Podcasts about opioids

When you look up Ken Rideout, you get a wild list of labels: prison guard. Wall Street trader. Opioid addict. Fastest marathoner in the world over 50.In this episode, Ken sits down with Zac to talk about reinvention – and what it actually takes to change your life. From crushing opioids and cocaine, and hiding addiction while building a career in finance, to detoxing, rebuilding from the ground up, and eventually becoming a World Champion marathoner, Ken's story is one of radical ownership.We talk about:The brutal reality of opioid addictionSuboxone, Vivitrol, kratom – and the hard truths about “shortcuts”Why getting sober is the foundation for everythingRunning 4,000 miles a year as a new addictionTherapy, trauma, and what Onsite taught himMarriage, cancer, fatherhood, and what actually mattersWhy the timing is never perfect to make a changeThey also discuss Ken's new book, The Other Side of Hard, is for anyone standing at the edge of a decision – sobriety, career shift, health reset – wondering if it's possible.His message is simple:No one is coming to save you.You can reinvent yourself.Take the first step.

In the case of an overdose, a person stops breathing long before most of us realize what is happening. That is why our mantra is simple and urgent: call 911 and give naloxone. We walk step by step through recognizing an opioid overdose, using nasal naloxone in under a minute, and staying safe while you help. You do not need a medical degree to save a life; you need a clear plan, Naloxone, and the courage to act when someone will not wake up.We break down how opioids shut down the brain's breathing center and why unresponsiveness plus poor breathing should trigger immediate action. You will learn the key visual cues, when pinpoint pupils help and when mixed drugs blur the picture, and why naloxone is still a smart move even if alcohol or other substances are involved. We also confront stigma head-on, separating withdrawal management from life-saving priorities, and share a powerful ER story where Naloxone rescued a patient from an overdose in minutes.Fentanyl demands new habits. We explain why it often takes multiple naloxone sprays, debunk fears about casual skin contact, and outline a compact PPE kit—mask, eye protection, nitrile gloves—to protect against airborne powder or accidental transfer. We cover re-overdose risks when naloxone wears off, the critical role of EMS observation, and practical tips on storage, expiration, and keeping naloxone in your glove box or bag. Along the way, we highlight Good Samaritan protections that reduce fear of calling for help, so more people step forward when it counts.If you care about harm reduction, community safety, and giving people a second chance, this guide is for you. Hit follow, share this episode with a friend who should carry naloxone, and leave a quick review so more people learn how to act when seconds matter.To contact Dr. Grover: ammadeeasy@fastmail.com

There are signs the presence of fentanyl, a powerful synthetic opioid, may be declining in Montana. The drug was largely responsible for the increase of opioid overdose deaths during the pandemic. Now other dangerous drugs are emerging in the state.

Send a textGene regulation through RNAs, the neurobiology of opioid addiction, and how psychedelics affect drug-seeking by modulating inflammation and plasticity. Not medical advice.TOPICS DISCUSSED:Gene regulation basics: DNA transcribes to RNAs, including non-coding types like microRNAs that inhibit mRNA translation into proteins, influencing up to 60% of the proteome.Non-coding RNAs in neuroplasticity: MicroRNAs and circular RNAs regulate synaptic changes, with activity-induced ones like miR-485-5p linked to rapid responses in drug cue memory and addiction reinforcement.Opioid addiction models: Rats self-administer heroin or fentanyl via levers, showing compulsive seeking; fentanyl's higher potency drives faster learning but similar long-term effects to heroin when doses are equated.Differences between opioids: Heroin and fentanyl both activate mu-opioid receptors for euphoria and dopamine release, but fentanyl lingers longer; no major behavioral differences in seeking once potency is matched.Psilocybin's effects on addiction: A single psilocybin dose post-abstinence reduces heroin-seeking in rats by dampening neuroinflammation in brain regions like the nucleus accumbens and prefrontal cortex.Brain Inflammation: Opioids induce pro-inflammatory changes via cytokines like IL-17A and pathways like TNF-alpha, leading to glial activation and blood-brain barrier leaks; psilocybin counters this.MicroRNA biomarkers: Blood microRNAs reflect gene expression patterns tied to disease states, with potential to predict opioid relapse risk, treatment response, or neonatal withdrawal severity non-invasively.Future research: Ongoing work links psilocybin's serotonin 2A activation to anti-inflammatory gene changes, plus human studies on microRNAs for personalized addiction treatments.ABOUT THE GUEST: Stephanie Daws, PhD is an associate professor at Temple University in the Center for Substance Abuse Research and Department of Neurosciences, where she researches mechanisms of drug-seeking behavior with a focus on opioids and psychedelics.RELATED EPISODE:M&M 2 | Psilocybin, LSD, Ketamine, InflamSupport the showHealth Products by M&M Partners: SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off. Lumen device: Optimize your metabolism for weight loss or athletic performance. MINDMATTER gets you 15% off. AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models. Seed Oil Scout: Find restaurants with seed oil-free options, scan food products to see what they're hiding, with this easy-to-use mobile app. KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime) For all the ways you can support my efforts

Community News and Interviews for the Catskills & Northeast Pennsylvania

Construction is full of tough people… and that toughness is costing lives. In this raw conversation on masculinity, enoughness, mental health, addiction, and suicide prevention, Brandon Anderson (a construction safety leader and mental health advocate) explains why the construction industry has one of the highest suicide rates—and why the real danger isn't just the jobsite. It's the silence. The “suck it up” culture. The belief that men are disposable. The coping that turns into alcoholism, opioids, and overdoses. If you've ever felt like you had to carry everything alone, this episode will hit hard—in the best way. You'll hear why most people don't need perfect advice… they need someone to listen. You'll learn a simple 60-second check-in that can save a life, what to say when someone opens up, and how to spot the quiet signs when a friend is not okay. This is for construction workers, blue-collar men, leaders, fathers, husbands, and anyone who wants to help someone struggling with depression, addiction, or suicidal thoughts. You are not alone. And your story isn't over. You'll learn why “tough guy” masculinity can block men from asking for help and how that fuels mental health struggles in the trades. You'll hear what to say when someone finally opens up, including how to avoid turning it into a comparison story and instead respond with presence and trust. You'll learn the 60-second pause technique—how to ask “No, really… how are you?” and listen long enough for the truth to come out. You'll also hear why hope matters, how “Hold On, Pain Ends” reframes suicidal pain, and how leaders, coworkers, and friends can create a culture of care without turning it into performative “touchy-feely” nonsense. 00:00 Intro00:18 Meet Brandon Anderson + construction background02:22 Why construction has a major mental health + suicide problem07:13 The “suck it up” culture and why men don't ask for help10:12 Feeling disposable at work and in society11:35 Most people just need someone to talk to15:13 The real demographics affected (not just “kids”)20:16 Opioids, injury, and the overdose pipeline21:39 Personal loss + why conversations like this matter24:09 Hope stands for Hold On, Pain Ends33:14 What to say when someone opens up34:01 The 60-second check-in that can save a life36:52 The Hope Coin idea and reaching the unreachable41:14 Trust your gut and reach out44:05 Listening as leadership (and real ministry)48:09 Practical takeaways to take action today49:37 Where to connect with Brandon (LinkedIn/IG/Facebook) #MensMentalHealth #SuicidePrevention #ConstructionLife #AddictionRecovery #Masculinity Learn more about your ad choices. Visit megaphone.fm/adchoices

Episode 187 of Limb Lengthening LIVE is an open mic discussion! Patients are invited to join the stream, share their stories, updates, and ask questions in real time._____________________Audio Podcast - will be available within 24-48hrs after stream endsTimestamps - 0:00 Intro3:25 Opioid tapering, pain expectations & early recovery5:37 Over-lengthening risks, ballerina foot & complications11:08 What limb lengthening pain actually feels like13:46 Genetics, height goals & safe lengthening ranges16:34 Guest MD joins — weight gain, diet & recovery talk20:03 Safe height goals by starting height (5'7 example)21:48 Knee clicking after femur lengthening — rehab advice25:24 PT vs gym training — what matters most during LL28:04 Hiding limb lengthening, lifts & social perception31:10 Surgeon selection — experience vs newer clinics35:34 Walking mechanics, glute training & fixing the waddle41:08 Tibia lengthening challenges, stretching & inversion49:42 Cosmetic surgery stigma, mindset & motivations58:10 Recovery timelines, work during lengthening & lifestyle1:08:05 Housing, travel logistics & patient routines1:15:08 Accordion technique explained (bone healing strategy)1:24:29 Dating, proportions & real-life confidence after LL1:32:08 Bodybuilding talk + physique vs bodybuilding goals1:40:08 Rapid fire Q&A — nails, height goals & safety1:45:25 OutroFind Links to Everything Here and Below: https://sleekbio.com/cyborg4life

Opioids, Methamphetamines & Benzodiazepines In Part 2 of our evidence-based series on substance use in pregnancy, we're diving into substances that often come with the most fear—and the most misinformation. In this episode, we cover: Opioids (including prescription pain medications, heroin, and fentanyl) Stimulants, including methamphetamine Benzodiazepines (such as Xanax, Ativan, and Klonopin) We break down what the medical research actually shows about how these substances can affect pregnancy, the fetus, and the newborn—without judgment, shame, or scare tactics. We also talk about neonatal abstinence syndrome, treatment options during pregnancy, and why supportive, medically guided care leads to better outcomes for both parent and baby. Whether you're pregnant, supporting someone who is, or simply want reliable information, this episode is about replacing fear with facts and stigma with science.

How one addiction clinic in Baltimore has found success combining addiction care with support for the many other health problems older Americans often face.Guests:Malik Burnett, Medical Director, REACH Health ServicesLisa Clemans-Cope, Senior Research Fellow, Urban InstituteRenee Gray, Patient, REACH Health ServicesPhyllis Lindsay, Peer Recovery Specialist, REACH Health ServicesMaggie Lowenstein, Assistant Professor, Medicine, University of Pennsylvania Perelman School of MedicineVickie Walters, Executive Director, REACH Health ServicesLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.

Opioid use disorder is the third most prevalent substance use disorder worldwide. Author Alexander Walley, MB, MSc, of Boston Medical Center and Boston University joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss the efficacy, safety, and practical considerations of treating patients with medications for opioid use disorder, opioid withdrawal, and opioid overdose. Related Content: Medications for Opioid Use Disorder, Opioid Withdrawal, and Opioid Overdose

This podcast will discuss the CPS Statement on Managing Newborns at Risk for Neonatal Abstinence Syndrome (NAS)/Neonatal Opioid Withdrawal Syndrome (NOWS): Updates and Emerging Best Practices. This Podcast was created Lauren Wilkinson, a second-year medical student at Queen's University, andDr. Astrid Guttmann, a pediatrician at SickKids Hospital. This PedsCases podcast focuses on an overview of managing newborns at risk for neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS). There are no conflicts of interest to disclose by the authors.

