (This case was at the center of Beth Macy's best-selling book, "Dopesick," and the Hulu television series of the same name that first premiered in October 2021.)   After moving to the US Attorney's office headquarters in Roanoke, Virginia, Rick led the investigation and prosecution of Abbott Laboratories for its false marketing of the epilepsy drug, Depakote, resulting in criminal and civil penalties totaling $1.5 Billion (at the time the largest pharmaceutical settlement involving a single drug in U.S. history).   As acting/interim U.S. Attorney from January 2017 through April 2018, Rick led the federal response to the violence at the Charlottesville Unite-the-Right rally on August 12, 2017, personally directing the opening of the federal civil rights investigation of Heather Heyer's killer and other violent extremists, ensuring that the federal case was staffed by the office's best attorneys, coordinating with the local prosecutor's office, and coordinating with the Department of Justice's Civil Rights Division and the Federal Bureau of Investigation. He also initiated the federal-state task force to address gang violence in Danville, Virginia, resulting in the return of federal indictments against members of two violent gangs.   Now with the Virginia Attorney General's Office, Rick currently works to address the opioid crisis by conducting parallel criminal-civil investigations of health care providers who prescribe controlled substances without legitimate medical purpose.   In our conversation, Rick shares insight from the Perdue Pharma case and speaks to the larger issue of corruption and how that led to America's addiction epidemic. We also discuss the negative impact of stigma toward those who struggle with addiction as well as the importance of prevention and education. Resources mentioned in this episode: BOOK: Empire of Pain by Patrick Radden Keefe SAMHSA Helpline: 1-800-662-HELP (4357)      

