Podcasts about opioids

In this week's episode, we dive into the latest cannabis headlines from around the world: Macky covers a ground breaking discovery—scientists have identified a THC-free cannabis compound that could provide opioid-level pain relief without intoxication. Australia's Greens Party renews its push for legal cannabis as reports show $700M in annual tax revenue from recreational sales. Margaret discusses new research on cannabis and brain function, including the potential risks for young adults. She also highlights how medical cannabis is proving to be life-changing for individuals with Tourette syndrome. Billy explores growing concerns in the Netherlands, where coffeeshops warn that the country's regulated cannabis experiment is at risk of failure. A new survey finds that NHS doctors are increasingly open to prescribing cannabis for chronic pain, signalling a shift in medical attitudes in the UK. Join us for an in-depth discussion on these stories and their impact on cannabis users, patients, and the industry! Come and join in the discussion about any of these news articles on our cannabis growing forum, Discord server, or any of your favourite social networks. Visit our website for links.  Website: https://highonhomegrown.com Discord: https://discord.gg/sqYGkF4xyQ Youtube: https://www.youtube.com/highonhomegrown Thank you for downloading and listening to our cannabis podcast! I hope you enjoy this episode.

Opioid drugs worth approximately GH₵20 million have been intercepted at Tema Port. The shipment was en route to Niger, its final destination. This was made possible through the efforts of the Customs Division of the GRA, in collaboration with other stakeholders.

20% of all adults suffer from chronic pain, while up to 80% will experience acute pain from injury or surgery.   $600 billion is spent annually in health care costs and loss of productivity due to pain.  In this episode, you'll discover:—Dr. Prather's theory that pain comes from a blockage of energy in one or more of The 5 Pathways Of Pain.  And how each pathway needs to be treated in a different way. —Why Dr. Prather says his patients will first feel an increase in their energy level before they feel a decrease in their pain level.—How 80% of chronic Headache patients have actually given up on finding a solution, but Dr. Prather says that his office is "pretty much 100% successful" with Headaches.—The difference between the medical approach of pain management that masks the symptoms versus the Structure-Function approach of actually fixing the underlying cause of the pain.—Why Opioids and NSAIDs actually "make the pain problem worse" long-term by damaging the body.  And the long list of natural, safe, non-pharmaceutical alternatives Dr. Prather uses in his office that produce better results than the drugs.—How the treatments offered by Holistic Integration are exactly what an independent government commission recommended as the best approach to pain…until the pharmaceutical companies interfered.—Why Dr. Prather says that "Chiropractic is one of the best things you can do" when you're talking about pain relief.  And the reason why Holistic Integration begins with making sure the Atlas is in its proper position.—How Acupuncture "can actually reverse" Opioid addiction by stimulating the body's own natural Opioid production.  And how "everybody" has some issues with a blockage of their Electromagnetic pathway, which makes the biggest difference for Chronic Pain patients.—The link between the Lymphatic pathway of pain and Fibromyalgia, for which Dr. Prather's office gets "remarkable results".  And how the B Vitamins are particularly effective for Nerve Pain. —The Cerebrospinal Fluid blockage that is "easy to diagnose" and is "a different type of pain" which responds well to Craniosacral Therapy at Holistic Integration.  And how Dr. Prather considers a lot of the deep joint pain as a blockage of the Circulatory pathway, which can be treated by "pumping" the joint.http://www.TheVoiceOfHealthRadio.com

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309

Jeff Shipley is wearing a suit tonight. Watch the video of this teaser here: https://youtu.be/EzPKCil-ghE Watch the full episode with a $5 subscription here: https://www.patreon.com/posts/124273837 Listen to the episode without video for just $1: https://www.patreon.com/posts/124273835 https://rockhardcauc.us

Lisha Adcock is a hair stylist from Meridian, Mississippi, who became addicted to opioids after struggling with chronic pain. After years of chaos and draining her bank account to pay for pills, she had to find a way out. Kratom is a natural product made from the leaves of a tree in Asia. It has been used as a stimulant and pain reliever in that part of the world for hundreds of years, and has become popular in the United States as the war on legal opioids has intensified over the last 15 years. Lisha shares her story of hope as kratom helped her overcome her opioid addiction and be able to manage chronic pain and continue to work and be present for her kids. You can read Lisha's story here from The Magnolia Tribune and read more kratom news and stories here. 

You should know how to use all of the tools in your toolbox.Link to full podcast:⁠⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-220-Long-Acting-Opioids-e2vojfb⁠⁠Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This episode discusses four MMWR reports. In our first report, Idiopathic Pulmonary Fibrosis Mortality by Industry and Occupation - United States, 2020-2022, workers in some industries and occupations have higher-than-expected death rates from idiopathic pulmonary fibrosis, a progressive lung disease. In our second report, Enhanced Identification of Tobacco Use Among Adult Medicaid Members - King County, Washington, 2016-2023, identifying tobacco product use during Medicaid enrollment provides opportunities for states to help people quit smoking, improve their health, and lower health care spending. In our third report, Tobacco Product Use Among Adults - United States, 2017-2023, exclusive cigarette smoking has decreased, while exclusive e-cigarette use has increased, leading to no overall change in tobacco product use among adults from 2017 to 2023. In our last report, Detection of Vaccine-Derived Poliovirus Type 2 in Wastewater - Five European Countries, September-December 2024, variant poliovirus was detected in wastewater in five European countries last Fall.

In this episode of the Prehospital Care Research Forum's Journal Club, we discuss the findings of a qualitative study examining the acceptability of providing take-home naloxone kits by EMS to individuals at risk of opioid overdose. Discover the insights from the study, including patient perspectives, potential barriers, and the implications for overdose prevention strategies. Join us for a thought-provoking conversation on how EMS can play a pivotal role in combating the opioid crisis.https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2435034?src=

Meanwhile, across the country, it appears voluntary drug testing is on the rise. Drug Foundation NZ's communications director Hayden Eastmond-Mein joins Mark Leishman.

Brad explains why ketamine replaced morphine as the drug of choice for combat medicine.Link to full podcast:⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-220-Long-Acting-Opioids-e2vojfb⁠Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Acknowledgement of Country//Headlines// Please note that the following clip may touch on themes including domestic violence, childhood sexual abuse, organised abuse, colonial violence, suicide, mental illness, self harm and drug use. If you need immediate support, you can call Lifeline 13 11 14, Suicide Callback Service 1300 659 467, 1800 RESPECT (1800 737 732) or LGBTQ peer support QLife 1800 184 527 (3pm - midnight). If you're a First Nations person who'd prefer mob only support, you can call 13 YARN (13 92 76) or Yarning Safe'n'Strong 1800 959 563.//We replay conversation between Amy Ciara, Jasmine McLennan and president of the Blue Knot Foundation, Dr Cathy Kezelman, during last Wednesday's special broadcast marking  Dissociative Identity Disorder Awareness Day and supported by 3CR's Brainwaves. In the following interview, Amy, Jasmine and Cathy explore the nuances of living with complex trauma and dissociative identity disorders, also known as DID.// Lebanese-Australian lawyer and first-time filmmaker Nicholas Hanna speaks with us about his recently-released documentary, 'The Last Sky', which provides critical insight into Israel's war on Gaza within a broader context of its aggression against the Palestinian and Lebanese people. The film, which was produced by Palestinian media producer and filmmaker Rihab Charida, focuses unique attention on the perspectives of Palestinian refugees in Lebanon during the genocide, bringing together footage recorded in the region by Hanna and Charida in both 2004 and 2024.// We listened to part 2 of Priya's conversation with Jinsella Kennaway, Co-Founder and Executive Director of UK-based Demilitarise Education, who joined us to unpack the organisation's work to equip organisers with tools in the fight to break the links in the military-industrial-academic complex. In today's segment, Jinsella continues our discussion about the Demilitarise Education Treaty, a foundational framework that provides a pathway for action for universities to publicly commit to and implement full demilitarisation across investments, research and teaching activities. Head to 3cr.org.au/thursday-breakfast to listen back to part 1, which aired last week.// Professor Alex Collie is an applied public health and social policy scholar at Monash University. His research and teaching focus on work injury rehabilitation, occupational health and social protection schemes for personal injury. He joins us to discuss the latest study published 06 Mar 25 "Early High-Risk Opioid Prescribing and Persistent Opioid Use in Australian Workers with Workers' Compensation Claims for Back and Neck Musculoskeletal Disorders or Injuries: A Retrospective Cohort Study" which raises concern about opioid prescribing to injured Australian workers.// SongsBetter Things - Kee'ahnCaged Bird - Miiesha//

Illinois saw a drop in drug overdose deaths in 2023, according to newly released data from the Illinois Department of Public Health. And in Cook County, that trend seems to have held in 2024 as well, according to preliminary data from the county coroner's office. Reset talks with Fanya Burford-Berry, a community worker at West Side Heroin Opioid Task Force, where they provide outreach to hear what's led to this decrease and what's needed to bring the numbers down even further and WBEZ reporter and anchor Araceli Gomez-Aldana. For a full archive of Reset interviews, head over to wbez.org/reset.