In this week's episode of High on Home Grown, we're covering major busts, powerful medical stories, and some interesting shifts in policy and public opinion: Macky starts with a huge find from the BBC, where police discovered a £7.1 million cannabis operation inside a derelict high school. It's another example of the scale some underground grows are reaching, and the strange locations they're turning up in. He also shares the touching story of a young girl whose family says medical cannabis has transformed her life, highlighting once again the real human impact behind the ongoing fight for better access. John brings political developments from the US, where Wisconsin senators have approved a Republican-led medical marijuana bill, even as Democrats continue pushing for broader recreational legalization. It's a clear sign of how the conversation is evolving, even in more conservative states. We also look at an opinion piece explaining why many law enforcement officers are supporting Trump's rescheduling move, a shift that shows attitudes are changing even within traditional enforcement circles. And Smee rounds things off with new research showing daily opioid use dropped by 9 to 11 percentage points following recreational legalization, adding to the growing evidence that legal access may play a role in reducing reliance on more dangerous substances. Another packed episode full of real-world impact, changing attitudes, and stories that show how fast the landscape continues to shift.

This Day in Legal History: 20th AmendmentOn February 6, 1933, the 20th Amendment to the U.S. Constitution officially went into effect, reshaping the timeline of federal political power transitions in the United States. Commonly known as the “Lame Duck Amendment,” it was ratified just weeks earlier, on January 23, 1933, but became operative on this day. The amendment moved the inauguration dates of the president and vice president from March 4 to January 20 and newly elected members of Congress from March 4 to January 3.This was a significant reform. Previously, there had been a long delay—about four months—between election and inauguration. The result was a period where outgoing officials retained power despite potentially losing their mandates, often leading to inaction and political stagnation. This was particularly problematic during times of crisis. For example, after Franklin D. Roosevelt won the 1932 election, he had to wait until March to take office while the nation was deep in the throes of the Great Depression, and President Hoover remained largely inactive.The 20th Amendment also clarified procedures for what should happen if the president-elect dies before taking office, a scenario not fully accounted for in earlier constitutional provisions. Section 3 addresses this contingency, while Section 4 gives Congress the authority to legislate procedures for succession and emergencies.By speeding up the transfer of power, the amendment reduced the influence of “lame duck” sessions, promoting a more responsive and democratic governance structure. It also underscored a constitutional shift toward greater efficiency in the federal system.The Trump administration has appointed 33 new immigration judges, 27 of whom are temporary, following the dismissal or departure of over 100 judges since Trump's return to office in January 2025. This reshaping of the immigration court system is part of a broader push to increase deportations and speed up case processing. The newly sworn-in judges will serve in courts across 15 states, including Texas, California, and New York.A significant number of the appointees have military experience—half of the permanent judges and all of the temporary ones—reflecting a Pentagon-supported effort to deploy Defense Department lawyers into immigration roles. Critics, including the American Immigration Lawyers Association, argue that the mass firings have severely depleted judicial capacity, especially amid a record backlog of 3.2 million pending immigration cases.The administration is also set to introduce a regulation reducing the time migrants have to appeal deportation rulings from 30 to 10 days. This fast-track process would give the Board of Immigration Appeals greater authority to summarily dismiss appeals, a move likely to draw legal challenges given prior rulings against similar reinterpretations of immigration law.Trump administration names 33 new immigration judges, most with military backgrounds | ReutersBrad Karp has stepped down as chairman of Paul, Weiss, Rifkind, Wharton & Garrison LLP following revelations of his extensive correspondence with Jeffrey Epstein. The emails, released by the Department of Justice, revealed years of personal and professional interaction between Karp and Epstein, including Karp's praise of legal arguments dismissing victims' claims and discussions about sensitive financial matters involving Epstein's associates. Though Karp has not been accused of any criminal wrongdoing, the disclosures created internal and public pressure leading to his resignation.Karp will remain at the firm in a non-leadership role, while corporate department head Scott Barshay has assumed the chairmanship. Barshay is known for high-profile mergers, including deals involving Chevron and Anheuser-Busch. Karp had led the firm since 2008, building its revenue significantly and taking on both corporate defense and progressive political causes.The fallout also reignited criticism over Paul Weiss' controversial 2025 deal with the Trump administration. In that arrangement, Karp brokered pro bono legal commitments in exchange for the rescission of an executive order that limited the firm's federal work—an effort that involved direct lobbying by Robert Kraft and a meeting with Donald Trump.Epstein emails lead Brad Karp to resign as Paul Weiss law firm chairman | ReutersA federal jury in Phoenix has ordered Uber to pay $8.5 million to Jaylynn Dean, who said she was assaulted by a driver at age 19. The trial, the first of over 3,000 consolidated cases, served as a bellwether to assess the legal strength and settlement value of similar claims. The jury found the driver acted as an agent of Uber, making the company liable, but declined to award punitive damages.Dean's lawyers argued Uber knowingly failed to implement safety improvements despite rising reports of assaults. The case highlighted Uber's marketing to women as a safe option, which attorneys said misled passengers about real risks. Dean was intoxicated when she ordered a ride in Arizona in 2023 and was allegedly attacked after the driver stopped the vehicle.Uber denied liability, stating the driver had no criminal record and that the incident was unforeseeable. The company emphasized that it passed background checks and claimed the jury's decision supported its broader safety efforts, though it plans to appeal.The trial has implications for both Uber and Lyft, whose shares dipped following the verdict. Analysts believe the case may lead to enhanced background screening across the ride-hailing industry.Uber ordered to pay $8.5 million in trial over driver sex assault claims | ReutersA legal fight has emerged between a group of U.S. states and pharmacist T.J. Novak, a whistleblower seeking a portion of the $4.7 billion opioid settlement the states reached with Walgreens. Novak previously filed a federal False Claims Act case accusing Walgreens of unlawfully filling opioid prescriptions and billing government health programs. The U.S. government settled with Walgreens for $300 million, including $150 million tied to Novak's claims—earning him a whistleblower payout of over $25 million.Novak now argues that the states' massive 2022 settlement with Walgreens also resolved his state-level claims under their respective false claims statutes, entitling him to additional compensation. The states dispute this, saying their deal addressed public nuisance concerns, not false claims violations. They warn that granting Novak a cut would force courts into a complex and inconsistent analysis across 28 different state laws and could open the door to broad whistleblower entitlements in future state actions.Key states like Rhode Island, North Carolina, and Virginia filed briefs opposing Novak's claim, stressing the differences in statutory frameworks and the nature of the claims resolved. The outcome could impact future whistleblower litigation involving parallel state and federal claims tied to nationwide corporate settlements.States square off with opioids whistleblower over payout from $4.7 billion Walgreens settlement | ReutersThis week's closing theme is by Felix Mendelssohn.This week's closing theme is Lied ohne Worte, Op. 109, by Mendelssohn, a composer whose refined lyricism shaped the early Romantic era. Born in 1809, Mendelssohn was a prodigy who bridged Classical form and Romantic expression with grace and clarity. His Lieder ohne Worte—or “Songs Without Words”—are brief piano pieces that aim to convey the emotional depth of a song, but without lyrics. Op. 109, one of the last in the series, is especially introspective and serene, a quiet farewell rendered in music alone.Today, February 6, holds subtle resonance in Mendelssohn's legacy. Though his death is commonly dated to November 4, 1847, some historical sources using the Julian calendar recorded it as February 6, making this date a quiet point of remembrance in certain circles. In that light, Lied ohne Worte, Op. 109, feels like a particularly appropriate selection—a final musical gesture from a composer who believed some feelings transcend words.It's also a fitting close to a week of heavy stories—legal struggles, political reshuffling, and institutional reckonings. Mendelssohn offers no commentary, just clarity and calm. In the hush of his music, we're reminded that reflection doesn't always need a headline.Without further ado, Lied ohne Worte, Op. 109, by Felix Mendelssohn – enjoy! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.minimumcomp.com/subscribe

Send us a textPharmacology & neurobiology of psychedelics & MDMA, focusing on isomers, sex-specific effects, and mechanisms in animal models. Not medical advice.TOPICS DISCUSSED:Biased agonism: Different drugs activate the same receptor (e.g., 5-HT2A) but trigger varied intracellular pathways, explaining why LSD is psychedelic while similar lisuride is not.Enantiomers & isomers: Mirror-image versions of drugs like MDMA (S and R forms) and LSD (four isomers) often produce distinct effects; only one LSD isomer is psychedelic, for example.MDMA isomer effects: S-MDMA induces stronger head twitches (psychedelic proxy) via serotonin release, and increases dendritic spines in male mice but not females; R-MDMA has somewhat different effects.Sex-specific drug responses: In mice, females show stronger psychedelic effects (head twitches) from psilocybin and DOI at the same dose, but males exhibit greater post-acute benefits like reduced opioid withdrawal.Psilocybin in opioid addiction models: A single dose reduces place preference for oxycodone and withdrawal symptoms in male mice more than females, with opposite spine density effects in reward-related brain areas.Mechanisms beyond 5-HT2A: Psychedelics involve other receptors like metabotropic glutamate receptors, forming dimers with 5-HT2A to enable dual signaling pathways; effects in subcortical regions like nucleus accumbens are 5-HT2A-independent.Clinical implications: Street MDMA may vary in S/R ratios, affecting experiences; clinical trials often use racemic mixtures without weight-adjusted dosing, potentially missing sex differences.ABOUT THE GUEST: Javier Gonzalez-Maeso, PhD is a professor of pharmacology and toxicology at Virginia Commonwealth University, with a PhD in medicine from Spain focused on G-protein coupled receptors and human brain studies in depression and addiction.RELATED EPISODE:M&M 230 | Psilocybin & MDMA: Inflammation, Stress & Brain-Body Communication | Michael WheelerSupport the showHealth Products by M&M Partners: SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off. Lumen device: Optimize your metabolism for weight loss or athletic performance. MINDMATTER gets you 15% off. AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models. Seed Oil Scout: Find restaurants with seed oil-free options, scan food products to see what they're hiding, with this easy-to-use mobile app. KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime) For all the ways you can support my efforts