INTRODUCTION:Mercedes Killeen is a Toronto based award-winning professional author, editor, and blogger with over 12 years of professional writing experience. Her work has been published widely in places like Shameless Magazine and The Financial Diet. She's released two collections of poetry, Tulips (2016, 2018), and Using a Spoon as a Knife (2020), with Grey Borders Books. Mercedes is openly queer and interested in discussing LGBT+ topics, as well as mental health advocacy/sobriety.INCLUDED IN THIS EPISODE (But not limited to):·      A Breakdown Of Some Original Poetry  ·      LGBTQIA Terms·      Identity Fluidity ·      Cougar Confessions·      Coming Out·      Catholic Cuntiness·      Family Religious Fuckery·      Mental Health Struggles·      Daddy Issues·      Substance Misuse·      The KONMARI METHOD CONNECT WITH MERCEDES: Website: https://www.mercedeskilleen.comEmail: mercedes.killeen@gmail.comUsing A Knife As A Spoon: https://amzn.to/3pyZhaNTulips: https://amzn.to/3rPs6CD MERCEDES' RECOMMENDATIONS:·      LGBTQIA DEFITNITIONS: https://bit.ly/3pF7wST·      THE KONMARI METHOD: https://bit.ly/3pz3jA5 CONNECT WITH DE'VANNON: Website: https://www.SexDrugsAndJesus.comYouTube: https://bit.ly/3daTqCMFacebook: https://www.facebook.com/SexDrugsAndJesus/Instagram: https://www.instagram.com/sexdrugsandjesuspodcast/Twitter: https://twitter.com/TabooTopixLinkedIn: https://www.linkedin.com/in/devannonEmail: DeVannon@SexDrugsAndJesus.com DE'VANNON'S RECOMMENDATIONS:·      Pray Away Documentary (NETFLIX)o  https://www.netflix.com/title/81040370o  TRAILER: https://www.youtube.com/watch?v=tk_CqGVfxEs INTERESTED IN PODCASTING OR BEING A GUEST?:·      PodMatch is awesome! This application streamlines the process of finding guests for your show and also helps you find shows to be a guest on. The PodMatch Community is a part of this and that is where you can ask questions and get help from an entire network of people so that you save both money and time on your podcasting journey.https://podmatch.com/signup/devannon TRANSCRIPT:[00:00:00]You're listening to the sex drugs and Jesus podcast, where we discuss whatever the fuck we want to. And yes, we can put sex and drugs and Jesus all in the same bed and still be all right. At the end of the day, my name is De'Vannon and I'll be interviewing guests from every corner of this world. As we dig into topics that are too risqué for the morning show, as we strive to help you understand what's really going on in your life..There is nothing off the table and we've got a lot to talk about. So let's dive right into this episode.De'Vannon: Good day to you all. And thank you so much for joining the sex drugs and Jesus podcast. Again this week, I appreciate each and every last one of you immensely today, I'm talking with Mercedes Killeen, who was based out of Toronto. She is openly queer. She is in love with herself and she is here to help you get more in love with yourself too.She has blessed the world with two poetry books. One is called tulips and the other one is called using a spoon as a [00:01:00] knife ain't that a hell of a title in in both of those books, she really gets into some interesting poetry that has a strong sexual and religious nature to it. And I found it to be quite fascinating.And in this episode, we'll talk about coming out mental health struggles, something called the KonMari method. And we'll also talk a little bit about. How I'm enjoying becoming a Cougar as I approach 40 years old. Thank you so much again for listening and I hope you enjoy the episode.Mercedes, welcome to the sex drugs and Jesus podcast today. How the fuck are you feeling? Mercedes: I'm doing okay. I'm doing okay. How are you?De'Vannon: Oh my God. I'm just grand and fabulous on a Friday afternoon. I love your, I love your name. Mercedes reminds me of that song. I think it's from the eighties or the nineties. And it was do you?on a ride in my Mercedes Mercedes: Well, I don't think I've heard that one. [00:02:00] Oh, I need to check it out.De'Vannon: and the hook. And then she goes, do you on a ride in Mercedes boy this she's like, right, bro, you got your whole song out there. Mercedes: I don't even know. Yeah. De'Vannon: Well, now you now that's your homework. All right. I'm super excited today to be talking with you. You have such a youthful energy and a strong literary angle that you're bringing to the table. You know, of course you have your two fabulous poetry books using a spoon as a knife and tulips, and you have a cute website and interesting blog and everything of, so I'm going to give you a moment or two, just to tell us anything else you'd like to like everyone in the world to know about you.Mercedes: Yeah. So I work in marketing, like that's my [00:03:00] day job. But yeah, my passion is writing. So I've been doing poetry pretty much forever since I was super young. And then the past few years kind of transitioned more into like personal finance, blogging. But yeah, kind of both are my passions. And yeah, I, I write a lot about mental health.That's kind of my main topic that I write about. And just, yeah, really trying to break down the stigma surrounding it with my work. Yeah.De'Vannon: No, that's a very, very good. Now I want you to do for us a poetry reading of like your favorite poems , because in researching you, I read where you've had the experience of when you've been out doing a reading or performance of not sure the exact right way to term for it, but UV. That you can motion from the audience that you had people coming up to you telling you their personal stories of addictions [00:04:00] and whatnot after so and no, no people, I didn't warn her shit.And I was gonna ask her I'm notorious on here for getting like musicians and people to just do impromptu performances and shit. And I don't tell them Mercedes: Okay. My books to have them on the side.De'Vannon: she wasn't worn. She wasn't one more that never warned them. This is, this is my way of having fun. Mercedes: So do you want me to just do one phone? Like one of my favorites.De'Vannon: Yeah. Any anyone that you would like to do? I don't care what it is. Just go for it. Mercedes: Okay. Let me just,so this one is from tulips and it's called oral fixation swallow medication. Brush teeth, eat, smoke, a Belmont chew gum, put on lipstick, bite your lip all day smoke another Belmont, eat smoke to [00:05:00] kiss, blow, smoke to swallow medication, brush teeth. So that's probably one of the, yeah, it's more it's dear to my hearts.De'Vannon: Applause applause, applause. You know, we snap our fingers like they do in the speakeasies and so Mercedes: Perfect.De'Vannon: much for that written dish. And I noticed that there was a strong sexual theme in your writings in such. Why might that be.Mercedes: I'm I just feel like I'm just a very sex, positive person. I think it's definitely like a part of my identity and something, you know, loves to talk about. Yeah. You know, like I know, like with your podcasts, from what I've read, like it's very like talking about taboo topics. So that's kind of what I aim to do with my writing is kinda talk about things that sometimes people don't want to talk about including mental health or sexuality or things like that.[00:06:00] Yeah.De'Vannon: And how do you identify sexually Mercedes: Yeah. I I'm queer. I use either queer or bisexual kind of whatever feels better on any given day. But yeah, I liked the term queer. Yeah.De'Vannon: as you identify as like what gender? Mercedes: I identify as a, she, her as a woman. Yeah, yeah,De'Vannon: I can feel you on that. How it feels on that day? I like to be all the letters, LGBTQ I a we'll have them all at the X, Y, Z by the time we're done. And or like how, how God says in the Hebrew Bible, when they, when Moses asked him what his name is, the Lord told him, I am that I am Mercedes: That's me.De'Vannon: trying to put me in a box Moses and get, Mercedes: I love it.[00:07:00]De'Vannon: but he doesn't know, you know, he fell a little different. I was hanging out with my boyfriend and north of Atlanta in his home town, like a week or two ago. And I met some of his hot childhood friends with the first time that we've been together almost three years. Mercedes: Okay.De'Vannon: And one of them, he needs me and I'm fucking with him.And I'm like, he's all like calling me like a sir or something like that because I'm a Cougar, you know, my board was like 24 and all of his friends are like in the, I think the low to mid twenties. And I was just getting my jolly life, just all the young masculine energy. And so I'm a total succubus.And and I was like, no, call me ma'am. And he couldn't like, it didn't click in his head. And he just kept like wanting to like, not today. My eyebrows are waxed perfectly. I just left the salon and everything like that. And now today he is a she.Mercedes: I love it. Love it.De'Vannon: And so how do you feel about [00:08:00] the way we can, you know, choose to identify and everything? You know, a person might want to feel like a man the day, like a woman tomorrow. Maybe they want to be. Non-binary today, maybe they might, you know, get a sex change, you know, is this, you know, does this, you know, is this a confused of the thing or is it good that we're able to explore?What do you think. Mercedes: I think it's a beautiful thing. Yeah. Like that fluidity. I, yeah, I think it's a great thing. Like if more people feel more comfortable to be more fluid in, you know, their sexuality or their gender identity, I think that's only a good thing. Yeah, we shouldn't be, have to put people in boxes, you know, be, feel different day-to-day and your identities can change too.De'Vannon: Absolutely. And there's people out there who had never gone to accept that. And that's okay. What we're creating here, safe space and safe community so that people know that they are not alone. [00:09:00] So there, you know, if there's anybody out there who, some days you feel like the man, some days you feel like a woman, honey, you, my favorite line from the movie girls trip you know, you really can have it all. Mercedes: Yes, yes, De'Vannon: you reallyMercedes: can. Yeah.De'Vannon: it. You say, Hey man, Oh, wow. Mercedes: Oh, sorry. Did you say, do I say, or can I sayDe'Vannon: I thought you had just, I thought you had just given me an amen? here on a Friday,Mercedes: amen? Sorry. I didn't, I didn't mean to turn you down. I thought you said, do you say it, like, do I say it normally?De'Vannon: because you do have some, some church references that we're going to get into when I talk about one of the points there in the moment. So, so that's that's all very hella hella. Cool. So Demi sexual is a term I recently discovered, and I think that it's. Sexy. And I think that I'm in that category too.And a demisexual [00:10:00] person is somebody who can be attracted to any, any kind of pansexual transsexual doesn't matter. But the, the, the, the hook there is that we have to have some sort of emotional connection with not saying we're going to run off in Mario ass, but we're saying we do need to know at least your name and maybe like some of your ambitions in life before you stick it in Mercedes: yeah, yeah. I can feel that. Yeah. Yeah. I can understand that.De'Vannon: which, which gets away from meaningless sex in your and one of your points. You talk about how you like that in a way to, with everything that you are no apps, and you get annoyed with this, and you're annoyed with that. And you mentioned that you were annoyed with the absolutely. And because of how casual sex can be or what, what was it exactly about it? Mercedes: I just, I find dating [00:11:00] exhausting. I find, I find the whole thing. Exhausting. And yeah, I mean, I don't really Yeah. I, I don't really, like sometimes I will just have casual sex and link. That's cool. So I wouldn't say that's like really what annoyed me about the apps? I just, I dunno, it's just a lot, like, you know, the messaging and then the, you know, meeting up or doing now zoom calls or whatever.It's just like, it's a lot, it's like going on, like job interviews or something. It's a lot of effort. De'Vannon: Okay. Mercedes: Yeah.De'Vannon: Okay. Yeah. I hadn't been single in a long ass time, but I remember the, it was exhausting. You're like, you know what, I'll just back into masturbate, play with a couple of dildos tonight and call it a day. Mercedes: Really.De'Vannon: So, what do you feel like are some of the issues facing the LGBTQ plus alphabet mafia community? Mercedes: Yes. [00:12:00] Something that I've experienced a little bit is like, kind of like BI erasure or like femme or Frasier with like people just because I present as more as like a femme, like woman you know, people kind of assume that I'm straight. So like, even when I've gone to LGBT plus plus events people would just be like, oh, are you like an ally or something?And I'm like, no, I'm an ally. Like I'm super gay. But it's just like, I do encounter that a little bit with, with presenting more as like a traditionally feminine kind of presentation.De'Vannon: That's interesting. No, so that the, does it make you feel bad or offended? Like how do you feel about that though? Mercedes: Yeah, it just I don't know, it's, there's so many different ways to be queer or to your part of [00:13:00] the LGBT plus community. So it just give you a little frustrating, like when people will just like assume that I'm straight, just because like, I like lipstick or something, you know? But yeah, it can, it can just be a little frustrating. I've definitely had a hard time, like, like with the mental health stuff, like I have a lot of social anxiety, so it can be kind of, I've found it kind of hard to like find that community like after coming out. But yeah, a lot of that, I feel like it's just my, my social anxiety as well. Yeah.De'Vannon: How did you come out? What was that experience like? And when did that happen? Mercedes: Yeah. I came out about four or five years ago, so I was around like 21 or so. And yeah, it was, I came out first to my friends. And then it came out to my family. But it was definitely like, you know, a little bit later, like a lot of people are coming up quite young these days, so it definitely felt like, you know, I could've come out sooner, but [00:14:00] I was like, you know, like we're, if we're going to get into the church stuff, but I was I was raised Catholic, so I De'Vannon: Oh Lord. Mercedes: Yeah. I had a lot of shame. Yeah.De'Vannon: anything but Catholic. Mercedes: Yeah. I had a lot of shame around my my queerness. Even though I didn't. Pretty much from the time I ever first had memories that I was definitely like, not straight. I just, yeah, it took me a long time to get there to actually like admit it to myself. Yeah.De'Vannon: Okay. So did you come out to your friends first? That's kind of like training wheels or your family, or was it because you were more comfortable with your friends? Why them first? Mercedes: Yeah. I think I was just more comfortable with my friends. I knew it was going to be like super chill. I didn't really anticipate, you know, anyone being like rude about it which they were lovely. And yeah, I wasn't super scared with my family. But yeah, I just felt, felt more comfortable with my friends first.Yeah.De'Vannon: What is it that the Catholic [00:15:00] church told you that made you so uncomfortable with who you are? And I know they say a lot of shit, so just like, just whatever you want to say, you didn't have to tell me the whole Canon. Mercedes: Yeah. I think just basically the idea that, you know, being gay is a sin and you know, you're going to go to hell and, you know, just generally portrayed as not a great thing. So then when you're a kid and you start having these feelings and you're thinking maybe, you know, maybe I like girls, then, then it's not something you're like really itching to tell people, like, it's something you're like, okay, maybe this is something I'm going to like, keep to myself, like, I'm going to, I'm going to keep this one under wraps.And yeah, I, I would kind of a unique position because one of my uncles is gay and like has been openly gay since I was a kid. So I knew, like I had a member of my family who like had a husband and was like out and proud and everything. And my parents were. Very accepting of him. So I didn't have from my family, [00:16:00] those messages of like being gay is bad or anything like that, but it was more like internally.I was just didn't want to talk about it.De'Vannon: Right.in. You know, churches like that are very abusive. In my opinion, the people who are, you know, LGBTQ I'm a big proponent, you know, and I've said it before, and I'll say that, but Julian times are people non straight people, stop going to churches that do not celebrate you. Mercedes: Yeah.absolutely.De'Vannon: You're doing yourself a disservice.And let me be clear this whole what's the bullshit they tell us. We, we love you. We just don't love the sin. That, that buttery, that that's like a fuck that too. We're we're, we're, we're moving beyond going to places where we're just merely going to be tolerated or partially accepted and all of that.Now you there [00:17:00] player, there are spiritual institutions out there. That are fully LGBTQ plus affirming who accepts you or however many of you, all the interrelationship, however you identify it doesn't matter. Your gifts are celebrated. The wholeness of who you are, those are the, is what's accepted. Those are the sort of places that you want to go stop going to churches that preach against your lifestyle.That was uncomfortable for them, but don't give them our money. The gay dollar is strong. They don't deserve one fucking penny. And you're just, you're just doing a mental, mental, you're hurting yourself mentally by going in a place like that. And, and look, I know your parents have had to, or trying to influence you.And that happens a lot in Catholicism. People are like, okay, we are a Catholic family. And so you must do this. I don't believe religion is something that's supposed to be inherited from family. I think that it's a personal journey and each individual person should find their own path. [00:18:00] So I would like to.Release people today from the bondage of feeling like you have to be whatever religion that your family is, and that's the bitch to break away from. I know it's difficult, Mercedes: Yeah.De'Vannon: but I am gonna say this. And then I'm Michelle, shut the hell up. I just think the Catholic church has balls at you fucking big. They just come up with shit on their own.Like they say, somebody commit suicide. Then they have to go to hell. Mercedes: Right.De'Vannon: You know, who came up with that? That's not in the Bible, Mercedes: Yeah, De'Vannon: but what are your thoughts on some things like that? The Catholic church says, and the influence that family has over people's religious choices. Mercedes: I I'll just say I'm not a fan of the Catholic church either. I went to Catholic elementary school, Catholic high school, like I was in it. So yeah, it's not [00:19:00] something, I mean, if someone really feels called and is like, You know, the core values, you know, the they're able to bring that into their lives and be loving people like you know, you do you, but it's not something I would ever, yeah.I want to support myself after having been in it for so long. Yeah, I think there's, yeah. Other, other ways to like, find out how to be a good person or to find meaning other than religion. But yeah, it, it's hard. It's tricky with the family piece, you know, it's hard, it's, it's such a cultural thing and yeah, it can get tricky.Yeah.De'Vannon: And then when the thing about it, that was when we. Di transitioned into our spirit forms and we stand in front of our creator. You know, our families are not going to be there with us. You know, it's, it's going to be very much a personal conversation about how we lived our lives and mom and dad and sister and brother, and for God's sakes, not the preacher or the pastor, the Cardinal know they alone.They ain't [00:20:00] got shit to do with it unless they told you wrong and led you astray, but then that'll be a part of their own judgment, but the shit was no different in the Pentecostal church where I grew up at everything was a sin with them, dancing, drinking, smoking, masturbation, you know, wearing the women, wearing too much jewelry, you know, every damn thing.And so it was this bad, bad, bad, bad, bad. So it's no surprise that, you know, you have your own history of mental health struggles. I do. Mental health issues are a big fucking deal in the, in the gay community. It's this like ridiculous. And our suicide rates are through the roof and, you know, our. You know, people cutting themselves and hurting themselves, you know, or in various different sorts of things, you know, where is this coming from?You know, what do you think Mercedes is? We, we, we weren't born with the inclination to not like ourselves. Where the fuck, where do do you think we're getting this from. Mercedes: Yeah, I think it's something learned. Like I definitely, [00:21:00] you know, didn't like, I don't think I like was born thinking that my queer identity was something bad or inherently wrong or that I needed to hide or that was shameful. But yeah, it's definitely something that you pick up. I mean, I would say even outside of the church, just our culture, every culture in general, just growing up, I, I didn't feel. You know, to me, I didn't feel like being queer was something that I don't know. I didn't see it being celebrated or being portrayed you know, in popular media and things like that. So I think just over time, I just kinda, yeah. Developed, yeah, just like this shame and like, just not wanting to talk about my queer identity, even though I was very, very accepting of other people being queer or, or LGBT plus or whatever.For some reason I felt like it wasn't okay for me, like to be queer.De'Vannon: Well, it is very okay for you to be queer. I accept you for who you are on whatever day of the week. It [00:22:00] might be who or whoever you might be that weekend. And I love your variety. Mercedes: Thank you. Appreciate it.De'Vannon: Oh, anytime sugar. So your book using a spoon as a knife why did you call it that? What would make you name your book that. Mercedes: So it's a very particular thing. I when you're in the mental hospital in a crisis unit a lot of the times they won't give you knives when they serve you your meal. So I had like just this vivid memory of like sitting there and being in a mental hospital in a crisis area, trying to cut a piece of meat, like two little plastic spoons. And it's just like this like weird image or whatever where it's like, you know, you just don't have your humanity, you know, you're not even allowed to have a knife. And I understand [00:23:00] why for safety, but it's just a very dehumanizing experience to be sitting there, like trying to cut through a piece of meat with a spoon.De'Vannon: Oh, Yeah,I've been in a couple of those mental hospitals, myself, you know, no shoestrings allowed making macaroni art, that type of shit. Mercedes: exactly.De'Vannon: But tell me what led you to the mental hospital? How many times have you been in one? Mercedes: A lot, I'd say like 20, 30 plus times. Yeah, a De'Vannon: Ah, okay. Well that blows my two or three trips out the water. Mercedes: Yeah. It's been, it's been a journey.De'Vannon: Okay. Well, give me like your most dramatic story that landed you in the mental hospital. Mercedes: Honestly every time was basically the same as I just get suicidal. And that's usually what sent me probably the wildest one was like me ending up there after. necessarily attempting [00:24:00]suicide, but just like drinking to the point where like, you know, that could have been possible, like just drinking an insane amount of, of like whiskey or whatever. So just like being there and, you know, just vomiting all the time that I'm there and trying to talk to like the nurse or whatever. And I'm like having her run to the bathroom, I'm just like dying. That was probably one of the more wild times. Yeah.De'Vannon: You tried to pull an Amy Winehouse girl. Mercedes: Yeah. Yeah. It wasn't good. It wasn't good.De'Vannon: Oh my God. But I bet you felt so like Ben and detox after all that and vomiting. Mercedes: Oh my God. It was, it was wild. And even after that, I didn't get sober, which is like insane. Like I literally almost died and then it was like, not, no, like next weekend, let's do this again. Like let's, let's drink again. Like it's, it's wild.De'Vannon: That's how it goes, you know? And, and so alcohol was your, as, as I guess we would say [00:25:00] drug of choice, so no, hard drugs for you or nothing like that.Mercedes: no no, other than that, I just like, I smoke weed. I have, I finally got a prescription for it, so I do it like with a doctor and everything now. But yeah, mainly it's just that I've done like some shrooms and stuff like that. But nothing else. Alcohol was the only one that was like really, really like destructive in my life.Yeah.De'Vannon: I don't mean you enjoy your week prescription to the very last drop. Mercedes: Yes.De'Vannon: So, so in, in using spoons as a knife, you opened with like several different disorders. So I was curious. If this is everything that you're diagnosed with. Mercedes: Yeah. You got it.De'Vannon: Okay. So let me, let me read this to everyone, because this is quite an impressive list.Mercedes: Oh no. Oh no, De'Vannon: Is that okay if I do that? Mercedes: that's fine. That's fine.De'Vannon: So well, Yeah,I guess so. Cause it's already published.Mercedes: Yeah,De'Vannon: So [00:26:00] this seat go y'all Mercedes has, has triumphed and overcome over generalized anxiety disorder, persistent depressive disorder, major depressive disorder, substance use disorder, borderline personality disorder. And then, then you also threw in daddy issues, which I don't think is an official clinical diagnosis or is it,Mercedes: I don't think so, but it's, De'Vannon: might be. Mercedes: it's a thing.De'Vannon: So tell me about the daddy issue. This is what I want to know about. Mercedes: Oh man, it's hard. Yeah. So I dunno, I feel bad cause like my dad and I are in a much better place now. And I are very close and, you know, have gotten through a lot of stuff, but there was some, you know, emotional abuse growing up which was yeah. For my dad and yeah, it, you know, it's not something easy to deal with.De'Vannon: [00:27:00] Just what's. So tell me what had happened. Give me an example of. Mercedes: oh, I feel so bad. Cause like M and I are closed now. I don't wanna be like, just bashing De'Vannon: oh, I'll go first. Me and my dad have a better relationship now, but that doesn't change the fact that he was a total whore. So when my mom was pregnant with me, he went off and fuck some bitch. And then when I was in the eighth grade, he fucked some other bitch. And then he ended up in the mental hospital because the Heath, you know, when it all came out and everything like that, and it was all very dramatic and he tried to turn it around, you know, make, it makes me like it was my mom's fault.He would yell at me in front of school. He would come and yell. Like it could be like hundreds of people in the auditorium and he would come and yell and dragging me out and everything like that. I would get beatings with a belt. One time he beat me so hard that my inner forearms was swollen. And my grandmother had to put like what rags on it to try to get the swelling to go down, you know, we're in.And then we finally had a [00:28:00] falling out one night. I was trying to buy me some crack rocks across the street from where they live and everything like that. And so he was leading at his driveway to judge me when I came out from the crack house and I was like, oh no, no, no, no. no. Adulterer , you know, you're not about to throw stones in this glass house, bitch, you got me fucked up.Mercedes: Yeah.De'Vannon: So, and so we're in a better place now, but you know, he feels like he's overcome his issues and he should be able to talk about them publicly in my opinion. But you know, I won't force you. I just wanted to break the ice. So, but you don't have to talk about your dad if you don't want to. Mercedes: Yeah. I feel, yeah. I'm sorry. Yeah.De'Vannon: Okay. No problem. So, so let me see. So then let me ask something in a different way, the end, because if you wrote, if it was important enough for you to list in your book within, it was meant to be written for [00:29:00]Mercedes: Yeah.De'Vannon: a reason. So what, what do you feel like the points, you know, the sections, you know, why didn't you list that?What are you trying to help people like what's the, what's the end game of mentioning it, mentioning it at all. Mercedes: The daddy issues. De'Vannon: Yeah. Mercedes: Yeah, I mean, you know, it's, it's something that a lot of people deal with. Like whether it's daddy issues or mommy issues, or, you know, it's, it's something that a lot of people, you know, have troubled relationships with their parents and yeah, it can have a huge impact on your life and you know, can make things really difficult. So I think it was, yeah, it was just something I was dealing with at the time and trying to work through and, you know like having those types of issues, like, you know, it changes the way that I relate to like men and especially like older men and looking for that like older male attention sort of thing. So it's like, it's [00:30:00] definitely shaped my journey in some ways. So that's kinda like why I did I did include it and why it has been a big part of my writing in the past. Yeah.De'Vannon: Okay. So you're saying due to the fracture relationships we have with our parents, that could cause us to act out in different ways. Mercedes: Yeah. De'Vannon: Okay. I can