In this episode, the focus is on the complicated issue of "takeaway doses" in opioid substitution therapy. Opioid substitution therapy is a treatment program that aims to help people overcome opioid addiction by substituting their drug of abuse with a safer and more controlled opioid, such as methadone or buprenorphine. One aspect of opioid substitution therapy is the use of "takeaway doses." This refers to the provision of extra doses of the opioid substitute to patients, which they can take aw...
Feb 22, 2023•20 min•Season 1Ep. 80
Inhalant Abuse: Understanding the Dangers of Hydrocarbon and Nitrite Inhalation - Hydrocarbon inhalants are substances that are inhaled for their intoxicating effects. They include a wide range of products, such as gasoline, paint thinner, glue, and aerosol sprays. These substances are commonly abused by inhaling the fumes, which can produce a feeling of euphoria and relaxation. However, inhaling hydrocarbon fumes can be extremely dangerous and can lead to a number of negative health effects, in...
Feb 15, 2023•19 min•Season 1Ep. 79
Medicinal Cannabis Part 2 – In this episode of Cracking Addiction, Dr. Jim Connel joins us again and we discuss the side effects of cannabis, in particular psychiatric side effects, harms that may be associated with medicinal cannabis, the current regulations with regard to driving and medicinal cannabis, the experiences in other countries where medicinal cannabis has a longer history than in Australia, predictions with regard to the future role of medicinal cannabis, and potential roles of medi...
Feb 08, 2023•16 min•Season 1Ep. 78
Medicinal Cannabis Part 1– In this episode of Cracking Addiction, we are joined by Dr. Jim Connell, a GP and medicinal cannabis prescriber and the founder and chief medical officer of Heyday Medical. In this episode of Cracking Addiction, we discuss the endocannabinoid system, cannabis, and the cannabinoids that comprise cannabis, the history of medicinal cannabis, the current indications for medicinal cannabis, the evidence for cannabis for anxiety, depression, chronic pain, and sleep, and whet...
Feb 01, 2023•18 min•Season 1Ep. 77
The distress that individuals undergoing opioid withdrawal can experience can range from mild to severe, depending on the type and duration of opioid use, as well as the individual's overall physical and mental health. Different opioids can cause slightly different withdrawal symptoms, which can include physical symptoms such as muscle aches, sweating, and insomnia, as well as psychological symptoms such as anxiety, depression, and irritability. One of the most challenging aspects of opioid with...
Jan 25, 2023•25 min•Season 1Ep. 76
In the 75th episode of Cracking Addiction we discuss nitrous oxide or nangs and their medical uses and indications and the use of nitrous oxide as a euphorigenic and sedative substance of abuse. We discuss the side effects and harms associated with nitrous oxide use and emphasise in particular the functional B12 deficiency that can be associated with nitrous oxide use and in particular the neurological side effects and the treatment and management options for B12 deficiency. We also discuss the ...
Jan 18, 2023•21 min•Season 1Ep. 75
Cocaine toxicity - In this episode of Cracking Addiction, we discuss the metabolites of cocaine, the different organ systems affected by cocaine, and the harms associated with cocaine use. We discuss the harms of coingestion in particular of alcohol and cocaine and the toxic metabolite cocaethylene. We also discuss the common adulterants mixed in with cocaine and the harms that can be caused by these adulterants. Discussions and comments in our videos are for informational purposes only and shou...
Jan 11, 2023•20 min•Season 1Ep. 74
Cocaine, Crack and Freebase -In this episode of Cracking Addiction we explore cocaine, it's origins, the difference between powder cocaine and crack and freebase and the effects of cocaine on various organ systems and in pregnancy. Cocaine is a stimulant drug that is made from the leaves of the coca plant. It is a powerful psychoactive substance that is commonly used for recreational purposes. When ingested, cocaine produces feelings of increased energy, alertness, and euphoria. It is also a pot...
Jan 04, 2023•23 min•Season 1Ep. 73
Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in providing written reports in the field of addiction medicine. There are many agencies or entities that might request a formal opinion from an addiction medicine specialist. These include Vic Roads, insurance companies, AHPRA and the coroner’s court. When writing reports for Vic roads one must bear in mind the private and commercial driving standards. Such reports usually are requested after a patient has ...