Welcome to Episode 53 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! News Reports Mission Local. (2025, December). Timeline of the fatal stabbing at a San Francisco hospital. https://missionlocal.org/2025/12/sf-hospital-killing-timeline/ YouTube. (n.d.). News report on stabbing at SFG [Video]. https://www.youtube.com/watch?v=JAGzwGwJcXI Segment 1: The Wet Read (1 min | YouTube Short) JournalFeed. (2020). Epinephrine 0.3 mg or 0.5 mg for anaphylaxis? https://journalfeed.org/article-a-day/2020/anaphylaxis-guidelines-2020/ JournalFeed. (2020). Anaphylaxis guidelines for 2020. https://journalfeed.org/article-a-day/2020/anaphylaxis-guidelines-2020/ Hayden, F. G., Sugaya, N., Hirotsu, N., Lee, N., de Jong, M. D., Hurt, A. C., … Baloxavir Marboxil Study Group. (2018). Baloxavir marboxil for uncomplicated influenza in adults and adolescents. New England Journal of Medicine, 379(10), 913–923. https://www.nejm.org/doi/full/10.1056/NEJMoa1716197 Wang, Y., Chen, L., & Zhang, Y. (2021). Clinical efficacy and safety of baloxavir marboxil in the treatment of influenza: A systematic review and meta-analysis of randomized controlled trials. Journal of Infection. https://www.sciencedirect.com/science/article/pii/S0163445321000512 Segment 2: Dry Scan (2–3 min | TikTok) JournalFeed. (2023). New PECARN C-spine rule. https://journalfeed.org/article-a-day/2023/new-pecarn-c-spine-rule/ JournalFeed. (2023). C-spine clearance in kids: What you need to know. https://journalfeed.org/article-a-day/2023/c-spine-clearance-kids/ JournalFeed. (2024). New, dangerous synthetic opioids hit the streets. https://journalfeed.org/article-a-day/2024/new-dangerous-synthetic-opioids/ JournalFeed. (2024). Synthetic opioids: The nitazene wave. https://journalfeed.org/article-a-day/2024/synthetic-opioids-nitazenes/ Segment 3: Oral Contrast (10 min | YouTube / Instagram) JournalFeed. (2023). Can we spot potentially violent patients at the door? https://journalfeed.org/article-a-day/2023/spot-violent-patients/ JournalFeed. (2023). What precedes and leads to workplace violence? https://journalfeed.org/article-a-day/2023/workplace-violence-healthcare/ JournalFeed. (2024). Healthcare violence is too high—3 ways to break the cycle. https://journalfeed.org/article-a-day/2024/healthcare-violence-cycle/ Our social media: TikTok: https://www.tiktok.com/@ccme_courses Instagram: https://www.instagram.com/ccme_courses Facebook: https://www.facebook.com/CenterForMedicalEducation LinkedIn: https://www.linkedin.com/in/rickbukata Our podcasts: The 2 View Podcast (Free): Subscribe on Apple Podcasts https://apple.co/3rhVNZw​ Subscribe on Google Podcasts: http://bit.ly/2MrAHcD​ Subscribe On Spotify: http://spoti.fi/3tDM4im Risk Management Monthly Podcast (Paid CME): https://www.ccme.org/riskmgmt ** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. The information in this video is for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem. Nothing here should be construed to form an attorney-client relationship. ** emergencymedicine #cme

Contributor: Alec Coston, MD Educational Pearls: BiPAP is often effective in severe asthma, but many patients struggle with mask tolerance due to intense air hunger–driven anxiety, often compounded by hypoxia. Benzodiazepines are commonly used for anxiety, but they can depress respiratory drive, making clinical improvement difficult to interpret (a lower RR may reflect sedation rather than true physiologic improvement). Low-dose fentanyl is a useful alternative when patients cannot tolerate BiPAP despite coaching. Opioids blunt the perception of dyspnea and are well established for treating air hunger. When carefully titrated, fentanyl provides anxiolysis without significant respiratory suppression. It is rapidly titratable (e.g., 25 mcg IV every 5 minutes). Evidence primarily comes from palliative and oncology literature, but growing clinical experience supports its use in severe asthma to improve BiPAP tolerance. Failure of fentanyl should prompt escalation to ketamine, often signaling impending need for intubation. References Pang GS, Qu LM, Tan YY, Yee AC. Intravenous Fentanyl for Dyspnea at the End of Life: Lessons for Future Research in Dyspnea. Am J Hosp Palliat Care. 2016 Apr;33(3):222-7. doi: 10.1177/1049909114559769. Epub 2014 Nov 25. PMID: 25425740. Summarized and edited by Meg Joyce, MS2 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

Fatal overdoses are rising among adults 45 and older and stigma often keeps this age group out of the conversation. In this episode, Dr. Philip Chan, Consultant Medical Director at the Rhode Island Department of Health and a practicing primary care physician, discusses Rhode Island's No Matter Why You Use campaign. Dr. Chan explains why middle-aged and older adults face elevated overdose risk, how isolation, medical prescribing, and a contaminated drug supply intersect, and why personal storytelling is key to reducing stigma about accessing care. The conversation also highlights Rhode Island's overdose prevention strategies—from widespread naloxone access to community partnerships—and shares lessons other states can apply to save lives and start conversations sooner.Webinar Registration - ZoomOverdose Prevention | ASTHO

This episode breaks down ACEs (Adverse Childhood Experiences) and the Opioid Risk Tool (ORT) — what these tools were actually designed for, and how they're often misapplied in pain care to flag patients as “high risk” and deny treatment.We walk through:• what ACEs really measure• how the Opioid Risk Tool was created• where the sexual trauma question came from• why these tools were never meant to be used to deny care• and how trauma history screening is being used against pain patients in practiceThe misapplication of these tools is what pushed me to become an advocate in the first place, and we've spent years documenting and raising awareness about this issue.This recording was originally shared privately with our Patreon community in 2024. I've now made it public so anyone can hear the full explanation directly, with the research and context included.If I reference documents or screenshots during this episode, you can find the full video version on our YouTube channel.—