feel you on that. I think that when I was in the military, I slept with very, very masculine men trying to feel that void. And I think I knew I was doing it at the time.I mean, and, but you know, it never really fixed anything. Mercedes: Right, right.De'Vannon: So how did you finally get sober? And then what, what is your definition of self. Mercedes: Yeah. So I'm sober, like just from alcohol, like that's the only thing that I really track my sobriety from or whatever. But I think like sober can mean different things to different people. For some people it might be from like any mood altering substance for [00:31:00] some people, it might just be one specific substance, you know, like everyone's kinda got their own take on it or how they kind of identify. But yeah, for me, I, I stopped drinking alcohol. Finally just yeah, after getting to a point of realizing, you know, this is really isn't getting me anywhere. And you know, it, yeah, it was just making everything worse, like in terms of the mental health issues and things like that. It, you know, it just got to a point where, you know, you get, you get tired of your own shit and you're like, you know what, like this needs to stop.Like I need to, I need to cut this out. So I was eventually able to get sober. I'm about two and a half years sober now from alcohol, but.De'Vannon: Did you do any sort of program that you do, like a harm reduction or did you do a, like a rational recovery or did you just do it on your own? Mercedes: Yeah, the weird thing is for me for the longest time, like all of the [00:32:00] doctors in my life and all the mental health professionals were like, oh, you need to stop smoking weed. Like, this is, this is your problem. And nobody was concerned about the alcohol use. Cause it was just kind of on the weekends. And I'd be like blacking out on the weekends and stuff, but nobody was really concerned about the alcohol.They were like, oh, you're smoking weed. Even though it was like to cope with like a lot of things. And so I was told like, you need to quit weed, you need to quit weed. And then eventually like once I got. The weed, like prescribed by a doctor and I'm like, okay, doing this methodically, then I'm like, okay, I don't actually think this is the problem here.Like, there's like, why am I blacking out every single weekend and doing this to myself and, you know, getting myself into all these situations. And it's like, that's actually more destructive than anything. So it kind of took a while for me to be like, oh, okay. I need to like, actually be focusing on this alcohol piece because this is not, not helping anything.De'Vannon: So, how did you focus on a, did [00:33:00] you start drinking less every week or. Mercedes: I quit cold Turkey. I, I just quit. Yeah. Because I wasn't and I'm in therapy, so like that's a big piece I'm in therapy. You know, I'm on like a lot of different mental health medications that helped me. I tried doing some 12 step stuff. It really. With me anything like religious I'm like, no, I can't, I can't do it like anything with the prayers and everything.It was just like, no, it's not for me. But yeah, just generally just doing doing therapy and yeah, just basically just getting fed up with my own, you know, shit and being like, I really need to get this under control kind of thing.De'Vannon: Do you feel like the weed with kind of like helps you to get off of the alcohol? Mercedes: Yeah, I think in general, the weed just helps. Like for me personally, like with my [00:34:00] case, like, it just has been very helpful for me. It has helped me get through a lot of things. I don't know if I would be here without that coping mechanism and something that really, really helped me when I was extremely suicidal. And then yeah, actually doing it in a more methodical way, the weed, then it just kind of led me to reassess substances in general. And then I, yeah, I was kind of looking at the alcohol piece a little more critically.De'Vannon: What's your telling me found, have you heard of harm reduction before? Mercedes: Yes. Yeah.De'Vannon: Would you say that your story kind of somewhat kind of sounds like that? It cause a little bit, cause like, from my learning of harm reduction, it's like it's like the. Like you might trade off, like something that you like, maybe you might trade heroin for weed, you know?So you'll do like a less severe thing or maybe you do what you're doing, but less of it. So it almost sounds like, and I [00:35:00] don't think like harm reduction is like swapping addictions or anything like that. I don't, I don't think that, I think that it is what it says that it is. So that's what it kind of sounds like to me.So for other people out there who have found the dead end at the 12 stuff program, that's why I'm, you know spending some time here. I agree with you about the 12 steps, the spiritual aspect doesn't bother me about it so much as the other holes that I find in it. Like the fact that they don't define alcohol.And I mean, sorry, they don't define tobacco and cigarettes is mood and mind altering substances. Mercedes: Oh, okay.De'Vannon: Like Yeah.they are. So, okay. So does I'd like to get out of your experience, some sort of recommendations for other people who have met a dead end at 12 step programs so that they, because they're marketed, like they're the only thing out there, but there are other stuff, but they're not as well [00:36:00] known as in, but 12 step we're talking about like alcoholics anonymous, crystal meth, anonymous, sex anonymous, all the whole anonymous movement, which they all stem from AA, which is a totally, a very churchy spiritual program, Mercedes: right.De'Vannon: kind of like anti women too, like the way it was originally written. Mercedes: Yeah.De'Vannon: And so, so what, what would you say because you, to, to people out there who may want to overcome something, and I know everybody's different and maybe the 12 step program didn't work for them and they didn't think there was anything. Mercedes: Yeah. I think, you know, there's so many different ways to get sober and to go on your intake and to, or to, you know, do harm reduction or whatever you want to do. Like whether you're completely sober doing harm reduction. There's so many different ways to get there and yeah, 12 steps is not the be-all end-all you know, yes.If it helps you like more power to you, but for me, it, it, I didn't [00:37:00] identify with it. It didn't work for me. It wasn't my sort of thing. And there are other ways to heal and to get better for me. Doing therapy, you know, for many years has, has definitely been helpful. Something else I find useful is like doing yoga, things like that.Like, I guess that does have its own spiritual element to it. But just like anything like anything that is like helping your mind and your body and you know, anything that is just really helping you heal. There's, there's just so many ways to do that. So, you know, don't feel like discouraged if 12 steps doesn't really feel right for you.Like you can go on your own journey and you can find things that work for you.De'Vannon: In one of your blogs on your website, you mentioned that the con KonMari KonMari Mercedes: Yeah.De'Vannon: method that you use. So can you explain to us what that is and how it helped you? Mercedes: Yeah. So Marie Kondo who wrote the life-changing [00:38:00] magic of tidying up? I read that book, I guess it would have been, I don't know, maybe three or four years ago. And before that I was. Such a hot mess. Like my, if you look to my room, you'd be like, I dunno, what's going on? You know, I was like, it was, it was just, everything was like super messy and like chaotic and just not good. I had so much just stuff that I didn't need. And you know, and it's stressful, like to be like living in an environment that's like super or it was for me, like it was stressful to be in an environment that was like cluttered and like, you know, just, it was hard for me to find something if I needed a document. So eventually I read her book and kind of went through her method which is basically going through everything you own by category and then asking yourself with each item does this spark joy in my life. And then if it does you keep it. [00:39:00] It doesn't and then you get rid of it. So I got rid of like a ton of like clothes, books, you know, papers, just random things that were just cluttering, like my, my space. And I was moving to an apartment, like quite a small apartment, so it was like just trying to downsize everything. And it was like, surprisingly. Yeah, like literally life-changing like, I didn't think that the title would be like that true, but it was yeah, it was just, I didn't, I wasn't ready for how, like how helpful it was mentally, like just to be living in like a nice clean space where like, I could get things.If I needed a document, I knew where it was. And yeah, it just really helps me like kind of streamline my whole life. And I found that it helped my mental health a lot in turn.De'Vannon: When I read through it, it seemed like very rigid Mercedes: Yeah. De'Vannon: hours. And then it kind of reminded me, it kind of almost sounded like [00:40:00] some sort of like re rehabilitation program and also kind of sounded like I was back in the military again, Mercedes: Okay.De'Vannon: because, you know, she was getting into like, Folding clothes, you know, and doing things and, you know, and being very, like, not flexible about it.Like there really isn't a lot of room in it for like your own twist to Mercedes: Yeah. Yeah. So it wasn't good for you. Like you, you weren't interested in it. Yeah.De'Vannon: Oh, I just researched it when I was researching you. I'm Oh, oh, okay.that part of the military I still have with me, I'm very much like a neat freak. I'm organized. I got, got shit where it's supposed to go. And if I don't, they told me that in the military, you're not using it. You can get rid of it. Mercedes: Yeah.De'Vannon: so that that's not a, you know, clutter is not an issue for me, you know, not even the least, but but you know, everybody's different, you know? So did you feel like when you were growing away, something that [00:41:00] didn't spark you, do you feel that maybe as you were clearing that out, you were clearing out emotional baggage as well? Mercedes: probably. I mean, I think, yeah, for me it was just, it was just really helpful. Yeah. To just kind of, yeah. I don't know. I guess just finding more space, like literally, and just, you know, trying to keep things in my life that are really valuable to me and that, and that bring meaning to me. Instead of just like buying a lot of stuff that isn't really important.And I think like, I guess you could relate it to the process of like, even like getting sober later on where you kind of. Going through your life and, you know, even going through like relationships and being like, does this relationship really bring meaning to my life? Like, I don't know about you when I got sober.I was just kinda like, oh my God, like half these people in my life. I don't even know if we [00:42:00]have anything in common. Like when we're not drunk, like, it was like, oh my God. Like, it was really wild. So I think like maybe there are some parallels to draw with that as well.De'Vannon: So, did you clear everything out at once or was it like a gradual process? Mercedes: a big thing. It was, I did it all at once. I'm very like all or nothing. I like. Yeah.De'Vannon: Is that, is that the way the con mark met the recommends to do it all at once? Mercedes: I can't remember if there's like a specific timeline, but the basic idea is that like you do this. Purge or whatever you, you, you like evaluate all of your, all of the items that you own and you get rid of what doesn't spark joy. And then the idea is that then you never really have to do this again because you've done it.You've cleared yourself. And then when, like, when you are like purchasing a new item or like bringing something into your home, you're kind of a little bit more discerning of like, okay, is this actually important? Do I actually need this? Is this bringing meaning to me? Or can I [00:43:00] like donate this or recycle this?Or, you know, whatever. So I found like, yeah, it, it influenced like kind of how I felt about bringing stuff into my home as well.De'Vannon: As we're talking about this, I think about like how they have the the hoarders and stuff like that, the on TV and stuff. And when they try to take things from them, they break down and cry and throw like a whole fucking tantrum and everything like that because they seen the Hampson. Emotional attachment to this thing, or maybe having all that stuff is like maybe comforting to them on some level.And they really fucking hate to let it go. Mercedes: for sure.De'Vannon: I wonder, did you cry when you got rid of anything, Mercedes: No, I was just, honestly, I was kinda like, I dunno how I let it get to this point. Like, I wasn't like a hoarder by any means, but it was just like a bunch of crap that I just didn't need, like clothes. I didn't wear like things. I didn't use like books. I was never really going to read or reread. And it was just [00:44:00] kinda like, I just felt like, kind of like upset with myself.Like, I don't know why I bought all this crap. Like this is just, I don't know. I was more like, just more critical of myself when I was going through it.De'Vannon: that's your space feel like void and empty when you cleared so much out or that you feel like you could exhale? Mercedes: Yeah. I definitely more like an exhale. Yeah. It was more like, oh, this is, this is nice. Like, this is, this is good. This is, and, and then, yeah, like when you w I found for me, like when I don't have as much stuff, it's obviously much easier to stay organized. So I just find myself being much, much more organized and like this more on top of things and, yeah.De'Vannon: Yeah.it seems like it would be so like energetically speaking, metaphysically, speaking, funks way, you know, speaking, it seems to all be along a good vein of best practices to have more [00:45:00] space in terms of like the living space. Yeah,Then, then what you need, whether it in ticking up all of the space, but everything is like being overextended in debt.You wouldn't want to use, if you have $30,000 in available credit, you don't want to use $29,999 and 99 cents. Mercedes: Yeah.De'Vannon: So this, this, this no different than our living space. You know, we want to have some vacant room, you know, it was better. And when you do that, then you can think better. You can create better, you have better health.In my opinion, I think you sleep better. And in a deeper spiritual sector, there is the belief that like bad spirits, that evil spirits to contend, to congregate like in clutter Mercedes: Oh, okay. De'Vannon: butter. But then when you get the cleaning things out that you get to banishing file spirits that may have set up camp in your home because they liked junk.They don't like clean spaces. Mercedes: Oh, [00:46:00] interesting. Nor thought about it that way.De'Vannon: You know, if it's something I like to put forth. So and so so in terms of the mental health advocacy, so you have your, your books, your blogs. Are there anything else that you're doing that we, that we might need to know about? Mercedes: No, I'd say those are kind of the main things. Yeah, like obviously pre COVID. I would do like poetry readings or like do like talks and things like that. So I, I try to definitely focus on mental health, like in those as well. But yeah, with, COVID not doing a ton of appearances, but but yeah,De'Vannon: we, we will have our day in public again, Mercedes: yeah, one day.De'Vannon: but you know, I commend you on getting two books out there because the, the thing that I love about writing books and. And even doing like my show is that these things will live as soon. Like your wisdom and your stories, your transparency is not to be there to [00:47:00] help the ages, you know, along after your, you know, transition into a butterfly or a spirit or whatever it is that you want to be when you die, then you want to be a butterfly. Mercedes: OhDe'Vannon: Oh no. You're saying like, the hope is for your work to help people. It is, you know, people learn in different ways. You know, some people may not read a memoir or watch a documentary. Some people are very poetry minded. And so they'll also, they'll be able to read like, you know, through your poetry books and stuff like that, and really see themselves.And there's something that's incredibly healing about. Here hearing or seeing, or understanding that somebody else has a similar situation to ours. It doesn't have to exactly mimic, you know, every detail of it. But even if it's remotely in the arena is like it undergirds, you had girds up your strength, you get strength [00:48:00] like in your, in your inner man and a woman in our, however you want to enter, however you want to identify or you like, you can go a little further, you know, Mercedes: absolutely. I've, I've definitely felt that like, seeing other people be open about their mental health, that was how I felt like, oh, maybe I can do this too. Like, it makes you feel a little less alone.De'Vannon: and it doesn't require anybody to give any advice, even though that's not, that's not a bad thing at all, but just some just really knowing you're not alone is super powerful, but a lot of our self-destruction comes from the illusion of isolation. Mercedes: yeah.De'Vannon: 'cause when I got HIV, I was like, have I got, I'm like the only one with this.I didn't know anybody. And you know how fucking far from the truth that is. But you know, like in my head, I didn't think that I thought that I was completely alone and therefore I was ready to die or at least I thought so perception is everything. And, and so that's why you have a [00:49:00] big mouth about what you've been through now.And I have a big mouth about the things that throw it out because we're not going to let that shit happen to anybody else. Mercedes: Exactly. De'Vannon: The, what was the, you were in the mental hospital all of those times. And everything was, if the weed medication that finally got you to a point that you stopped going, or w when was the point that you knew? Okay. You know, you're not, you got to control on the drinking, but what about the suicide stopping?And, you know, when did the, when did the trips to the mental hospital stop. Mercedes: Yeah. I mean, I'm not going to lie. I was literally at the ER last week, but it was my first time in three years. So like in general I have very much stabilized. But For me a big transition was actually getting the borderline personality disorder diagnosis. I thought for the whole time I had been diagnosed, I just thought I had depression and anxiety.And I was like, I don't know why any of this stuff isn't working, like all this therapy, I'm doing [00:50:00] all these medications. I'm on. Nothing is really like cutting it. Like I still want to kill myself. And this is like, you know, it was, it was awful. And it was actually someone like I had dated they had like had studied psychology or whatever, and he just asked me, you know, have you ever heard of something called borderline personality disorder?Cause that kind of sounds like what you're describing to me. And so next time I was like seeing a psychiatrist, I sort of brought it up and they were like, oh yeah, like you, you for sure, like have borderline. And I was kind of like, well, why didn't anyone tell me? And there's like a lot of stigma with that label.So a lot of doctors even don't want to give people that diagnosis. But actually it was like super empowering for me because then I was able to be, to realize what type of treatment was going to be helpful, which is primarily DBT, like a type of therapy. That's for people who have borderline or like intensely suicidal or self-harming. So that was kind of a big shift for me. That was [00:51:00] one of the big things that really helped.De'Vannon: Okay. So then the lesson there y'all is to get a second opinion and a third and a fourth Yeah. because the mental health practitioners are not made equally when it was being seen at the department of veterans affairs, Mercedes: Yeah.De'Vannon: which now I go to have the they are, they pay for me to go to a private civilian doctor because they sucked so fucking bad. Mercedes: OhDe'Vannon: They had me diag on like the 200 milligrams. They have like Depakote and shit like that, a lot of fucking debit code and then come to find out there was no diagnosis in the system and they had me like on two or three different medicines. And then I sat down with a different doctor. Well, actually, you know, one time.And he was like, well, why is all this medicine here? And there's no diagnosis. I was locked up if I know, welcome to the VA. And Mercedes: Yeah. Like it's on my jobDe'Vannon: and so you gotta be that'd be real careful about that if you felt like you're not getting the [00:52:00] best care bitch go somewhere else. Mercedes: a hundred percent.De'Vannon: And okay. So I'm just going to talk about a couple of Cohen's from using a spoon as a knife, I found one called 2016 fusion Shiraz. It'd be very dear to me. You have a couple of them in this book about wine and you know, I'm a red wine girl. Actually I drink Mercedes: Yeah,De'Vannon: especially the red, red wine.It is so beautiful swirls in the glass. Hopefully, hopefully this isn't triggering for Mercedes: No, no, I'm good.De'Vannon: And so, and now you have some parallels in here about the church. You're you, you talk about chugging $8 wine at 11:00 AM, which is happens to be a lot of times some church services starts. I don't know. There was some sort of reference there, you know, you would, or anything about communion to, so are you, are you, there's this poem about you actually having communion at church?Or what, what is what's going on [00:53:00] here? Mercedes: Yeah. So, yeah, it's kind of trying to play on the idea of yeah. Taking wine at church or, you know, drinking wine by myself, in my room at 11 o'clock in the morning sort of thing. And then as we kind of touched on before, there was like a lot of a lot of imagery about like like some type of male figure, I E God you know, me trying to be good enough for him or, you know, just basically seeking that sort of like male approval. So it's, yeah, it's supposed to kind of play around with these themes of like wine and, you know, you know, some type of male figure or like higher power sort of thing, and kind of what I was dealing with in my own mental health stuff and addiction and things like that. So it's kind of trying to bring some parallels between the two.[00:54:00]De'Vannon: Yeah.I'm not a read a bit of that because I like how you sexualize the community and convenient experience.Mercedes: Yeah.De'Vannon: that was chatting $8 bitter at wine alone. 11:00 AM feeling like I'm back at church, gulping wine in the hopes of salvation. Maybe this time he will enter me. Maybe if I break this bread, I will swallow him whole.Maybe if I break myself down, I will be perfect enough for a man to love me. Oh, drink this cup trust in him and you will not thirst. Drink this cup, drink this cup, drink this bitter cup and you will be whole break your body. Break your body, break your each goat, each Gulf each go by. Look to the heavens. I stare at the ceiling like I'm back at charity.I look up with each dove. I look up and wait for this to be over.Mercedes: I need you to do my poetry readings for me because you do them better than me.[00:55:00]De'Vannon: Hey, nothing like a little bit of debris. I'm a girl. I was a little bit of geranium, a. So I touched on this one earlier. I call it annoyed by life. You were just like annoyed by everything. I'll read this into, is it says I am annoyed by life, more than I am depressed by it. And that is a lot more than anything. I am annoyed, am annoyed by the tarmac. I'm annoyed by the people smiling. I'm annoyed by the dating apps.I am annoyed by the sunshine. I'm annoyed by the rich I sleep on a bed made of vomit in GEs. Talk to me about the vomit hinges. Mercedes: This is very literal, literal thing that the condition of my bed of waking up in my own vomit you know, that was like a regular occurrence. Like when I was, you know, addicted to alcohol, it was, it was a real thing. [00:56:00] It was, it was a real occurrence that happened pretty often. Yeah. De'Vannon: That wasn't me. Like some guys, just some other. Mercedes: Yeah. Yeah, yeah, yeah.De'Vannon: So this like matches is full of many different guys come or this like some fresh come, like how was this? Mercedes: Yeah, probably mostly not at once, but over time. De'Vannon: Okay, Mercedes: Yeah. Yeah,De'Vannon: cool. Cool. So why, why ignored by the tarmac? Why the tarmac? I get the people, the sunshine, all of that, especially if you like high as fuck you like damn son go away. But Mercedes: yeah. De'Vannon: the tarmac. Mercedes: I think I was just trying to throw, I guess, some type of different imagery in there. I think just like the idea was basically, yeah, like pretty much everything, likeDe'Vannon: Right. Okay. Mercedes: just existence in general. Yeah.De'Vannon: All right. And then the last one. And then I'll [00:57:00] let you have the last word we've had as we've had a most delicious conversation here. The one called the Blinken blue and pink Paisley scarf. It sounded like maybe like one of your trips to the hospital for maybe a suicide thing. And I'm curious who the guy is.Cause you mentioned, I think it's a male and you talk about how nobody who's nonmedical sees you naked like this. You talk about how he's checking out the nurse, I think, and how he can describe her panties in perfect detail. Once he, when she walks out of the room, it's explained to me what happened that inspired you to write a balloon pink Paisley scar. Mercedes: Yeah. I think you nailed it. That's pretty much the situation. Yeah, bloom pink. The scarf was a scarf that I, you know, would think about hanging myself with. So that's the title of the poem. But yeah, it was some guy I was sleeping with who [00:58:00] yeah. Drove me to the mental hospital when I needed to go and was there with me.And then yeah, with when the nurse left the room, he's talking about, you know, her ass and her, whatever he saw her underwear or something. So you know, not the healthiest,but a yeah. Very literal thing that happened.De'Vannon: It was good with bad, but it was real. baby. It wasMercedes: It was real. Yeah.De'Vannon: Okay, my dear. What what advice would you give to the world? I'm going to let you have our, our, our closing a word here. I feel like we've had a delicious conversation. I felt like people will be helped by your transparency. God knows suicide is such a big issue in the alphabet mafia community. And I'm thankful you've written so much about yours.So what, [00:59:00] what would you say to the globe upon which we live? Mercedes: Well, thank you for this kind words. Sure, sure. I guess just to say that, you know, healing is possible and, you know, even if you feel really like, isn't hope for you and you know, you're trying things and things aren't getting better, you know? Yeah, just healing is possible. Sobriety is possible even when it feels like that could never be a thing for you. Yeah, I think, you know, just hang in there and, you know, try to find some sense of community. Whether that's, you know, friends, family going to a poetry reading or watching a poetry reading, or connecting with some type of music or whatever, you know, that, you know, you can, you can find help and, you know, you can find that connection.And I guess, you know, the things that you, you might feel ashamed of [01:00:00] now, like maybe you're ashamed of mental health issues or you feel, you know, scared to come out or things like that. Like, you know, like it's okay. And, you know, you'll get there eventually. Basically I would say.De'Vannon: And I would say, well said my dear. One thing I did want to point out, you mentioned sobriety and reminded me. So like you said, you were just at the mental hospital a couple of weeks ago, but hadn't been like three years. So in some circles, especially like saying the 12 step circles, they would consider that to be like some type of relapse.I don't, I don't agree with that at all. So I don't consider it like a weakness or anything like that because. I don't, I don't think the whole point, like with somebody who was off of drugs is still, I could never ever do them again. I think it's about knowing where you're strong, where you're weak while you're weak and having a plan in place and working on doing it.So if [01:01:00] you went from, you know, basically getting your mail at the mental hospital to not, you know, being there for three years, I think that's a great victory. I don't think that ending up back there is falling off the wagon or anything like that at all in, so and so and so I still take my hat off to you, you know, you you've gotten back up, you know, and you're still trying, and that's the whole thing is that never give up.So, so you're a living testimony and hopefully somebody can take encouragement from that. Mercedes: Thank you so much.De'Vannon: Absolutely. Thank you for coming on the show today, Mercedes, and you look up that song. Thank you all so much for taking time to listen to the sex drugs and Jesus podcast. It really means everything to me. Look, if you love the show, you can find more information and resources at sex, drugs, and jesus.com [01:02:00] or wherever you listen to your podcast. Feel free to reach out to me directly at DeVannon@SexDrugsAndJesus.com and on Twitter and Facebook as well.My name is De'Vannon and it's been wonderful being your host today and just remember that everything is going to be all right. 