Dec 28, 2022•25 min•Season 1Ep. 72
Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in the care and management of clinicians who find themselves struggling with addictions. Clinicians face significant stigma when dealing with their own illnesses, and even more so in the situation of mental illness and substance use disorder. An additional barrier to accessing treatment is the regulatory environment within which clinicians must access care. This includes the potential for mandatory reporting...
Dec 21, 2022•24 min•Season 1Ep. 71
In this episode of Cracking Addiction I speak with Associate Professor Suzanne Nielsen about the opioid epidemic and what we can do about it. In the USA there seems to be more a problem with heroin whereas in Australia we are struggling with prescription opioid dependence. Even though a doctor may be prescribing your pain killers, it is still possible to become addicted to pain killers. The traditional treatments we have for opioid dependence in general include methadone and buprenorphine based ...
Dec 14, 2022•19 min•Season 1Ep. 70
In episode 69 of Cracking Addiction we discuss the difference and similarities between general practice and Addiction Medicine. We discuss Addiction Medicine consultation liaison services in hospital, inpatient and community management options with regards to Addiction Medicine. Lastly we discuss the role general practitioners play in managing patients with substance use disorders within the community and the breadth of community presentations and continuity of care that they provide their patie...
Dec 07, 2022•25 min•Season 1Ep. 69
In this episode of Cracking Addiction we discuss the class of drugs known as gabapentinoids, a group of GABA analogues. In this episode we discuss the clinical uses of gabapentinoids and also the increasing rates of prescription of gabapentinoids in recent years and the resultant harms associated with gabapentinoids including the risks of dependence/addiction as well as increased rates of overdose and polypharmacy harms. Discussions and comments in our videos are for informational purposes only ...
Nov 30, 2022•20 min•Season 1Ep. 68
In episode 67 of Cracking Addiction we discuss the management of acute intoxication of MDMA and discuss the principles of both MDMA and stimulant withdrawal including supportive management options as well as the importance of psychosocial interventions in particular contingency management and CBT based interventions. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before mak...
Nov 23, 2022•17 min•Season 1Ep. 67
In episode 66 of Cracking Addiction we discuss MDMA or ecstacy and discuss its analogues PMA and PMMA and discuss the pharmacokinetics of these drugs, the unique properties of MDMA as both an atypical amphetamine-type substance and its effects as an empathogen. We also discuss the usage as both a recreational drug but also the new and emerging evidence of the clinical effects and benefits of MDMA and its increased usage in medical practice. MDMA has many effects on the body and we discuss the ef...
Nov 16, 2022•26 min•Season 1Ep. 66
In this episode of Cracking Addiction we discuss the timeframe of GHB withdrawal, the severe and significant symptoms of GHB withdrawal and the potential life threatening sequelae of GHB withdrawal. We explore the approach to GHB withdrawal management including medications that can assist to manage these symptoms and the need to speak specialist help promptly given the potential for significant deterioration. Discussions and comments in our videos are for informational purposes only and should n...
Nov 09, 2022•19 min•Season 1Ep. 65
In this episode of Cracking Addiction we discuss GHB and its analogs GBL and 1,4-butanediol and the differences between these drugs. We explore the clinical indications for GHB as well as the pharmacology and pharmacokinetics of this drug. We discuss the side effects of GHB and some of the symptoms of GHB withdrawal. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before mak...
Nov 02, 2022•16 min•Season 1Ep. 64
In this episode of Cracking Addiction we speak to Professor Peg O'Connor, a professor of moral philosophy who is in recovery from alcohol use disorder and who addresses an audience much like herself: those in recovery who have struggled with the Christian-centric God at the heart of Alcoholics Anonymous. She brings our attention to a little-known fact: the term “higher power,” a touchstone in the twelve steps of Alcoholics Anonymous, was coined by William James, philosopher, psychologist, and in...
Oct 26, 2022•36 min•Season 1Ep. 63
In this episode of Cracking Addiction we discuss people who use drugs whilst in hospital and discuss the ethics of treating people who use drugs, harm reduction measures that can assist with patient engagement, the stigma and marginalisation people who use drugs experience and the evidence and ethics around behaviour contracts. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor...
Oct 19, 2022•21 min•Season 1Ep. 62
Kamini an Ayurvedic opiate-Kamini or Kamini Vidrawan Ras is an Ayurvedic medicine containing opiates as well as some heavy metals. It is a medicine marketed for a variety of indications ranging from premature ejaculation and impotence to increased stamina. There is increased recognition and awareness of patients presenting to specialist Addiction Medicine services with opioid dependence secondary to Kamini Vidrawan Ras often requiring treatment with opioid substitution therapy. Discussions and c...