Lesley Logan sits down with Sam Mandel, co-founder of Ketamine Clinics Los Angeles, to discuss the transformative potential of ketamine therapy for mental health. They debunk common misconceptions, explore its impact on PTSD, anxiety, and depression, and highlight how it empowers individuals to reshape their personal narratives.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe.In this episode you will learn about:What ketamine therapy is and how it differs from traditional treatments.How ketamine enhances neuroplasticity and helps reframe traumaThe science behind ketamine's impact on depression, anxiety, and PTSD.The difference between medical ketamine use and recreational misuse.What to expect during a ketamine therapy session.How ketamine therapy can help individuals reconnect with themselves and regain motivation.Episode References/Links:Ketamine Clinics LA Website - https://Ketamineclinics.comInstagram - https://www.instagram.com/ketamineclinicslaFacebook - https://www.facebook.com/KetamineClinicsLASam Mandel Instagram - https://www.instagram.com/thesammandelGuest Bio:Co-founder & CEO of Ketamine Clinics Los Angeles (KCLA), Sam Mandel, is a tour-de-force of compassion and innovation in mental health care. From volunteering at a teen-to-teen suicide prevention hotline at twelve to pioneering one of the world's foremost Ketamine Infusion Therapy clinics in 2014 alongside his father, Dr. Steven L. Mandel, Sam has channeled his lifelong passion for healthcare advocacy into transforming lives for the better. Sam was featured in Entrepreneur's list of Top 10 Inspiring Healthcare Entrepreneurs to Watch in 2023 and acknowledged by MSN as an Entrepreneur Leading the Business Frontier in 2024. Numerous media outlets have interviewed Sam for his expertise in Ketamine Infusion Therapy, and he is a frequent speaker at medical conferences and events. Under his leadership, KCLA has provided over 30,000 infusions to over 6,000 patients with an 83% treatment success rate, establishing the field's gold standard treatment protocols and patient satisfaction. If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox.DEALS! DEALS! DEALS! DEALS!Check out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSoxBe in the know with all the workshops at OPCBe It Till You See It Podcast SurveyBe a part of Lesley's Pilates MentorshipFREE Ditching Busy Webinar Resources:Watch the Be It Till You See It podcast on YouTube!Lesley Logan websiteBe It Till You See It PodcastOnline Pilates Classes by Lesley LoganOnline Pilates Classes by Lesley Logan on YouTubeProfitable Pilates Follow Us on Social Media:InstagramThe Be It Till You See It Podcast YouTube channelFacebookLinkedInThe OPC YouTube Channel Episode Transcript:Sam Mandel 0:00  When you look at trauma, for example, ketamine is extremely helpful for depression and anxiety, but also for PTSD and a lot of people have some trauma that is at the root of one of those issues, and ketamine helps people to recraft the story around that trauma. Lesley Logan 0:16  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started.Lesley Logan 0:59  Okay, Be It babe. This is going to be a different kind of episode, but in the best way. I have Sam Mandel, who is a founder of Ketamine Clinics in LA and I was really intrigued by what I know about ketamine from my friends' holistic doctors. And when he came up as someone I could interview, I was like, oh, we need to do this, because there is a lot of misinformation about ketamine and what ketamine can be used for, and I'm on a mission to help you be it till you see it. And I really want you to understand all the different ways that you can have support in feeling more like yourself and not letting things get in your way. And so that is why we're going to talk about ketamine today. And if you think you know what it is, I strongly encourage you to just stay and listen, because I thought I knew and I learned so much. And then on top of all of that, I really enjoy Sam's story of how he started these clinics and what he and his dad did. And so there's just a lot of beautiful information in this episode, and I can't wait for you to hear it. So here is Sam Mandel. Lesley Logan 2:00  All right, Be It babe. I am really excited. I can tell you for a fact, we've never talked about this on the Be It Pod. And only is it quite timely, I think it's actually extremely imperative that we have this discussion so we have Sam Mandel here on the show. We're gonna talk about ketamine and all things about it, ketamine therapy. Sam, can you tell everyone who you are and probably why you rock at ketamine therapy?Sam Mandel 2:25  Yes, yeah. Thank you so much for having me, Lesley. So, I am Sam Mandel. I'm the co-founder and CEO of Ketamine Clinics Los Angeles. We're one of the first ketamine clinics in the country, established in 2014 and we specialize in IV infusions of ketamine for mental health, but we also offer several other innovative therapeutics for mental health. Lesley Logan 2:45  I love that mental health is something more people are talking about, and there's like more awareness around it, but also that there can be clinics that are working on different ways of helping, supporting mental health, including these infusions. For people who have heard about ketamine, and maybe not the positive ways, can we kind of, can we just dive in and ease their nerves about what we're talking about here?Sam Mandel 3:07  Let's do it. Some of your listeners are definitely like, ketamine what? And there's five different people saying that it's five different things, and all of them are correct. So that's one of the interesting things about ketamine. It is, first and foremost, an FDA-approved anesthetic for humans. It was FDA-approved in 1970. This is an old medicine. It's also commonly used in veterinary medicine. So a lot of people know of it as a horse tranquilizer or a cat tranquilizer. In some circles, it's more commonly known as that than as a drug for humans. But there's a lot of medications that we use for humans, that we also use in veterinary medicine. And it's also a drug of abuse, or something that people use recreationally or self-medicate with, depending on how you want to look at it, known as Special K. Same drug. It's used as an analgesic, as a pain reliever, in emergency room departments and crisis situations, trauma situations, when someone's in a terrible accident, they're in pain, they need sedation, or someone goes in and they need their shoulder reset, they commonly will use ketamine for conscious sedation. So it is a ubiquitous drug. It has a lot of different uses and applications, and one of its most recent, or probably its most recent, addition to that list of its identities, if you will, is as a mental health treatment. And in the last 25 years, there's been a growing body of clinical research proving ketamine to really be among the fastest, if not the fastest-acting, safest, most effective depression treatments available today.Lesley Logan 4:36  I mean, it's kind of amazing that it can be all these different things, also not, right? Like there's so many things, I feel like there's a lot of untapped medicines out there that we're already using, and we don't realize it could be done for other things. Can we talk about how it helps? Because I'll say my family's understanding of mental health treatment is when you sit on a couch and you talk to a therapist and you go weekly if you're depressed, you can take a pill that will kind of help with some hormonal imbalances. But that's not what this is. Sam Mandel 5:01  Yes, that is not what this is. And by the way, talk therapy is great. I go to therapy every week, you know, even when I'm in a good place and I don't necessarily feel like I have a lot to talk about, it's like going to the gym. I just go. I show up every week no matter what. And I think that's really good and healthy, especially if you have a therapist who you think cares about you and is invested in you, and you can just talk about, you know, life. And I'll tell you, sometimes when I go and I don't have anything bothering me or an agenda is when I do the most important work in those sessions, sometimes, so you just never know. But talk therapy is great, but it can only go so far. The conscious mind really gets in the way. Finding someone who cares is difficult the right credentialed person is expensive. A lot of the best people typically don't take insurance. It's not true for all of them. There's wonderful people out there who do, but a lot of the really good ones don't, and so it's a tough thing, but it has its limitations, like with anything. Ketamine and other psychedelic medicines, because ketamine, for all intended purposes, really is a psychedelic, and it's really the only legally available psychedelic in the United States, has the ability to really dissolve these barriers that get in our way. It helps people to get out of their own way and with exponential growth in ways that really are not possible and haven't been seen in any other treatment or modality. And the way it does that is really two primary mechanisms of action. The first is the neuro chemical effects and what's going on in the brain and how ketamine is impacting the brain and our neurochemistry in ways that really nothing else does. And the other is the experiential component, psychologically, what is going on during the experience or the trip that people have when they're receiving this medicine. And both of those are profound and really create lasting impact. On the neuro-chemical level, there's a neurotransmitter called glutamate. It's the most abundant neurotransmitter in the brain. It's present in 85% of the brain. All the other neurotransmitters combined comprise only 15% but for some reason, we've been disproportionately focused on them with mental health treatment. Those are the common ones you know of. Serotonin, dopamine, norepinephrine, you know, the most common class of antidepressant medications are SSRIs. Those are selective serotonin reuptake inhibitors, and those are targeting serotonin. They're a tool. They help some people. They really don't help a lot of people, too, and the people they do help, they really cause a lot of negative side effects and weight gain, sexual dysfunction, dried mouth, blurred vision, even increased suicidality, and the list goes on and on, really terrible side effects that are really debilitating for a lot of people. Even when those side effects are not as debilitating, the quality of relief is typically not very good. So people will say, oh, well, I definitely am not as depressed, but I don't feel happy either. I'm just kind of existing. They have the spectrum of life and of the human experience narrowed, so the lows are not as low, but they're not really thriving either. Not a nice place to be. Is it better than being in bed all day? Absolutely. But that's not the goal. That's not my goal for my life. That's not my goal for other people's lives and for the patients who come to our clinic. We want people to really thrive. Ketamine has the ability to help people to truly thrive. It restores compassion for self and others. It is enhanced energy and motivation for most people. It's a genuine reconnection of self. One of the things that happens with this, with the glutamatergic system and other processes that are occurring in the brain with IV infusions of ketamine, is it causes and promotes neurogenesis, enhanced neuroplasticity, actual new pathways, new connections forming in the brain. This helps people to form new habits, new patterns, new ways of thinking and being that can be very, very positive by disrupting a lot of the automatic responses and reactions we have in our day to day life that get so deeply enmeshed in us that they become a part of our personality, and ketamine can kind of push the reset button on that so that we have the opportunity to consciously choose who we want to be and how we want to be, and helps us call into question the things that we've accepted as just that's the way that I am, or that's the way that it is, and that's not the case most of the time. You look at trauma, for example, ketamine is extremely helpful for depression and anxiety, but also for PTSD, and a lot of people have some trauma that is at the root of one of those issues, and ketamine helps people to recraft the story around that trauma. So what happened is fixed and can never change. The past is the past, but our stories about it can change at any given moment, who we are and who we were and the other people and our role in it, and their role in it, and what happened and what didn't happen, and ketamine provides this kind of objective clarity on that that can be extremely healing and transformational for people.Lesley Logan 9:50  Yeah, this is fascinating. What I've known about ketamine, and I have friends who, I have a holistic doctor friend who offers it as a treatment, and I've heard of these amazing effects that can happen, but I never understood on the brain level, like what's going on and why it's different than the antidepressants that people are on, and how it could, so if someone comes in, first of all, what are some of the reasons why they're coming in for treatment, and then what is the, what are the expectations? Are they coming in one time for an IV infusion? Is this a weekly thing? And how long can the effects last? Can it be forever? Do they have to keep coming back? Can I get the lowdown on that? Sam Mandel 10:25  Yeah, you're asking all the right questions. So what treatment looks like is typically a series of six infusions over two to three weeks after that process I just explained where people are cleared for treatment. They come in, we have them fill out some paperwork, do a brief physical exam, and they come back to a private room. We help them to become comfortable in a recliner with noise canceling headphones, a sleep mask, unlimited selection of relaxing music, pillows, blankets, and we start an IV, and then we infuse the ketamine for 50 to 55 minutes. And it's a slow, gradual, steady state of infusion. People are conscious and awake the entire time. There's a level of dissociation where we don't want them to go so far that they don't know what's happening, but we want them to go into it far enough that they can kind of have a little bit of that quieting of the noise and chatter in their minds, and get a little bit of that clarity that I was describing earlier, and this separation really from themselves in a healthy way to take a look at things that can be really therapeutic, and doing that inner work. We monitor them the whole time. We use hospital-grade monitoring equipment. So that's like pulse, oxygen, EKG, blood pressure, continuous monitoring. I mean, it's a very safe medicine when it's used responsibly in a clinical setting like Ketamine Clinics Los Angeles. We still do all the proper monitoring just to make sure that people are comfortable and safe. And yeah, it's, that's pretty much the, you know, summary of the experience.Lesley Logan 11:53  Yeah, no. Thank you for sharing that, because I think, I don't think anyone's ever explained that, and I'm trying to think about people listening. It's like, well, what does it look like, you know, because let's just talk about what, we have heard about ketamine in the news lately, and it will continue to be in the news as people are going on trial, like when we hear Matthew Perry pass away from not the best use of ketamine, I think people are like, well, then how do you, what does it look like? Am I doing this myself? And I love that you have a wonderful protocol that allows people to be safe and use it in the best way that gets them the best results. But can we talk about the dark sides of ketamine, and what are some signs that people might not be in the safest situations using ketamine?Sam Mandel 12:30  Yeah, well, I'll definitely answer that with your reference to Matthew Perry, which is obviously a really sad situation. He was taken advantage of by people he trusted. He was a addict. He had a really, he's really struggled with addiction. He was very public about that, and not with ketamine specifically, but with really any substance that he could get his hands on. And was in a lot of pain, obviously, and it's a terrible situation. I think it's really important that people understand, though, that that has nothing to do with ketamine therapy. And the media created a lot of confusion for people saying that he had had ketamine therapy a few weeks ago and but that wasn't really a part, a factor in his death. But by the way, he had that and, you know, saying that he died from the acute effects of ketamine, that's just it was really, really distorted. He took more than 10 times the dose of ketamine that we give in the clinic by himself, in combination with buprenorphine, which is essentially an opioid, and Lorazepam, a benzodiazepine, which is another sedative. So he's combined three powerful sedatives, one of them in really absurd doses, by himself in a hot tub. And of course, what happens? He becomes incapacitated and he drowns. This is not, this is such a departure from what we do when we use ketamine in a therapeutic context. There's no correlation, but the way that it's been reported on, and what the average person hears is, oh, ketamine is a bad, dangerous drug, and that's it. That's the takeaway, and that's really a sad thing for people to to get from it. What they should get is that addiction is a serious illness. What they should get is taking lots of sedatives in combination is dangerous. Taking drugs unsupervised, alone in a hot tub is dangerous. These are the takeaways. There was even medical doctors involved in supplying it to him, but they were part of an illicit, underground, illegal drug ring. You know, this is not like mental health care, you know?Lesley Logan 14:25  I know. It's so sad because, well, first of all, the whole situation is sad. It's sad that someone was taken advantage of. It's sad that someone died from combining too many things, but also because they had doctors doing it, like all of that is sad, and, but, really, what I find, and one of the reasons I wanted to talk with you is, so this podcast is called Be It Till You See It, and one of the things that I am always on a search for is like, what can keep us from being it until we see it, what's holding us back in our life, or what can help us more? And the facts of what ketamine therapy that you do that is supervised, and you have pre-screened people to make sure that this is the right therapy for them, the benefits can actually change people's lives, like you said at the beginning, to choose what they want, and that allows them to step into the person that they want to be, like to me, this can be an amazing option for people who they know what they want, but they are just stuck, and they've got other things going on that with their mental health that the talk therapy hasn't helped with, or antidepressants haven't helped with. And so I really wanted to, like, clear the air and go, this can be an option for the right person.Sam Mandel 15:30  Absolutely and I'm really grateful for the opportunity to speak with you and for you creating a platform to have conversations like this, because people deserve to know the truth. And you know, you talk about talk therapy. I mean, a number of patients have literally said that was like 20 years of therapy in an hour. I mean, it really is that exponentially transformational. And it's not instead of therapy, but in addition to, right? When you can do a treatment like this and then work through the material and the learnings that come up for you with someone who understands mental health, who you trust, that's where a lot of even more growth can happen, and you can implement those learnings into your day to day life in the weeks to come. That process is usually referred to as integration, and it can look a lot of different ways, but then you have your experience. How do you integrate it into your life and actually make lasting change? Ketamine really does produce transformation for most people. In the almost 11 years that we've been doing this, we have done over 30,000 infusions. We have an 83% success rate, and we're typically not seeing people who are just wanting to have growth because they're stuck. We're seeing people who have treatment resistant depression, complex PTSD, severe anxiety, suicidality. I mean, there are definitely more moderate cases, but we see a lot of people have really just they've tried a lot, and some of them tried everything, and they haven't benefited. And this really works for them, because it works on under a completely different mechanism of action than the conventional treatments like antidepressant pills or even ECT or talk therapy, or really anything else out there. Lesley Logan 17:04  Yeah, when I think about PTSD, we obviously a lot of things about vets. People have been in the military, but there are people with PTSD who have had other traumas. It doesn't have to be that you've been to war. You could have been in a bad car accident, you could have been assaulted. Can you kind of explain and maybe it's redundant, but just how does ketamine help with PTSD, and then what does someone's life look like? What with one, do you have a case that a person who you can talk about, like, who had PTSD and like, what their life was like after the ketamine treatment? Sam Mandel 17:29  I'm glad you bring that up, because while a lot of us do think of military and war, there's actually many more cases of PTSD among the civilian population in the examples that you mentioned with violence, assault, accidents, etc. So it's super common, unfortunately. I believe there's around 16 million Americans suffering from PTSD who are at least diagnosed. There's many more, I'm sure, who are undiagnosed. And ketamine really does help with the neurochemistry in the brain and helping to rewire the brain, and it also really helps with the perception that we have of ourselves, of the event. People who have trauma are able to go back and revisit the trauma without being as emotionally triggered by it. And so sometimes, when I've talked about this with you know, friends, they say, yeah, you can revisit your trauma and work through it, and it's so great. And they're like, whoa, whoa, whoa. Why would I want to revisit my trauma? What are you talking about? I'm going to go and spend time and money to go there? No, thank you. I spent time and money avoiding my trauma, not going to visit it. But it isn't like that. You know? There's this ability to work through it without having the kind of pain of going there that is so often keeping people from addressing it head on in talk