The following is an AI-generated rough transcript of the Equipping Hour. It may contain inaccuracies.  Opening and Introduction Smedly Yates: Well, good morning. Happy Sunday. Welcome to Grace Bible Church this morning and to Equipping Hour. This morning, we’re going to be doing a follow-up from an equipping hour that Jake taught on January 11th on dementia. And that was, Jake, that was riveting and encouraging. And I thought you taught us everything we needed to know, but apparently you didn’t. Because the numbers of follow-up questions from that equipping hour broke all records. So we’ve sort of accumulated those questions. And let me just encourage you, if you didn’t get a chance to listen to that equipping hour from January 11th, pull it up on the website, go back and listen to that. And this morning, what we’re going to do is just put the questions that many of you asked in person and submitted. Or just get to ask those of Jake in front of all of us. And so Jake really is going to give most of the answers here. I don’t know if I have a whole lot to say. Other than these are the questions we got, Jake, help us. So with that, let me open us in a word of prayer and we’ll get started. Heavenly Father, thank you so much for your kindness to us. We don’t deserve to have physical ability endure in this life. We don’t deserve to have mental capacity sustained in this life. We truly only deserve condemnation under your wrath for our sins. And so anything that you give to us, we pray to use as a gift, as a stewardship, to use well and for your glory, and to be content and to trust you as things diminish. And we thank you for the preparation, for mental decline. You’ve already given us from principles from your word. We pray even now as we discuss caring for one another and seeking to glorify you in personal worship in our physical existence that you would be honored as we listen and apply and are strengthened and sharpened to help others. We ask all this in Jesus’ name. Amen. I’m going to start with kind of a personal question that came in, Jake, and it goes like this. If I try not to get dementia, you gave us a lot of helps, dietary exercise, sleep, some of those things that were really helpful, practical things. So if I’m doing those things, if I’m trying not to get dementia, am I expressing distrust and dissatisfaction in God and his sovereignty? Stewardship, Planning, and God’s Sovereignty Jacob Hantla: Maybe. So, yeah, we spend a lot of time talking about the practical ways that you might want to steward this life and this body that God’s given you. The big hitters were exercise, right? We said if there’s one that you can do, it’s that. But there’s a lot more. There’s a, but if you’re doing those things, is that sinful? It might be. There’s a way to do the right thing for the wrong reasons. Planning, though, is not unbelief. Planning like God doesn’t exist is unbelief. or planning like God’s way isn’t best in your selfishly, arrogantly grabbing after your own desires. That’s unbelief. That’s sin. So the issue isn’t whether you should steward, but it’s whether an action that you’re saying is stewardship is actually a mask for control, pride, and fear. Proverbs 27:12 says the prudent sees danger and hides himself. There’s a way to see that. Where you see danger, you hide yourself from it. You take planned steps in order to avoid it that actually roots itself from fear of the Lord. And that would be right. And in contrast, it says the simple go on as if that danger isn’t there and they suffer for it. So there’s nothing inherently righteous or right and just saying, I’m going to trust the Lord and use that as a mask for just lazy thoughtlessness. Similarly, there’s nothing righteous at all in saying, I don’t want what I fear is coming and I’m going to grasp after what I want. But James 4, you guys might want to open there. This is, a really, really helpful section of scripture for planning. And it reveals why we actually have to, at the heart of all of this, guard our hearts, not merely do the right thing. James Chapter 4. And this is in the context of the warning, or the command to humble yourself from verse 10, humble yourselves before the Lord because God resists the proud and gives grace to the humble. And now, he says, come now, verse 13, you who say today or tomorrow, we’re going to go into such and such a town, spend a year there trade, and make a profit. Yet you do not know what tomorrow will bring. What is your life? You’re a mist that appears for a little time and then vanishes. Instead, you ought to say, if the Lord wills, we will do this or that. So the take home from that is not don’t plan, don’t run a business, but rather as you run it, run it as one who actually embraces and recognizes your temporalness, your weakness, your dependence, and God’s sovereignty. Smedly Yates: If we zoom out from the topic of dementia, and we just think about the principle underlying that, we’re dealing with the realities of God using human means in his sovereign plans. If we rephrase the question, we might say, is it sin and distrust of the Lord to study for your chemistry exam? No, of course not. Can you sin by studying for your chemistry exam without thought toward God and exalt your own pride and intellect and your hard work? Yeah, that’d be wrong. A godless, practical, atheistic approach to effort would be sin. But a laziness that says, well, I’m just trusting in the Lord, but I’m not going to go apply for a job, study from my exam, practice for the athletic endeavor, or whatever is sin the other way. And I love the example of evangelism. We know that God will save people, but we know that God uses means to do it. So is it a failure to trust God when I go out and share the gospel with people? No, it’s actually the obedience that God uses as a means to accomplish his ends. Now, I can’t control the results. So you can be faithful, worshiping the Lord, telling others how great Jesus is all day long and nobody gets saved and God is honored and we trust him. Jacob Hantla: Yeah. There’s two biblical, I love the illustration. It’s throughout the Bible of horses and chariots. You can write down Proverbs 21:31 and Psalm 20:7. In Proverbs 21:31, it says, the horse is made ready for the day of battle. Who does that? We do that. The people do that, and they go, battle, but it says, but victory belongs to Yahweh. And similarly, in Psalm 20:7, this, this was actually one of my favorite passages in fighting cancer. I stole it from Piper in his book, Don’t Waste Your Cancer. He says, some trust in chariots, and some in horses, but we trust in the name of Yahweh our God, which doesn’t mean go to battle with slow horses and broken down chariots, it’s wise to get the best you can. If you know that you might be facing a future with dementia or anything else you might face, chemistry test or other health problem, be diligent to plan, but do it in a way that when you don’t get dementia, it wasn’t your effort that gets the glory. It was Yahweh’s. And if you get dementia anyway, you say, it was the Lord’s will. It’s best, I trust. Reverse Sanctification and Dementia Smedly Yates: A question came through, and really there were several facets that sort of get at the same kind of question. But people wondered, and this comes obviously from people who have worked hard to care for people with various forms of dementia. But it seems like Christians at times can experience what looks like reverse sanctification. Is that what’s going on there? Have people been abandoned by the Holy Spirit when behaviors change in mental decline. Jacob Hantla: Yeah, I think probably about five, six of you asked that question with very particular circumstances in mind. And the question doesn’t overstate the reality of what occurs. So reverse sanctification. Sanctification is the process of progressively being conformed to the image of Christ from the point of salvation, usually, and normally for a Christian, until the point when they finish well, die, and are taken home, and then glory. But that doesn’t always happen for Christians. The reality is sometimes in dementia, some Christians become more childlike in their faith. It’s not inevitable that your sanctification will reverse. And I don’t think that’s the right term. It’s the observed reality that we see. But sometimes their faith becomes more simple, but not less godly. They might tell the same stories over and over again. Or if you imagine sometimes what happens in dementia, your existence in the moment is separated from what’s gone before it. So you’re always disoriented. That’s terrifying. And so you see the Christian in those moments having a childlike trust questions that you feel bad for them, but they are trusting the Lord in a real way. But sometimes, and this is the words of Dr. John Dunlop, wrote a book on the Christian and dementia. He goes, dementia can indeed change personalities. It has transformed wonderful, loving, godly people into tyrants. And that happens. I’ve seen, you see somebody who was self-controlled loving. and as they progress into dementia, they curse. They use language that’s not befitting a Christian at all. There’s inappropriateness in all kinds of ways. And so what’s going on there? I think it’s helpful. I’m going to do another physiology lesson. Bear with me, I promise it’s worth it. It helps me. So there’s some types of dementia, especially that there’s one we talked about called frontotemporal. What does that mean? It’s the area of the brain in which it happens. And it changes the way that your brain physically works. So there’s an, I’m going to oversimplify a little bit. So, but this is, this is helpful. If you think of your prefrontal cortex, you might have heard that word because we joke. Teenagers, their prefrontal cortex isn’t fully developed. And that’s true. It’s why you don’t trust your kids to make life-altering decisions. But the prefrontal cortex is, you could think of it as the executive control center of your brain. It houses the part of your brain for abstract thought, concentration, working memory, and most critically, inhibition of inappropriate thoughts and actions. You and I do it all the time you think it’s like the breaks. There’s a filter on, thank God there’s a filter, right? Something comes to your mind and it doesn’t come out your mouth. Because of the prefrontal cortex, it overrides automatic impulsive thoughts. It helps you consider the consequences in the future before acting. It connects your current behaviors to the past experiences and your goals. And when that area is damaged, somebody has a really hard time choosing the appropriate behavior for the situation. The damage, it sort of removes the filter. There’s another thing, orbital frontal cortex. It’s just another area of your brain. You don’t need to know the big word. But what that is is that’s particularly critical for regulating social behavior. When that area of the brain gets damaged, like if you get a cancer to that area or a surgery that affects, that area instantly, that person can explain what appropriate social behavior is, but they don’t recognize when their behavior violates that. So it’s manifested by like just a list from a textbook that I looked up on this. It’s greeting strangers in an overly familiar manner, standing too close to others, inappropriate touching, being aware of social norms, like I said, but unaware that your behavior violates that, and that can go to extremes, sexual inappropriateness, language inappropriateness, and they’re just unaware. You and I, if we were to be saying that, it would be sin. In this case, it actually may represent a physical inability. So what’s going on there? I want to think about the brain and the believer. When the Holy Spirit expresses self-control in a believer. So, right, the fruit of the spirit is self-control. And I just said, well, self-control comes from the prefrontal cortex. So are we just our brains? No. When the Holy Spirit makes a believer new. And when the Holy Spirit controls that believer, he does it in a way through the working of our physiologic brain that enables us to submit to him, which means that he’s actually using our prefrontal cortex in a renewed way. I think it’s helpful. Open your Bible’s to Ephesians 5:18. I think this is really helpful. And there is an inner working between the way our brains and our most inner us, your soul, your mind, you’re who you are. There’s a working there that we, don’t truly understand, but that we can get glimpses into here. And I think that that, if we think of the way our brains in the working of the Holy Spirit to accomplish things like self-control, I think this is a helpful verse. Ephesians 5:18, do not get drunk with wine, for that is debauchery. And what’s that contrasted with? But be filled with the Holy Spirit, with the Spirit. So what does alcohol physically do? Alcohol in a person, it actually, you’re going to now see why I did this physiology lesson, it actually dramatically reduces prefrontal cortex activity. It takes the break off. It takes the filter off. You may still have the Holy Spirit, but the physiologic means that he uses to exercise control of, you would use to minimize your expressions of sin while in this body that’s falling apart, you’ve now chemically altered that. And so you have a lack of self-control, an impaired moral reasoning, increased risk-taking. Similarly, your orbital frontal cortex goes dysfunctional. That’s why I mentioned those two things. That happens with alcohol and anything that stimulates GABA receptors. That would be like benzodiazepines, some sleeping pills, some anti-enactylase, some anti-enactylase. anxiety meds, it can lead to social inappropriateness for those same reasons. Opioids. Research shows that chronic amphetamine and opioid use alters decision-making by ways that are very similar to focal damage to that orbital frontal cortex. You can see now chemicals interacting with your brain in a way that we’re used to seeing those people don’t act right. THC from marijuana, same thing, decreased brain volumes in chronic use, especially in the orbital frontal cortex. Sleep deprivation. Tons of breakdown, temporary, and the connection between amygdala, which is like your fighter flight, your stress area, and your prefrontal cortex connectivity. So sleep deprivation triggers this. You basically don’t have a brain. on your emotional regulation. So why am I going through all that? If we have the ability, it’s right for us to keep ourselves from breaking our brain intentionally. Don’t be drunk. Avoid chemicals that would alter those areas and make the expression of self-control more difficult or less likely. and you can actually, you see it in your kids when they’re unslept, more prone to sin. You see it in yourself. So imagine yourself with 48 hours without sleep, then drink a little bit of alcohol. You will become disinhibited, irritable, and be much more prone to sin. Don’t do that to yourself. But now what happens if that’s actually happening physically because areas of your brain are dying, they’re tangled up with proteins, or they’re otherwise that they can’t access the energy stores to function? That’s effectively what they’re, but they can’t sleep it off or sober up. It helps you be probably a little more understanding and maybe see that it’s not actually a reversing of sanctification, but rather, I think it’s a, well, let’s just turn to 2 Corinthians 4, and I think we’ll see what it is. You see that dementia can change behavior by damaging the brain’s physiologic instruments of restraint and judgment, but it’s not the same thing as the Holy Spirit moving out. sanctification isn’t stored in a lobe of the brain. You are more than your brain. It’s actually our brain is that part of us that’s wasting away. It’s not our inner man. So 2nd Corinthians 4:16, we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. day. This is helpful to remember in somebody whose outer self is falling apart, not just physically their body doesn’t work anymore, but their brain’s not working. This light momentary affliction is preparing for us an eternal weight of glory beyond all comparison. As we look not to the things that are seen, but the things that are unseen, the things that are seen are transient, but the things that are unseen are eternal. It’s really helpful. when we look at somebody with dementia and it looks like they’re becoming less and less Christian. I love the way John Piper says it. He has a helpful ask Pastor John on dementia. And he says, Paul’s telling us that weak, in glorious, demented shadow of a once strong Christian in front of us is on the brink of glory and power. You need to go into nursing homes and think that way. These people are on the brink of glory and power. We must keep this continuity in mind between diminished powers of human beings here and the spectacular powers that they’re going to have in the resurrection. It’s so important if we lose a sense of that continuity for the Christian, will assume that we are becoming less human rather than being on the brink of gloriously superhuman. So it’s helpful to see that your brain is the outer person that’s wasting away. And that isn’t necessarily connected to the what God has done in the most inner you. Confrontation, Rebuke, and Care for the Weak Smedly Yates: Given that reality, Jake, we think about somebody whose inhibitions are broken down. The manifest ability for self-control allows things in the heart to make their way out. Is there ever a place for confrontation, rebuke, encouragement, help for somebody who’s still living the Christian life, still susceptible to sin? At what level is it appropriate? How should we think about, you know, helping behavior and rotten speech and things like that? Jacob Hantla: Yeah, absolutely. There is. You have to recognize that the purpose of rebuke would be repentance, right? And just like with children and with all Christians, it’s really wise and necessary to discern when possible between sin and inability. The reality is that we can’t always do that. But before I go there, I want to get back to this question. Let’s think about ourselves and what we’re going to be prone to do with what I just said. I’m going to be prone, you might be prone, to say, well, I didn’t sin. It’s just my physiology that made me do it. You don’t get off the hook ever in the Bible because your physiology had a weakness. God uses our weakness and our physiology as the platform in which he demonstrates his power, and particularly his power over sin. Our brains, actually a significant part of why they’re weak and why they break like this, is because it’s a part of God’s judgment for us. Romans 1, right? We became futile in our thinking, and our minds were darkened as a result of our unwillingness to acknowledge God as God. We are not merely our brains, and yet the dysfunction of our brains is actually a significant part of the fall. God renews that. He changes that in the believer. And if you as a Christian say, I know where I am particularly vulnerable, maybe I’m heading down a path towards dementia, or maybe I have some particular weaknesses where I haven’t slept much this week. I just had back surgery. I know I’m going to be on an opioid for pain, and I know that I’m going to have a particular—even if you can’t say the area of your brain that’s going to not function right—you're going to say, all right, Jake taught me that I’m going to tend to act inappropriately towards people. I’m not going to view myself rightly. I’m going to have a lack of self-control. I better ask for help. I’m not going to justify sin, but I’m actually going to be more vigilant for it. Fight it more diligently and get people around me to help me fight it. So now let’s go to the question of, is it ever appropriate to rebuke a dementia patient? Let’s assume that person is a Christian. Go to 1 Thessalonians 5:14. If that person is a Christian and they are sinning, even if they’re not even aware of it, they’re going to say, will you please come to me and help me? I’m going to need help. We need to, as best we can, use the right tool for the situation. Discern weakness, faint-heartedness, and still don’t hesitate to admonish unruliness or idleness. So 1 Thessalonians 5:14: “We urge you, brothers, admonish the idle or the unruly, encourage the fainthearted, help the weak.” Do you see those three different instructions? Somebody might be expressing sin. All three of these might be evidences of—in all of these three cases—there might be somebody evidencing unbelief or something that needs turning, changing. And in one case, the tool is admonishment. In another, it’s actually help. And in the other, it’s encouragement. Now consider the person with dementia. Their brain is not functioning the way that yours is. They can’t connect their actions to what’s socially appropriate. They can’t connect their actions with the goals they’re aiming at. They might be unclear as to even the situation that they find themselves in, the context of their life. That’s a pitiable—in all the right ways—pitiable circumstance. That would tend to make that person fainthearted, very weak. What they probably need more than admonishment is help and encouragement. I love Poithress. This is from Piper and Grudem’s book, Recovering Biblical Manhood and Womanhood. He says, “Our privilege as Christ’s children altogether should stimulate rather than destroy our concern to treat each person in the church with the sensitivity and respect due to that person by reason of his age, gift, sex, leadership status, personality,” and I would add mental status. So how should you do this? With mild impairment, let’s just go down a category. If you had somebody with mild impairment—not all dementias, it’s not this catch-all where everybody’s all the same—you can have a mild impairment. Probably normal accountability. They’re going to tend to need more admonishment and help and encouragement, but be slower, be gentle, be more concrete. You’re probably not going to be able to string together three or four if-then statements to logically get them there. Make it simple. Sort of like when you’re admonishing your three-year-old, maybe your five-year-old, your seven-year-old. You still do it, but not in the same way that you would a 25-year-old or a 35-year-old. But then with moderate impairment, your correction probably becomes more redirection. Just simple statements of, “That’s not okay. Let’s go over here.” Change the environment. And then severe impairment, probably treat it more as symptom