In episode 72 we discuss a telemedicine protocol for outpatient symptom-triggered alcohol withdrawal management. Sloan ME, Ngoy A, Xiao KB, Barker B, Buckley L, Fodor M, Hardy K, Hendershot CS, Kahan M, La Fleur S, Le Foll B, Manicone M, Sanches M, Simpkin E, Quilty LC, Wyman J, Tang VM, Bozinoff N. Symptom-Triggered Alcohol Withdrawal Management Delivered Over Telemedicine. J Addict Med. 2025 Nov-Dec 01;19(6):708-715. We also discuss Trump Administration actions that facilitate addiction, inclu...
Mar 09, 2026•35 min
In episode 71 we discuss dental problems caused by buprenorphine. Tuan WJ, Clebak KT, Jawadi E, Snyder J, Zgierska AE. Risk of Oral Health Problems in Adults With Opioid Use Disorder Treated With Transmucosal Buprenorphine. J Addict Med. 2025 Sep-Oct 01;19(5):529-535. We also discuss over-the-counter naltrexone and what RFK said at his senate confirmation hearing about substance use disorder. JAMA Psychiatry: Over-the-Counter Naltrexone to Address Unhealthy Alcohol Use NPR: RFK Jr. says he'll fi...
Mar 02, 2026•34 min
Quick summaries of our last 10 articles, perfect for busy people! 61. Safety of Buprenorphine/Naloxone vs. Buprenorphine in Pregnancy Straub L, et al. Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone. JAMA. 2024 Sep 10;332(10):805-816. 62. Naltrexone Pills vs Injections for Alcohol Use Disorder Magane KM, et al. Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use Disorder: A Randomized Clinical Trial . JA...
Feb 23, 2026•54 min
In episode 70 we discuss an article about prescription stimulant misuse. Han B, Jones CM, Volkow ND, et al. Prescription Stimulant Use, Misuse, and Use Disorder Among US Adults Aged 18 to 64 Years . JAMA Psychiatry. 2025;82(6):572–581. We also discuss the ASAM toolkit for addressing problems at the pharmacy with buprenorphine, and results of the 2024 NSDUH study. ASAM: Addressing Issues at the Pharmacy with Buprenorphine Prescriptions Link to report pharmacy issues STATNews: Tobacco use, binge d...
Dec 15, 2025•47 min
In episode 69 we discuss cytisinicline for smoking cessation. Rigotti NA, et al. Cytisinicline for Smoking Cessation: The ORCA Phase 3 Replication Randomized Clinical Trial. JAMA Intern Med. 2025 Jun 1;185(6):648-655. We also discuss treating opioid use disorder in nursing homes and compulsive TikTok scrolling. Carolina Public Press: NC nursing home lawsuit settlement could expand access for people with drug issues MedicalXpress: Adults 65 years and older not immune to the opioid epidemic, study...
Dec 01, 2025•28 min
In episode 68 we discuss an article about adding behavioral treatments to buprenorphine for opioid use disorder. McHugh RK, et al. Behavioral Therapy as an Adjunct to Buprenorphine Treatment for Opioid Use Disorder: A Secondary Analysis of 4 Randomized Clinical Trials . JAMA Netw Open. 2025 Aug 1;8(8):e2528529. We also discuss online gambling addiction, and neuroanatomy that predisposes adolescents to addiction. Stat News: Head of addiction medicine society warns of treatment cuts and rising thr...
Nov 17, 2025•41 min
In episode 67 we discuss an article about starting buprenorphine injectables without stopping fentanyl or going into opioid withdrawal. Waters RC, et al. Injectable-Only Overlapping Buprenorphine Starting Protocol in a Low-Threshold Setting . JAMA Netw Open. 2025;8(8):e2527016. We also discuss over-the-counter magic mushrooms and banning cigarette filters. JAMA Network Open: Active Constituents of Psilocybin Mushroom Edibles The Conversation: Cigarette filters do nothing for smokers’ health and ...
Nov 10, 2025•26 min
In episode 66 we discuss an article about smoking during substance use disorder recovery. Parks MJ, Blanco C, Creamer MR, et al. Cigarette Smoking During Recovery From Substance Use Disorders . JAMA Psychiatry. Published online August 13, 2025. We also discuss how the White House is pressuring the FDA to fast-track nicotine products and shenanigans regarding alcohol in the upcoming FDA dietary guidelines. Reuters: US FDA to fast-track nicotine pouch reviews amid White House pressure Vox: RFK Jr....
Nov 03, 2025•32 min
In episode 65 we discuss varenicline and bupropion for alcohol use disorder. Söderpalm B, Lidö H, Franck J, Håkansson A, Lindqvist D, Heilig M, Guterstam J, Samuelson M, Askerup B, Wallmark-Nilsson C, de Bejczy A. Efficacy and safety of varenicline and bupropion, in combination and alone, for alcohol use disorder: a randomized, double-blind, placebo-controlled multicentre trial . Lancet Reg Health Eur. 2025 May 13;54:101310. We also discuss medical marijuana for anxiety in Pennsylvania, and RFK’...