therapy and in life. We avoid, naturally, what's painful, but it isn't painful for most people in this context, they're able to have this detachment that is healthy in this way, to revisit it and to understand who we are, who we were, what our role was, what It was and etc, and to get clarity on that. And it can be really healing. It can really provide closure for a lot of people. And just with the whole cascade of different chemicals going on in the brain, it gives people generally a better mood and more positive outlook and demeanor, and enhanced feelings of compassion towards oneself and towards others and energy and motivation and just all around wellness, it's an elevator in that way which can just be really motivating for people to be able to do the things that most of us know we need to do and just struggle with in terms of our lifestyle, like fitness and eating healthy and sleeping well and talk therapy and having healthy relationships with people, getting outdoors and getting some sun and some fresh air, doing things we enjoy, all that stuff is absolutely critical for longevity, and for someone who's really severely depressed or anxious or dealing with real trauma, they can also feel like it's almost impossible to do a lot of those things. Lesley Logan 20:00  Yeah, yeah. You know, it's really interesting. If you're not someone who has PTSD, or you haven't had, like, severe depression, it can be hard to understand that it becomes all encompassing, you know? But if you think about it, like, when you've had an injury, you've been sick for a few days and you can't leave the bed, that's the the domino effect of what happens to your strength, and then what happens to your ability to, like, feel like you can reach out and that you can connect with people because you've been sick for a week. It's an easy way to see like, oh, if that's my life all the time, you know, it's not easy to go outside, and it doesn't feel easy to connect with people. And so it becomes part of their whole life. And so it's really cool to hear that with ketamine treatments over a couple of weeks that they could have a new lease on life and enjoy it. And I love that you brought up longevity, because I think we forget that how we treat our bodies now is what dictates how long will you get to have them? Hopefully, there won't be anything that stops us from living the life that we're supposed to but if you don't see like a lease on life there, what longevity do you have, you know, so it must be really amazing to get to do what you do every day. You really help so many people.Sam Mandel 21:01  I love it. It's the most gratifying thing ever, you know. When I tell people a lot of my job, the reality of what I do on a day to day basis, I have to do a lot of things I don't like to do, I don't want to do. I'm the CEO of my company. I get the worst, toughest problems that no one else can deal with. I get the fires to put out, the problems, the issues that got escalated to me, and all the weight and pressure and responsibility of it, and there's a lot of stuff, this is not fun, frankly, but I do it because of the, for the patients and for my team, and the work that we're doing, the impact that we're having. It's hugely motivating and gratifying. And when I see patient who I pass in the hallway in the clinic, and they just, can I just give you a hug, or I just want to say thank you so much, or we get a new Yelp review, and someone goes through and lists, you know, half my team by name and how amazing each one of them is, and how life-changing this has been for them. That's what gets me up in the morning, and that's what helps me to keep going every day. I just love it. The transformations are very abundant. And, you know, like I said, 83% it's not magic. It doesn't work for every person every time. It's not perfect, but it is a really incredible treatment.Lesley Logan 22:04  Yeah, yeah, I do understand that. I mean, my husband and I run our own businesses, and sometimes you can forget what you do while you're doing it, because you're doing all the fires, yeah? But then you do get stopped by someone who's been helped by it, or their life has changed, and you're like, oh, that's why I do this. Obviously, you know, it's been a journey to get to do this. Can you take us back how you figured out how to create a space where people could have ketamine therapy? You know, you are the first in the country. So, like, there wasn't really a model to go off of. So I feel like there's a be it till you see it story in there.Sam Mandel 22:36  Oh yeah. Started with me building the website with GoDaddy website builder, drag and drop modules, not knowing a lick of code, never built a website or anything of the sort, not even the most tech savvy guy, and literally just dragging and dropping and, you know, doing research on articles and clinical research, and conferring with my father, who I co-founded the practice with. He's a physician, and I'm talking about, what do you think about this? I'm just trying to make sense of it all in a way that I could understand it well enough to then be able to put it into layman's terms and explain it to other people. What is this? How does it work? And just putting it together, and then going to Radio Shack and getting a motorLesley Logan 23:17  That's how long ago this is because I don't even think they're around anymore.Sam Mandel 23:20  They're not, They went bankrupt. Lesley Logan 23:22  Was it the Radio Shack on Santa Monica Boulevard underneath the yoga place? Because that was my favorite. Sam Mandel 23:27  It was the Radio Shack in Marina Del Rey by the CVS and little strip mall off of Max Stella or something. Anyways, I got a Motorola flip phone prepaid, and I said to my father, you ready to launch the site? We're going to make it live. And made it live, and started taking calls on this cell phone. We were renting space in another doctor's office that was literally this closet. No kidding, they used it as a utility closet before we rented it, and once we moved out and got our own space. They went back to just keeping boxes in there. That's how tiny this room was, no kidding, and it was just really a trip. We had a operating room, recovery area, recovery room for an OR right outside of that little closet that we were in, which, by the way, we were sitting at literally just two folding chairs, a folding table with two laptops, and that was it, no kidding. And we use this recovery area to see patients. And we saw our first few patients, and their transformations were so incredible. We went, this is just too special. We have to do whatever it takes to do more of this. And my father was working as an anesthesiologist. He also has a master's degree in psychology. He was chief of anesthesia in this plastic surgery suite where we were. And so it started out with, well, he's already there, doing anesthesia for the surgery. Maybe we see a couple patients here or there, see how it goes. And next thing we knew, we just started getting busier and busier. The word got out. This was such a radical thing that a lot of people were very incredulous, very suspicious. A lot of people were very critical, but we were like, it doesn't matter. I mean, this is just too special. And it got to the point where my father had to choose between doing our cases or doing ketamine infusions for patients. And I, I remember that quite vividly, where I said, it's really gotta pick. We can't continue to do both. And it was a big risk, you know, it was a really big risk. So I have a lot of respect, you know, for him, for that and that we both just said, let's be all in on this. And, you know, we bootstrapped it. We put everything on credit cards. We had no investors, no financing, no loans, nothing. It's just a little bit of cash, credit cards. And really, just brick by brick, built it up, and now we have 15 employees, 5000 square feet, a really beautiful purpose-built office. I still have, well after the falling table, I had a custom desk built because of maximizing every inch of that space. So I had, there was a little nook between two pillars in that room, under a window, where they made this skinny little desk that was probably literally eight inches wide by three and a half feet long or something. Just stick it in this little nook so I could sit at a proper desk, and I still have that here in our suite now, and so that's kind of fun, but, yeah, it's just truly been an incredible journey.Lesley Logan 26:12  I thank you for taking this back, because we do have a lot of people who are entrepreneurs, and I think that they need to hear that like even a ketamine clinic, the first of its kind, starts in a utility closet. You know, people don't realize, because if you, one, you have to know if people want the thing. You knew it was great. You knew it could be amazing. But you have to get people to buy in, and especially on something that long ago, where people might not know all the amazing things that it can do. And even today, now, even with a beautiful space that can attract people in and make them feel super safe, doing something that changes lives, but also going up against where misconceptions, misinterpretations, and also the people who are misusing it can affect the majority getting the help that they need. I love hearing the stories of how things come to be. And also that is pretty amazing that your dad was like, yeah, I'm gonna quit my safe job. There's always gonna be surgeries, you know. So that's so, so, so cool, and it's really amazing. Is there anything about ketamine therapy that I haven't asked you, that you want to make sure people know? Is there anything else that we can help people understand why this would be something they might need to use, or might use so that they can have the life they want to have?Sam Mandel 27:19  Yeah, I do want to mention, you know, I was talking about how, you know, Matthew Perry was misusing it, and how different that situation is from what we do. And ketamine is still something that people do use recreationally or abuse or misuse. It's not as common, I think, as sometimes it's portrayed, but it definitely can happen, but it's also not in the same category as most other substances, because ketamine is not addictive in the way that most others are. And what I mean by that is you don't develop a physical dependence on it if, for example, like nicotine or opioids or alcohol or benzodiazepines, all you can get to the point where you actually need it to not feel sick. I mean, you have physical symptoms of feeling like nausea, headaches, wanting to throw up. Even with benzos, you can actually, if you abruptly stop taking high doses, you can literally have seizures and die. And you know, you can have symptoms from abrupt cessation of alcohol if you're a heavy alcoholic. That doesn't happen with ketamine. So some people can use it in the way that they're using it as a means to escape, but that's not really that different as far as the psychological dependence in the way that someone can use ice cream or chocolate or, you know, sour candies or sex or any of these other video games as a means of escape or avoiding or to self-soothe. So I think it's important that people understand that. It also has a very, very high therapeutic index. There's actually no known lethal dose of ketamine, so you can obviously be in a bad, unsafe environment, where, if you take a bunch and get into a car, that's not a not such a great outcome for you, or in a jacuzzi, but the medicine itself is unlikely to hurt you on its own. Most of the issues are people in bad situations, or they're combining it with other drugs. Virtually, almost all of the fatalities that are related to ketamine were one of those two, either in combination with other drugs and or in a situation like behind the wheel of a car. So I just want people to know that it's not to say that there aren't people who have an issue with misusing ketamine, because there are, but it really is distinct from most other substances that people are misusing or abusing.Lesley Logan 29:20  Thank you for saying that, because I do think, as a child of the night, you know, I grew up in the 80s, so it's, like, always just say no to drugs. Sam Mandel 29:25  The cocaine epidemic. Lesley Logan 29:28  Yeah, so I know they really that didn't really help them, did it? But, like, they thought it would. But I, like, grew up, so it's really funny when I have friends who, like, talk about doing some sort, some psychedelics, or do I have this innate like, I don't, I don't know, I don't know if I could do that. I'm afraid to try. I'm like, I'll be addicted on the first dose. Sam Mandel 29:45  Right, right, right. Lesley Logan 29:47  This is my fear, which is why I drink, right? That's what people do. And so they said no to drugs, but then they drink. But I really appreciate because it's nice to know that if I were to do a ketamine therapy, I'm not going to be dependent on coming to ketamine therapy every single week or I'll be using it at home, like, it's nice to know that it's a non-addictive thing that people can use to get the benefits. And I think that can make a lot of people feel more comfortable, you know. Sam Mandel 30:08  Yeah, because people are afraid of that, they think, God, well, if I go and do this, even if it's in a therapeutic way, am I going to become a ketamine addict? You know? I'm going to go and then be looking to score some on the street the next day. It's really a sad perception that some people might have due to the media or for whatever reason or they know somebody who misuse ketamine or the DARE program, like you said, or the 80s. A lot of baloney. Lesley Logan 30:28  Oh, and by the way, the DARE program was a lot of baloney. I just heard a whole podcast about it, and I was like, ah. So, but it, but it does put in people's minds, and also good for good reason. Like, I don't want people going out there doing other drugs we do know our addictive and like, hoping that they are fine out there the first time, but I am on this mission of helping people figure out how to get out of their own way and live their best life, and sometimes our own way are things that are really outside of our control, the PTSD, the depressions, the mental health, the suicide like I think it's important that people have access to forms of therapy out there that they may not know about or they may have misconceptions. Because we do know that the media does like to click bait things into headlines that get people to look at them, but don't actually give all the information. So I'm just so grateful that you were here to just really explain all this and the benefits of it.Sam Mandel 31:22  Absolutely, yeah, no, I appreciate the opportunity. Yeah, there are drugs that you can do once or twice and develop a real serious problem with pretty fast, methamphetamine, probably not one that you need to ever try. You know, if you're curious about trying drugs, I'd say take that one off the list. Heroin, probably not a good idea. Pretty easy to die, pretty easy to get addicted to that one, right? Opioids, crack, cocaine. These are some that maybe you don't need to, you don't need to check out, but maybe there's some others that if you really want to with the right mindset in the right context, if you're going to be safe or responsible, maybe you'd be okay with. And by the way, I'm not advocating for you to go do illicit drugs illegally either. But there are some that you can have, even in a controlled environment, such as ours, where you don't need to be afraid of them. I'll tell you what are the most dangerous, though, is the prescription legitimate drugs. As a matter of fact, prescriptions are more commonly abused than any of the other illicit drugs. You look at your stimulants like Adderall, your benzodiazepines, like Xanax, opioids, I mean, these are drugs that are a lot of people are really hooked on and that are killing a lot of people, especially the opioids, but because they're from big pharma, they're not all that bad. I mean, people are finally starting to scrutinize the opioids, but the others are still kind of under the radar, and they're really widely abused, but the focus is on the big, bad, illegal ones. Lesley Logan 32:39  I know of a client who's a social worker, and she used to work in a hospital, and we're talking about pain meds, and she's like Lesley, I watched a 14 year old kid come in super healthy, just had a broken arm. They had to have surgery, but within the three days they were there, they were extra tapping the pain meds. And she's like, we create addicts with these pharmaceutical drugs quickly, but we don't think of it like that, because they had a prescription written. And so it's important for us to educate ourselves, to be informed and to be able to advocate for ourselves or advocate for others when we have this information we can. So, thank you so much. I'm not gonna let you go. We actually are gonna take a brief break, and then we're gonna find out Be It Action Items from you. Lesley Logan 33:19  All right, Sam, where can people find you, follow you, connect with you. If they want to know more about ketamine therapies, if they want to come to your clinics, how can they connect with you best?Sam Mandel 33:28  Yeah, so ketamineclinics.com. That's K-E-T-A-M-I-N-E-C-L-I-N-I-C-S dot com. Lots of great information on there. People are more than welcome to call us, 310-270-0625. Consultations are free. We're always happy to chat see how we can help you. We do offer other treatments we really didn't talk about today, TMS, General Psychiatry, medication management, we take 12 of the biggest insurance networks in California, including Medicare, so there's a lot more that we can cover with you. Whether or not ketamine is the right fit if you are dealing with a mental health condition, I would encourage you to call and see if there's anything we can do to help. And we're on social it's ketamineclinicsLA on all socials and my personal is theSamMandel on all socials. And just really happy to connect with people and hear their stories, answer questions and help in any way that we can. Lesley Logan 34:23  I love it. Thank you. And that's also so cool, because we mentioned, like, it can be really hard to find a therapist these days because they don't always take insurance. So to hear that you do. It's really nice. Okay, we always ask people bold, executable, intrinsic or targeted steps they can take to be it till they see it. What do you have for us?Sam Mandel 34:41  Oh, I wasn't ready for that one. I would say action. Take action. Just do it. Take Nike slogan. I mean, honestly, planning and strategizing is important, and thinking things through and figuring out who you are. What you want, what you like, what you don't like, putting together a plan matters. But I think most of us, or almost all of us, spend too much time on that, and there's just too many unknowns and too many things that you really can't solve for until you're in it and doing it, and it's too easy to let perfectionism keep us from taking the steps that we need to take to get done what we want, become, who we want to be, and who what our potential is. And I personally struggle with this too. So I say that from, you know, my own experience, and I really strive, and I want to encourage other people to really strive, to just get out there and do it, and you're going to make mistakes, and that's okay, but it's really the only way to succeed in life. You have to be on the fields, on the court, in it, and behind the scenes, thinking, planning, strategizing is only going to get you so far.Lesley Logan 35:58  Yeah, yeah. Oh, thank you for that. And also, I can tell you, practice what you just preached, because it's true. You started with a utility closet and some folding chairs and a Motorola phone, I mean. But also, you're correct. People do spend too much time in the planning, or they're waiting for it to be perfect, or they're waiting for the perfect decoration, and then they have the perfect branding and all the things. And if you guys had done that, you wouldn't have been able to help the thousands of people that you have today. So thank you so much, Sam for being here, for educating us, for informing us. Lesley Logan 36:29  And, you guys, how are you gonna use these tips in your life? Please share this episode with a friend as you hear conversations come up about the misuse of ketamine, and now you know you could share this with them to educate them, and also, if you have friends and family or yourself who needs this, please contact Sam and his team, because there's help out there for you. Until next time, Be It Till You See It.Lesley Logan 36:50  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 37:33  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 37:38  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 37:42  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 37:49  Special thanks to Melissa Solomon for creating our visuals. Brad Crowell 37:53  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Support this podcast at — https://redcircle.com/be-it-till-you-see-it/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Transitioning from ketamine to a long-acting opioid can be a great technique to spare your (very short-acting) ketamine.Link to full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-220-Long-Acting-Opioids-e2vojfbThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In today's episode, we explore the evolving landscape of buprenorphine prescribing through telemedicine with Dr. Stuart Gitlow, a distinguished expert in addiction medicine. Dr. Gitlow returns to discuss the Biden administration's new ruling that enables providers to prescribe buprenorphine via telehealth, including audio-only visits, without requiring initial in-person evaluation.Building on our previous conversation about the elimination of the DATA waiver, we examine how physicians have responded to these expanded prescribing capabilities. Dr. Gitlow shares insights from his extensive experience with telemedicine during COVID-19 and addresses the implications of allowing 6-month prescriptions through virtual visits.We also discuss critical aspects of this new framework, including pharmacy verification requirements and the role of emergency departments in initiating buprenorphine treatment. Join us for this timely conversation about expanding access to addiction treatment while maintaining appropriate safeguards and quality of care.For listeners new to our series, we recommend listening to our earlier episode "History and the Elimination of the DATA Waiver" featuring Dr. Gitlow, where we explored the historical context of addiction treatment regulations.