But he seems tyrannical. And his dad thinks he is Darth Vader. We need massive reform of the psychiatric industry. No, I'm not taking Depakote right now, Dr. Nazrul Islam. The post I have never seen Mark Zuckerberg suck a dick. appeared first on Software Engineering Daily.

INTRODUCTION:Today's guest lives by one mantra: Choose Your Struggle! His name is Jay Shifman He is a speaker, a consultant and he also hosts the very popular Choose Your Struggle podcast. Jay has certifications in Psychological First Aid, Drug Policy and the Social Contexts of Mental Health and Illnesses, Suicide Prevention and Coaching, among others. Aside from all this Jay has a B.A. in Psychology from Northern Kentucky University, has served as the Political Director for the bipartisan consulting organization MainStream Strategy and he has written for publications including David's Voice, New York Minute Magazine and Guy Talk. Jay has a very intense story of his own struggles with drug misuse, overdosing, suicide attempts and recovery and it is super inspiring to me the way he has channeled his troubles into such great triumphs.INCLUDED IN THIS EPISODE (But not limited to):·        How You Can “Choose Your Struggle”·        Alternative Approaches to Addiction and Recovery·        Why the “Anonymous” Programs Often Fail·        Substance Misuse vs. Substance Abuse·        Helping the Homeless·        Misusing Prescription Drugs·        Overdose·        Suicide Attempts·        Negligent Doctors ·        What It's Like Inside Psych Wards·        Psychological First Aid Defined·        Mental Health Red Flags·        Micro Dosing MushroomsCONNECT WITH JAY:Website - https://www.jayshifman.com/Podcast: Choose Your Struggle - https://podcasts.apple.com/us/podcast/choose-your-struggle/id1502017563?uo=4Linkedin - https://www.linkedin.com/in/jayshifman/Instagram - https://www.instagram.com/jayshifman/Twitter - https://twitter.com/JBShifmanFaceBook - https://www.facebook.com/JayShifmanJAY'S RECOMMENDATIONS:The Abstinence Myth - https://amzn.to/2WaOA3qIn the Realm of Hungry Ghosts - https://amzn.to/3mefoKRChasing the Scream - https://amzn.to/3ghgy4vSDJ MEMBERSHIP (FULL EPISODES):·       $2.99 per month.·       Donate any amount for 30 days of access.·       $25 per year.https://www.sexdrugsandjesus.com/membership-account/membership-levels/TRANSCRIPT:[00:00:00] You're listening to the sex drugs and Jesus podcast, where we discuss whatever the fuck we want to. And yes, we can put sex and drugs and Jesus all in the same bed and still be all right. At the end of the day, my name is Davanon and I'll be interviewing guests from every corner of this world. As we dig into topics that are too risky for the morning show, as we strive to help you understand what's really going on in your.[00:00:24] There was nothing on the table and we've got a lot to talk about. So let's dive right into this episode.[00:00:31] Today's guest lives by one Monday. Choose your struggle. His name is Jay Schiffman. He's a speaker, he's a consultant. And he also hosts a very popular choose your struggle podcast. Jay has certification in psychological first aid drug policy and the social context of mental health and illnesses, suicide prevention and coaching among others.[00:00:54] Aside from all this, Jay has a bachelor's in psychology from Northern Kentucky university has [00:01:00] served as the political director for the bi-partisan consulting organization to mainstream strategy. And he has written for publications, including David's voice, New York minute magazine and guy talk. So he has a very intense story of his own struggles with drug misuse, overdosing, suicide attempts, and recovery.[00:01:17] And it is super inspiring to me the way he has channeled his troubles into such a great triangle.[00:01:29] [00:01:29] De'Vannon: Jay, Jay, thank you so much for coming on my show today. We're so happy to have you. How are you doing, [00:01:36] Jay: buddy? I'm good. Thanks so much for having me, man. It's a, it's a pleasure to be here and I'm cycled to do it. [00:01:43] De'Vannon: Yeah, you're, you're, it's very rare to find somebody who can match my excitement level, but you know what?[00:01:49] I'm not, I'm not surprised because you know, we both been through a recovery and we dealt with things and, uh, you know, sometimes when people have struggled more, they enjoy life. [00:02:00] [00:02:01] Jay: I couldn't agree more. I, you know, one of my favorite things to do is just get out there right before this. I, I had lunch with a friend and I left half an hour early and, and strolled afterwards just to be out in the city and enjoy it, even though it is definitely hot.[00:02:17] Uh, but it was just nice to be out and be around people after the last year, you know? [00:02:22] De'Vannon: Absolutely. And I just want to say happy belated birthday. I say you had a birthday on the 10th of July. [00:02:28] Jay: Yeah. So thank you for the donation to the birthday fundraiser. I agree. [00:02:34] De'Vannon: Of course. Anything I can do to help is so, so to start out, I'd like you to speak to us about your passion.[00:02:44] You do quite a bit of things that we're going to get into a lot of those things, but it's what is, what do you feel like is the epicenter and the core of what makes you get up every day to do what you do? [00:02:58] Jay: Yeah. So the, the there's [00:03:00] two goals that my business choose. Your struggle has stated goals that I get up every day and dedicate myself to, and they are number one, ending stigma, number two, promoting honest and fact-based education around mental health, substance misuse, and recovery and drug use and policy.[00:03:17] And I truly believe those two go hand in hand because we have a lot of organizations to do one without the other. And I kind of like to put it this way, if you're talking to someone and you're trying to educate them, but they don't know where you're coming from. They're not going to be as receptive. And if you just try to break down stigma and tell your story, that's amazing.[00:03:37] But then what, you know, what do you do after that? And so I truly believe that number one, you know, we have to tell our stories, we have to help break down that stigma, as they say, you can't hate up close. And once you've got that, that a wall of stigma broken down, then you can start helping people understand that everything that they've been told, everything that they were taught about [00:04:00] drug use about substance misuse, about addiction.[00:04:03] 90% of it is flat out false. And so having these conversations and promoting honest and fact-based education is so incredibly important, [00:04:14] De'Vannon: sounds like a man on a mission. I love the purpose in that very determinant way that you speak. And so, so you, you mentioned do user struggle. That's your podcast and you're also a speaker and a consultant.[00:04:30] And, um, we're going to talk a lot about. The all the purpose that you just mentioned to us now, I'm going to break down exactly how you feel about every, what can be improved about it, how the previous programs have gone wrong and what you're doing different. Um, the justice briefly, I do want to talk about, uh, you being a speaker and a consultant.[00:04:56] I read up on you and you know, you're a speaker now and [00:05:00] you're all, both and everything, but at the beginning it wasn't quite that way. Or she said that you felt like your story put like a Scarlet, a upon the story of the Scarlet letter has to do with the woman who was the whore of the village and everything like that.[00:05:15] And everyone stayed at her, but she was the one who Jesus would have went and picked up by the hand. So, so you said that you felt ashamed and reluctant, and it was your dad who had a very short quote to you, or maybe one small piece of advice one day. Change your trajectory. So speak to us about how you're so bold now, but you didn't start off this.[00:05:39] Jay: No. And by the way, you did your homework. So, so nice work. Uh, I, uh, you're right. You are, you are, you hit the nail on the head. And I think that, unfortunately, that experience is all too common for people in recovery. You know, we, uh, have been taught for forever that this is, this is something to be ashamed of.[00:05:58] And I will say to make that [00:06:00] abundantly clear, no one ever said that to me, in those words, what, what happens instead is you internally. The this thinking and, and it's, it's everywhere. It's movies, it's TV. It's the way our politicians talk about people who struggle with addiction and mental health. Uh, and honestly the biggest damage, the most damage that's being done is the number one organization.[00:06:24] For people who are in recovery has the word anonymous in its name. We are taught to stay silent about this. And as you it's so perfectly alluded to the story with my dad. Uh, I was invited to tell my story by a buddy of mine who runs a storytelling organization. And I said no three times, uh, but he was persistent.[00:06:45] He knew that this was a good story. He was one of the few people in my life who knew this story because I was very private about this. And I went home to see my parents for dinner. And, um, I walk into my dad's office and he's sitting there reading the paper and I just started telling him about [00:07:00] this, about how I, I keep being asked and, you know, to, to be very clear.[00:07:03] This was six years ago. My dad at the time was not a very, let's say woke on this topic. It wasn't that he truly believed you had to talk about these things the way that he does now. Uh, because obviously seeing my work has changed the minds of a lot of people around me, but, but at the time, His thinking was not like that.[00:07:23] Instead he looked at me and he said, why wouldn't you do this? And I said, well, cause I'm terrified. And he said, fear is never a good reason not to do something. And then he picked up the paper and started reading again, as if he didn't realize he just blew my world apart. Right. But he was right. He was so right.[00:07:42] You know, th th all of the things that I was scared of, none of them came true. And in fact, most of them were flat out the opposite of what actually happened. And so, again, it wasn't that he thought this was a, an important topic to talk around. Instead he was. Disappointed that I [00:08:00] would limit myself like that.[00:08:01] And he was right. And, and I, I'm glad I listened to him and I'm glad that I followed through with it. I agreed the next day to tell my story, uh, and ended up doing so. And it literally changed my life. It was one of the few nights in my life that has completely launched me in a new direction. You know, here I am six years later doing this work full time, uh, that would not have happened if it wasn't for that one night of telling my story.[00:08:25] And I wouldn't have told it if it wasn't for my dad. Uh, basically it's saying that I was an idiot for not doing so [00:08:31] De'Vannon: nothing like an advantageous [00:08:32] Jay: change. That's exactly right. [00:08:36] De'Vannon: Advantageous changes. That's one of my, um, declarations that I speak often, you know, advantageous changes coming to me and things like that.[00:08:45] And so tell us about your now your consultant business has an unusual name. It's our name? Yeah, they stationed consulting. That's right. I was wondering, does that name have a special [00:09:00] meaning to [00:09:00] Jay: it or it does. Um, so my wife, uh, her, her family's Hispanic or her grandmother is Mexican and, um, In the south where my wife is from she's from Charleston and not really the south.[00:09:13] I shouldn't make that broad statement on the coast, uh, on the island. It's, it's sort of a tradition that, uh, that's not really called streets. Every street is a station. Um, now why that is, I couldn't tell you, but someone probably could. Uh, and she grew up on station. I think it was 23 or 22, right? Uh, on the island that she grew up on, uh, just off outside of Charleston.[00:09:36] And, uh, when we got together, uh, she moved in with me in Cincinnati where I was, where I was born and raised. And she said, we got to give our house a name, uh, cause in the south, everyone, you know, every house has a name. And, uh, we decided to honor her grandmother and her Hispanic heritage. By naming it or an Ellis station.[00:09:56] And so when I started my consulting business, [00:10:00] uh, that's where the name came from and it was honoring my wife, uh, who was, you know, my biggest source of support. And in honor of her, I wanted to give the, the, the business, that name that would be an homage to her and her family. [00:10:13] De'Vannon: Messy. I love deep meanings like that behind things I think is especially powerful.[00:10:19] What we name things or each other when we're having children or pets and things like that. Yep. No, that's very, very [00:10:27] Jay: cool. So it's funny you say pets because, so, so my business, my number one business is choose your struggle, which is my personal brand. I own the copyright and all that kind of stuff. Right.[00:10:37] But a trademark, excuse me, not the copyright. Uh, but, but all of my consulting and all of that is under Ornella station. And our house here in Philadelphia is called Ornella station east. Uh, but our dog who we love very much, uh, her name is Nell after or Nellis. So it is, it very much is a, a name that has taken over a lot of things in our life.[00:11:00] [00:11:01] De'Vannon: Absolutely. And I'd like to just speak briefly about your, like your, your community service work. I know you recently joined the Savage sisters board and you do a lot of other stuff too. That one really stood out to me is I want people to know just how well-rounded you really are. [00:11:21] Jay: Well, thank you. And I will say for the listeners, he's not talking about my physique, which is also well-rounded.[00:11:27] Um, that was an easy, that was an easy one. I love you. So, um, you know, it's super important to me as a guy who comes from a lot of privilege. And I mean that in multiple ways, as, as a white man in this world, and especially this country, as, as a guy who was born with, with plenty of financial privilege, it's very important to me to not be the traditional privileged guy who puts his money.[00:11:59] [00:12:00] Somewhere maybe serves on an arts organization board, which is also important. I don't want to minimize that, but some of these stereotypes are true. I wanted to make sure as a person with lived experience as a person, myself in recovery, that I also put my time, uh, you know, th there's an old adage. My, my, my, uh, past, uh, career was in fundraising and in nonprofits, there's an adage, uh, that, which is that people give three different things, their time, their talent, and their treasure, a treasure, obviously, obviously being money, a time being, you know, hands-on in talent being okay, I'll serve on a board, I'll do that kind of stuff.[00:12:35] So it's important to me to give all three. Um, and the community outreach, the community service is where I give my, my time and a lot of my talent as well. Uh you're right, right now, most of that effort is going towards a group called Savage sisters here in Philadelphia. They're a harm reduction and recovery housing organization.[00:12:55] Uh, they're the one that I was doing this birthday fundraiser for. Uh, I'm actually, after we're [00:13:00] done here, I'm going to do some outreach with them today, uh, where we give out things like Narcan, the overdose, reversal, drug, food, and water, clothing, that kind of thing to people, uh, currently experiencing homelessness and struggling with, um, uh, very severe and unhealthy drug use.[00:13:15] Uh, and, and they also, like I said, have houses for people who are fresh into recovery. So, uh, that's an organization I care deeply about. In the past, I've served on multiple different boards, uh, volunteer with multiple different organizations, um, you know, depending on what sitting I'm in. And, uh, these are things that are very important to my wife and I, we, we are new here to Philadelphia.[00:13:37] We've only been here for about three and a half months, and we've done things like, uh, organized trash pickups, um, and, and, uh, you know, gotten involved with our neighborhood group and stuff like that, where making sure that, that we use our privilege for good, uh, is something that we are incredibly cognizant of.[00:13:56] De'Vannon: I appreciate that. Um, especially [00:14:00] going out and reaching out to the homeless people like that, uh, having lived on the street for some time myself, I can tell you whatever, whatever comes along is, is greatly appreciated. It really goes a long way. And I think it's really, really humbled of you to have come as far as you have to still be that connected to you.[00:14:20] Where you no longer are and then to be turning that into such triumphant productive work. Thank you for that. Absolutely. And so tell us, how about your podcasts for a, for a moment? Oh, choose your struggle. Oh, I love the original music by the way. [00:14:41] Jay: He's pretty great. Right kid mentally very talented. [00:14:45] De'Vannon: Oh yeah.[00:14:46] I had, you know, my snap back on his Bob and my head up and down. And so it's a very, um, it's a very cool podcast. I want you to tell us, tell us about the name, choose your struggle with it has [00:15:00] a whole history and meaning behind [00:15:01] Jay: it. That's right. So choose your struggle is my podcast. It's the name of my company.[00:15:06] Uh, as I said earlier, I do have the trademark on choose your struggle. Uh, I it's all over my merge, all that kind of stuff, but what it really comes from is the realization. That when I was at my worst, which was 2008 and 2009, when I was fully in the throes of addiction, um, my mental health was struggling.[00:15:26] I had lost the ability to choose what I was going to struggle for. And by that, I mean, every day my struggles were to avoid withdrawal and to just get off my couch and try to be a, a person that contributed to, to the world. Rami, right. Those were the things that I was, uh, struggling for it. And I didn't choose that my situation did.[00:15:48] And once I got into recovery and once again was able to choose where I was going to struggle what I was going to dedicate my time, my talent, my treasure, all that kind of stuff. Do it made me realize that while [00:16:00] I had, um, the, the, the, the loss of my choice, uh, sort of decided for me, by my struggles with mental health and substance misuse, we all have things in our life that, that threatened to take away our ability to choose, uh, whether that is living in extreme poverty.[00:16:18] What are that is, um, uh, living with health, uh, limit limitations. I mean, obviously the examples go on and on. And it is difficult at times to, to find the choices that we do have when these genes, um, uh, giant factor is our are, are, are weighing on our choices. And so one of the things that I work with people on is trying as an outside observer or helping them themselves to take a step back and recognize, all right, these things are outside of your control.[00:16:49] Of course, we all have things are outside of our control. And depending on our level of privilege in this world, depending on our, our, uh, current situation yeah. In our lives, those [00:17:00] could be bigger or smaller factors, but we all have things that, that threatened to take away that choice. However, we all do have some choices in our lives and, and helping people recognize where they can choose is a passion for me, because of that, uh, previous experience I had had where I had lost my job.[00:17:20] De'Vannon: Well, first of all, let me say congratulations on having over 10 years of recovery time was thank you. Come. And I want you to talk about when you lost it choices, I've read up back when you were like in your early twenties, it seemed like it started with some prescription medication. Um, and, uh, can you tell us about how you begin to lose this choice and where things begin to go off the rails?[00:17:46] Jay: Yeah. So it really all started as a preteen. I was diagnosed with ADHD, um, as well as depression, anxiety, OCD, a bunch of other stuff, but, but ADHD was the really important one. And, [00:18:00] uh, at the time this was the late nineties. I'm 35. When the explosion of, uh, diagnosis or rates of diagnosis of ADHD was in full throws.[00:18:12] We went from roughly 350,000 young people in this country diagnosed with that particular disorder in the mid eighties, uh, to almost 2 million when I was diagnosed myself in the late nineties, which is just unreal. Right, right. Uh, and this was also the time when all of these, these medical companies were pushing out nude pills like every day.[00:18:32] So my therapist puts me on a succession of these four or five in about a four year span. Um, at the same time, I'm struggling with these other mental health things. As I said, And, uh, I'm a person going through puberty. We all remember how difficult that is. Right? And you take all those factors together and that person is going to struggle.[00:18:52] I mean, that, that is, it is going to be difficult for that person. Unfortunately for me, my therapist saw this and gave it a new name, a [00:19:00] mood disorder, which he then gave the name bipolar and started treating me for that in my late teens. Uh, by my early twenties, I was on over five different medications a day, all of which I was misusing or addicted to, and my life just got progressively worse to the point.[00:19:15] As I said earlier, where, uh, in 2008 and 2009, I was 22 and 23 and very much just had lost control. Uh, and in the summer of 2009, I attempted suicide twice and overdosed in a two day span about a 36 hour span. Um, and, uh, that really launched me. Into a new direction. Debt was not a good one. Uh, I spent three weeks in a locked down unit, uh, three months in a long-term care facility.[00:19:43] What we would have called a mental institution 50 years ago before finally, uh, deciding to basically take charge myself and trust myself for the first time. Uh, in my adult life, I checked myself out of this, um, long-term care [00:20:00] facility in on January, our December 31st, 2009. And on January 1st, it doesn't tend to started to make my way to Arizona, to live with my grandparents, where I went through.[00:20:12] What's called step-down detox, uh, which took me almost four months, uh, and stepped down as the opposite of cold Turkey where instead of stopping in one day or just all at one point, which is what cold Turkey is, uh, I took a little bit less every couple of days. And as I said, that took me almost four months to.[00:20:33] De'Vannon: Such a young age to, um, to fall prey to the whole prescription medication. I don't know if you would call it, uh, maybe epidemic that has, you know, had a, such a negative impact on our nation because you know, it was being prescribed to you by the doctors that you trust, um, who you're expecting to take care of you and give you more than what you [00:21:00] need.[00:21:00] And so, cause you know, we're taught, you know, bad things I suppose, to come from like the streets or from a bad place or from the creepy neighbor guy, walking around the neighborhood, watch a guy, you know, an all black shifty eyes and stuff like that. And so, you know, so your guard is down, you know, when you're at the doctor and they're giving you this medicine and then, you know, only, you know, what's really going on inside of you so that you feel like.[00:21:28] You know, at that age, what was going on with you mentally, they just kind of say it like this here, take some medicine and just get out the door. Do you feel like that they were really addressing the problems that you have? [00:21:41] Jay: Yeah. So at some point my doctor knew what was happening, uh, and there's records of that because, uh, by the end I was taking, uh, roughly a month, well, a month worth of, of, of medication and roughly 10 to 12 days.[00:21:55] So you cannot get a renewal at that point [00:22:00] without a doctor's permission. Um, clearly, uh, because I was still able to get the drugs that was the doctor's permission. So, uh, he knew, um, now by the end, did he recognize that he had really screwed this up? I don't know. I'll never know. Uh, in fact, I used to hold out hope that I would have the sort of, you know, sitting in a courtroom or, or, or in whatever, across from him.[00:22:24] And he would say on, so it's like, it's a bunch of, a bunch of bullshit. Right? I was working with a therapist about four years ago, who finally said to me, Jay. That's never going to happen and it's not going to happen because if he did that, he would go to jail and he will never admit to you that he messed up.[00:22:45] And I needed someone to tell me that I needed someone to say to me, you're not going to get that apology that you thought that you you're hoping for. You need to move on. And I did. Um, and that was very helpful. I wasn't carrying around a lot of things. Uh, but there was some [00:23:00] resentment, there were some, some, like I said, some hope for closure that will never come.[00:23:04] And so I needed this person to someone who knows someone who, who, you know, cared about my mental wellbeing to say, you know, for the good of your own health, you need to realize that you're, you're grasping at straws and it ain't going to happen. Um, that being said, I am, there is a little bit of, of reassurance every time I tell this story to a new therapist and our watch their face fall, and them say things like, oh Lord, good God.[00:23:31] You know? So, so, so them saying, oh my God, that's so terrible. Um, I had a doctor look over my medical records. I, I got all of them from like Walgreens and CVS and I showed this to a doctor and he read over him and he went, Jay, I know, you know this, but you know, this is criminal. Right. So, so those are the things.[00:23:50] That gave me a little bit of that reassurance that I needed. Um, but, but it allowed me to move on and not hope for, for the apology that was never going to come. [00:24:00] [00:24:00] De'Vannon: I totally, well, first of all, I'm sorry that, that happened to you. I can identify because I was, I had experienced anger and resentment and stuff like that at the doctor who had left my positive HIV results on a voicemail, on a new year's Eve, uh, back in 2011.[00:24:18] And it was the same thing, you know, I was, I don't know if it was apology. I wanted her money from a lawsuit probably more than money. Cause I was like broken homeless anyway, uh, at the time. But there were ages that I felt that him and an idea to go after him to get like, you know, medical records and stuff like that.[00:24:38] But you know, the, the Texas medical board. And from what I understand, this is kind of how it goes in this country. They tend to get behind their doctors anyway, whether they've done right or wrong and they take their side with it. And I, and the only reprieve that I got from that was exactly what you just said was when I talked to other doctors and nurses and [00:25:00] they go, then somehow it comes up in the conversation.[00:25:02] You know, how I found out about HIV, you know, I wasn't brought in, into a facility, you know, with the mental health people and all of that. He just like left it on a voicemail and was like, you know, click. And so, and then they, and I get that same reaction from them, like what the fuck, you know? And so it makes me feel like really great that that happens.[00:25:22] And so, um, and so, um, I totally identify with you on that. [00:25:28] Jay: So I want to underscore something that, that is a very common thread in both of our stories that I hear that. And when people see these big national lawsuits, you know, against sack, the Sacklers with Purdue and all this kind of stuff, there's this thinking that these sorts of things, getting them to admit wrongdoing.[00:25:47] It's not that it's a slam dunk. I don't think anyone thinks that, but then it's easier than it is. You are so right. It is almost impossible to get any sort of a person in the medical field, uh, to [00:26:00] not only admit fault, but to be, to be, um, uh, declared at fault in a legal setting and sort of de to underscore that point when I was getting all my medical records, you know, CVS and Walgreens, one of them gave it to me.[00:26:13] The other one said, unfortunately, I'd, I'd asked over five years later and they only keep records for five years. I don't remember which one it was. Um, the long-term care facility. I got all my records, the, um, uh, the, the lockdown unit got all my records, the one place that, I mean, that took a little bit of fighting, but I got it.[00:26:30] The one place that gave me by some estimates, maybe only 10% of my actual records was my therapist office. And it was because they. The, you know, rallied the troops, they, they drew the wagons or whatever the expression you want to use and gave me only what they legally had to. Now I could get a lawyer and fight this.[00:26:51] I'm not going to, um, because at this point, uh, as, as we're saying, you know, we're not going to get that, that, we're sorry, we're not going to get that. You know, [00:27:00] the, the, the, the, the siting in our favor, and at this point, it's not worth the fight, but, but there is very much a, you know, protect our people at all costs mentality.[00:27:12] De'Vannon: Right. And, um, and I'm gonna extend that into the realm of veterans. I'm also a, a veteran, um, from the air force in the six years that I did in there. And we may not be able to get that, but what we can do is pay attention to ourselves. And, uh, I, I prefer to look at it more like we're consulting with the doctors as opposed to they're managing our health because they tell us something that's not right.[00:27:39] Or if it doesn't balance out that we don't have to do what they say. And when I first started seeing getting mental health from the department of veterans affairs, they had me say like on 200 milligram Depakote, which I thought was like a bit much considering I had never taken it before and all these other drugs.[00:27:56] And later on, I went to go get what's called like a problem list at the VA, [00:28:00] which has all your diagnosis on it. And they didn't have me diagnosed with anything. And so I was like, usually when you prescribe medicine, you treat them right. And so they prescribed me all these high bills medicines, but it was attached to no particular illness.[00:28:17] And so, but even more so to the point, dealing with the government in the private sector, they're really the most you can do, but get a second opinion and go somewhere else. So I would like to encourage people to take control. Of their medical direction, especially considering the, the money that's paid to the doctors, they really, really should be doing a better [00:28:38] Jay: job.[00:28:39] Yup. Yup. It's very sad. I mean, we have to be our own advocates for this and it, it, you know, it's incredibly disheartening because, uh, first off you're right. It's, it's very common for people to not get second opinions. You know, someone told me I had bipolar and we said, you know, we trust this guy. He says it, I believe [00:29:00] it.[00:29:00] Um, that isn't the case with physical health. You know, my aunt had cancer, she went to second, third, and fourth opinions for everything and got the best treatment. Uh, so that is very common with mental health. And second, um, you know, we are in a country that debt, you know, that the, the medical industry is so broken that as actually, I was just having lunch with someone who we were talking about this, and she described it as collective Stockholm syndrome that we've sort of become defensive of any positives in the medical field.[00:29:32] Like we don't want change because what if we lose this thing? And it's like, yeah, but that's the one point positive over 50 negatives, right? This whole industry is so broken. Uh, I'm new to Philadelphia. As I said, I've been here for three months. Uh, I cannot find it. Um, I've been calling I've called three different places now to, as soon as they could see me was September, uh, for those lists that are, I don't know when you're putting this out is currently the middle of July.[00:29:56] Uh, this is ridiculous. Uh, I called 13 [00:30:00] therapists. Only three of them got back to me, two of them weren't taking new patients. And the one that was literally refused to see me, she didn't like my insurance, even though it was in her network. And she said, no. So, uh, I don't know what to tell ya for people who think that this, this, uh, insurance and medical industry is working just fine because you know, you're wrong.[00:30:20] De'Vannon: They, um, um, I wonder if a lot of that has to do with, like, I would fit in the, in like a lot of stress that people have had in terms of availability, but for sure. I really am not overly fond of how like insurance and things like that can prevent people from getting help need. Um, now you actually have insurance and you got rejected, but there's so many people out there who don't have it, right.[00:30:49] Or maybe it's insufficient or something like that. So they can't, uh, get what they need. When I was in rehab, one guy had to leave. It was a, it was a [00:31:00] veteran VA veterans affairs rehab, but he had private insurance from his job. And somehow they only would allow him to be there for so long or pay for so much, but he had to leave in the middle of treatment because of a financial concern.[00:31:13] And I think that's absolutely ridiculous. [00:31:16] Jay: Yep. I couldn't agree more. And to make it even putting him in a finer point on that, you know, we are one of the only countries in the world where our insurance is tied to our employer. And, uh, if which is already a problem, but a recent study just came out that said that, uh, by 2030, it is expected that over 50% of people in the job market will either be gig workers or less than full-time workers, which means that we are facing a cliff at which point, over 50% of the people in those in this country may not be, may not have insurance that is starting.[00:31:53] De'Vannon: Well, you know, I think a large reason why that might be, as people are getting tired of the bullshit that they're having to [00:32:00] deal with pulling up work every day and more companies coming up as a result of that, that's empowering people to go to work for themselves and to do things on their own. And then they're like, they'll figure out the medical, but they want to have peace of mind every day.[00:32:14] They did have to go about their day. And I don't blame them. [00:32:18] Jay: Not one bit. [00:32:20] That's all we have for the free version of the sex drugs and Jesus podcast, my beautiful people, but Hey, if you're vibbing on what you're hearing and want to take it to that next level. Then perhaps a subscription may be in order access to full length episodes only cost $2 and 99 cents a month. Or you can do $25 for a year, or if you're down on your cash, you can literally donate[00:32:47] Any amount for 30 days of full access, all of this information can be found@sexdrugsandjesus.com, where you'll also find my blog and lots of resources as well. [00:33:00] Your subscription strengthens our ability to reach the world and help hurting people. And by subscribing, you would become a part of that effort.[00:33:08] Thank you so much for listening and just remember that everything is going to be all right.  