management, prioritizing safety, comfort. Simple statements still: “That’s not okay.” Like you would use for your one-year-old: “Use your hands for gentleness. We don’t speak like that. That doesn’t honor the Lord.” Normal Aging, Forgetfulness, and Dementia Smedly Yates: Statements like that. This is so helpful, Jake. I think partly because we don’t want to be in a position where we’re shocked and our black-and-white categories of sanctification, justification, get in the way of compassionate care and love for someone who is in a weakened state that needs help. It’s not dismissing sin, but just really helpful, compassionate care. I have a more personal question for you. Last evening, we had a number of friends in our home, and I got confused and thought that a dear sweet friend was somebody else altogether. And it occurred to me later, I asked a really strange question that didn’t make any sense to her at all. Do I have dementia? Jacob Hantla: I don’t think so. But you are getting older. There’s a forgetfulness that’s just a part of being human. And there is a forgetfulness that’s increasingly normal with age. Smedly Yates: You’re right behind me. You’re catching up. No, you’re not catching up, but you’re behind me. Jacob Hantla: Percentage-wise, I’m catching up, and I will never in an absolute, absolute way. So there’s normal aging, and some normal cognitive decline with aging is very different than actual dementia. So if you do have questions about that, it’s helpful. Regardless, if you just say, hey, I’m getting old. I’m not sleeping as well. Just as a result of not sleeping as well, as a result of just being weaker, maybe having more history behind you, some more stuff to forget, or whatever, you realize, hey, I don’t have dementia, but I’m not who I once was. That’s not a bad place to be. There’s a weakness there that’s helpful to get people around you to augment your weaknesses. How much more, if you were heading toward dementia. I promise I’ll tell you if I see it. You do the same for me. But regardless, you might or you might not. I don’t think you do. But let’s say that you’re saying, I forget stuff, do I have dementia? The second that you start thinking that, you’re probably not the right person to be making that call. It’s wise to get family members, elders, even medical professionals, doctors to assess: is this dementia? Is it a reversible cause? What’s the probability it’s going to accelerate? And then as you start seeing more and more likelihood that, yeah, this is progressing, start getting people around you to start relinquishing intentionally controls that you might have on your life. Can you double-check me on any purchases greater than X amount of money? Let’s go update the will. Let’s get you on a power of attorney. Invite them to take away the keys at the appropriate time. Even if you say that’s a long way from now, that’s a really humble way to invite, in a godly way, people who love you to be enabled to help you. Forgetting the Gospel and Childlike Faith Smedly Yates: Jake, can a believer forget the gospel in a mentally diminished state or not have the ability to articulate the gospel? Jacob Hantla: Yeah. They can. Memories are stored in our brain. And you might not have access to those memories even while you are saved. Right? That unbreakable chain of salvation will end in glorification from Romans chapter 8: all those whom he foreknew, and it gets all the way to glorification. And in the midst of that may be a trial like your memories are disconnected from you in a way that you can’t explain concepts like substitutionary atonement, you might not even remember that Jesus is your Savior, though he is. And so if somebody has forgotten those things, don’t tire of reminding them of those things. Because even if that memory can only stay with them for that one moment, it’s real. And it might help them endure that moment. It’s a really complex, I can’t say that we understand it at all. But God does. There’s a complex relationship between our thoughts, our memories, how those connect to our actions, and what our ultimate status before God that’s normally expressed through faith. And you can’t have faith without trusting in Jesus. So how can somebody who doesn’t even know who Jesus is trust in him? I’m just going to say I’m not God. God knows. And when you are in your right mind, if you do, that’s evidence of God’s work in you. Because nobody can say Jesus is Lord apart from, in me, and being it, apart from God changing them, saving them, making them new. And so if their brain breaks, and they no longer are able to say that in the same way, I don’t think that’s going to be devastating because they weren’t saved on the merit of faith, but they were saved by grace through the exercise of faith. That faith may look different now. But it’s helpful to think of what kind of people go into the kingdom. Like the disciples, when the children were coming, and they said, no, don’t let them near. And Jesus says, no, it’s, it’s that kind of person who gets into the kingdom. Don’t think that those, faith doesn’t have to be complex. Faith doesn’t have to be well reasoned out. That doesn’t mean that you have an excuse not to think. Peter says, add to your faith knowledge, right? We are expected to grow in faith. I’d love to hear you expound on this, Smed. But there’s a childlikeness of faith that actually in your dementia, you might be able to express that. In your arrogance, maybe in your self-trusting when your faculties are working, it may actually be God’s means of separating you from your strength, because when we’re weak, we’re strong in him, that we don’t get to see all the interplay of that, but we may be a means moment by moment of reminding the Christian who forgot who Jesus was of who he is. Smedly Yates: I think that’s so helpful. The weakest place you will ever be in life are at your last moments on the earth. No matter how it is you go out of this life. Just last night I was working through the details of the resurrection in 1 Corinthians 15. And listen to this, Paul is comparing the resurrection to a seed sown into the ground and then what comes out afterwards. And there are different levels of glory from sun, moon to stars, different kinds of bodies, fish, and other things. But not everybody’s the same. But every human being who faces physical mortality ends life here and then experiences resurrection, every one of us will experience the most profound weaknesses in the last moments. And here’s how Paul describes it. The body is sown, placed into the ground like a seed, corruptible. Subject to absolute humiliating corruption, raised incorruptible. No longer ever subject to corruption. And when we think about brain deterioration, that word corruption is weighty. Sown in dishonor. The last moments of anyone’s physicality are the most dishonorable. Stripped of power, stripped of strength, stripped of dignity, but raised in glory. And Jake, what you shared earlier about somebody being on the brink of the kind of glory that C.S. Lewis described—if we were to see a resurrected saint now we’d be tempted to fall down and worship them or run away in abject terror. We just have no idea what this glory is like on this side of it. But we go from the lowest, most undignified, most powerless spot in our earthly existence in those last moments. And he goes on and says, put in the ground in weakness, raised in power, put in the ground natural, raised supernatural. And so the earthy is first and then the spiritual. And so it’s just helpful to think about not being surprised when someone is at their most profoundly weak, not just physically but mentally, end-of-life scenarios. Jacob Hantla: Yeah, it’s profoundly humbling. And it makes us want to say, I don’t want to be there. Can I avoid that? Okay. I mean, do your best. And ultimately God may bring us there in a way that all of us, sometimes our last moments are momentary, sometimes our last moments of that corruptible humiliation last a really long time. In this tent we groan, longing to put on our heavenly dwelling, if indeed by putting it on, we may not be found naked. For while we are still in this tent, this physical body that’s falling apart, we groan, being burdened. Not that we would be unclothed. It’s not merely saying, hey, let’s take this thing off, but that we would be further clothed so that what is mortal may be swallowed up by life. It’s not even worth comparing. And so if that’s the way that God has to be glorified in us—to go back to that first question—okay, I’ll do that. It’s light and momentary, even if it lasts a long time. And even if I’m not even able in the moment to contemplate what time is, it’s humiliating. And you know what? I’m going to ask the Lord to take that from me. I’m going to say, God, please don’t. That’s an okay prayer. That’s similar to what Paul prayed and said in 2 Corinthians 12. And Jesus says, no, my grace is sufficient for you, for my power is made perfect in weakness. And if Jesus says that to you, Christian, you can say, okay, I’m going to be content with weaknesses. And man, if you get to care for somebody in their weak moments there, it’s helpful to have these things in mind to know they’re on the brink of glory. Marriage, Roles, and Dementia Smedly Yates: I want to move to a practical and theological question related to roles, thinking particularly about husbands and wives honoring biblical roles in marriage, particularly when a husband is experiencing mental decline and dementia. How does a wife caring for a husband honor those roles with a diminished ability? Jacob Hantla: Yeah, that’s a really helpful question. I loved thinking through this. Smedly Yates: I came up with it myself. No. Several people asked. I just wrote it down. Jacob Hantla: You did. I think we want to avoid two opposite errors. One is a view of submission and leadership as a rigid subservience. If a husband can’t lead, the wife can’t act. Or on the other side, a role evaporation. That illness or inability cancels biblical patterns. Both of those would be absolutely wrong. Did you get that? One would be if the husband can’t lead, then the wife shouldn’t be able to act. And if the husband can’t lead because of inability, role distinction, that God set out that is grounded in creation order, not in ability, right? Men aren’t pastors because we’re better at it or smarter at all or better teachers. That’s not where God grounds it. But in his purposes. And so it’s helpful. If we think about what femininity is, so we’re helping a wife whose husband is just incapable of leading in the ways that she wishes he could, a heart that longs to follow. You think of 1 Peter 3:4. The adorning for the woman is in the imperishable beauty of a gentle and quiet spirit, which in God’s sight is very precious. Normally, that’s going to be expressed through submitting to husbands, to their leadership, even in ways, as long as their leadership—for unbelievers, as long as their leadership doesn’t lead them to go against the Lord—even submitting to that with a gentle and quiet spirit. That’s going to play itself out differently for a husband who can’t lead through inability or poor decision-making due to brain decline. You go to Proverbs 31. This breaks the category of a submissive wife as one who’s subservient and just says, “Tell me exactly what to do, so I only do that thing.” No, an excellent wife who can find, she’s far more precious than jewels. The heart of her husband trusts in her. He will have no lack of gain. She does him good and not harm all the days of her life. You see right there a husband who can trust his wife, whose wife is working for his good and not harm, that’s a wife who’s embraced godly roles. It’s not a wife, it’s not neediness that she expresses, but productivity and care. Jump forward to verse 15 of Proverbs 31. She rises while it is yet night, provides food for her household, portions for her maidens, she considers a field and buys it, the fruit of her hand, she plants a vineyard, she dresses herself with strength and makes her arms strong. She perceives that her merchandise is profitable, her lamp does not go out at night. This is a woman who can work, who can work hard, but very different from that which feminists would say, hey, a woman who doesn’t need a man, a woman who functions for her own good, depart from him, but this is a woman who’s functioning strong for the good of her husband. And her husband trusts, she, verse 27, looks to the ways of her household. She doesn’t eat the bread of idleness. Children and her husband call her blessed and praise her. Charm is deceitful, beauty is vain, but a woman who fears the Lord is to be praised. This biblical femininity is rooted in fear of the Lord, love of her husband, not a desire to dominate over the husband, but to come alongside as a God-given helper to build him up, that can be demonstrated in very unique, very God-glorifying ways with a husband whose mind is increasingly not working. It’s fundamentally a disposition to honor and support the husband voluntarily and gladly. Leadership often involves delegation. So, husbands: if you’re heading that way, plan in advance for the kinds of ways so that your wife, even when you can no longer give your preferences, she knows, and it seems like in the moment, she’s actually working against it when you no longer understand what’s going on. She’s actually able to follow. So it’s good and right for the wife to be productive, capable, in a way that might look independent, but with a hard attitude that supports. So anticipate that. I want to give a personal example. This is actually hard and a little bit embarrassing. So dementia is different than delirium. Delirium is something that’s short-term, usually from a cause. You see it in elderly when they get like UTIs. You can see it from medications. Post-surgery, I see it all the time with anesthesia. As many of you guys know, I spent a long time in the hospital with Burkitt lymphoma. I was getting a lot of chemo. They stick a needle in my spine, give me chemo directly into my cerebral spinal fluid around my brain. I was on tons of pain medication and all kinds of other medications that did weird things to my brain. I don’t remember this time, but there was apparently a few days—I remember bits and pieces of it—where I was out of my mind. I at one point apparently tried to hit Kiki. I took all my clothes off and tried to go in the hall at the hospital. Kiki was a loving, submissive, supportive wife by helping me not do that. I am very grateful for her tearfully persevering, guarding me from myself as my brain was failing me. At that point, thankfully, in a reversible way. But she was not stepping out of her God-ordained role by saying, “No, Jake, you cannot go in the hall naked. No, Jake, you cannot hit me. Jake, get in bed,” and even physically and chemically restraining me for a time. That was a gracious expression of role differentiation that I think honored the Lord and honored me. I remember also, just husbands to wives, me at the—I was reading my vows this morning from almost 25 years ago. I wrote in those vows. And I’d encourage you guys to think through that now. And singles, as you’re thinking through marriage, think through what it might mean in all the different stages. I said, “I pray that as we grow old together, our love will grow stronger because we are together growing as one closer to Christ. I commit myself to loving you, even when your beautiful body is gone, even when your mind is not sharp, even when you do not recognize who I am. No matter what the cost to me, I will be married to you until God takes you.” And that’s what it means. That love isn’t in it for what the other one can give. It’s not self-seeking. It actually seeks the good of the other. So have this mind in you, which is yours in Christ Jesus, who though he was in the form of God, did not count equality with God a thing to be grasped after, but he emptied himself, taking the form of a slave, being found in human form. He did that all the way to the point of death, death on the cross. That’s what husbands are called to. That’s what all of us are called to. So thinking, I am above changing this diaper or correcting my spouse for the thousand and seventy-second time this week. Stooping that low is nothing compared to our Savior’s humble condescension to us. And so you actually are embracing God-given roles as a Christian when we help and endure and love our spouse to the very end. Honoring Parents and End-of-Life Care Smedly Yates: And that’s a great segue, Jake. When I think about what you just described, our parents did those very things for us when we were helpless. There may come a time where those roles are reversed and we’re helping our parents in their end-of-life situations. I’m going to ask you a series of questions that came in and you can answer whichever ones you want. I’ll try to go faster so we get through them. Maybe. Maybe we do a part 17 of this series, whatever. But I’m thinking about the command, the prohibition, do not sharply rebuke an older man. And the positive commands honor your father and mother. Those commands don’t expire. And when I think about don’t sharply rebuke an older man, there ought to be an elevated view of those who have walked this life longer than we have. We’ve lost that in an American culture, right? Tribal cultures have kept that in some ways. Other places, other cultures have kept that. We just sort of disregard the elderly as a new cultural phenomenon. And, you know, the word euthanasia, the beginning of the word is, is eu or good and thanasia, thanos, death. Good death. It’s not good. And we don’t discard people when they’re no longer of utilitarian purpose. But that is where our culture is going. And Christians must look very different. So when we think about how do we gently, compassionately, lovingly honor God, honor our parents, loving them through end-of-life scenarios. Here’s a series of questions. How do I honor those relationships when compassionate care, sometimes correction, help the 1,077th time. Dad, use your words. Don’t use your hand. You know, whatever it is. Give me the keys. How do we do that and honor them in our disposition? Number two, is it sin to employ the resources of home health care or a live-in situation, a retirement community, etc.? And then what do we need to think about with end-of-life scenarios? Yeah. That’s a lot of questions. Let’s go. Jacob Hantla: Let’s go. So I think honoring your parents means, first off, it’s a disposition of the heart, but it’s a disposition of the heart that is connected to meeting their physical needs. You went to 1 Timothy 5. Do not sharply rebuke an older man, but encourage him as you would a father. And then dot that dot, second, verse 2, older women as mothers. And then it rolls into, let’s think of widows who are truly widows. Open to 1 Timothy 5. This is maybe a section that you’re like, you might not read this honor widows who are truly widows section, thinking it applies to you. It does. And I think in it is the answer to this question, or at least a significant part of it. Verse four, the thought here is the church needs to take care of widows, but don’t do so in a way that robs a family of the responsibility and need to take care of their own parents. So look at verse four. If a widow has children or even grandchildren, let them first learn to show godliness to their own household. And now look at this three part: make some return to their parents. So rooted in just a mom, dad, thank you for however many years of my life. You changed my diapers and fed me and looked after every need. It’s okay if my career is messed up because I have to have you in my home and I have to go take care of you. That is, do you see what it says? That is actual showing of godliness. I love what you just said. It’s so different than the culture. The culture might do this in a way that Christians have to be sharply different than. It is godliness to make return for the way that your parents cared for you. Number two, this is pleasing in the sight of God. You don’t do it out of social obligation—well, who else is going to do it? They don’t have enough insurance. Or even if they do have insurance and you do get the privilege of having live-in help. No, you are seeking to please the Lord as you make return to them. This is pleasing. Yeah, and then the third was, yeah, so godliness, make return to their parents. It’s please the Lord. Take care of your parents. Meet the needs. And if you don’t, verse 8, do you see what it says? If anyone does not provide for relatives, especially members of his household, do you see what you’re saying? You have denied the faith and you are worse than an unbeliever. This is what James is referring to in chapter 2. That’s a faith that’s dead being by itself. The religion, end of James 1, the true religion, takes care of orphans and widows in their distress. How much more are your parents? So, yes, take care of your parents. You have to. It’s a great privilege. It’s actually God’s ordained means of living out godliness. So can you send your parents to a care home? Does that mean you have to maximally sacrifice? Not necessarily. It doesn’t mean that you have to perform every task. Neglect is sin, but using help may be wisdom. The reality is dementia needs are often 24-7. They involve skilled needs at times. They may wander, fall, be incontinent, unsafe swallowing. Care at home at all costs—that may be rooted in love. It may also be rooted in pride or even foolishness. Honor can actually look like choosing a good facility, visiting often, advocating, overseeing care. Encourage the church to be involved, but don’t demand the church do the work at you avoiding it. I don’t remember what the other questions were. Smedly Yates: That’s all right. We got one minute left, Jake. Would you close our time in prayer? Closing Prayer Jacob Hantla: God, thank you for your word and just how replete it is with wisdom and principles and instruction and most of all revelation of who you are and what pleases you. God, I pray from this and just from this lesson and all the trials that you bring us through related to dementia and so many others that you would increasingly form us each individually and then corporately as your body. Form us into your image. Increase our godliness and then, God, bring us safely home. We love you. Be glorified in our lives and in our church. In Jesus’ name we pray. Amen. The post Equipping Hour: Dementia and the Christian Q&A appeared first on Grace Bible Church.