In this conversation, Dennis and Brad discuss the evolving landscape of pain management, particularly focusing on the apprehension surrounding the use of opioids like morphine and hydromorphone. They explore the historical context of opioid use, the introduction of ketamine, and the importance of transitioning between different pain management techniques. The discussion emphasizes the need for a strategic approach to pain management, considering factors such as respiratory rate and the context of the patient's condition. In this conversation, Brad and Dennis discuss the complexities of pain management in medical settings, particularly during recovery and transport. They emphasize the importance of monitoring vital signs, effective communication with patients, and the careful selection of medications to manage pain while minimizing side effects. The discussion also highlights the need for thorough training and preparation to handle emergency situations effectively.TakeawaysMedics are increasingly fearful of using longer-acting opioids.Ketamine has become a preferred option over traditional opioids.Morphine and hydromorphone still have a place in pain management.Understanding the context of drug use is crucial for effective treatment.Transitioning from rapid-acting to long-acting agents requires careful monitoring.Respiratory rate is a key indicator of patient comfort and need for medication.Historical perspectives on drug use can influence current practices.Education and experience play significant roles in drug administration confidence.The evolution of pain management reflects changing medical practices and perceptions.Effective pain management requires a balance of various medications. Respiratory rate is a critical indicator for pain management.Patients often have cultural expectations about pain levels.Effective communication can significantly improve patient care.Medications should be administered based on patient stability.Ketamine can be a beneficial option for pain relief.Understanding individual responses to medications is essential.Training and practice are vital for emergency preparedness.Developing a strategy for pain management is crucial.Monitoring vital signs helps determine medication needs.Practicing scenarios can reduce mistakes in real situations.Chapters00:00 Understanding the Fear of Opioids08:18 The Evolution of Pain Management14:57 Transitioning Between Pain Management Techniques25:34 Practical Application of Opioid Dosing31:31 Understanding Pain Management in Recovery39:02 The Role of Communication in Patient Care47:09 Managing Side Effects of Pain Medications57:04 The Importance of Training and Preparation in Emergency CareThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