Oct 12, 2022•17 min•Season 1Ep. 61
In this episode of Cracking Addiction we discuss the timeframe and symptoms of benzodiazepine withdrawal, how to stabilise a patient on benzodiazepines and weaning and tapering of benzodiazepines within a community setting. We also discuss and highlight the importance of psychosocial support and lifestyle interventions in managing benzodiazepine dependence and withdrawal. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical ...
Oct 05, 2022•19 min•Season 1Ep. 60
In this episode of Cracking Addiction we discuss the effects of chronic benzodiazepine usage and the mechanisms of which tolerance and dependence to benzodiazepines develops and discuss the time course in which these syndromes can occur as well as discuss the diagnostic criteria for a benzodiazepine use disorder. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making ...
Sep 28, 2022•20 min•Season 1Ep. 59
In episode 58 of Cracking Addiction we discuss the pharmacology of benzodiazepines and their interaction with the GABA-A receptor, the different types of benzodiazepines and their different half lives and effects, discuss how to calculator benzodiazepine dose equivalence, the increased risks of benzodiazepine overdose when compared with other medications especially with opioid medications and the pharmacokinetics and metabolism of benzodiazepines. Discussions and comments in our videos are for i...
Sep 21, 2022•21 min•Season 1Ep. 58
In today's episode of Cracking Addiction we are joined by Dr Sam Manger the President of the Australasian Society of Lifestyle Medicine and host of the GP Show podcast who discusses lifestyle interventions in substance use disorders. Lifestyle interventions can be safe and efficacious interventions and there is a growing evidence base for certain lifestyle interventions in some substance use disorders. For further information on lifestyle interventions in substance use disorders please read our ...
Sep 14, 2022•29 min•Season 1Ep. 57
In this episode of Cracking Addiction we discuss relapse prevention strategies with regards to methamphetamine use and discuss harm reduction strategies, how to avoid a lapse becoming a relapse, the Matrix Model, motivational intervention and contingency management. We also discuss the importance of peer support programs in aiding people on their path to recovery from substance use disorder and discuss the evidence surrounding pharmacotherapy interventions for methamphetamine use disorder. Discu...
Sep 07, 2022•18 min•Season 1Ep. 56
In this Episode of Cracking Addiction we discuss the three phases of methamphetamine withdrawal, strategies to manage the methamphetamine withdrawal including possible medication options and the ongoing psychosocial support required to support patients during methamphetamine withdrawal. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical...
Aug 31, 2022•17 min•Season 3Ep. 55
In this episode of Cracking Addiction we mainly speak about methamphetamines but also amphetamines and discuss the amphetamine class of drugs and their physiological effects, the different types of methamphetamines, symptoms of intoxication with amphetamines, side effects of methamphetamine and amphetamines including the various organ systems they impact and in particular the potential psychological and psychiatric harms and focus on drug induced psychosis. Discussions and comments in our videos...
Aug 24, 2022•23 min•Season 1Ep. 54
In this episode of Cracking Addiction we are privileged to have Steven McDonald who discusses his lived experience with addiction and his path towards recovery. Steven speaks openly and honestly about his past history and his experiences. Steven has written a book 'Thanks for Letting Me Share' which is a book of 368 quotes that have helped him along his journey. The book is available on Amazon https://www.amazon.com/dp/B09BCG67JK/ and Facebook https://www.facebook.com/Thanks-for-Letting-Me-Share...
Aug 16, 2022•37 min•Season 1Ep. 53
In this episode of Cracking Addiction we discuss cannabis hyperemesis syndrome, the various theories surrounding the pathophysiology of cannabis hyperemesis, treatment of cannabis hyperemesis syndrome, diagnostic criteria for cannabis hyperemesis syndrome and discuss the other potential differential diagnoses of cyclic vomiting symptoms and how cannabis hyperemesis syndrome is often a diagnosis of exclusion. Discussions and comments in our videos are for informational purposes only and should no...
Aug 10, 2022•17 min•Season 1Ep. 52
In this episode of Cracking Addiction we discuss the variety within the class of synthetic cannabinoids, symptoms of synthetic cannabis intoxications, side effects and complication of synthetic cannabis usage and specific considerations in withdrawal management. Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle. ...
Aug 03, 2022•15 min•Season 1Ep. 51