Oct 27, 2025•30 min
In episode 64 we discuss an article about addictive screen use and suicide. Xiao Y, Meng Y, Brown TT, Keyes KM, Mann JJ. Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths. JAMA. 2025;334(3):219–228. We also discuss the impact of the first 100 days of the Trump administration on addiction treatment, and the DEA scheduling of 7-OH (hydroxymitrigynine). Journal of Addiction Medicine: The First 100 Days: The Trump Administration and Changes t...
Sep 08, 2025•38 min
Quick summaries of articles 51-60. Enjoy! 51. Fun Activities and Recovery Acuff, S. F., et al. A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092. 52. Buprenorphine-precipitated Fentanyl Withdrawal Thakrar AP, et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895. 53. Methadone Vs. Buprenorphine Nosyk B, Et al. Bup...
Aug 25, 2025•58 min
Four addiction specialists talk about what it takes to keep your knowledge current. The Addiction Medicine Journal Club is joined by Dr. Casey Grover ( Addiction Medicine Made Easy Podcast ) and Thomas Bannard (VCU Health) to discuss how to further your knowledge as a busy professional. PSAM Review (Page 6): Staying Current: How to Keep up with the Addiction Medicine Literature --- Some of Our Favorite Addiction Medicine Resources: Email alerts Google Alerts Evidence Alerts Email newsletters Rec...
Aug 12, 2025•47 min
In episode 63 we discuss the association between buprenorphine dose and neonatal opioid withdrawal syndrome. Marc B, Marion D, François B, Lakshmipriya L. Is buprenorphine maternal dose associated with neonatal opioid withdrawal syndrome severity? Am J Addict. 2025 Jan;34(1):15-20. We also discuss private equity in health care and nitrous oxide (Galaxy Gas). AMA Journal of Ethics: Is Pursuing Profit Commensurable With Providing Good Health Care? David T. Zhu : presentation on private equity at t...
Jul 28, 2025•36 min
In episode 62 we discuss the article “Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients with Alcohol Use Disorder.” Magane KM, et al. Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use Disorder: A Randomized Clinical Trial . JAMA Intern Med. 2025 Jun 1;185(6):635-645. We also discuss reduced overdose deaths and changes in buprenorphine labelling to include higher doses. NPR: Drug deaths plummet among young Americans as fentanyl carnag...
Jul 14, 2025•36 min
In episode 61 we discuss pregnancy outcomes with bup/nlx compared to bup alone. Straub L, et al. Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone. JAMA. 2024 Sep 10;332(10):805-816. doi: 10.1001/jama.2024.11501. We also discuss the elimination of SAMHSA and methamphetamine-related deaths. STAT News: Trump’s mental health and addiction problem New York Times: As Fentanyl Deaths Slow, Meth Comes for Maine --- This podcast offers category 1 and ...
Jun 16, 2025•35 min
In episode 60 we discuss treating methamphetamine use disorder with lisdexamfetamine (Vyvanse). Ezard N, et al; The LiMA Investigator Group. Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial. Addiction. 2024 Dec 19. We also discuss why some people don’t get hangovers, and tianeptine, otherwise known as gas station heroin . New York Times: The People Who Never Get Hangovers Pain Therapeutics: Tianeptine, an Antidepressant with Opioid Agonist E...
May 26, 2025•43 min
In episode 59 we discuss outpatient low-dose initiation of buprenorphine. Suen LW, et al. Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. We also discuss impulse control dysregulation from ropinerole, and the new non-opioid painkiller, suzetrigine. BBC: Prescription medication made me a gambling addict Grall-Bronnec M, et al. Dopamine agonists and impulse control disorders: a complex association . DrugSaf. 2018;41(1):19-75. FDA...
May 05, 2025•34 min
In episode 58 we discuss a randomized controlled trial of semaglutide for alcohol use disorder. Hendershot CS, Bremmer MP, Paladino MB, Kostantinis G, Gilmore TA, Sullivan NR, Tow AC, Dermody SS, Prince MA, Jordan R, McKee SA, Fletcher PJ, Claus ED, Klein KR. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Feb 12:e244789. We also discuss benzodiazepine tapering guidelines and new ways to use Sublocade. ASAM Clinical Practice Guideli...
Apr 14, 2025•41 min
In this episode we discuss 4 more articles that changed our practice. Listen to us talk through real cases, what we used to do, and what we do now. Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial. JAMA. 2024 May 28; 331(20):1722-1731. Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fentanyl Use: A Post Hoc Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2024 Jun 3;7(6):e2417377. U...