Send us a textIn this episode, the hosts discuss the current state of cannabis legalization, focusing on its gradual normalization rather than sweeping legislative changes. Key topics include the NRA's alignment with cannabis advocates in a Supreme Court case, the proliferation of hemp THC drinks, and the emergence of city-run dispensaries. The hosts also touch on the evolution of laws regarding cannabis users' Second Amendment rights and the impact of research on cannabis legalization. Highlights also cover regulatory challenges faced by the hemp industry and updates from various states on cannabis policies, including Alabama's controversial bill on cannabis odor and child welfare, and Florida's ongoing legal battles over marijuana possession.00:00 Introduction to Cannabis Legalization and Normalization01:12 NRA and Cannabis Advocates Unite02:27 Cannabis and Firearm Rights Debate04:59 Opioids and Cannabis: A New Perspective06:09 Hemp THC Drinks and Market Dynamics09:11 Challenges in Cannabis Legislation and Market17:02 Federal Regulations and Hemp Production19:25 Licensing and Regulation Challenges21:23 CBD Regulation and Market Dynamics22:42 State-Specific Cannabis Legislation24:44 Municipal Control and Market Impact27:04 Legal and Social Implications30:02 Industry Trends and Future Outlook37:43 Concluding Thoughts and AnnouncementsSupport the showGet our newsletter: https://bit.ly/3VEn9vu