Antidepressants, mood stabilizers, antipsychotics, benzodiazepines, stimulants.....READY SET GO!Med cheat sheetSSRIs (selective serotonin reuptake inhibitors)-- Prozac, Lexapro, Paxil, Celexa, Zoloft, Luvox, Trintellix, Viibryd-- They are generally NOT antidepressantsMainly helpful for OCD, body dysmorphia,  panic (if not from trauma), depression if postpartum or fueled by neuroticism or ruminative anxietySNRIs (serotonin norepinephrine reuptake inhibitors)-- Effexor/venlafaxine, Cymbalta/duloxetineMostly helpful for combined depression/anxiety, especially with insomniaWellbutrin/bupropion-- very stimulating (prison crack!), true antidepressant; can trigger/worsen anxietyMAO  (monoamine oxidase) inhibitors-- powerful antidepressants, lots of side effects and med interactionsLamictal/lamotrigine-- definitely ALL THAT and a bag of chips (see My Desert Island Meds in Season 1)Atypical antipsychotics-  Abilify/aripiprazole, Latuda/lurasidone, Seroquel/quetiapine, Saphris/asenapine, Vraylar/cariprazine, Risperdal/risperidone, Zyprexa/olanzapine, Geodon/ziprasidone, Invega/paliperidone Generally good mood stabilizers (in contrast to the putative "mood stabilizers" below); typically more helpful for severe depression and bipolar disorder than true psychosis (Zyprexa and Risperdal excepted)"Mood stabilizers"- (big misnomer, most effective for  mania/agitation, not depression)-- Depakote/valproic acid, Trileptal/oxcarbazepine, Tegretol/carbamazepineLithium- it's not clozapine, but gets the silver medal as a true mood stabilizer (see My Desert Island Meds in Season 1)Clozapine- the winner of the psychiatric med decathlon in most every event; needs weekly blood monitoring and has a few very serious potential side effectsBenzodiazepines- Xanax/alprazolam; Klonopin/clonazepam, Librium/chlordiazepoxide, Ativan/lorazepam, Valium/diazepamStimulants- Adderall/amphetamine; Vyvanse; Ritalin/Concerta/Focalin/methylphenidateAmphetamines are more euphoria-inducing, thus more abused and addictive and also tend to have more side effects; both amphetamines and methylphenidate are roughly equally effective for ADD/ADHDBFTAhttps://www.craigheacockmd.com/podcast-page/

In this episode I interview Attorney Michael Mosher who has 30 years of experience. Mr. Mosher has an extensive background in pharmacokinetics, the adverse reactions of various drugs as well as the proper administration of each psychotropic drug including anxiolytics (eg. Xanax, Ativan, Klonopin), hypnotics (Halcion, Dalmane, Restoril), stimulants (eg. Ritalin, dexedrine, Adderall), anticonvulsants (eg. Tegretol, Depakote, Neurontin), antidepressants (eg. all the SSRIs, Effexor and the tricyclic antidepressants), and neuroleptics, (eg. Zyprexa, Risperdal, Seroquil, Abilify). Mr. Mosher has also settled numerous cases against doctors and drug companies involving illnesses and damage due to addiction/dependence via the use of Xanax, Klonopin and other benzodiazepines as well as injuries resulting from SSRIs.

Depakote is a mood stabilizer that is helping me beat my mania and hypomania which I haven't been able to get rid of for many months.  Depakote is saving my life.  This episode details my experience with it.

This episode tells the story of me leaving one psychiatrist, and finding a new one.  This involves topics related to medication, psychiatry, therapy, support networks, growth, and hard work.  Primary medications touched on are Depakote, with references to Lamictal and Lithium.

Andrew McIntyre, Patient, Master Grower, Extractor and Caregiver discusses Cannabis and Health for all, including his fragile patients, many of whom are children.Andrew is a 50 year old survivor of a childhood seizure disorder born in 1970 with severe allergies. Those allergies later surfaced as a seizure disorder primarily during deep sleep that essentially interrupted immunity and then cognitive function and developmental delay. He was one of the first pediatric patients in the world to take part in the Anti Epileptic Drug (AED) trial of Depakote in 1976 at Tufts Hospital in Boston. In 1979 he discovered that using non psychoactive raw edible forms of Cannabis with this diet decreased his severe headache and ADHD symptoms during the day and his seizures at night. This experience compelled him to study the plant's medicinal properties several years later as a teenager, in order to try and explain how it was working. https://unitedpatientsgroup.com/be_informed_be_well/https://unitedpatientsgroup.com

Depakote is effective prevention for Migraine.  Learn about it.

Thank you to Cam Mecham, OM III from RVU, St. George Campus and Jed Roundy, student at Utah State University for participating in this discussion. This podcast is judged to be of moderate value in shelf exam prep for the 3rd year psychiatry rotation.