When teaching a technique, it's super important to make sure the students understand the context.Link to full podcast:https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-220-Long-Acting-Opioids-e2vojfbThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

You've used your ketamine..how to transition safely to a long acting opioid? Posting tomorrow.Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This episode discusses four MMWR reports. First, 2024-2025 COVID-19 vaccination provides additional protection against COVID-19-associated emergency department/urgent care encounters and hospitalizations. Second, this season's flu vaccines protect against flu-related medical visits and hospitalizations. Third, a new CDC report finds that 13% of children who have died from seasonal flu this season had influenza-associated encephalopathy or encephalitis, a potentially severe neurologic complication. Last, as HPV vaccination has increased, a steep decline in cervical precancers has occurred.

On this West Virginia Morning, we look at a bill that would make opioid treatment centers in the state unlawful, and The David Mayfield Parade brings our Song of the Week. The post Lawmakers Weigh Limiting Opioid Treatment Centers, Plus Our Song Of The Week, This West Virginia Morning appeared first on West Virginia Public Broadcasting.

Clark County Jail in Vancouver recently became the first jail in Washington state licensed to provide methadone on-site through a treatment program for opioid use disorder. A team of specialists at the jail also administer naltrexone, another medication approved by the FDA to manage withdrawal symptoms and the cravings associated with drugs like fentanyl.  More than half of the jail population in Washington has an opioid use disorder, according to researchers at the University of Washington. Last year, Clark County Jail installed a vending machine in its lobby that dispenses free fentanyl test strips and naloxone to reverse potentially fatal overdoses. Joining us to talk about these harm reduction efforts and the opioid treatment program at Clark County Jail are Anna Lookingbill, the jail transition manager, and Matt West, the addiction medicine medical director at the jail’s Comprehensive Treatment Center, which is operated by Acadia Healthcare. 