In 2025, Cook County saw the fewest opioid overdose deaths in a decade. The West Side Heroin/Opioid Task Force has been at the forefront of that work. Host Jacoby Cochran and executive producer Simone Alicea visit the task force's new office near the Pulaski Green Line stop to learn more about their work, what's driving these trends, and how to use an opioid reversal drug. Want some more City Cast Chicago news? Then make sure to sign up for our Hey Chicago newsletter.  Follow us @citycastchicago You can also text us or leave a voicemail at: 773 780-0246 Learn more about the sponsors of this Jan. 29 episode:  Chicago Theater Week Steppenwolf Paramount Theatre Window Nation Access Contemporary Music – use promo code PIANO for 20% off Become a member of City Cast Chicago. Interested in advertising with City Cast? Find more info HERE

The governor expresses disdain with President Donald Trump's immigration crackdown in Minnesota, and a team of Vermont midwives is inviting you to learn more about efforts to open the first freestanding birth center in the state.

Dr. Beth Weise is the Research and Overdose Prevention Coordinator for The Sidewalk Project, a non-profit organization that aids unhoused, drug-using, survivor & sex worker populations by providing direct services including crisis response, system advocacy, wound care, job placement, medication-assisted treatment (MAT), and creative community resources for mental health. Her work aims to influence future drug policy with novel evidence-based research that also advocates and empowers people who use drugs to feel safe and prevent fatal overdose. At CannMed 26, Beth will present “Cannabidiol to Mitigate Opioid Induced Respiratory Depression“. During our conversation, we discuss: What causes Opioid Induced Respiratory Depression and how cannabinoids play a role How CBD can be used in combination with Naloxone to reduce withdrawal-related side effects How Beth's research can be applied in real-world scenarios Thanks to This Episode's Sponsor: Humanity Heroes Humanity Heroes provides compassionate support to the unhoused community by delivering essential supplies and resources directly to those in need. Humanity Heroes partners with other nonprofits by empowering them to extend their reach and impact within their own communities. Together, they strive to create a world where every person has access to the resources and support they need to thrive. Learn more at JoinHumanityHeroes.org Additional Resources: THRRIV.org [Webinar] Bridging the Gap: Tech-Supported Peer Connections to Reduce – Overdose Fatalities – Register for CannMed 26

Are you ready for NAEMSP?! In this special edition of the Prehospital Emergency Care podcast, host Greg Muller is joined by Guest Editor Remle Crowe to discuss the journal's latest special issue: "Enhancing Prehospital Care for Patients with Opioid Use Disorder". This episode goes beyond the statistics to explore the deeply human experiences behind the data. The episode features in-depth conversations with leading researchers on the front lines of the crisis: • Bringing Treatment to the Streets: Dr. Andrew Godfrey and Advanced Practice Paramedic Vicki Coles discuss the implementation of a prehospital buprenorphine program in Wake County, North Carolina, sharing lessons on clinician education and the vital role of "buprenorphine champions" in bridging the gap to long-term recovery. • The Pediatric Perspective: Drs. Stephen Sandelich and Garrett Cavaliere reveal surprising findings on how the opioid epidemic affects children and adolescents, discussing how the crisis transcends socioeconomic boundaries and why EMS must shift its approach to screening younger patients. • Innovative Strategies: A preview of the issue's 30 peer-reviewed articles, covering topics from drone-delivered naloxone and natural language processing to the qualitative lived experiences of clinicians facing burnout.   This episode serves as a vital primer for EMS professionals, policymakers, and researchers looking to move from traditional response models toward sustainable, patient-centered pathways for care.   Access the full special edition here: https://www.tandfonline.com/toc/ipec20/29/   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

Two bewildered old men try to work out addiction and how best to deal with it. People dying on our streets. Is that the best we can do?Show notes at: https://stationeryadjacent.com/episodes/218

Public Views About Opioid Overdose and People With Opioid Use Disorder JAMA Network Open This study completed a national web-based survey of 1552 adults in the United States in April 2025 to assess perceptions of opioid overdose deaths and opinions of people who use opioids. Those who responded to the survey primarily identified as female (60.5%) and aged 30-44 (33.7%). Political views varied, with 28.9% conservatives, 39.6% moderates, and 31.5% liberals. Most respondents viewed opioid overdose deaths as serious (88.2%). Respondents felt that people who use opioids (81%) and pharmaceutical companies (72.7%) were most responsible for reducing overdose deaths, with more liberals identifying pharmaceutical companies as responsible while moderates and conservatives more often identified individuals as responsible. 38.3% of respondents reported they were unwilling to have a person with OUD as a neighbor and 58.4% were unwilling to have a person with OUD marry into their family, with higher percentages of conservatives than liberals endorsing these beliefs.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Virginia's opioid crisis has carried a $5.2 billion price tag, with some of the highest per-resident costs now concentrated in cities like Portsmouth and across Hampton Roads.

In this episode, @geoengineering1 is joined by Britta Clark, a postdoctoral researcher at Harvard University, to unpack why solar geoengineering is increasingly compared to opioids. They discuss how this framing casts SRM as temporary “relief” from climate warming and why it raises concerns about potentially slowing emissions cuts. The conversation focuses on how climate models, policy debates, and public discourse can quietly shift expectations about how fast emissions reductions should happen once solar geoengineering is considered, even when people say it should not delay the energy transition. Together, they explore why this tension matters and what it could mean for future climate decisions.Paper: Clark, B. (2025). Solar geoengineering, delay, and addiction. Climatic Change, 178(11), 209. https://doi.org/10.1007/s10584-025-04059-3Open access version: https://philpapers.org/rec/CLASGD-2To stay updated on all things geoengineering-related, subscribe to:Carbon Removal Updates Substack: https://carbonremovalupdates.substack.com/Solar Geoengineering Updates Substack: https://solargeoengineeringupdates.substack.com/

Greg Belfrage interviews South Dakota Attorney General Marty Jackley about cracking down on drug use in South Dakota Prisons, the opioid settlement, the HALT Fentanyl Act, marijuana rescheduling, vape shop regulations, and his run for congress. See omnystudio.com/listener for privacy information.

The Counter Momentum of Spin, with Dr. Franco Musio – The Maduro regime was indicted by the US Department of Justice in 2020 (and again recently) as a significant hub of illegal drug transit and a state sponsor of narcoterrorism (to include abetting many drug cartels with their support of violence, human smuggling, and significant profits from the illicit production and selling of narcotics)...

This first Addy Hour episode of 2026 is a must-watch/must-listen. We delve into the truths about cannabis and opioid use in teens and adults, and we honestly consider the many reasons people use. We address stigma head-on and the ways it shows up for those navigating substance misuse, other mental health challenges, chronic illness or other health concerns. Our guests also highlight the necessity of meeting people where they are. We talk about the importance of embracing and welcoming folks back into the community, especially after times of treatment or rehab. We also push the boundaries to highlight the essential ways institutions and universities can learn from our communities, for the good of all. In this episode, you'll also hear powerful stories about our guests' journeys and their transformative work. You'll hear about programs providing addiction services within the church. And you'll hear about strategically establishing clinics in neutral zones between gang territories to facilitate accessibility across gang affiliations. This free-flowing and in-depth conversation will leave you inspired, encouraged, and empowered.

Mark Parrino has been involved with the delivery of health care and treatment for opioid use disorder (OUD) since 1974. As the president of the American Association for the Treatment of Opioid Dependence, Inc. (AATOD), he works with treatment providers across the country to develop and improve treatment protocols. In December 2022, AATOD worked with the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to initiate a first-of-its-kind census of all patients currently receiving treatment from government-certified opioid treatment programs (OTPs). Their findings, based on responses from over 1,500 OTPs nationwide, show the breadth and distribution of addiction treatment in America, and are the product of almost fifty years of medication-assisted treatment (MAT) in the United States. I spoke with Mark about his census results, as well as the history of MAT, and specifically methadone, treatment in America. You can see the full report here. Emily Dufton is the author of Grass Roots: The Rise and Fall and Rise of Marijuana in America (Basic Books, 2017). A drug historian and writer, her second book, on the development of the opioid addiction medication industry, is under contract with the University of Chicago Press. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Mark Parrino has been involved with the delivery of health care and treatment for opioid use disorder (OUD) since 1974. As the president of the American Association for the Treatment of Opioid Dependence, Inc. (AATOD), he works with treatment providers across the country to develop and improve treatment protocols. In December 2022, AATOD worked with the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to initiate a first-of-its-kind census of all patients currently receiving treatment from government-certified opioid treatment programs (OTPs). Their findings, based on responses from over 1,500 OTPs nationwide, show the breadth and distribution of addiction treatment in America, and are the product of almost fifty years of medication-assisted treatment (MAT) in the United States. I spoke with Mark about his census results, as well as the history of MAT, and specifically methadone, treatment in America. You can see the full report here. Emily Dufton is the author of Grass Roots: The Rise and Fall and Rise of Marijuana in America (Basic Books, 2017). A drug historian and writer, her second book, on the development of the opioid addiction medication industry, is under contract with the University of Chicago Press. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

Mark Parrino has been involved with the delivery of health care and treatment for opioid use disorder (OUD) since 1974. As the president of the American Association for the Treatment of Opioid Dependence, Inc. (AATOD), he works with treatment providers across the country to develop and improve treatment protocols. In December 2022, AATOD worked with the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to initiate a first-of-its-kind census of all patients currently receiving treatment from government-certified opioid treatment programs (OTPs). Their findings, based on responses from over 1,500 OTPs nationwide, show the breadth and distribution of addiction treatment in America, and are the product of almost fifty years of medication-assisted treatment (MAT) in the United States. I spoke with Mark about his census results, as well as the history of MAT, and specifically methadone, treatment in America. You can see the full report here. Emily Dufton is the author of Grass Roots: The Rise and Fall and Rise of Marijuana in America (Basic Books, 2017). A drug historian and writer, her second book, on the development of the opioid addiction medication industry, is under contract with the University of Chicago Press. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/public-policy

Mark Parrino has been involved with the delivery of health care and treatment for opioid use disorder (OUD) since 1974. As the president of the American Association for the Treatment of Opioid Dependence, Inc. (AATOD), he works with treatment providers across the country to develop and improve treatment protocols. In December 2022, AATOD worked with the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to initiate a first-of-its-kind census of all patients currently receiving treatment from government-certified opioid treatment programs (OTPs). Their findings, based on responses from over 1,500 OTPs nationwide, show the breadth and distribution of addiction treatment in America, and are the product of almost fifty years of medication-assisted treatment (MAT) in the United States. I spoke with Mark about his census results, as well as the history of MAT, and specifically methadone, treatment in America. You can see the full report here. Emily Dufton is the author of Grass Roots: The Rise and Fall and Rise of Marijuana in America (Basic Books, 2017). A drug historian and writer, her second book, on the development of the opioid addiction medication industry, is under contract with the University of Chicago Press. Learn more about your ad choices. Visit megaphone.fm/adchoices

Male Loneliness Is Exploding...Tech, AI, and Society Are Making It Worse Scott Galloway — NYU Stern Professor of Marketing, serial entrepreneur, bestselling author of Notes on Being a Man, and one of the most influential voices on culture, masculinity, and economics — returns to Mayim Bialik's Breakdown for a brutally honest conversation about what's happening to young men today… and why it affects all of us. In this wide-ranging discussion, Galloway breaks down why young men are more lonely, economically insecure, and socially disconnected than any generation before them, and how technology, AI companionship, and synthetic relationships are hijacking young male brains at an unprecedented scale. We explore the growing maturity gap between men and women, why women are now surpassing men financially and educationally, and why young men are struggling so badly in the modern dating market. Scott also dives into the alarming rise of AI chatbots and synthetic relationships, especially among young people, and the hidden dangers no one is talking about. Scott also breaks down: - Why young men today are at a disadvantage compared to prior generations - How tech, AI, and economic insecurity are fueling male loneliness - Why women's success does NOT cause men to fail - Why young men are falling behind in education, income, and dating - Shocking prevalence of human–AI relationships and why they're dangerous - Why resilience is the most important trait for long-term success - Why older generations of men have a moral obligation to pay it forward - How single-parent households affect children, especially boys (The U.S. has the highest rate of single-parent homes in the world!) - Best ways to truly connect with your kids in a digital world - Why Scott identifies as a reluctant atheist and how belief, meaning, and purpose fit into modern life This is a conversation about masculinity, responsibility, technology, parenting, faith, and the future, and why fixing the crisis facing young men is one of the most important challenges of our time. Scott Galloway's latest book, Notes on Being a Man: ⁠https://a.co/d/0VNktwg⁠ Follow us on Substack for Exclusive Bonus Content: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bialikbreakdown.substack.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠BialikBreakdown.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube.com/mayimbialik⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

D.C. is set to receive more than 80 million dollars in opioid settlement money over the coming years. Survivors and their families say it's difficult to follow how it is actually spent.