All right. Welcome to the gut check project. I'm here with your host, Dr. Kenneth Brown. I'm Eric Rieger. This is gut check project, Episode Number 26. We're going to wind up 2019 with some awesome info. What's up, Ken?What's going on Eric? How are you doing, man? Episode 26. Unbelievable. I apologize if I'm a little too sexy today because I'm just coming off of a small cold. I think the hottest people are those that are sick.Well, I'm not sick. I'm post sick. Remember, the viral prodrome. The reason why we always like pass so many viruses is that you tend to pass the virus before you even know that you're sick by the time you're actually sick. You're probably okayYeah. At that point you can go back and say I heard you might be sick. I was too back then.Yeah, exactly. Good to see you?Well, today's episode is going to be pretty awesome. We're going to tackle number one, we've received tons of email in your clinic because you also sell the KBMD CBD at your clinic, you get these questions. These have been coming in Fast and Furious over the last little over 14 days. And it's questions about the safety of CBD oil and its application. So we're going to tackle that I do need to tell everyone. Thank you. We're on episode 26 because the first 25 shows were so well supported by all of you who've been keeping up with a gut check project. We grow every single day. Paul, the guy who's helping us put together the production now and helping us spread the word. We just hung up the phone with him. We've gotten more and more downloads each week. So thank thank you every single one of you for liking, sharing, emailing, telling your friends about it. We sincerely appreciate it.We learned so much about it like today we have a new a different guests we do Instead of gutsy our little mascot or green frog, but since we do film on a green screen, he gets blocked out did not know that didn't even realize that. So now we're going to go with a dung beetle, right here? Yeah, yeah, we did. So that's Dilbert, the dung beetle,Dilbert, the dung beetle. So one of my favorite things is whenever we're bringing any patients back and somebody sees you, and they're like, hey, you're Eric, I watch your show that just warms my heart. So if you happen to be a patient and show up and you watch the show, if you say that it just makes us both feel really, really well...needed wanted, appreciated.Yeah. At least outside of me putting you to sleep. Take five or six good deep breaths. Exactly. Today's episode is sponsored by Atrantil. Your bloating relief, it's what we do. So go to Atrantil.com or lovemytummy.com/KBMD. Today it's also sponsored by KBMD CBD oil. You can find your own KBMD CBD oil at kbmdhealth.com which of course, the initials KB, Kenneth Brown, it's endorsed by the guy who's sitting across the table from me. So Ken, why is...What does MD stand for? Well, I'm not really sure.I thought it was your buddy Mike Doyle, but I don't know.Yeah, it's probably. So tell us a little bit about KBMD CBD. Alright, so KBMD CBD oil. I got involved with the science of CBD because I saw the beneficial effect with my patients when we developed Atrantil I then learned that the science of Atrantil the polyphenols in it actually augment CBD. So I'm seeing this combination do incredible things for people. So this particular CBD is one that we have researched, I've seen it work clinically. And we know that it comes with a certificate of analysis. It is organically grown, it is naturally extracted with co2, so it meets all the criteria that you want in your CBD because this is important. The rest of this podcast is going to be all about the dangers of CBD.Definitely and It's really interesting since we do have so many people who have begun to purchase CBD find benefit. It's really kind of weird what's occurred over the last two weeks. And what I would say is a little bit of misinformation. But it's more or less probably just misunderstood information and or or misapplied information. But regardless, the benefits of CBD used correctly, have been undeniable with the people who've come back through the clinic with people that we've scoped, and how well that they are doing. And so, hopefully today, we're going to provide some context on why more or less the dangers that you may or may not have read about in the news recently are really a little concerned. But we'll, we'll see. We'll see how far along we get in at the last. The last thing. Our last sponsor is the KBMD health box. You can find KBMD health box by going to kbmdbox.com. Now last week we did a full unboxing which is something I think we're going to try to do at least once a month. But essentially, if you want almost $300 of physician vetted supplements that can help you benefit your life and get them for only $147 which you would spend, not you would spend more than $147 worth of time driving somewhere to pick them out for yourself and having someone handpick them for you. Go to KBMDbox.com. What was one of the things that we had a patient come through just earlier this week, who showed us his lab results that he took to his primary care physician? So we're starting to make a difference in the landscape of health here in the DFW Metroplex and different places. I've been getting emails and calls from people around the country that will actually hear the podcast and then they'll want to sign up for the box. And what we're seeing is that these vetted supplements actually are making a difference with both subjective how they feel and objective the labs. So the reason why I chose these things is they all have third party analysis. And they all have some scientific background that actually explains how they're going to help you. So much so that I'm thinking of ordering my household, another box. So although it is the KBMD Health box, I actually I love the fact that I can get these things that I'm going to purchase anyways, they come into my house, so my whole family's on it. Now we're running out of stuff. So I'm gonna end up having to double up on everything. So it's one of those things that I feel really good that we can look at different aspects. And when somebody says, Oh, I tried X, Y, and Z, I didn't notice anything. I'm like, oh, did you try one that had a third party analysis? No. And then they do and they're like, Oh my gosh, big difference. Same thing with CBD. I mean, a lot of CBD out there doesn't really have what's on the label. And we're going to get into that because we're going to talk about what the FDA thinks about it. We're going to talk about the different media and what they're doing, and hopefully get into all that but that's the whole point of that box is I want to deliver these vetted things to your house monthly so that you can continue to improve your health. Hundred percent. So without further adieu, be sure to like and share the gut check project. We certainly appreciate all of the support to date. We're going to hop right into it. So what we've received here recently is a lot of speculation and concern from people who have said, Hey, I'm interested in CBD. I know that you and Dr. Brown have heavily studied, been entrenched with CBD and its application over the last few years. I just learned that the FDA is associated or made public a study that says that it may be hepatic toxic or bad for my liver. It's, unfortunately, it's a weird jump off point. So I'm going to kick it to you. Because immediately I had lots of different thoughts and instead of getting emotional, what did we do? We went and tried to find the sources of where this information came from. We want to backtrack on how they got to that conclusion. And I think that we can put a lot of questions at ease and even help people learn how to be a little bit more critical with the data that they receive when they receive it. Because let's face it, lots of stuff that we see on the internet, or that we hear on the news or reading the paper, it's basically clickbait. It's basically things to keep you engaged, whether or not the actual substance is worth the headlines that are written so...So what you're referring to is recently the FDA put out a statement, a consensus statement in the news and it's making all kinds of traction in the news that they're saying that CBD is not as safe as people think not only that it can be harmful. Now this has bled onto TV and my patients have been asking me about this FDA statement. Then there's been other news articles like the one that Forbes published, read said that CBD causes liver failure. Failure. That was the title liver failure caused by CBD. I want to get into all that I wanted to take a really deep dive into the science of all of this as a gastroenterologist, I'm board certified gastroenterologist, which means not only am I a simple country, butt doctor from Texas, but we actually have to learn liver disease, hepatology, I'm not a hepatologist like some of my other friends where I send like really complex things, but we at least have to understand the liver, how it works and what it does. So a lot of these articles discuss this but they don't clarify so many little things. Because and they shouldn't it's a it's a journalist writing an article they want they want it to be shared. And anytime you mentioned CBD, anytime that that is thrown out there, you're going to get some clicks, you're going to get a whole lot more clicks. If you say you're going to die from taking CBD. It reminds me of the I remember Jerry Seinfeld was on Saturday Night Live one time and they were making fun of the nightly news where they always do the promo at like three o'clock. Like five household items that are guaranteed to kill you, tonight at six.You're like what? If it was so important, they probably wouldn't make you wait.No, I'm gonna die before you put this on the air. So what I'd like to do is talk about the briefly the science of the endocannabinoid system and CBD, then do a little bit deeper dive into the liver. So everyone's going to get a primer on the liver 101 here, because these studies don't make sense unless you know, some of this knowledge. It's just sensationalism. For some of it, some of it is a little bit unfair. I think some of it is for what the FDA got, and it's there. But I just want this podcast today to be something that can be useful for industry people that can be useful for patients or people that are thinking about taking CBD and it can be useful for a subset a small subset of people that may be should not consider taking it. Yeah. So all of this is kind of, you know, for the future of this podcast, It's almost going to be a bit of a rebuttal. Not necessarily a defense of hemp derived CBD. But let's just buckle up and kick some science. This might be a little bit I don't know how long we're going to go where we're going to go with this. We're just going to feel it out and see what happens. But I at least want to be able to explain why I still believe that a lot of people should be taking CBD even though Forbes is like you're gonna die from this.Yeah. It's not arsenic people. No it isn't and I think another cool application here is there are people out there who have been on the fence on whether or not I should try CBD or is this something that's good for a family member for me? And unfortunately, there you hit this intersection, where a news headline is written that CBD causes liver failure. Well, if they've been on the fence, that's a pretty big No, no, right? So now you've taken away maybe an avenue that they were considering to help them out. What I hope that we can do with this particular episode is basically let's temper and let's see things in context. I think context is a word that as you get into sensationalism is something that is kind of the rescue item. If I could put something into context, then at least I'm giving someone a fair chance to understand the information that's before them. I don't feel like sensationalized headlines do things like that. Then again, I also don't feel like someone who shakes, hand picked or cherry pick studies is doing that either. So what I think today that we can do is fairly evaluate and talk about the process of how the liver works, and why some of these studies are or are not applicable to the nature they were presented.Absolutely. So the first one we got to discuss is what what what the heck did the FDA say? Sure. So the FDA came out and they mentioned that they've got several issues with the safety of CBD. The two main ones that they're really concerned about are potential for liver injury, and interactions with other drugs. What they actually said is that they're concerned that people may mistakenly believe that trying CBD can't hurt the agency wants to be clear that they have seen only limited data about CBD safety. And these data point to two real risks that need to be considered as part of the drug review and approval process for the prescription drug containing CBD. Interesting. Now, what I say this is because the FDA is referring to the data that was presented to them by GW Pharmaceuticals, who has a epid... eipdi..x you know?E-p-i-d-i-o-l-e-xYes, which is the first FDA approved prescription CBD isolate,Right,for seizure disorders.It's important to point out that is not full spectrum. Correct. That is not full spectrum. And there's some that's important because here later in the podcast, and think we're going to draw some comparisons and just if you're listening, just remember, epidiolex is a CBD Only isolate it is not a full spectrum product.So let's talk about what the FBA what the FDA actually does. So the FDA has a really daunting task. The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy and security of products. So it is super daunting because there's a lot of products hitting the market, and the FDA has tried keep up with this to try and protect people. And let's be honest, let's look at the elephant in the room. The elephant in the room is that there are a lot of bad CBD products out there. Yep. In fact, in a jam article 2017 showed that 70% of the CBD products that they looked at did not have what was on the label and what was there could be higher levels of CBD could be lower levels of CBD. So it's a gamesmanship that's going on right now. So it is totally true that you need to make sure that you've done your homework on what type of CBD that you're actually taking. There currently is little to no regulation in the CBD industry. There is the President and CEO of Natural Products Association NPA. His name is Daniel Fabricant. He's a PhD. I love this quote. He's quoted as saying it is well past time to bring science into the equation, as federal rules require safety and Consumer Protection must come first. I agree. And we all agree with that. Sure. And I think that all companies that have reputable CBD companies, they all want that. Problem is when you have these different stories leaking out, which gain much more traction, it just starts creating a little bit of confusion misconception, and then people don't really know where to turn. So the feeling is, is that possibly statements by the FDA saying that it creates this narrative that questions the safety of CBD overall, strictly to address a few number of companies which are producing quite frankly, some crap products.What was the number that we learned the last time that we were in Utah at meeting I believe it was one out of every 23 to 24, I could be off it was definitely in the 20s. But every to every 23 or 24,25, CBD labels available for retail purchase. One is seen as a reputable well marketed or correctly labeled product, which means that even if it happens to be off a little bit, you've got 23 or 24 other labels which are just not truthful or probably not correct, don't have a certificate of analysis or are blatantly, just not even what's in the bottle.100%. There's a lot of people out there trying to take advantage of this wave that's coming. So I do not. I believe that the FDA is doing their job by looking at the data that was actually presented to them Agree. So let's take some time and break all this down for the consumers, health care providers, industry personnel. Starting with the question, does CBD cause liver damage? Unfortunately, or fortunately, because I like science we really need to talk about what the endocannabinoid system is. Because if somebody's listening to this, they're like, Well, I was thinking about taking this but I'm worried becasue it can cause liver failure. I don't know why I'm taking it. Why in the world should I be taking it? So let's do a quick one minute discussion of the endocannabinoid system. Let's do it!All right, the endocannabinoid system. The endocannabinoid system is a system which was discovered in the 90s that we now realize it's probably everywhere in the body. There's primarily two different types of receptors, but essentially, the way that I try to explain it to my patients, it's concentrated more so in the neural areas, nerves, brain and the immune areas. Although we now know it's in every single organ, that's where all the original research was. We now realize that its job, the endocannabinoid system is to produce these products called endocannabinoids. Which work as traffic cops. They just kind of get your body to get back to an area of balance. If you've got too much activity, they go Whoa, slow down a little bit. If it's not enough, they go, come on. Let's go ahead and get some more going here. So you have this fantastic system in your body that really just tries to keep balanced. Think of it that way. And you're going to hear a little bit later why I think most of America is out of balance. I think most of America needs some replenishment of their own endocannabinoid system. So that's the important thing is is that there's a dire need to try and get us all back to a certain balance, because the reality is we're getting sicker as a nation. And one of the causes could be that we took hemp derived foods out of our diet and out of our livestock diet. And there's a theory on that, that possibly that's one of the reasons why we're having more autoimmune diseases, why we're having more of the other problems that we're seeing, Well at least contributing factor.Certainly at least a contributing factor. So keep this in mind. So the the primer on the endocannabinoid system is if you're, if you have ears and you're hearing this, you also have an endocannabinoid system, and you have a higher than likely chance that you are out of balance with that. And if you are out of balance with that, then you probably could benefit from some of this. Sure. So right now you're going well, I'm out of balance, I'm going to probably benefit but I'm going to go into liver failure if I do this. So let's talk about what liver failure means. You have a genius living within you. You probably have multiple geniuses living within you.Thank you. That feels great. Sometimes the voices in your head don't say to do bad things.The evil genius. Yeah.Well, one of the geniuses living within you as this beautiful origin called your liver. So you have this and it's amazing. So to understand where they're going with this, let's talk about what the liver actually does. So we all have livers. And they work differently in every single person, and they can continue to adapt, evolve and change. One of the only organs that you can transplant a partial portion of it and it will grow into a full liver. So the nephrologist think that the kidneys, the smartest organ, the neurologists will think that the brain is the smartest organ The cardiologist says if you don't have blood, you can't think so It must be the heart. Yeah, yeah, exactly. I'm gonna say, well, for health span, smartest organ in the body is the endocannabinoid system. So eventually, we're going to have Endocannabinoidologists. Because what ends up turning out is that the endocannabinoid system is in all these different organs.Correct.They're not completely separated. So let's talk about the liver. The liver is responsible if you ever wonder what the liver does. So do you have any idea what the liver does? I've got a little bit of an idea... Little bit of an idea. So the liver is responsible for selective uptake, concentration, metabolism, and excretion of the majority of drugs and toxins, also known as xenobiotics. So let me just say that again. Basically, the liver takes the crap that you bring into the world. And it says, I'm going to convert it to something useful, or I'm gonna get rid of it for you. Yeah, it can detoxify it, or it can say, Oh, you need to be this and then you're useful. That's why I say it's a genius in your body. And it the liver figures this out, it figures out what you need, and it determines if it's a drug, or if it's a toxin, and it can turn into a better form. Now, one of the problems I have with these different articles that I've been reading, is that they discuss that then enzymatic process called the P 450 system, and they just write it like that they're like, CBD has been shown to affect the P 450 system. What doesn't affect the P450? So that's the issue. So let me break that down, I bring up the P 450 because in the lay literature without even describing what it is, it is a complex. It's called a phase one metabolism of the liver. Under p 450. It's an umbrella term that has over 60 different genes, that code for hundreds of enzymes to break down anything that comes your way. So the P 450 enzyme is like saying, Oh, I don't even know an analogy, but it's top of the funnel down. It's like you just so generic,  that you can't just say that. So but they write it in the lay literature almost as a sounds sciency so I'm sure that it's, I'm sure that it's right. That's kind of my feeling on I'm like, why would and all these people it's almost like these news articles parrot each other. And nobody's stopping going, wait a minute, because as it turns out, the P450 system, not the P450 enzyme, the system breaks down almost everything that we put in our bodies. Yeah, no joke. So a lot of going back to the pharmaceutical days, I remember that was one of the biggest challenges with with any of the drugs that we detailed a physician on was, how is it affecting the P 450. And that would be something that they would be all salespeople be coached on that before they would go on calling a physician. But the truth is, it doesn't have to be a compound. It doesn't have to be a medical pharmaceutical compound for that to be somewhat important. Something as simple as grapefruit juice. Also, detectibily inhibits the metabolic ability of the P 450. So there's all there's a handful of different drugs that people who are elderly, maybe caution, don't drink grapefruit juice, because it will inhibit your ability for your body to clear this particular drug. And I say that to say this. It's not nothing is inherently just special because it does or does not directly affect the P450, almost everything you take into your body is either cleared quickly or slowly by that same system.Yeah, so they kind of imply like CBD is the only thing that gets...Not even close....that gets processed in the in the P450 system. In fact, we know that there are multiple medications that can be altered by certain foods. Grapefruit is the most common one, and that really affects like immunosuppressants tremendously and that's where it really came up. When they realized, oh my gosh, you have these different drugs, let's say blood thinners and immunosuppressants, which have a very narrow therapeutic window, you have to have these things like right dialed in. Yeah. And then people talk about grapefruit but you know, other things that have actually been shown to do this cranberry juice, black tea, pepper, even chocolate Yep. has been shown to affect drug absorption and they have been shown to affect certain pharmaceuticals. We don't even know the tip of the iceberg on this because you have to do the study on it. You have to do the pharmaco kinetics, the PK is what it's called to actually determine that which is so funny because they say oh CBD is metabolized by the P450 system. That means nothing. And so if you take CBD and or chocolate and or drink tea, be careful. I mean...I think a good analogy a seriously a good analogy is it the P450 being metabolized by the P450. It may be good for base knowledge, but the truth is, is does it overwhelm that, as you put it system, if it is overwhelming that system, chocolate, for instance, for most intents and purposes would be like a single car driving down a six lane highway by itself. It's not really if the highway was a P450 and the car was the chocolate. It doesn't take anything to funnel that that car through.Correct.The problem is is whenever you happen to overwhelm that system. And that is important to know. But I would say in terms of context, kind of the way that we started this discussion in context. It's not my belief through what I've read and seen that CBD inherently overwhelms or becomes more than a single car down that six lane highway.So not only is it just one single car going down the highway, remember that not only foods but drugs, nobody's talking about drug drug interaction.Right.So there's a reason. So I see a lot of patients that one drug may be very effective one thing may be very effective, but there's so many variables like for instance, drugs, the sex of the person plays a role, you may have different levels, the age of the person and any diseases can all affect this whole system called the P 450 which produces enzymes. So not only that, but then genetics play a huge factor, alcohol intake.Alcohol intake, all of that. I mean, genetically, this may be why some drugs work on certain people and why they don't work and others fact there's a whole field of science right now where people are trying to determine the genetics ato go, Oh, you're going to need a higher level of whatever Plavix which is one that they've actually looked at. Or you can, you're going to take less. So we this is a whole field of this beautiful science where we can go Okay, genetically, you're going to be predisposed to need more medications. So when these enzymes get used up, basically if you've got this one chocolate, which is a car, one on six lane highway, and then you add fluconazole, which is an antifungal, that's an but that's not a car, that's a semi now and then you add alcohol, which is a minivan could be ccould be a couple minivansand then you do whatever something else, but you can see that the liver has to try and process this right. So what happens is it becomes this once it becomes a traffic jam. Then people start getting angry, they start honking their horn that is a rise in your what we call lfts liver function panels liver function test Yeah, so AST and ATL are the two ones that we always talk about, that's exactly what the FDA was referencing. So I want everybody hear this. When you overwhelm the liver with multiple cars using your analogy, then honking starts and the honking the warning sign is this rise in AST and ALT. So, for instance, your body can adapt to it. We've seen this all the time. If you drink alcohol on a regular basis. you build more lanes, you build more lanes, you get really good at metabolizing alcohol. Build tollways. I'll use myself as an example.Not with alcohol.With coffee, Okay.I always have to laugh. Whenever I go to the my own doctor. They say how much coffee do you take? I just write obscene amount because I've down regulated by receptors or I've had the ability to ramp up my my livers ability to convert that coffee into an inert thing and there it is. So you see it as an anesthesiologist or as a crna. I mean, describe what your experiences whenever you try and put somebody to sleep using propofols, different medications.Yeah, well, I mean, definitely, if someone says that they happen to be a large consumer of or a consumer of large amounts of alcohol, it generally takes anywhere between 20 and 30% more of an agent to put them to, to sleep safely, say, But back to your point of body habitus, for whatever reason, even just something as simple as someone being a redhead fair skinned, those people generally take more agent to make them go to sleep. Yeah, let's go ahead and clarify this. This is a well known thing in anesthesia. You're not being prejudiced? No, not at all. No, they literally just for whatever reason, the metabolism rate of someone who's fair skinned with red hair is typically higher than the average calculation and you can go through any types of weight based medications that we use to bring sedation to someone and generally fair skin redhead folks just take more. Is that interesting?Yeah, it is. So that is more than just anecdotal like they've actually done some studies on this and they've actually shown probably because whatever lineage, they come from Scotland, Ireland, they have a higher P450 to metabolize that particular or a higher subset of the P450 systems. So just keep that in mind. So when you take certain foods or drugs, everything's competing for your liver, to do to just say, hey, fix me, you know, figure out what's going on. Fortunately, it is a badass organ and the liver is tough and it can handle a lot, the largest solid organ that we have in the body. So usually it can handle everything. Now the most common example like we've talked about, if you take grapefruit juice with certain immunosuppressants and things then that particular combo because those drugs need exact or how they were manufactured need exact metabolism numbers. Not only that, did you know that like nutrition plays a big role. So, high protein diet will actually affect your P 450 and malnutrition will affect it. of course it will. So those are all of our paleo friends over at paleo FX and such those guys have revved up p 450s. Eating a lot of protein working out a whole lot, they're able to do this. Unfortunately, malnourished people probably can't tolerate as muchNo and they aren't they aren't they honestly they don't have the supply to rebuild the enzymes that are that are used within the P 450 I mean it's just malnutrition is going to deplete all different types of systems, not just the liver.So in the intro, I kind of mentioned that we're getting sicker. And so let's use nutrition as an example. federal policies tightened by the controlled substance act of 1970 essentially banned the production of industrial hemp during the war on drugs effectively we made hemp CBD illegal and put it under the umbrella of cannabis cultivation. Now what were we were talking with Will Clyden of O-hi energetics right, who actually discussed this and he said some cool stuff on this. He back before this when they were they were using hemp and hemp has been used for ever like since we landed in America, hemp has been using hemp has been used in China for thousands of years and all this other stuff that we were feeding because it's a fantastic crop. It's it detoxifies the soil. And it actually works. It grows quick. It's a great crop industrial. What were we thinking making it a banned substance, I don't know, separate discussion. But they've got data to show that when they were feeding chickens, so for everybody out there I had a patient today who said I said Oh, she was suffering from some things and I think CBD would help with and I mentioned Hey, have you ever considered CBD Oh, I would never ever, ever, ever do anything like that. I am not like that. I said, Okay, that's cool. said hey, let me tell you something. Do you know that before 1970 we were actually feeding animals like chickens and cattle. One of the primary things that we would feed them would be hemp, and it's been shown that you can take a chicken egg and it had over 250 milligrams of CBD, right so right now if you're somebody that just spent $200 on your CBD that has 300 milligrams in 1968 you could've just had an egg.A three cent egg.I know 3 cent egg. And I looked at the literature and I and I could not find anything that said death by egg otoxicity. It didn't so everybody that's sitting there thinking oh my gosh, no. I'm not going to do CBD. We were having CBD in our diet. A great Great example, to learn a lot more about this and do a deep dive. Our friend Chris kresser had Will Clyden and the CEO of O-hi, O-hi energetics on and he went into this tremendously. It was so cool. It was just like I just it's crazy that we stopped like, and I as a physician have seen that we are getting sicker as a country. So in 1970, we've got since 1970. We've got more chronic disease, we've got more dementia, we've got more autoimmune disease. coincidence, like we said in the intro, maybe it's at least a contributing factor. And now we have the FDA saying that CBD can be harmful yet it was in our food supply up until 1970.That's nuts, dude.It is nuts. And it doesn't make sense and if you look at mean hemp seed, birds eat seeds, birds consume seeds, they do all kinds of things where they can they take in product, What's the matter? No, I'm just looking at I'm trying to make sure we get through everything.Okay good, but I mean they eat everything and people have been consuming eggs from not just chickens they've been consuming eggs from all different birds on the planet for that long. The fact that we've restricted hemp growth etc has only taken away one of the natural things that birds were eating.If you're if you're really interested in this like I said go to Chris Cressors podcast where he's got Will Clyden on there is really cool wills smart dude Chris is super smart dude. So those guys those guys kick some crazy knowledge.Right?So that is it's weird that we're talking on this episode about CBD causing hepatotoxicity. And we've already shown that the liver's pretty badass, right? It can do a whole lot and we've already shown that the endocannabinoid system is necessary and since 1970, or up until 1970. We are taking in significant amounts of CBD in our dietRight.Weird.It is weird, but it's not so weird when we get down to why everyone's alarmed. So you want to get into a...Now let's go ahead and look at the studies. So that is sort of the phase one of this podcast because now we're going to start geeking out a lot. So I hope I didn't hope I didn't lose everybody with a but you kind of need that background to understand what we're going to talk about next.Sure, you definitely that background.Alright. So what they're talking about is the FDA published this revised consumer update. So this is the consumer update that they put out there for everybody detailing the safety concerns about CBD products. Now, this was based on the studies provided by GW Pharmaceuticals, GW Pharmaceuticals has done multiple different studies looking at different things to get their FDA approval. And I'm going to say right now, that kudos to GW for being the first company to step up and really try and make something for a group of people with intractable seizures have an alternative. Kudos to the FDA for doing their job and looking at the data that was presented to them. What I'm going to do is go next level and say, Well, you didn't look at everything. That's the bottom line here. So I'm not bashing anybody. Let's make let's make certain of this. Sure. So there have been several randomized, controlled and open label trials that studied the effects of epidolex, I'm going to call it epidolex from now on it's just easier, which is a 99% pure oral CBD extract on patients with refractory epilepsy. So this in turn led to the FDA approval for two diseases, dravet syndrome and Lennox-Gestaut syndrome. So if you recognize those names, bless you, because you're dealing with some serious stuff, It's a serious seizure issue. If you don't know those. Count your blessings. It's one of those times to go well, no matter where you're at in life. It's like well, thank goodness that I don't have to Deal with a child that has this because that's, that's a really big deal. These are intractable seizures. So they looked at the data on that. And in these studies, the kicker here is I'm going to say it again, getting back to the lane highway, the patients maintained on their stable drug regimen with a median of three anticonvulsant drugs. That's important. It's super important. Three anticonvulsant drugs. So when we use the analogy of the car on the road, imagine a six lane road. And three of those roads. Three of those lanes are double semis.Yeah, that are closed construction... Or closed, Yeah, that's more likely or closed. So let's talk about that. So when we're talking about three different agents used to control seizures, some of those agents would be and I'm assuming here, but probably Depakote, probably Dilantin, also known as phenytoin, or fosphenytoin, which is seravex. There's a handful of anti seizure medications and through my knowledge, all of them, all of them have been recorded as raising the enzyme levels used by the liver which of course would lead to ALT and AST elevation, showing that the liver is essentially working overtime to long term process these drugs right or wrong?Correct. Correct, which is exactly what the FDA is supposed to do. They're supposed to look at this data and go Okay, so let's just look at the study that they're talking about. So the FDA accumulated this data, and they looked at what GW presented GW presented in isolette of CBD, not a full spectrum. And the dose they ramped up to 20 mg's per kick 20 mg's per kick. What that means is a guy like me would take 1954 milligrams a day.That's a lot more...of CBD isolate. Now I see the effects, beneficial effects of taking KBMD health CBD 15 milligrams twice a day,that's 30 milligrams,that's 30 milligrams.The exact dose of what makes people feel better is very argued because all the data coming out of Israel shows that a lot higher doses, but I'm seeing effects at these doses So let's be real quick let's stop for context. So right now at this intersection what we're what you're saying is with a full spectrum and we said this at the beginning of the podcast that what GW Pharmaceuticals has with epidiolex is a CBD isolate and what they've done...You're saying epidiolex now that's funny. Yeah, whatever it is, Well, because I started with that. Then you told me no, that's not how you say it.I think we should switch it up the whole time. EPA max the way it was edimax. What they did is they were able to establish that almost 2000 milligrams for you would be the ideal dosage however, you...isn't that correct? That's the dosage that they went for or the dosage that they felt was safe, Safe. Okay, I'm sorry. So but but on the upper end of... That was what they were aiming for on everybody. In essence, though, from where you have had beneficial effects, you're talking 60 times that amount, two months worth, is what they are saying the safe level would be in one day where you're finding the beneficial spectrum. So just just in terms of context, full spectrum, CBD, one 60th of the dose that they're saying it's a it's a safe level is really all that you need from our experience.Yeah. Now in GW's defense, let's look at the data. So in dravet syndrome, seizures dropped 39% and in Lennox-Gestaut 42%. So... that's good. So they probably did their homework and said, well, we need to get up that high to actually help that so I don't know anything about that. I'm not a neurologist. That's where it's at. But I'm just saying that when we look at that dose, no average consumer is going to be able to consume that Much CBD in a single day, unless it comes through this 2 full grams a day is more than most take Yes,yeah. Now here's the problem 94% of the people had side effects. Okay 94% at the highest dose compared to 75% placebo, kind of weird. So there's just a huge placebo side effect profile that doesn't get discussed at all.Did they say what it just had a curiosity do they state with the placebo was for the control,They did not stay with the placebo was oh, I take that back. I don't know what they use, but basically they left people on the same medications. So, essentially, let's just look at this and say okay, but the good news is, most of it was not a big deal. Most of it was what the FDA also discussed beyond the liver tests and beyond the drug metabolism. They also said Oh, CBD can cause nausea. It can cause drowsiness. It can cause all these other kind of nuisance things. That's what they're referring to right here. It's interesting though, that have a side effect profile assigned to a placebo that's that exceeds around the 30% range, because that's generally the throwaway number. Yeah. So we've gone twice away from the throwaway number. And they've had they've had reported side effects, which I'm not trying to over draw conclusions here, but it could at least indicate that side effect profiles assigned to CBD in this study probably weren't solely to CBD, Well, you're dealing with one of the highest risk populations you can get your hands on, when I did clinical research and when we would do a moderate to severe Chron's study. The placebo arm would have tons of side effects because the disease is bad. That's what's going on here also. So most was not a big deal, upper respiratory tract infection, somnolence, decreased appetite, diarrhea, blah, blah, blah, blah, blah. But the one that they focused on is the increase in amino transferase concentrations. This once again was a revised consumer update, they put this out to the public and their statement is increase in liver amino transferase concentrations when I just got done explaining what the liver does. Did I ever say amino transferase concentrations? No. I said liver enzymes. right? frickin talk to the public if you're going to release a consumer paper. yeah, liver enzymes. AST ALT. This is hiding behind scientific garbaly goop. It's like you're doing half science half anyway. But but whatever. So a patient show up and they're like, I need you to check my amino transferase concentrations. I'm like, Whoa, why? They Hand me this, this, this news article. Right? This is what we're trying to address right here. So what they found is that in the higher dose, 20 mgs per kg, there was a rise in some patients in three times the level which is significant, so if your normal is 20. You can be 60 if your normal is 40 it can be 120. When patients come into me and it's three times the level it sounds alarming. Do you know what happens when somebody gets hepatitis A acute infection? It's way more than that thousands of times the level when somebody goes into foaming at failure there AST and ALT will go from 40 to 10,000.AST and ALT have risen for almost everyone who's listened here, way more than three times throughout their lifetime multiple times in acute or in very isolated settings. It happens with illness.So getting back to your highway analogy, which I think is really cool analogy. I'm glad you came up with that. Thank you .Getting back to the highway analogy. 80% of them were taking a drug called valproic it matters Depakote Yeah, that matters. That matters a lot.It's when you take these medications, which is why at the beginning of the show, I said you're more likely don't have to worry about it. But if you're on certain medications, keep it in mind. Now that being said at the lower dose didn't see this stuff. So there is a dose dependent usage of the P450 enzyme you can if I give you one drink, or if I give you a bottle of tequila 512 which in my opinion is really one of the tastiest, most fantastic tequilas you can ever get your hands on. It is delicious. It's delicious. I'm gonna I'm gonna digress right here. Oh my God, Tequila 512... Also sponsored by Tequila 512Tt was really good seriously, ummm in every single person with liver test rose.They went back to normal if they decreased the anticonvulsant or decreased the CBD. So either one it went back to normal. So it wasn't number one, it wasn't permanent liver damage. More than likely correct they were able to  return back to normal. And number two, it was simply A case of an overwhelmed P450 pathway more more than likely.So you want to get really confusing? Not really but we might as well try. I don't want to but here's what's really interesting, then they kind of get a little geeky. So GW presented their their stuff and then they showed that the P450 in this enzymes and they went into will, the CYP to, 2c19 CYP three a four can inhibit the CYP blah, blah, blah. Those are all just cytochromes people. Those are all just cytochromes It's under the umbrella of P 450. That's how complex this is. Yeah,It is nuts how complex. The highest plasma concentration to CBD occurs within two to three hours after exposure to the Epidolex. With medication, so timing of these medications going to play a role, which actually got me down a weird rabbit hole where i started thinking. We haven't done this much analysis on what happens if you take your Ace inhibiter and you take your cholesterol medicine, timing wise PK analysis on different people and everything. Because when they do these pharmacokinetics, they do it to get the FDA approval, they do it on people that are healthy, that they can understand it. Let's put this into context again, if you're listening to this you've ever taken tagamet. Have you ever thought about when you take your tagamet, you probably only take it whenever you're afraid that you're going to have acid problems, right? Cimetidine?Yeah, guess what? It's also known as a high level p 450 inhibitor if it's over consumed. So I guess what I'm saying here is, there's probably way more alarms being driven over something that yes, is handled by the P 450 system, but is far less invasive or it's much it's a much smaller vehicle on this highway than some of the other things that the alarms are not sounding over.And then surprise surprise after I just got done talking about the liver and the genetic variability and all these other things. When they looked at the pharmacokinetics there was tremendous variation. Hmm. Weird. Yeah. Odd, right? So and anybody that's listening to this that is a, a pharmacist or is a scientist or like Well, yeah, duh. Like I know, duh. But why put out such an alarming statement? Yeah. Without context.Yeah, yeah, you're right. So it for Okay, so it's a little bit of clickbait stuff, right. And so maybe even the journalist who wrote it doesn't understand specifically, the implication, they may have only seen P450, written somewhere turned to a health care provider and said, What is this? Well, that's indicating that things are rising up, they freak out. They write a headline that says CBD causes liver failure. I just learned that from this health care provider. So I'm going to write this piece.Well, that we're going to get into that. The liver failure. This is still just the FDA. Oh, yeah. To the consumer. So I hope that the FDA looks at this and says, You know what? That's right. All that stuff that was just being said it's right. But we didn't have the time to do it. We couldn't sit there put that on paper, we'd lose everybody. I get it. It's quite true. We all we all but we all have a responsibility, much like any doctor to try and explain. You and I have this ability to have this forum to reach hundreds of trillions of people.Yeah. It eflects in our subscriptions on YouTube. They so many trillions of people subscribed, they started his back over to about 200. Yeah, so every time we got trillions, they start back over. Yeah. So So anyways, so what what you're realizing here is exactly what we're talking about. When you put stress on the liver. The liver honks its horn and does a little rise and the lfts goes, Well, hey, guys, maybe not so much. Can we just back off the traffic a little bit and see what's happening here. So additional studies have shown that levels of the anticonvulsant drugs actually caused the daily effects. So now we start wondering that the that the CBD may actually rise some of the anticonvulsants and then you have more side effects from that comes down to the same thing we're talking about how many things do you want to tax your liver, that's the bottom line. To summarize high dose of a pure CBD isolate, not full spectrum, while using a mean of three other anticonvulsants can cause temporary rise in liver tests and affect the metabolism slightly of the anticonvulsant. Of note, it did not happen at lower doses. So one more time, if you are on an anticonvulsant discuss with your doctor and make sure that you stay well below the 2000 milligrams a day. Yep. So this whole thing of Oh We're going to block the P 450 the P450 is So frickin complex, it is nuts. So anything you want to add to that, because I'm going to move on to the thing that I really want to, like kind of make fun of No, not really, I just want to say that I think that the FDA, unfortunately, is a very important and serious organization within our government. And I think that for all of the flack that they take their, unfortunately, with any other entity, there are limitations on what it is that they can do. And I do believe that they try their best to fairly ascertain and address situations as they are presented to them. Regardless of how frustrated that one of this may get is we don't get a result from them. A lot of it is just simply because there's not enough manpower. Oh, absolutely. They get thrown everything think about, think if you're in an organization where you know that 70% of the crap that's out there needs to be pulled off the shelves and you're limited. It's a government organization. These people making these statements are MD's. I'm really limited fortunately, I have well, we have the show where I kind of enjoy looking up some of this stuff. Fortunately, we have some friends of ours that are that work in the nutrition industry that are fantastic at researching articles. And some of that gets gets brought to me I want to make sure that we all get better this is the whole purpose of this.Hundred percent.I want to help the FDA and help GW I want to help the CBD industry. I want to help all of it. But let's just talk about this because something super weird happened. And this is the one that got the most press A Forbes article came out that promoted a mouse study and made the sensational claim that CBD causes liver failure.Yeah, that's kind of what I was referencing earlier. I may steal the thunder but yeah, you're right.Yeah, so this is you're exactly right. In the intro, you said it was clickbait. I really after looking at this study after pulling the study, because how many people read that article are actually going to pull the study.Well is the is the person who wrote this study that well versed in reading studies like that. I mean, that's that's an important thing. I mean, they I think that probably even the author of the article feels like that they are doing a service to the reader, but probably doesn't understand. And if they do, then shame on them, but if they don't, I think that would be a better explanation doesn't fully understand how to read the study and the quality and the qualifications of that study to make a statement like that.Yeah. And you know, this, this could be an arguable point, I'm sure that the person that that wrote this feels very strongly that what they said was right, the bottom line is the goal of this study was to investigate CBD cannabidiol hepatic toxicity, meaning liver issues in an eight week old male mouse. So they they took a group of eight week old male mice, and then they gave them a CBD that they produced. The CBD that they produced and Will Clyden will just jump up and down when he hears this because he decided Is this on Chris Cresser's podcast. The CBD that they produced was used to extract using hexane, which is a molecule that is known to be hepatotoxic. Yeah, you're not supposed to have heaxane. Don't do that! Will Clyden talked about the fact that if you find a CBD with an outrageously high amount of of CB, if you find a full spectrum CBD with an outrageously high amount of CBD more so and the price ranges, okay? Because what they did is they extracted that with hexane in a cheap way and threw it in their bottle and said, there you go. Now you can check that's got 10,000 milligrams of CBD or whatever. And it's really interesting because there's so much going on in the industry like this. So this particular study out of the University of Arkansas, took the CBD, or they made their own CBD using hexane which is a hepatotoxic in itself and in their certificate of analysis. It was there and then they gave it to these mice. Second thing neatI don't even know there has to be a second but we can hear it. Because I mean seriously, that's, that's like saying, I know your stomach hurts. You should take this Pepto bismol. And then I don't tell you that I've broken up some glass shards and have you drink it and you're like i'm bleeding now! What's going on? I'm like, I don't know. Yeah, but you only paid half the price.I made it myself.Which, by the way, that last batch of propophol that you did in your bathtub is working phenomenally. I'm sure it is. Now we do not make propophol in our bathtubs.Alright, so the second issue. If we have any mice that are subscribers to our show, or listening, I would like you to have your children removed from the room at this moment. Because they took these poor mice, and they gavaged to them. Would you mind defining what gavaged is? I think it's when you kind of force feed somebody I don't think it's willing. That's your I think gavaged something you kind of threw one at me there I think to gavaged someone you basically introduce a funnel to the esophagus and well you kind of get after it, don't you? Yes, I'm currently gavaging my mic right now trying to figure it out. I just undid everything. You're gavaging our ears with your, your microphone adjustments?All right, so gavage is they forcibly give these mice?The CBD extract? Yeah, I don't think it's comfortable nor pleasant.No typically through a tube feeding or down the throat to the stomach is how they generally gavage things. A quick side note, now because I'm now all of a sudden I feel like I'm living in a glass house when I was an undergraduate student. I actually did my first surgery on a rat and we took out their adrenal glands. And I'm just saying that so I don't want to sit there and pretend like I'm not done mean things to an animal. But that was when I knew immediately I could not be a bench researcher. I did not like that. At all, now I was like, I need to, I want to heal. I want to heal. I don't want to hurt these animals, but it's it's a whole separate discussion. So anyways, so they gavage these animals with different doses, and it's really interesting. Now in what they call their defense, they call it allometric dosing, which means they're trying to get the body weight to human weight ratio appropriate. I've read some rebuttals of this article where it is a joke, you just can't do that. And when I read vitamin weed Michelle Ross? Michelle Ross, when I read vitamin weed she dis... she specifically discusses why research on CBD versus mice is very difficult to do because the weight basing the endocannabinoid system is different, all these other things. So allometric dosing being said, assuming that they're saying it's right, so the dose would be the equivalent of what they gave and What a human would give So I'm doing the allometric dosing, which I think is actually higher than what it actually is separate thing. They took mice and they gavaged them with zero milligrams of hexane derived CBD 246 milligrams per kilogram 738 milligrams per kilogram or 2460 milligrams per kilogram of dirty CBD. It doesn't make sense dirty CBD isolate. So for instance, in a horrible alternate universe where humans are now the test subjects and we have large mice which are running tests on us, and they decided to gavage me with the same thing. That would be the equivalent at the highest dose of 241,080 milligrams of hexane derived CBD isolate. I'm not even sure what the hexane would do it 240,000 milligrams 242,000 milligrams.No I mean that being the more or less than now at this point, it's just an additive. It's just I mean it's it's not an excipient It's a straight up additive. That would not make sense at all. Oh, it's crazy.It's poison.This article came out in Forbes and said CBD causes hepatotoxicity. Also hexane causes hepatotoxicity.It is nuts. Alright, spoiler alert. The mice suffered hepatic toxicity and death at the highest dose. Shocking... You know what? I also hear it's bad to have breakfast cereal with not milk but drain-o. Just something that I'm gonna go out on a whim. Don't think you're supposed to do that. It just doesn't make sense. It's It's It's not. That is not an apples to apples comparison if you're talking Okay, so we talked about it earlier. reputable CBD source there is no reputable CBD producer that's going to have and Will special shout out to you it's going to have hexane as a byproduct or an excipient in their full spectrum COA approved which is also why KBMD Health with powered by olyxenol hundred percent is does not have that. I mean they do co2 extraction, which is the important thing which is a reason why we partnered with them to make that product. So we are the one out of the 23 or 24 that is the safe and trusted COA back no hexane etc etc. Doing this study is not an apples to apples comparison on what would happen because who knows? Who Okay, I don't get it because GW we already did that study. They determined that 20 Meg's per kg which is still a shit ton. It's a lot. It's a lot. Yeahis the safe maximum dose. These guys went times it by 100.Yeah, they did.And see what happens? Yeah, it's it's a bad it's a bad comparison. I mean, yeah, honestly, if you wanted to find out if CBD plus hexane causes liver toxicity at a ridiculous amount, top to bottom, then that's a great study outside of that, since nobody does it, I would say it's a bad study. Speaking of road, that's a road to nowhere.Yeah. And so study like this, uh, like you had mentioned is essentially it's not science. It's clickbait. Yeah. And right now that that author, that journalist is just kind of laughing. He's like, I know, and now you're bringing it up, and I'm going to get another whatever, because that's what people are trying to do. They're trying to get attention at this point.So at that point, good for you, you got to click but I would be truly interested if possibly that particular journalists would say, you know what, I didn't fully understand it. I mean, that's okay. Let's look reading studies, right? There's there's a study to reading studies. I mean, we heard that we heard the breakdown that kresser did on Joe Rogan is he Twice had to address his approach to completely different topic about the the plant based diet and then how he had to re approach that with the rebuttal. All that just simply to say, there is a science to reading studies and being really good at understanding what is and is not applicable and then how to find studies that you can compare to each other for good meta analyses. So what we're doing right now is I'm telling you that maybe sometimes there aren't studies, but my anecdotal evidence, I have a busy practice, you hear the patients, we hear them talk I listen to them, when they say that doesn't work. I go, Okay, I'm not publishing it. I don't have time to do that. I wish I did. If I published everything that we're gathering data on, if we're looking at, you know, just so many different things, CBD is just one of them. We've got I love I'm a huge fan of brain.FM for the ability to use sound to change your mood. I Would love to they're unpublished, a lot of studies on stuff like that. There's, there's tons of stuff. So when people go, oh, the studies aren't out there, there is something to be said about the Socratic method, or I'm sorry, the paternalistic method, the way that medicine used to be where the guy in front of you that saw thousands of patients, this is the method that he has. You see me scope, I mean, there's a difference in scope techniques.So they, although some may even still say it qualifies as anecdotal, I will say that there's objective data in both in a scope, somebody can't just come, anybody can come to you say I feel better. Anybody can even if they don't mean it. But they can't make the disease disappear from the imaging that we see in their colonoscopy, or the the mucosal samples that you take. And that's something that's completely objective data. That we see. So those are the everyday results that we see from these types of applications where you just, look it's not made up whenever we okay full pleasure when we first started looking at CBD, I thought was bullshit. Who you looking at?Just anybody who's out there. But when we first started talking about it, I didn't believe it. I was like, man, let's see, because we've been down this road before but we tried new, new without throwing a bunch of things under the bus. We tried new or innovative different things and high hopes. And unfortunately, low expectations and the expectations get met and the hopes are never never realized. The opposite for me personally occurred with CBD over the last three and a half years. And that is it actually stinking works.Dude, I knew that we were onto something with Atrantil, because after we did the initial studies,  everybody came back and said, I want more. I knew that I was onto something or I was not on something. I knew that CBD had a viable place in my practice, because I bought and the story goes all the way back which is why we work with which is why it's powered by elyxenol right now, when we went to paleo FX, and I ordered a couple cases and I just gave them away to patients. That was not cheap. Not because I was sitting there trying to be altruistic, not because I was doing charity. I'm like, I don't know. I didn't. And I told everybody, I don't have a clue. I haven't even looked at this yet. All I know is try this. Tell me what happens. And when about 80% of them came back said I want more. And I went, Okay, we're onto something. And that's when I took my clothes off the deep dive into the science and went, holy cow. Yeah,this is crazyUp until that point, I just didn't know there was a whole lot to it. I mean, it really didn't. And then the fact is, oh, and to clarify, it's not like Brown just handed out CBD to just anybody who came to the clinic. You literally just like we did with Atrantil you found very diseased patients to say and who had gone through a gamut of different pharmaceuticals and weren't finding relief, and suddenly they're like, this is working for me. Tell me more about it. And I was, I was blown away.So let's talk a little bit. So we're I'm over here going well studies I haven't published and everything. Let's talk about a few studies. So I've got a Mendeley account, I know how to look at PubMed. I know how to get a Google Scholar, I just want to talk about a couple studies have come out recently. And let's kind of compare it and see if it still makes people concerned that they're going to die of liver failure.Sure. Alright. So in the Journal of Clinical Pharmacology published in 2019, the this was actually a study, also sponsored by GW Pharmaceuticals, as part of the process of getting the FDA approval that the FDA did not reference the best I can tell they did not reference this. This is way more complex and it gets super cool, because what they're looking at is the pharmacokinetics or how CBD is actually metabolized by that beautiful genius called a liver. In high doses in people with liver disease. Yeah, they went through the trouble to take high doses of CBD and give it to people People that did not have liver disease had mild liver disease moderate and severe. This was ballsy to say the least, because using a product like this in somebody with liver disease is is risky. This thing could backfire and it could shut down the whole process. Here's what's nuts, the pharmacologic and safety of a single oral dose of 200 milligrams of epidolex, which is the CBD isolate. They were assessed in subjects they had eight people with moderate or with mild disease, six people with moderate and eight people with severe and then they had this collection of normal people. Blood samples were collected to check for the pharmacokinetics This is how drugs are looked at. They give you a drug and then they check your levels. Basically, the blood concentration was higher in the hepatic impairment and they describe it in nanograms. So the nanogram comparison is that it's a little bit higher in those with severe hepatic impairment. But this is what's nuts there was no increase in adverse reactions. There was no change in blood levels. So basically, the only adverse reaction that they found was a little bit of diarrhea. And it all happened in the mild hepatic impairment. So the FDA had mentioned Oh, studies have shown that it causes diarrhea. What was really funny about