Dr. Mellar Davis discusses the joint guideline from MASCC, ASCO, AAHPM, HPNA, and NICSO on opioid conversion in adults with cancer. He reviews the limited evidence, and the formal consensus process used to develop the guideline. He shares the key recommendations on pre-conversion assessment, how opioid conversion should be conducted, including opioid conversion ratios, and post-conversion assessment. We touch on gaps and questions in the field and the impact of these new recommendations.  Read the full guideline, “Opioid Conversion in Adults with Cancer: MASCC-ASCO-AAHPM-HPNA-NICSO Guideline” at www.asco.org/supportive-care-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/supportive-care-guidelines. Read the full text of the guideline in the Supportive Care in Cancer, https://link.springer.com/article/10.1007/s00520-025-09286-z   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Mellar Davis from Geisinger Medical Center, lead author on “Opioid Conversion in Adults with Cancer: Multinational Association of Supportive Care and Cancer, American Society of Clinical Oncology, American Academy of Hospice and Palliative Medicine, Hospice and Palliative Nurses Association, Network Italiano Cure di Supporto and Oncologia Guideline.” Thank you for being here today, Dr. Davis. Dr. Mellar Davis: Thank you. I'm glad to be here. Brittany Harvey Before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Davis, who has joined us here today, are available online with the publication of the guideline, which is linked in our show notes. So then, to dive into the content here, Dr. Davis, can you provide an overview of both the scope and purpose of this guideline on opioid conversion in people with cancer? Dr. Mellar Davis: This is an important topic in management of cancer pain and this topic came up as a result of a survey that MASCC had done, which involved 370 physicians in 53 countries. They were queried about how they change or convert one opioid to another, which is a common practice, and we found that there was quite a divergence in opioid conversion ratios. To step back a little bit, about two thirds of patients with advanced cancer have moderate to severe pain and most of the time they're managed by opioids. But about 20% or 40% require a switch either because they have an adverse reaction to it or they don't respond to it, or the combination of both. Rarely, it may be that they need a route change, perhaps because they have nausea or vomiting. So, the opioid conversion works basically because of the complexity of the new opioid receptor which has at least four exons to it as a result of that non-cross tolerance between opioids. As a result of the survey, we convened a group of specialists, 14 international specialists, to look to see if we could develop an international guideline. And we did a systematic review which involved viewing 21,000 abstracts and we came up with 140 randomized trials and 68 non-randomized trials. And after reviewing the data, we found that the data was really not strong enough to provide a guideline. As a result, ASCO, MASCC, the AAHPM, the HPNA and the Italian Group formed a supportive network that allowed us then to do a Delphi guideline based upon ASCO modified criteria for doing Delphi guidelines. And so we then involved 27 additional international experts informing the guideline to it. And this guideline is then the result of the Delphi process. It consists basically of a pre-conversion ratio recommendations, conversion ratios, which is actually a major contribution of this guideline, and then what to do after converting someone to another opioid. Our target audience was not only oncologists, but also we wanted to target nurses, pharmacists, hospitalists, primary care physicians, patients and caregivers. Brittany Harvey: I appreciate that background information, particularly on the evidence that is underpinning this and the lack of quality of evidence there, which really transformed this into a formal consensus guideline. We're glad to have all of these organizations coming together to collaborate on this guideline. So then next I'd like to review the key recommendations. So starting with, what is recommended for pre-conversion assessment? Dr. Mellar Davis: In regards to pre-conversion, physicians and clinicians need to be aware of pain phenotypes. That is, there are pains that are more opioid refractory than others, such as neuropathic pain, hence, they may be more resistant to the opioid that you're converting to. One needs to be aware of the fact that patients may not be compliant, they're either afraid of opioids not taking what was prescribed, so it's important to query patients about whether they are taking their opioid as prescribed. Occasionally, there are patients who will divert their medication for various reasons. Pain may be poorly controlled also because of dosing strategies that are poorly conceived, in other words, giving only ‘as needed' opioids for continuous cancer pain. And there are rare circumstances where an opioid actually induces pain and simply reducing the opioid actually may improve the pain. The other issue may be cancer progression. So that poorly controlled pain or rapidly increasing pain may actually be a result of progressive cancer and changing treatment obviously will be important. And you need to assess the pain severity, the quality of the pain, the radiating localizing effects, which does require not only a physical exam but also radiographic examinations. But the other thing that's very important in opioid conversions are pain scales with function. A significant number of patients don't quite understand a numerical scale which we commonly use: 0 to 10, with 10 being severe pain and 0 being no pain. They may in fact focus more on function rather than on pain severity or pain interference with daily activities or roles. Sometimes patients will say, “Oh, my pain is manageable,” or “It's tolerable,” rather than using a numerical scale. Choices of opioids may be based on cost, drug-drug interactions, organ function, personal history or substance use disorder so that one will want to choose an opioid that's safe when converting from one to another. And obviously social support and having caregivers present and understanding the strategy in managing pain will be important. Brittany Harvey: Thank you, Dr. Davis, for reviewing those pre-conversion assessment considerations and particularly the challenges around some of those. So, following this pre-conversion assessment, what are the recommendations on how opioid conversion should be conducted? Dr. Mellar Davis: Opioid conversions are basically the safe dose. People have used the term ‘equianalgesia', but the panel and the consensus group felt that that would be inappropriate. So a conversion ratio is the dose at which the majority of patients will not experience withdrawal or adverse effect. It would be the safe dose. Thereafter, the dose will need to be adjusted. So, in converting, that's only the first step in managing pain, the doses need to be adjusted to the individual thereafter. There are a significant number of conversions that are done indirectly, that is that there has not been a study that has looked at a direct conversion from one opioid to another in which one needs to convert through another opioid. We call that a ‘morphine equivalent daily dose'. So, most of the time a third opioid is used in the conversion. It allows you then to convert when there hasn't been a direct study that has looked at conversion between those two opioids, but it is less accurate and so one has to be a little bit more careful when using morphine daily equivalents. We found, and I think this is the major advantage to the guideline, is that commonly used opioids - oxycodone, morphine, hydromorphone - we did establish conversion ratios to which we found in the MASCC guideline they were widely divergent and hope that actually, internationally, they will be adopted. We also found some conversion ratios for second-line opioids. However, we felt also that an opioid like methadone, which has a unique pharmacology, should be left to experts and that experts should know at least several ways of converting from morphine usually to methadone. There is what appears to be a dose-related increased potency of methadone relative to morphine, which makes it more difficult, particularly at higher doses, to have an accurate conversion ratio. Most patients will have transient flares of pain. We came up with two suggestions. One is using a 10 or 15% of the around-the-clock dose for the breakthrough dose, but we also realized that there was a poor correlation between the around-the-clock dose and the dose used for transient flares of pain. And so the breakthrough dose really needs to be adjusted to the individual responses. There was also a mention of buprenorphine. One of the unique things about buprenorphine is that if you go from high doses of a drug like morphine to buprenorphine in a stop-start dosing strategy, you can precipitate withdrawal. And so one has to be careful and have some experience in using buprenorphine, which can be an effective analgesic. Brittany Harvey: Yes, I think that the conversion ratios that you mentioned that are in Table 3 in the full guideline are a really useful tool for clinicians in practice. And I appreciate the time that the panel and the additional consensus panel went through to develop these. I think it's also really key what you mentioned about these not being equianalgesic doses and the difficulties in some of these conversions and when people need to really look to specialists in the field. So then, following opioid conversion, what assessments are recommended post-conversion? Dr. Mellar Davis: Post-conversion, probably the cardinal recommendation is close observation for response and for toxicity. And I think that probably summarizes the important parts of post-conversion follow up. So assessment should be done 24-48 hours after conversion and patients followed closely. Assessment scales should include patient personalized goals. Now, it used to be in the past that we had this hard stop about a response being below 4 on a 0 to 10 scale, but each patient has their own personal goals. So they gauge the pain severity and their function based upon response. So a patient may function very well at “a severity of 5” and feel that that is their personal goal. So I think the other thing is to make sure that your assessment is just not rote, but it's based upon what patients really want to achieve with the opioid conversion. The average number of doses per day should be assessed in the around-the-clock dose so those should be followed closely. Adverse effects can occur and sometimes can be subtle. In other words, a mild withdrawal may produce fatigue, irritability, insomnia and depression. And clinicians may not pick up on the fact that they may be actually a bit under what patients have or they're experiencing withdrawal syndrome. It's important to look for other symptoms which may be subtle but indicating, for instance, neurotoxicity from an opioid. For instance, visual hallucinations may not be volunteered by patients. They may transiently see things but either don't associate with the opioid or are afraid to mention them. So I think it's important to directly query them, for instance, about visual hallucinations or about nightmares at night. Nausea can occur. It may be temporary, mild, and doesn't necessarily mean that one needs to stop the second opioid. It may actually resolve in several days and can be treated symptomatically. Pruritus can occur and can be significant. So close observation for the purposes of close adjustments are also necessary. As we mentioned, you want to start them on an around-the-clock of breakthrough dose, but then assess to see what their response is and if it's suboptimal then you'll need to adjust the doses based both upon the around-the-clock and the breakthrough dose or the dose that's used for breakthrough pain. Also looking at how patients are functioning, because remember that patients frequently look at pain in terms of function or interference with their roles during the day. So, if patients are able to do more things, that may, in fact, be the goal. Brittany Harvey: Thank you for reviewing all of these recommendations across pre-conversion assessment, how opioid conversion should be conducted, including conversion ratios, and what assessments are recommended after opioid conversion. I think it's really important to be watching for these adverse events and assessing for response and keeping in mind patient goals. So, along those lines, how will these guideline recommendations impact both clinicians and people with cancer? And what are the outstanding questions we're thinking about regarding opioid conversion? Dr. Mellar Davis: I think it's important to have a basic knowledge of opioid pharmacology. There's, for instance, drugs that are safer in liver disease, such as morphine, hydromorphone, which are glucuronidated. And there are opioids that are safer in renal failure, such as methadone and buprenorphine, which aren't dependent upon renal clearance. I think knowing drug-drug interactions are important to know. And sometimes, for instance, there may be multiple prescribers for a patient. The family physician's prescribing a certain medication and the oncologist is another, so being aware of what patients are on, and particularly over-the-counter medications which may influence opioid pharmacokinetics. So complementary medications, for instance, being aware of cannabis, if patients are using cannabis or other things, I think, are important in this. There are large gaps and questions and that's the last part of the guideline that we approach or that we mentioned that I think are important to know. And one is there may be ethnic differences in population in regards to clearance or cytochrome frequencies within communities or countries, which may actually alter the conversion ratios. This has not been explored to a great extent. There's opioid stigmata. So we are in the middle of an opioid crisis and so people have a great fear of addiction and they may not take an opioid for that reason, or they may have a relative who's been addicted or had a poor experience. And this may be particularly true for methadone and buprenorphine, which are excellent analgesics and are increasingly being used but may in fact have the stigmata. There are health inequalities that occur related to minority groups that may in fact not get the full benefit of opioid conversions due to access to opioids or to medical care. Age, for instance, will cause perhaps differences in responses to opioids and may in fact affect conversion ratios. And this may be particularly true for methadone, which we have not really explored to a great extent. And finally, the disease itself may influence the clearance or absorption of an opioid. So for a sick patient, the opioid conversion ratio may be distinctly different than in a healthy individual. This is particularly seen with transdermal fentanyl, which is less well absorbed in a cachectic patient, but once given IV or intravenously has a much longer half life due to alterations in the cytochrome that clears it. And so conversion ratios have frequently been reported in relatively healthy individuals with good organ function and not that frequently in older patient populations. So just remember that the conversion ratios may be different in those particular populations. Brittany Harvey: Yes. So I think a lot of these are very important things to consider and that managing cancer pain is key to quality of life for a lot of patients and it's important to consider these patient factors while offering opioid conversion. I want to thank you so much for your work to review the existing literature here, develop these consensus-based recommendations and thank you for your time today, Dr. Davis. Dr. Mellar Davis: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

The opioid epidemic rages on in Arizona, but now, there are effective treatments for it. Hear from one Valley doctor who says they're still too hard to get. Plus, the controversy over a proposal to allow homes to be built at churches and other religious institutions.

This week I talk about the kratom wars: the argument over whether kratom is a deadly drug or a miracle cure (or somewhere in between). While some states are currently trying to ban kratom, others are working to make it easier and safer to get. Meanwhile, the federal government has been a bit all over the place on it, and with Trump 2.0 gathering early steam by pandering to Project 2025 nationalists, it's hard to say what attempted legislation might materialize in coming years. So let's talk about kratom. Check out the American Kratom Association to get involved or to find safe suppliers, local activists, or more information about kratom. Support the show

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

This episode discusses four MMWR reports. First, a new CDC study explores possible transmission of the virus that causes H5N1 bird flu from dairy workers to two indoor-only cats in Michigan. Second, the dengue outbreak in Puerto Rico continues, with children 10-19 years old being most affected. Third, wastewater testing and viral genetic testing can provide information on the community spread of hepatitis A. Last, scientists recorded a brief 110-fold increase in air lead levels during the 2025 LA fires.