In 2016, the Canadian federal government recognized the opioid crisis as a public health emergency, yet 10 years later, thousands of Canadians die from opioid toxicity every year.Health Canada committed $17 million to research projects and harm reduction initiatives aimed at substance use prevention in late 2025, but one problem that's hard to put a dollar figure on to fix is stigmatization and stereotypes surrounding safe consumption sites - which Ontario closed nine of last year.Host Maria Kestane speaks to Dimitra Panagiotoglou, the Canada Research Chair in the Economics of Harm Reduction and associate professor at McGill, to discuss her recent study on the relationship between crime associated with supervised consumption sites, and how Canadians can approach nuanced conversations surrounding substance use. We love feedback at The Big Story, as well as suggestions for future episodes. You can find us:Through email at hello@thebigstorypodcast.ca Or @thebigstoryfpn on Twitter

Some puppies are getting new homes after surviving an overdoes scare. AP correspondent Mike Hempen reports.

Male Loneliness Is Exploding...Tech, AI, and Society Are Making It Worse Scott Galloway — NYU Stern Professor of Marketing, serial entrepreneur, bestselling author of Notes on Being a Man, and one of the most influential voices on culture, masculinity, and economics — returns to Mayim Bialik's Breakdown for a brutally honest conversation about what's happening to young men today… and why it affects all of us. In this wide-ranging discussion, Galloway breaks down why young men are more lonely, economically insecure, and socially disconnected than any generation before them, and how technology, AI companionship, and synthetic relationships are hijacking young male brains at an unprecedented scale. We explore the growing maturity gap between men and women, why women are now surpassing men financially and educationally, and why young men are struggling so badly in the modern dating market. Scott also dives into the alarming rise of AI chatbots and synthetic relationships, especially among young people, and the hidden dangers no one is talking about. Scott also breaks down: - Why young men today are at a disadvantage compared to prior generations - How tech, AI, and economic insecurity are fueling male loneliness - Why women's success does NOT cause men to fail - Why young men are falling behind in education, income, and dating - Shocking prevalence of human–AI relationships and why they're dangerous - Why resilience is the most important trait for long-term success - Why older generations of men have a moral obligation to pay it forward - How single-parent households affect children, especially boys (The U.S. has the highest rate of single-parent homes in the world!) - Best ways to truly connect with your kids in a digital world - Why Scott identifies as a reluctant atheist and how belief, meaning, and purpose fit into modern life This is a conversation about masculinity, responsibility, technology, parenting, faith, and the future, and why fixing the crisis facing young men is one of the most important challenges of our time. Go to helixsleep.com/breakdown for a special partner offer including 27% off any purchase. If you're tired of being tired, this is your chance to finally get answers and get your energy back. Go to https://Superpower.com and use code BREAK for $20 off your membership this year. Scott Galloway's latest book, Notes on Being a Man: https://a.co/d/0VNktwg Follow us on Substack for Exclusive Bonus Content: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bialikbreakdown.substack.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠BialikBreakdown.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube.com/mayimbialik⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

A single syringe swap should never decide a patient's fate. We pull back the curtain on forty years of anesthesia medication safety to show what truly works—then tackle the hard part: getting proven safeguards into every OR, every time. From look-alike vial hazards to standardization that actually sticks, this conversation blends frontline realities with practical steps leaders can implement now.We dig into the high-stakes TXA wrong-drug, wrong-route crisis and explain why eliminating vials and moving to ready-to-administer IV bags is a must. Along the way, we unpack new FDA label warnings, the APSF–ISMP joint recommendations, and the forcing functions that prevent catastrophes, including NRFit for neuraxial routes and barcode verification at the point of care. We also surface quieter threats—vial coring, variable concentrations, and chaotic storages—and show how color-coded, readable labels and organized carts reduce cognitive load when seconds matter.Opioid safety gets equal focus. We connect preoperative risk assessment, multimodal analgesia, and smart postoperative monitoring to reduce opioid-related harm without compromising comfort. Technology has matured too: AI-driven clinical decision support can flag dosing and drug-choice risks in real time, but only if woven into workflows that clinicians trust. Throughout, we return to the implementation gap: success depends on leadership support, supply chain alignment, failure mode analysis, transparent reporting, and peer support that sustains a just culture.If you care about safer anesthesia—standardized labels and concentrations, prefilled syringes, organized storage, barcode checks, and a culture that learns—this is your playbook. Listen, share with your team, and help push your institution from knowing to doing. Subscribe, leave a review, and tell us which safeguard you'll champion next.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/289-forty-years-of-anesthesia-medication-safety-what-works-and-whats-next/© 2026, The Anesthesia Patient Safety Foundation

Opioidology Part 3: Opioid-Philia vs Opioid-Phobia The often-blurred lines of pain, addiction, and substance use need a deeper dive into the extremes of opioid-philia and opioid-phobia (building upon Opioidology Part 1: Our Opioid Story). Join Mark “Pain Guy” Garofoli and our two guests James Hackworth and Jim Potenziano to take that deeper dive based on their recent collaboration in the Frontiers in Pain Research article “The Burden of Acute Pain in the U.S. in the Wake of the Opioid Crisis”. • Frontiers in Pain Research Article: https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2025.1642035/full  • Article Key Takeaways • Rising Pain Prevalence • Balancing Act—Opioid Utilization vs. Undertreatment • Provider Reluctance to use opioids • Patient Reluctance • Massive Economic Impact • Call for Innovation & Policy Reform • Opioid Story charts: www.painguy.us

To justify bombing Venezuela and abducting President Nicolás Maduro, Donald Trump falsely accused him of leading the so-called "Cartel de los Soles". But the US Department of Justice was forced to admit that this "Suns Cartel" doesn't exist. The USA lied -- while the CIA actually has trafficked drugs in Latin America. Ben Norton reports. VIDEO: https://www.youtube.com/watch?v=44c0jf5ygyE Topics 0:00 US attacks Venezuela 0:21 (CLIP) Trump wants Venezuela's oil 1:12 Trump's colonial war on Venezuela 2:08 US DOJ admits it lied about Maduro 3:25 92-year-old judge oversees show trial 3:53 "Cartel de los Soles" doesn't exist 5:05 WMD lie 5:46 Venezuela does NOT produce fentanyl 6:28 Cocaine-producing countries 7:12 (CLIP) Biden official admits truth 8:21 CIA trafficked drugs in Venezuela 11:01 (CLIP) 60 Minutes on CIA drug trafficking 11:42 DEA agent accuses CIA of trafficking 12:58 CIA, cocaine, Nicaraguan Contras 14:47 Trump pardoned Hondura drug trafficker 16:13 (CLIP) Juan Orlando Hernández 16:39 Ecuador's drug-linked President Noboa 17:42 Colombia's drug lord Álvaro Uribe 18:50 USA armed Mexican cartels 19:34 US allies in Mexico are narcos 20:23 Drug links to Argentina's Javier Milei 20:43 Marco Rubio's links to cocaine trafficking 22:52 US Special Forces links to drugs 23:55 Trump attacks Colombia President Petro 24:37 Afghanistan opium production 25:59 Opioid epidemic in USA 26:34 Purdue Pharma and Sackler family 28:55 US imperialism based on lies 29:42 Outro

A highlight from exceptional sessions at the 2025 Midyear Clinical Meeting & Exhibition, this episode explores how pharmacists can bridge gaps in care for patients with opioid use disorder (OUD), highlighting strategies for prescribing and optimizing medications for OUD across primary, ambulatory, and acute care settings. We will discuss real-world examples, emerging practices like microdosing and direct-to-inject techniques, and ways pharmacists can make a tangible difference in improving patient outcomes. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

In this episode, Dr. Blythe Bynum joins the show to discuss her new article titled Navigating Choices: Pregnancy Options Counseling Experiences in Individuals With Opioid Use Disorder, featured in the November/December issue of the Journal of Addiction Medicine. Dr. Blythe Bynum is an assistant professor in the Department of Obstetrics and Gynecology at Thomas Jefferson University in Philadelphia, Pennsylvania. She is a board certified OBGYN with fellowship training in Complex Family Planning.    Article Link: Navigating Choices: Pregnancy Options Counseling Experiences in Individuals With Opioid Use Disorder

Quality Improvement and Patient Safety In this episode, Dr. Kevin Koo joins Dr. Andrew Harris, Chair of AUA's Quality Improvement and Patient Safety (QIPS) Committee, for a conversation on opioid prescribing practices and patient-reported pain outcomes following percutaneous nephrolithotomy (PCNL). They discuss the development and implementation of a tailored opioid prescribing algorithm that reduced unnecessary prescriptions, ensured adequate pain management, and highlighted the importance of multimodal analgesia in postoperative care.

Moderator: James P. Rathmell, M.D. Participants: Mark Bicket, M.D., Ph.D. and Lynn Kohan, M.D. Articles Discussed: Trends in Use of Medications for Opioid Use Disorder among Commercially Insured U.S. Surgical Patients, 2016-2022 Rising Treatment for Substance Use Disorder Presents New Challenges for Anesthesiologists as Perioperative Medicine Specialists Transcript

It's been nearly three years since landmark settlements were reached between states and major opioid producers. Since then, roughly $100 million has been dispersed to combat addiction, but it's unclear how much of that money has been spent so far.   The Current's Alena Mashke joins us for more on the lack of spending transparency. From Star Wars to Jurassic Park, Hollywood movies and TV shows have long relied on special effects to bring supernatural stories to life. This process often involves sculpting, puppetry, animatronics and technology – and has many times involved Louisiana native and Emmy-award winning special effects artist, Lee Romaire.Romaire grew up in Morgan City, Louisiana, before attending LSU and later moving to Hollywood to pursue a career in the industry. He joins us now for more on his 25 years in special effects and how his background in taxidermy set the foundation for his career.Tomorrow night marks the beginning of the 2026 Mardi Gras season. And in New Orleans, the Krewe of Joan of Arc will take to the streets on Twelfth Night. Back in 2018, WWNO's Jessica Rosgaard spoke with the Krewe's founder, Amy Kirk Duvosin, about the parade's history.—Today's episode of Louisiana Considered was hosted by Karen Henderson. Our managing producer is Alana Schreiber. We receive production and technical support from Garrett Pittman, Adam Vos and our assistant producer, Aubry Procell. You can listen to Louisiana Considered Monday through Friday at noon and 7 p.m. It's available on Spotify, the NPR App and wherever you get your podcasts. Louisiana Considered wants to hear from you! Please fill out our pitch line to let us know what kinds of story ideas you have for our show. And while you're at it, fill out our listener survey! We want to keep bringing you the kinds of conversations you'd like to listen to.Louisiana Considered is made possible with support from our listeners. Thank you!

60 MinutesPG-13This is a re-release of an episode with Trey Garrison. He is an author and investigative reporter who came on the show to talk about a book he wrote with his partner Richard McClure, "Opioids for the Masses: Big Pharma's War on Middle America and the White Working Class"Opioids for the MassesPete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's SubstackPete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.