This episode kicks off the MedSchoolCoach case series. Here, we will listen in on discussions about cases that Dr. Renee Marinelli or other physicians have seen in their practice. Dr. James Kelly sits in as the first guest to discuss some recent cases that he has dealt with. [1:09] 35-year-old man with double vision. This had been happening for about five days and kept getting worse. The patient was bipolar and depressed, and took Depakote to treat this. However, the day he started seeing double, he had taken one extra pill. You can have a Depakote overdose even with normal labs, so Dr. Kelly had to speak with the patient’s psychiatrist to get his levels down. [6:46] 55-year-old diabetic hypertensive man. He was complaining of left-sided headaches for about three months, and now they were spreading to the right side of his head. Dr. Kelly noticed the nerve on the back of his left eye was edematous, which is always a warning sign. An MRI was ordered, and it showed that he had a subdural hematoma on that side of his head, so he was immediately sent to a neurosurgeon. The patient had fell a few months ago and hit his head but failed to tell anyone. [10:50] Key takeaways. Always be on alert for anything a little bit suspicious and never make any assumptions. The best way to recognize red flags is by seeing a lot of patients and talking to your colleagues. Even when you haven’t seen a ton of patients, keep in-tune with your own sense. If something doesn’t make sense, look for something else. Learn to ask the right questions and take your time when something doesn’t sound right.

Valproate (valproic acid, Depakote) has numerous uses which includes migraines, seizures, and bipolar disorder. In a patient who is taking valproate, it is important to monitor for signs and symptoms of confusion as this drug can cause elevated ammonia levels. When switching between dosage forms of valproate, you must recognize that the bioavailability is not the same between each different dosage form. This could lead to toxicity or treatment failure. Valproic acid has a boxed warning for hepatotoxicity and liver function needs to be monitored. Valproic acid can increase lamotrigine levels which ultimately could lead to an increased risk of lamotrigine induced SJS.