In this episode, Dr Elle Wadsworth talks to Dr Noa Krawczyk from the Department of Population Health at NYU Grossman School of Medicine about her and her co-authors research report on self-reported experiences and perspectives on using psychedelics to manage opioid use among participants of two Reddit communities. Noa discusses the current treatments available for opioid use disorder and why psychedelics are having their moment as an alternative medicine, and what people who use opioids found when taking psychedelics with the intention of reducing or stopping their opioid use. · What is Reddit and why is Noa using it to answer her research questions [01:24]· The headline findings of the study [02:17]· The comparison of demographics of Reddit and the wider population of people who use opioids [03:46]· What the current treatments are for opioid use disorder in the US and why people are seeking alternatives [05:22]· Why Ibogaine stands out as a prominent psychedelic in the discussion [08:12]· The mechanisms of action found in the analysis [09:45]· The benefits and drawbacks of using psychedelics [13:26]· What we can take from the paper for policy and practice [15:28]About Elle Wadsworth: Elle is an academic fellow with the Society for the Study of Addiction. She is based at the University of Bath and her research interests include drug policy, cannabis legalisation, and public health. Elle is also a senior analyst at RAND Europe, working on projects focusing on national and international drug policies. About Noa Krawczyk: Noa Krawczyk, PhD, is an assistant professor in the Department of Population Health at NYU Grossman School of Medicine and Associate Director of the NYU Langone Center for Opioid Epidemiology and Policy. Her research focuses on studying ways to address barriers to evidence-based treatment for opioid use disorder at the individual, program, and policy levels. Her work centers on bridging research and practice by collaborating with drug user organizations, health system leaders, public health and government agencies, and advancing science that can help inform evidence-based policies and practices that reduce harm and promote well being.About co-author Megan Miller: Megan Miller, MPH, is a Research Coordinator in the Center for Opioid Epidemiology and Policy at NYU Grossman School of Medicine and served as the primary data analyst for the Reddit study. She holds an MPH from the University of North Carolina at Chapel Hill. NK receives fees as an expert witness in ongoing opioid litigation. MM has no conflicts of interest to declare.Original article: Self-reported experiences and perspectives on using psychedelics to manage opioid use among participants of two Reddit communities https://doi.org/10.1111/add.16767 The opinions expressed in this podcast reflect the views of the host and interviewees and do not necessarily represent the opinions or official positions of the SSA or Addiction journal. The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information. Hosted on Acast. See acast.com/privacy for more information.

GUEST: Third Rail Omar decries Musk cuts! Who are the "problem people" in the Middle East? AFTERWARD: Christianity and wisdom.The Hake Report, Thursday, February 27, 2025 ADGUEST: Third Rail with Omar https://x.com/thecomforter_1 | https://www.youtube.com/@Third_Rail AKA "The Empowered Man Podcast"TIMESTAMPS* (0:00:00) Start* (0:00:52) Topics* (0:02:38) Hey, guys!* (0:03:35) Omar eye issues, depression* (0:07:15) Trump zionists; Education; Deportations; DOGE; bad publicity?* (0:13:06) Spotlight? Creating opposition* (0:16:12) Techno Feudalism; Getting rid of bureaucracies; Constitutional crisis* (0:20:31) Foreign aid* (0:23:41) EU vs USA; LGBT, Obamacare, Opioids* (0:31:31) Elon Musk vs. Govt Waste* (0:36:00) Firing people* (0:37:51) Enforcement of law, Marijuana son, Saving the country* (0:42:30) Democracy, pot, NYC, Alcohol, smoking, food, and Islam* (0:48:08) Democracy vs Techno Feudalism, LGBT identity numbers* (0:51:17) Democracy debate, Trump the good businessman* (0:56:17) Trump Gaza, Netanyahu, Middle East, Hamas… Christians* (1:09:50) PAMBO, Greece: Muslim bad relationships, culture; Bosnia?* (1:12:13) PAMBO vs Omar: Bosnia, Orthodox vs Muslims, Dirtiness?* (1:20:51) PAMBO: Last word* (1:22:46) Supers for Omar…* (1:26:12) Closing with Omar* (1:27:39) Supers: Rap, Apprenticeship* (1:29:54) JAIME, MN: Marxism vs Critical thinking* (1:34:30) JAIME: Street preacher vs LGBT pastor; What's needed* (1:37:30) JAIME: Omar, Republic* (1:38:20) CHRISTIAN, UT: Flood, made the Grand Canyon* (1:44:20) CHRISTIAN: Is earth millions and billions of years, or thousands?* (1:47:20) JEFF, TX, 1st: War hawks!* (1:49:27) Sixteen Horsepower - "Black Soul Choir" - 1996, Sackcloth 'n' AshesLINKSBLOG https://www.thehakereport.com/blog/2025/2/27/the-hake-report-thu-2-27-25PODCAST / Substack HAKE NEWS from JLP https://www.thehakereport.com/jlp-news/2025/2/27/hake-news-thu-2-27-25Hake is live M-F 9-11a PT (11-1CT/12-2ET) Call-in 1-888-775-3773 https://www.thehakereport.com/showVIDEO YouTube - Rumble* - Facebook - X - BitChute - Odysee*PODCAST Substack - Apple - Spotify - Castbox - Podcast Addict*SUPER CHAT on platforms* above or BuyMeACoffee, etc.SHOP - Printify (new!) - Spring (old!) - Cameo | All My LinksJLP Network: JLP - Church - TFS - Nick - Joel - Punchie Get full access to HAKE at thehakereport.substack.com/subscribe

One central Florida county is doing just that. It's episode #726 of The ANEZ SEZ podcast...

This episode discusses two MMWR reports. First, CDC finds evidence of previous infection with avian influenza A(H5) bird flu in three veterinary practitioners who work with cattle. Next, the public health system responds to the first known case of clade I mpox in the U.S. and prevents its spread.

This month, how films are helping neuroscientists link brain activity patterns to specific thought processes, a breakthrough in managing opiate overdose, a technique to study animal teamwork, extracting more information from brain scan data, and how childhood adversity blunts later fear responses... Get the references and the transcripts for this programme from the Naked Scientists website

Send us a textAnesthesiologist Dr. Todd Bertoch speaks with Dr. Michael Koren in this exciting episode about the a new pain medication, Journavx (suzetrigine), which was just approved by the FDA in January, 2025. The doctors discuss this breakthrough pain management medication, its safety profile, side effects, and how it compares to NSAIDs, acetaminophen, and opioids. They also dive into the approval process, how trials were conducted and standardized, and where the medication will go from here.Koren's Key Takeaways:New options like suzetrigine for pain medication that are non-addicting are neededThis medication is another tool, not a replacement for opioidsThe clinical trials for this medication have been rigorousBe a part of advancing science by participating in clinical research.Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.comListen on SpotifyListen on AppleWatch on YouTubeShare with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.Follow us on Social Media:FacebookInstagramTwitterLinkedInWant to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.comMusic: Storyblocks - Corporate InspiredThank you for listening!

Dr. Tesha Monteith discusses Journavx (suzetrigine), a new medication for pain management. Show references: https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain https://link.springer.com/article/10.1007/s40122-024-00697-0 https://www.the-scientist.com/man-on-fire-syndrome-ion-channels-and-the-quest-for-safer-pain-treatments-72539

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.President Trump has threatened big pharma with tariffs unless they reshore manufacturing. He also refused to promise pharma executives that he would hamstring the IRA's drug negotiation program. RNA editing is fueling hope for rare and common diseases, with experts calling for more efficiency and breakthroughs in delivery methods. The FDA is rehiring scientists after Trump's firing spree, with around 300 staff being asked to return. Vertex's Journavx is changing the pain treatment landscape, but opioids are still prevalent. Trilink offers mRNA designs for reliable performance in various applications. In other news, a small Harvard start-up is fighting antimicrobial resistance, and OpinionAI is focusing on small molecules in the I&I space. Bluebird is going private, Mirum receives FDA approval for a rare disease, and PhRMA is meeting with Trump on various policies.Vertex's Journavx is changing the landscape of pain treatment, but opioids are still widely used. Non-opioid pain therapies, including Journavx, have been approved by the FDA, but their uptake remains uncertain. Meanwhile, RNA editing is showing promise in clinical trials for treating rare and common diseases, and artificial intelligence is making small molecules more attractive in the inflammatory and immunology disease space. The FDA is facing low morale after job cuts under Trump's administration, raising concerns about delays in new medicine approvals. Additional news includes Sanofi challenging Novo with an FDA approval for a biosimilar, FDA rare cancer approvals, and Lead passing on an option for Arcus' cancer drug.Thank you for tuning in to Pharma and Biotech Daily.

Opioid overdoses don't have to be fatal if the person gets help in time.In recent years naloxone, a medication that reverses opioid overdoses, has become more widely available in the United States. Narcan, a nasal spray version of naloxone, became available without prescription in pharmacies in 2023. That means more people can help reverse overdoses. Despite showing signs of decline, the number of people dying nationwide from overdoses eclipsed 100,000 annually from 2020 to 2023, according to national health data.Host Elahe Izadi talks with producer Elana Gordon about the lifesaving effects of the medication. They walk through the steps of how to use Narcan and what it feels like to experience an opioid overdose reversal. Today's show was produced by Ariel Plotnick. It was edited by Lucy Perkins with help from Alison MacAdam and mixed by Sam Bair. Download The Post's step-by-step guide for how to administer the naloxone nasal spray here.Subscribe to The Washington Post here.