Mar 24, 2025•33 min
In this episode we discuss 4 articles that changed our practice. Listen to us talk through real cases, what we used to do, and what we do now. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures . Journal of Substance Use and Addiction Treatment, Volume 158, 2024. 209252, ISSN 2949-8759. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge. JAMA Netw Open. 2024 Mar 4;7(3):e243387. Association of Cannabis U...
Mar 16, 2025•36 min
In episode 57 we discuss a new definition of recovery. Zemore SE, Ziemer KL, Gilbert PA, Karno MP, Kaskutas LA. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse. 2023 Sep 15;17:11782218231199372. We also discuss sports betting and why more people aren’t prescribing buprenorphine. STAT News: The misguided reason why providers aren’t prescribing more buprenorphine for opioid use disorde r Scientific American: How ...
Feb 24, 2025•41 min
In episode 56 we discuss how many attempts it takes to quit using addictive substances. Fontes RM, Tegge AN, Freitas-Lemos R, Cabral D, Bickel WK. Beyond the first try: How many quit attempts are necessary to achieve substance use cessation? Drug Alcohol Depend. 2024 Dec 8;267:112525. doi: 10.1016/j.drugalcdep.2024.112525. Epub ahead of print. PMID: 39719807. We also discuss capping nicotine content in cigarettes and how exercise affects cravings. Reuters: US regulators propose capping nicotine ...
Feb 10, 2025•40 min
In episode 55 we discuss the pharmacokinetics and pharmacodynamics of buprenorphine in pregnancy. Caritis, Steve N. MD; Venkataramanan, Raman PhD. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024. We also discuss fraud in Baltimore recovery houses, and the doubling of alcohol-related deaths. The New York Times: They Entered Treatment. Drugs, Overdoses and Deaths Followed. The New Y...
Jan 27, 2025•35 min
In episode 54 we discuss an article about 24-mg daily of buprenorphine and behavioral health hospitalizations. Axeen S, Pacula RL, Merlin JS, Gordon AJ, Stein BD. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization . JAMA Netw Open. 2024 Sep 3;7(9):e2435478. We also discuss the decline in overdose deaths and RFK’s experience with recovery. The White House: Biden-Harris Administration Marks Historic Progress Reducing Overdoses Across the Country The New York Times: RO...
Jan 14, 2025•42 min
In episode 53 we discuss an article comparing treatment retention and mortality in patients who are prescribed methadone vs. buprenorphine/naloxone for treatment of opioid use disorder. Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17. We also discuss the Modernizing Opioid Treatment Access Act, engaging non-abstinent patients in treatment, and hostility to medications with the recovery community. Modernizing Opioid Treatment Access ...
Dec 30, 2024•40 min
In episode 52 we discuss precipitated withdrawal in the era of fentanyl. Thakrar AP, Et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895. We also discuss kratom, brain injury after overdose, and syringe services. The Kratom Sobriety Podcast Making Kratom Safer The Conversation: Brain injury after overdose is a hidden epidemic NIDA: Syringe services for people who inject drugs are enormously effective, but remain underu...
Dec 16, 2024•33 min
In episode 51 we discuss the connection between fun activities and success in recovery from substance use disorder. Acuff, S. F., Ellis, J. D., Rabinowitz, J. A., Hochheimer, M., Hobelmann, J. G., Huhn, A. S., & Strickland, J. C. (2024). A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092. We also discuss whether people know their PCP can treat addiction, and alcohol use in Ireland. JAM...
Dec 02, 2024•34 min
41-50. Round-Up Quick summaries of our last 10 (actually 11) articles. 41. El ectronic Nicotine-Delivery Systems for Smoking Cessation 42. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures 43. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge 44 Association of Cannabis Use With Cardiovascular Outcomes Among US Adults 45. Association of random and observed urine drug screening with long-term retention ...
Nov 18, 2024•1 hr 2 min
In episode 50 we discuss 3 articles about kratom. We are again joined by our friend Dr. Casey Grover from the Addiction Medicine Made Easy Podcast . Smith KE, Dunn KE, Rogers JM, Grundmann O, McCurdy CR, Garcia-Romeu A, Schriefer D, Swogger MT, Epstein DH. Kratom use as more than a "self-treatment" . Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694. Hill K, Grundmann O, Smith KE, Stanciu CN. Prevalence of Kratom Use Disorder Among Kratom Consumers . J Addict Med. 2024 May-Jun 01;18(3):306-312. ...
Nov 04, 2024•54 min
In episode 49 we discuss the 12-week follow-up data from the ADAPT-2 trial about using ER injectable naltrexone and bupropion for methamphetamine use disorder. Li MJ, Chau B, Belin T, Carmody T, Jha MK, Marino EN, Trivedi M, Shoptaw SJ. Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial. Addiction. 2024 Jun 10. doi: 10.1111/add.16529. Epub ahead of print. PMID: 38856086. We also discuss fentanyl vaccines, and how easy it is to manufac...
Oct 21, 2024•37 min