Aquinas famously said: beware the man of one book. I would add: beware the man of one study. For example, take medical research. Suppose a certain drug is weakly effective against a certain disease. After a few years, a bunch of different research groups have gotten their hands on it and done all sorts of different studies. In the best case scenario the average study will find the true result – that it’s weakly effective. But there will also be random noise caused by inevitable variation and by some of the experiments being better quality than others. In the end, we might expect something looking kind of like a bell curve. The peak will be at “weakly effective”, but there will be a few studies to either side. Something like this: We see that the peak of the curve is somewhere to the right of neutral – ie weakly effective – and that there are about 15 studies that find this correct result. But there are also about 5 studies that find that the drug is very good, and 5 studies missing the sign entirely and finding that the drug is actively bad. There’s even 1 study finding that the drug is very bad, maybe seriously dangerous. This is before we get into fraud or statistical malpractice. I’m saying this is what’s going to happen just by normal variation in experimental design. As we increase experimental rigor, the bell curve might get squashed horizontally, but there will still be a bell curve. In practice it’s worse than this, because this is assuming everyone is investigating exactly the same question. Suppose that the graph is titled “Effectiveness Of This Drug In Treating Bipolar Disorder”. But maybe the drug is more effective in bipolar i than in bipolar ii (Depakote, for example) Or maybe the drug is very effective against bipolar mania, but much less effective against bipolar depression (Depakote again). Or maybe the drug is a good acute antimanic agent, but very poor at maintenance treatment (let’s stick with Depakote). If you have a graph titled “Effectiveness Of Depakote In Treating Bipolar Disorder” plotting studies from “Very Bad” to “Very Good” – and you stick all the studies – maintenence, manic, depressive, bipolar i, bipolar ii – on the graph, then you’re going to end running the gamut from “very bad” to “very good” even before you factor in noise and even before even before you factor in bias and poor experimental design. So here’s why you should beware the man of one study. If you go to your better class of alternative medicine websites, they don’t tell you “Studies are a logocentric phallocentric tool of Western medicine and the Big Pharma conspiracy.” They tell you “medical science has proved that this drug is terrible, but ignorant doctors are pushing it on you anyway. Look, here’s a study by a reputable institution proving that the drug is not only ineffective, but harmful.” And the study will exist, and the authors will be prestigious scientists, and it will probably be about as rigorous and well-done as any other study. And then a lot of people raised on the idea that some things have Evidence and other things have No Evidence think holy s**t, they’re right! On the other hand, your doctor isn’t going to a sketchy alternative medicine website. She’s examining the entire literature and extracting careful and well-informed conclusions from… Haha, just kidding. She’s going to a luncheon at a really nice restaurant sponsored by a pharmaceutical company, which assures her that they would never take advantage of such an opportunity to shill their drug, they just want to raise awareness of the latest study. And the latest study shows that their drug is great! Super great! And your doctor nods along, because the authors of the study are prestigious scientists, and it’s about as rigorous and well-done as any other study.

"Today I want to celebrate the day when I was baptized in the Holy Ghost with the evidence of speaking in tongues. 3 weeks prior I gave life to Christ fully Blood of Jesus cleansed me and I came out world.On December, 25th 2003 I woke up endued with power! Prior a week I went to the altar asked God for this, got hands laid on me and then God, within a week, manifested this glorious transformation: from being a struggling believer to a demon hunter! Before this day I was drug addicted from cocaine to heroin to crystal meth to the point of shooting in my veins. Now I’m free! Addicted not only with pills but lust, perversion, pornography! Now free! Full of angry! Now free! Suicidal! Now alive! Arrested 47 times in 5 different prisons for drugs, bar fights, 3 DUI’s! Baker act two times! March man act 2 times! But Jesus! I spent several years between jail and institutions! I was under witch doctors of government giving me false claim: bi-polar, ADHD. I was told I was mentally dysfuinctional! I was on from Klonopin, Depakote, to Lithium, Zoloft anti-depression and anti-anxiety! But Jesus! Twenty years smoking cigarettes and drinking alcohol, in and out of the lies of A.A. and N.A., trapped in my shame, guilt, anger, and condemnation. But Jesus! The light of the World filled me with salvation, truth and hope! Thank You Father, because Your spirit overshadowed me and brought me back to life!" This video was recorded during the memorial service of Herbie Roessiger, Shane's brother. Share with others. Maybe today is going to be their day of salvation. Watch the full message: https://youtu.be/xwKoDvz9PcA For more truth: http://www.hothouseoftruth.com/truthnotforsale/

That's right, Peer Reviewed Podcast is back! All rejoice. In this exciting come-back episode you get to hear such delightful content as a casual sex, a newly discovered hominin, and Daniel Frana's strange and alarming fetish.

Agent J brings a bag of new hip hop, jazz and funk to open December. Highlights for me are the most successful LabelGroovement release so far from Mecca 83, that Polystation track (Chilean beats from Discos Cetaceos) and the dons Jungle Fire, who I hooked up with on their Manchester date at Band on the Wall. An amazing band (featuring members of Orgone, Breakestra, Ozomatli and the like) who should smash 2014 - the track below is taken from their limited-to-3oo tour CD, available only at shows. Also a shout to the homie Depakote, who has a couple of features on this mix - his new one, Creative Freedumb, is out now on Zypher. Enjoy, and let me know what you think over on Twitter (@jamiegroovement) or Facebook (/groovementradio) 00:00 Early Reed and J Scienide - MANSION & A YACHT (cuts by DJ JON DOE) 02:49 Polystation - Descoh 05:39 Mecca 83 - All Mine 09:03 PrezSport - IFYA 13:28 Fatima - La Neta 17:49 Beat Spacek - ALONE IN DA SUN 19:43 Debian Blak - Say You ft Joshua Idehen 28:14 Slugabed - U RIGHT 31:30 Robot Koch - Sugar Owl 34:34 Depakote - bionic porn 37:18 Soul Khan - Praying for a River 38:18 Débruit & Alsarah - Alrahal 41:13 Sean Price & M-Phazes - Land of the Crooks (feat. Billy Danze, Maffew Ragazino & DJ Babu) 46:03 Madlib - Hold the Organ 46:54 Bolts - Luvblind 49:31 Jef Gilson - Choro In Blue 52:26 Teotima Ensemble - Nearly Everything 1:01:13 Harleighblu - Let Me Be 1:04:59 Jungle Fire - LOS FELIGRESES 1:07:28 The Liberators - Cairo Uprising 1:11:45 Jeftuz - Spaced Out 1:14:00 Jamall Bufford - Silencers (feat. Magestik Legend) 1:19:04 Early Reed and J Scienide - FULL CIRCLE feat. Kev Brown 1:22:54 Depakote - chilllllled mannnnn

This week, I talk about the chain of events that lead to the serendipitous discovery of valproic acid. Valproic acid is one of the key ingredients in Depakote, the most widely prescribed antiepileptic (seizure-controlling) drug in the world. I introduced the topic by talking about a recent lawsuit against Abbott Laboratories, the company that makes Depakote, for illegally marketing their product...

Comedian Brody Stevens has been seen in The Hangover, The Hangover 2, Due Date, Tosh.0, and has done stand-up on The Late Late Show with Craig Kilborn and Last Comic Standing.  He's been a warm-up comic for Chelsea Lately and The Best Damn Sports Show Period.  Brody sits down with Bob in the lobby of the Radisson Hotel at the Moontower Comedy Festival in Austin, TX. 

Click to Subscribe to All Ben's Fitness & Get A Free Surprise Gift from Ben. Click here for full written transcript of this podcast episode. If you like this podcast, use the Facebook "Like" button above!      A Cold Laser: just one of the many tricks Dr. Minkoff uses to keep his body rolling. In this July 28, 2010 free audio episode: re-feeding in your diet, psoriasis management, barefoot running, food allergy testing, high heart rate when running, anaerobic exercise and cortisol, fasting and amino acids, does glucosamine work, a drink called Spiz, bipolar medications weight gain, eating to avoid diabetes, training on a fixed gear bike, getting hungry after breakfast, exercising with a sweatsuit on, choosing your sport based on body type, difference between probiotics and digestive enzymes, and post workout fuel ratios. Remember, if you have any trouble listening, downloading, or transferring to your mp3 player just e-mail ben@bengreenfieldfitness.com. And don't forget to leave the podcast a ranking in iTunes - it only takes 2 minutes of your time and helps grow our healthy community! Justclick here to go to our iTunes page and leave feedback. Scroll down to donate anything over $15 to the show, and Ben will send you a BenGreenfieldFitness.com t-shirt...you can also conveniently donate any amount with your phone by simply clicking here. ----------------------------------------------------- Featured Topic: Dr. David Minkoff In today's featured topic, Ben Greenfield interviews Dr. David Minkoff, a complementary and alternative medicine expert, owner of Body Health, director of the Lifeworks Wellness Center in Florida, and finisher of 37 Ironman triathlons. To listen to the previous podcast #26 with Dr. Minkoff, in which he discusses the main causes of illness and poor performance, just click here. Dr. Minkoff has fascinating theories on the three main causes of illness and poor performance and has a series of unique steps individuals can take to optimize their body systems and return to health naturally, without drugs. Our interview includes: -A day in the life of a natural healing physician... -Techniques he uses to drastically enhance recovery... -Common health issues he finds among both athletes and the general population... -His top recommendations for what you can do to improve your performance and health... -And much more! During the interview, Dr. Minkoff mentioned his very popular "MAP" dietary and recovery supplement. MAP stands for Master Amino Profile, and you can get it by clicking here. Dr. Minkoff also mentions the website http://www.getprolo.com. ------------------------------------------------------- Special Announcements: -Think forward to your training next January...Will you be tired of the indoor trainer and the treadmill and that black line on the bottom of the pool? Are you going to be struggling to stay motivated for those wet 5-hour slogs in this rainy/snowy winter climate? Are you planning on ANY 2011 triathlon event from Olympic distance up to Ironman? Then this event is going to be perfect for you. Pacific Elite Fitness is proud to announced an Official 2011 Triathlete Training Camp, January 31-February 7, 2011 at the Endurance Ranch in Austin, Texas! Click here for more details or to register now. - Join Ben to race a double triathlon in Thailand.! Week 1: Laguna Phuket Triathlon; Week 2: Ironman 70.3 Thailand. Ben can still get you into the sold-out race AND organize your entire trip, but you must e-mail him at ben@bengreenfieldfitness.com within the next week. - Get insider VIP tips and discounts from Ben - conveniently delivered directly to your phone! Just complete the information below... First Name Last Name Email Cell # (1+area code) -Brand new book from Ben: "How To Qualify For Kona": Let's face it. Getting to the Ironman Triathlon World Championships in Kona, Hawaii can be pretty tough. But with this new book from Ben Greenfield and the Rock Star Triathlete Academy, you'll be instantly equipped with what you need to qualify. The comprehensive manual includes: -History Of Kona Ironman World Championships -Qualification Criteria -List Of Qualifying Races -Tips From The Experts On Qualifying -Qualifying Times per Age Group -What To Expect on Race Day -Tips From the Experts on Racing Kona -Race Day Pacing and Fueling Strategies This manual comes straight from the Rock Star Triathlete Academy, and contains all the insider tips you need to begin your road to Kona! Click here to instantly download "How To Qualify For Kona" for only $27. ---------------------------------------------------------------- Listener Q&A: Do you have a question for Ben? Just call 1-877-209-9439 and leave a voicemail, leave a Skype voicemail to username "pacificfit", or e-mail ben@bengreenfieldfitness.com. Listener Chandra asks: About a month ago, I started feeling hungry all the time. Two things happened in my life around this time. One, I removed wheat, dairy, and soy from my diet. Two, I hit distance in my marathon training that I have never done before (the big 18 miler). I immediately associated my hunger with the lack of wheat so after a week of not being able to get enough food to feel satisfied, I added the wheat back to my diet. I did not see any difference in the hunger at all. I changed my weight loss rate from 2 lbs./week (1250 cals/day) to maintaining weight (~2200 cals/day) and ate my exercise calories. I continued to have an appetite increase. I do not want to increase my caloric intake to a level that would result in cessation of weight loss because I still have ~35 pounds to lose. Should I be eating my exercise calories? Should I be allowing myself even more calories while training for the marathon? What is your opinion on the increase in my appetite? In my response to Chandra, I recommended my book "Holistic Fueling For Endurance Athletes", which is available at http://www.mindsettriathlon.com , http://www.marathondominator.com and http://www.triathlondominator.com Listener Lee asks: I just wondered whether you had any diet advice for those of us who suffer from psoriasis? Is there anything in particular that can help to prevent auto-immune reactions like this? Actually, one other thing, the food allergy testing that you recommended recently, would it be possible to access that from  Australia? I don't know what the rules are regarding international stool postage! belde024 asks via Twitter: @bengreenfield I read Born to Run and now I'm interested in barefoot running. What is your take on it, and do you think it is worth trying? In my response, I reference my barefoot running interview with Tellman Knudson. neworleansview asks via Twitter: @bengreenfield Ok 42 220 6ft tall resting hr 46-50 when running should my hr go to 140 with an easy jog? Listener Christine asks: "Is there a type of exercise that is better than others for dealing with stress and counteracting the negative effects of cortisol? Is anaerobic better than aerobic? Are high intensity workouts better than longer, low intensity workouts?" psaljoughian asks via Twitter: @bengreenfield i hear leucine w/o the presence of glucose causes an insulin release. Should I not be taking bcaa's before a fasted workout? Listener Scott asks: I have just purchased your triathlon dominator package and have a couple of questions. First, I am planning on doing the 70.3 in Galveston next April and was wondering if I should decrease the workouts for it or do the whole thing? And second have you ever looked at an energy drink called SPIZ, www.spiz.net , I have used it on some sprint and Olympic distance races with good results and would like your opinion of it. Listener Edwin asks: I am a Triathlete who has had a ACL reconstruction and am looking to preserve my mobility as long as I can. There was a huge GAIT study in the effectiveness of Glucosimine HCL and it showed the supplement was no better than a placebo. So am I wasting my time with the supplement? Also ASU Avocado-Soybean-Unsaponifiables have had use in europe and are gaining some popularity here in America? What are your thoughts on ASU? In my response to Edwin, I mention the CapraFlex from http://www.doctorschoicenaturally.com (use 5% discount code BGF) Listener Amy asks: I've recently hired a personal trainer (in June), and I work out 6x per week, as well as restrict calories to 1400-1600 per day. I've lost 14 lbs since June 16th. I take Depakote and wonder if it's causing me problems losing weight. I have to lose about 80 more lbs. I see you mention Depakote in your ebook, but you don't mention how to combat it. Do you have any tips? Listener Colin asks: Have a few quick questions about my workout plan. For my lower body workout i do stepups, lunges, inner and outer thigh machine and heel raises, standing and sitting. Is that enough for a lower body workout. i also have rotator cuff issues and iv'e been trying to devise a upper body workout, that doesn't make my rotator cuff worse. Any suggestions? Listener Chris asks: My first question has to do with foods to avoid for people with diabetes.  I recently found out my mom has type 2 diabetes, and have heard that dairy, although having a low glycemic index, can have a spiking affect of the insulin response, or something like that.  Does that sound familiar?  Should she avoid dairy?  Are there other foods that should be avoided that are less common sense than high GI foods for those with diabetes? Secondly, I just bought a fixed gear bike for running errands around town and for general biking pleasure.  Would there be any training benefits to riding a fixie or things I can do with it that I normally couldn't do with a freewheel hub that can make me a better cyclist?  Or should I just use it as a practical means of transport and fun, and leave the training for another time? Listener Graeme asks: I find myself eating all the time, I really struggle to go 2+ hours without 'feeding' so I have experimented in changing my breakfast meal.  I usually have porridge with red berries and muesli mixed in.  I eat at 9 and by 12 am starving and end up eating a big lunch.  To mix things up, I have tried eating a bagel with a large coating of peanut butter, on a couple of mornings including today, and do not seem to get hungry for 3-4 hours and also no energy/glucose rush straight after that I sometimes feel after the porridge , it also seems to really curb my cravings at lunchtime.  I have not looked into calorie counting on this although my hunch is that the calorie dense peanut butter may be a little bigger calorific meal. Listener hanoncs asks via Twitter: @bengreenfield Do you think jogging with a hooded sweatshirt on will make me lose more non water weight? I know it will make me lose more weight, But is it only water weight? Thank you! Listener David asks: I have been cycling for many years and just this year began dabling in sprint and olympic distance triathlons which has required improving my swim and run.  While I have enjoyed this season with some success, I have been asking myself the question, what next?  Realizing that this decision is my own and weighs heavily on my desires and own enjoyment, from a physical, competitive perspective, could you describe the advantages one might have and what body types are typically most succcessful in cycling vs. running vs. sprint/olympic triathlons vs. half/full ironmans? Listener Meredith asks: 1) how many pills are you popping in a day?! (12 amino acid capsules?!) I'm very much a real foodist (I vote Michael Pollan on the show if possible!) and I'd prefer trying to get most of my nutrients in actual absorbable food form and non-processed. however, for heavy training i'm willing to possibly supplement a bit if it will increase endurance and reduce soreness so: 2) what would the bare bones essentials be if you wanted to pop as few pills/powders as possible? 2) I think (uneducated hunch) the stomach pains I get after taking a gel might have to do with the lab created aminos. I've tried them during runs at all times of day and all levels of gastric emptiness to the same effect. I've had better luck eating a granola bar or stinger honey chews during a 12-14 miler, but i'd prefer not to carry those or pick them from my teeth during 26 miles if possible. help! 3) follow-up to gels: i've been told that you should absolutely not mix your electrolyte drink with your gel as that will create some intestinal distress, but the same folks say to take some gatorade at some point during your run. any advice on how to intersperse these time-wise? Listener Karen asks: I have heard you say that after a workout, you should eat 2 calories of carbs per pound of your target weight, and 1/2 of that for protein ( so 1 calorie of protein per pound). My question is: Is this ratio the same regardless of the type of workout you just did? Does it vary based on intensity and duration? My workouts don't vary much as far as the time, usually 1 hour or a little more. Some days I just lift weights, others I may do an hour spin class, or I may swim for a little more than one hour. Is my recovery meal the same? Also, can you suggest some products that will provide this type of ratio in a recovery meal? Listener Kara calls in and wants to know difference between probiotics and digestive enzymes. In my response, I mention the digestive enzymes from Millennium Sports (http://www.millenniumsport.net) and the probiotics from Mt. Capra (Caprabiotics)  from http://www.doctorschoicenaturally.com (use 5% discount code BGF). Do you have a question for Ben? Just call 1-877-209-9439 and leave a voicemail, leave a Skype voicemail to username "pacificfit", or e-mail ben@bengreenfieldfitness.com. -------------------------------------------- Remember, if you have any trouble listening, downloading, or transferring to your mp3 player just e-mail ben@bengreenfieldfitness.com And don't forget to leave the podcast a ranking in iTunes - it only takes 2 minutes of your time and helps grow our healthy community! Justclick here to go to our iTunes page and leave feedback. Brand new - get insider VIP tips and discounts from Ben - conveniently delivered directly to your phone! Just complete the information below... First Name Last Name Email Cell # (1+area code): Scroll down to donate anything over $15 to the show, and Ben will send you a BenGreenfieldFitness.com t-shirt...you can also conveniently donate any amount with your phone by simply clicking here. ------------------------------------------------------

Several studies have shown that the use of Depatkote (divalproex sodium) in pregnant women significantly increases the risk of birth defects, including: spinal bifida, cleft palate, hypospadia, heart deformities, facial dymorphism , limb reduction and skeletal defects. Depakote is marketed by Abbott Laboratories and is approved for the treatment of manic episodes associated with bipolar disorders and seizure disorders like epilepsy. If you have taken this drug while pregnant, contact Mark & Associates, P.C. today.

Several studies have shown that the use of Depatkote (divalproex sodium) in pregnant women significantly increases the risk of birth defects, including: spinal bifida, cleft palate, hypospadia, heart deformities, facial dymorphism , limb reduction and skeletal defects. Depakote is marketed by Abbott Laboratories and is approved for the treatment of manic episodes associated with bipolar disorders and seizure disorders like epilepsy. If you have taken this drug while pregnant, contact Mark & Associates, P.C. today.

In a special episode of Epilepsy.com's Hallway Conversations, Dr. Joseph Sirven, Professor of Neurology at Mayo Clinic Arizona and Editor-in-Chief of Epilepsy.com/Professionals, interviews Dr. Kimford Meador from Emory University. Dr. Meador will discuss a recently published study in The New England Journal of Medicine on the topic of valproate (Depakote) taken during pregnancy and its link to lower IQs in children. This is a live taping with no questions to be answered live.