February 24, 2025Have you had your dose of The Daily MoJo today? "Ep 022425:  - All The Right Moves?"Broadcast timing issues emerge as distractions occur before launch. A new coronavirus discovered in China raises concerns about its spread. Skepticism grows over COVID-19 death counts and health organizations. Dan Bongino's appointment as Deputy Director of the FBI signals leadership changes. Hooters faces financial struggles while Twin Peaks thrives. Concerns about foreign influence on farmland and skepticism about education and government spending are discussed. Opioid prescription management and dental care costs are also highlighted.Phil Bell's Morning Update - Something BIG was missing from CPAC 2025. HEREAnn Vandersteel - host of Steel News & Right Now with Ann Vandersteel and an outspoken constitutionalist - joins the program to discuss her views on everything from income taxes, conspiracies, the United States, North Carolina, and more. Find out more about Ann HERE.Get more about Ann's other ventures and how you can help HERE.Ron's Wonky Perspective - He's no longer a Waffle House virgin! HEREOur affiliate partners:Romika Designs is an awesome American small business that specializes in creating laser-engraved gifts and awards for you, your family, and your employees. Want something special for someone special? Find exactly what you want at MoJoLaserPros.com  There have been a lot of imitators, but there's only OG – American Pride Roasters Coffee. It was first and remains the best roaster of fine coffee beans from around the world. You like coffee? You'll love American Pride – from the heart of the heartland – Des Moines, Iowa. AmericanPrideRoasters.com   Find great deals on American-made products at MoJoMyPillow.com. Mike Lindell – a true patriot in our eyes – puts his money where his mouth (and products) is/are. Find tremendous deals at MoJoMyPillow.com – Promo Code: MoJo50  Life gets messy – sometimes really messy. Be ready for the next mess with survival food and tools from My Patriot Supply. A 25 year shelf life and fantastic variety are just the beginning of the long list of reasons to get your emergency rations at PrepareWithMoJo50.comStay ConnectedWATCH The Daily Mojo LIVE 7-9a CT: www.TheDailyMojo.com (RECOMMEDED)Rumble: HEREFacebook: HEREMojo 5-0 TV: HEREFreedomsquare: HEREOr just LISTEN:The Daily MoJo Channel Become a supporter of this podcast: https://www.spreaker.com/podcast/the-daily-mojo-with-brad-staggs--3085897/support.

This episode discusses two MMWR reports. First, the average percentage of emergency department visits potentially associated with fire and smoke inhalation increased eightfold to 0.5% during the first 6 days of the 2025 Los Angeles County wildfires. Next, firefighters had higher concentrations of PFAS - a group of chemicals linked to cancer and other health effects - in their blood 1 month after responding to the 2023 Maui wildfires than other responder groups.

Titan Medical Center Owner and CEO John Tsikouris, alongside Titan Medical Center athlete Big Dru, talk about different therapy stacks you could take to improve your quality of life. They also talk about the various Titan Medical therapies, which are designed to help you lose fat and gain muscle.

In this Huberman Lab Essentials episode, I explain how to optimize hormones—particularly testosterone, estrogen, and related sex steroids—to enhance fertility and overall well-being. I discuss the sources of testosterone and estrogen and how their levels fluctuate with age in both males and females. I also cover how behaviors such as exercise, cold and heat exposure, light exposure, illness, and breathing patterns affect hormones. Additionally, I examine specific supplements and replacement therapies, highlighting important precautions to consider when adjusting hormone levels. Huberman Lab Essentials episodes are approximately 30 minutes long and focus on key scientific insights and protocol takeaways from past Huberman Lab episodes. These short episodes will be released every Thursday, while our full-length episodes will continue to be released every Monday. Read the show notes for this episode at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Eight Sleep: https://eightsleep.com/huberman Function: https://functionhealth.com/huberman Timestamps 00:00:00 Huberman Lab Essentials; Hormones 00:01:15 Testosterone & Estrogen Sources & Age, Adrenals 00:03:34 Sponsor: Eight Sleep 00:05:05 Competition, Males & Testosterone; Dopamine 00:09:27 Testosterone Decreases, Expectant Fathers, Illness 00:11:30 Sleep Apnea, Testosterone, Estrogen, Cortisol, Tool: Nasal Breathing 00:15:57 Sponsor: AG1 00:17:00 Dopamine, Cortisol, Fertility, Tool: Light Viewing Behavior  00:19:31 Heat, Cold & Hormone Levels 00:21:14 Resistance & Endurance Training, Testosterone, Tool: Exercise Order 00:23:26 Estrogen, Menopause, Hormone Therapy 00:25:07 Sponsor: Function 00:26:54 Vitamins, Opioids, Supplements, Tongkat Ali, Cancer Risk 00:31:26 Luteinizing Hormone, hCG, Fadogia Agrestis, Tool: Blood Tests 00:36:00 Recap & Key Takeaways Disclaimer & Disclosures

Today’s show sponsored by: Goldco — 10% Instant Match in BONUS SILVER, for qualified JLP Show listenersLearn more at https://www.JesseLovesGold.com or call 855-644-GOLD

Show notes at pharmacyjoe.com/episode1002. In this episode, I’ll discuss some possible negative effects of using low-dose ketamine to achieve an opioid-sparing effect in critically ill patients. The post 1002: Less Opioid Consumption With Low-Dose Ketamine But at What Cost? appeared first on Pharmacy Joe.

This episode discusses three MMWR reports. First, U.S. health care providers report that concerns about time, cost, and confidentiality interfere with seeking care for mental health. Next, CDC releases the 2025 Child and Adolescent, and Adult Immunization Schedules.

Big news in pain management, the FDA has approved a new opioid-free pain medication. So how is it different from what's already out there? Plus, if you missed your flu shot in the fall, is it still worth getting one now? Dr. Sanjay Gupta answers your questions! Learn more about your ad choices. Visit podcastchoices.com/adchoices

It's the first FDA approval for a pain medication in 25 years. How does the drug work, and who is it for? Also, non-mixing layers of water and hydrocarbons thousands of miles deep could explain the icy planets' strange magnetic fields.The FDA Approves A New, Non-Opioid PainkillerIn January, the Food and Drug Administration approved a new pain medicine called Journavx (suzetrigine), made by Vertex Pharmaceuticals. It's the first time in 25 years the agency has given the green light to a new painkiller. Notably, it's not an opioid and, according to the company, it's not addictive. Unlike opioids, which act directly on the brain, Journavx instead blocks nerve endings across the body that transmit pain.Host Ira Flatow is joined by Dr. Sean Mackey, a professor of anaesthesiology and pain medicine at Stanford University and chief of the Division of Stanford Pain Medicine, to discuss how the new drug works, who should take it, and what its limitations are.Might Uranus And Neptune Have Deep, Multi-Layer Oceans?We've got a pretty good idea about what's beneath the surface of our nearest planetary neighbors, like Mars. But as you get farther out into the solar system, our knowledge becomes scarce. For instance, what's inside the so-called ice giants, Neptune and Uranus?Recent research based on computer simulations of fluids hints that the planets could contain vast multi-layered oceans, as much as thousands of miles deep. A layer of water that is on top of—but doesn't mix with—a deeper layer of hydrocarbons could help explain strange magnetic fields observed during the Voyager mission.Dr. Burkhardt Militzer, a professor of earth and planetary sciences at UC Berkeley, wrote about this idea in the Proceedings of the National Academy of Sciences. He joins Host Ira Flatow to explain his theories.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

Extra Extra, Read all about it! Actually, it's a podcast, Listen all about it!  New Pain Med! New Pain Med! New Non-Opioid Pain Med! Suzetrigine (Journavx) is now FDA Approved for Moderate to Severe Acute Pain in Adults, but what fun facts come along with it????? We turn to the Simpsons, Brugada, and enjoy some club seats while succinctly reviewing everything there is to know about this new non-opioid pain medication on the Pain Pod! Come one, come all, to the Pain Pod!!! Pain Guy • www.painguy.us  

Independence Blue Cross in Pennsylvania started limiting coverage for weight-loss drugs like Ozempic and Wegovy. Diesel fuel from an overturned fuel truck on a road near Pittsburgh is causing oil slicks in the Allegheny River downstream of the spill. The Delaware River has been voted 2025 Pennsylvania River of the Year. Ed Mahon of Spotlight PA tells us about a debate over how some counties are using money from settlements with drug companies meant to address the opioid overdose crisis.Support WITF: https://www.witf.org/support/give-now/See omnystudio.com/listener for privacy information.

In this episode, we explore groundbreaking new research on how chiropractic care can play a crucial role in reducing opioid-related adverse events, particularly in patients with sciatica. Tune in to delve into the compelling data that shows chiropractic care significantly lowers the risk of opioid dependency and enhances patient outcomes. With the opioid crisis still rampant, this research is not only timely but offers actionable insights for healthcare providers. Discover how to leverage this information in your marketing and patient education to better serve your community.Episode Notes: Association between chiropractic spinal manipulation for sciatica and opioid-related adverse eventsThe Best Objective Assessment of the Cervical Spine- Provide reliable assessments and exercises for Neuromuscular Control, Proprioception, Range of Motion, and Sensorimotor-Integration. Learn more at NeckCare.comTurncloud EHR- Minimalist design, without being sparse. Practical, yet elegant. Turncloud's design was to find the most efficient path in a day in the life of a chiropractic office. Connect with their team at www.turncloud.com Patient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

After the sudden passing of his son Drew, to fentanyl poisoning, co-founder of Fentanyl Fathers Gregory Swan turned his tragedy into a mission to educate high school students about the dangers of fentanyl. Gregory illustrates the importance of directly educating youth, for they're the most susceptible to this life-altering drug.     Fentanyl Fathers advocates against the use of Opioids while providing training for naloxone, which can reverse an overdose. Currently, they are working to expand the program nationally, with the help of the Drug Enforcement Administration.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Ingrid Jackson had never lived in a trailer before, or a small town. She was born in Louisville, Ky., the daughter of a man with schizophrenia who, in 1983, decapitated a 76-year-old woman. Jackson was 1 at the time. In 2010, at 27, she was in a car accident and was prescribed pain pills. Not long after that, she began using heroin. Over the next decade she went through nine rounds of addiction rehab. Each ended in relapse. Her most recent attempt came in 2022 after her son was sentenced to life in prison for murder; he was 21.In eastern Kentucky, a region that is plagued by poverty and is at the heart of the country's opioid epidemic, the burden of addressing this treatment gap has mainly been taken up by addiction-rehab companies. Many stand more like community centers or churches than like medical clinics, offering not just chemical but also spiritual and logistical services with the aim of helping people in addiction find employment and re-enter society. Unlock full access to New York Times podcasts and explore everything from politics to pop culture. Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify.