Trapped: Understanding Addiction

In this episode, I speak with Dr. Timothy Hall about the intersection of methamphetamine use and HIV in the LGBTQ+ community, particularly in men who have sex with men. Dr. Hall explains how methamphetamine use can influence HIV transmission as well as health outcomes for those who are HIV positive and how new HIV medications that can be taken every few months instead of daily may improve medication adherence for those struggling with a methamphetamine addiction. He also discusses the potential consequences of the changing landscape of the LGBTQ+ community.Dr. Hall is a Health Sciences Assistant Clinical Professor at the Department of Family Medicine and Center for Behavioral and Addiction Medicine at the David Geffen School of Medicine at UCLA. He has trained and studied at Harvard, UCSD, University of Chicago/NORC, Karlova Univerzita (Prague), the New Center for Psychoanalysis (Los Angeles), and UCLA.  He is co-chair of the Human Sexuality & Anthropology Interest Group (HSAIG) of the American Anthropological Association. He has conducted long-term ethnographic research in Prague, Czech Republic, with four years of fieldwork since 1999.  This project looks at processes of gay and bisexual men’s sexual identity formation and changes in the social and sexual networks of men who have sex with men (MSM) in the post-socialist era and since EU accession, with attention to HIV risk factors. He has also conducted fieldwork among non-gay-identified MSM in Los Angeles. His research interests include theories of sexual identity and the role of sexual identities and various forms of sexual-identity-based sociality in mediating risk for HIV, depression, and addictive disorders. He has worked as study physician on clinical trials of HIV pre-exposure prophylaxis (HTPN 073), the mStudy cohort study of HIV risk factors, and several trials of medications for methamphetamine use disorder (bupropion, varenicline, ibudilast, and bupropion/naltrexone). Dr. Hall is a psychiatrist with clinical interests in mood disorders, HIV psychiatry, personality disorders, and addiction.Learn more about Dr. Hall at ​​https://www.uclahealth.org/providers/timothy-hallIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I talk with Dr. David Goodman-Meza about the infectious disease complications associated with intravenous drug use. We discuss some of the most common infections seen in people who inject drugs (PWID), including Hepatitis C, HIV, skin and soft tissue infections, infective endocarditis, vertebral osteomyelitis, septic arthritis, and meningitis. Dr. Goodman-Meza goes on to explain the challenges PWID face in trying to get treatment for these infections and how he became interested in this field. Finally, he reviews strategies we can use to improve care for PWID, including having a specialty devoted to care of the entire patient struggling with substance use. David Goodman-Meza, MD, MAS is an Assistant Professor in the Division of Infectious Diseases at the David Geffen School of Medicine at UCLA. His diverse research interests include the epidemiology of HIV and STIs in high-risk populations, biomedical prevention of HIV in people who use substances, and improving infectious disease-related outcomes in people who inject drugs. He is site principal investigator for HPTN094, a randomized controlled trial evaluating the efficacy of mobile clinical units to improve health outcomes in people who inject drugs.Read more about Dr. Goodman-Meza here:  https://www.uclahealth.org/providers/david-goodmanIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I speak with Kristina Canfield, M.ED. about collegiate recovery programs. Kristina is the Executive Director for the Association of Recovery in Higher Education (ARHE), the sole organization exclusively representing collegiate recovery programs and communities. Kristina explains how collegiate recovery programs came about, their benefits for students in recovery, and how ARHE can provide education, resources, and community connection to those looking to establish a collegiate recovery program in their school. Kristina attended Ohio University in Athens, Ohio where she earned both her bachelor’s degree in History and a master’s degree in College Student Personnel. During her time at Ohio University, Kristina helped to establish the Collegiate Recovery Community in order to assist students in or seeking recovery from substance use disorders on that campus.  After graduation, she worked in an inpatient treatment facility where she continued to gain valuable experience in the continuum of care for substance use disorders. Previously, she was employed as the program coordinator for the Collegiate Recovery Program (CRP) at The University of Texas Rio Grande Valley and as the Substance Abuse Prevention & Recovery Coordinator for The University of Alabama at Birmingham. Kristina is very passionate about the field of collegiate recovery and prior to her current role, she worked closely with ARHE as Conference Manager for the ARHE/ARS/AAPG National Conference, Secretary of the Advisory Council, and Project Lead for two grant projects focused on advancing the field of collegiate recovery. Her vision is that one day, every institution of higher education offers support for students in or seeking recovery so that they feel supported no matter their chosen path of recovery.As we approach Collegiate Recovery Day, ARHE will be celebrating thirteen years of propagating and supporting the vision of collegiate recovery programs. ARHE offers time-tested, research and experience-based modeling for fostering and supporting those in recovery who seek to excel in higher education.  Learn more about ARHE at https://collegiaterecovery.org/If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

Welcome back. In this episode, I speak with Dr. Kenneth Saffier, family physician and addiction medicine specialist. Dr. Saffier serves as the Medical Director for Bi-Bett, a substance use disorder treatment center serving Alameda, Solano, and Contra Costa counties in California. He is also the past president of the Medical Education and Research Foundation for the Treatment of Addiction. Dr. Saffier will explain the principles and practice of motivational interviewing as it relates to substance use disorders. Motivational interviewing (MI) is a collaborative method of communication designed to strengthen motivation to work towards a goal by accompanying patients in their journey towards change rather than lecturing them.Dr. Saffier is an expert in this field and has provided over 50 motivational interviewing training sessions throughout the country. You can learn more about MI by visiting the Motivational Interviewing Network of Trainers. Learn more about Dr. Saffier at https://bibett.org/staffs/kenneth-saffier-md-fasam/. If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

Seatbelts for when you speed down a slick highway, cholesterol medication when you have a difficult time controlling your diet — these are tools we use to protect ourselves from our imperfect behaviors. Harm reduction is a set of practical strategies designed to reduce the negative consequences of risk behaviors, centered around accepting people where they are at. In this episode, Dr. Daniel Ciccarone talks about the principles and goals of harm reduction as it relates to substance use, what strategies are currently being employed, and how we can leverage the criminal justice and healthcare systems to expand its role.Dr. Ciccarone is a Professor of Family and Community Medicine at UCSF and principal investigator of the Heroin In Transition Study. His research focuses on contextual issues of treatment and prevention of HIV/AIDS, the medical consequences of use of various sources and forms of heroin, and the intersection of HIV and substance use. Learn more about Dr. Ciccarone at https://profiles.ucsf.edu/daniel.ciccarone#toc-id3If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I talk to Dr. Snehal Bhatt about the use of psychedelics in the treatment of substance use disorders. Dr. Bhatt was one of the principal investigators for an exciting study demonstrating the ability of psilocybin to reduce heavy drinking in patients with alcohol use disorder.  He reviews the history of psychedelic use in medicine, discusses their future therapeutic potential, and goes over the results of his psilocybin trial. Dr. Bhatt is the Chief of Addiction Psychiatry and Professor of Psychiatry and Behavioral Sciences at the University of New Mexico School of Medicine. Dr. Bhatt’s work focuses on improving access to addiction treatment in communities across New Mexico, novel pharmacological treatments for substance use disorders, and medical education.Read Dr. Bhatt’s study at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2795625If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

Hello everyone! Sorry for the delay, and thank you for coming back.In this episode, I talk to Dr. Noel Vest about his journey through addiction, incarceration, and, ultimately, recovery. Dr. Vest discusses the early influences on his drug use, his first experiences with drugs and alcohol, and how his addiction landed him in prison. He goes on to describe his path to recovery through education in prison and beyond and explains how finding one’s passion and committing oneself to a cause can lead to a lifetime of fulfillment.Dr. Noel Vest is an Instructor in the Department of Psychiatry at the Stanford School of Medicine and an advocate for social justice issues and public policy concerning prison reentry. His research focuses on the intersection of mental health and substance use disorders. He is also involved in several initiatives, like Unlock Higher Education, that promote opportunities for formerly incarcerated individuals. Learn more about Dr. Vest at https://profiles.stanford.edu/noel-vest.Follow @noelvest on social media.Here is a link to the "Spiritual Experience" Dr. Vest referenced during the interview.If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I discuss addiction in the LGBTQIA+ community with Dr. Brian Hurley, Medical Director of the Division of Substance Abuse Prevention and Control for the Los Angeles County Department of Public Health and President-Elect of the American Society of Addiction Medicine Board of Directors. Dr. Hurley reviews the data we have on the prevalence of use disorders in sexual and gender minorities, what risk factors might predispose individuals to the development of an addiction, and why engaging with patients in a respectful and inclusive manner is essential to successful treatment.Dr. Hurley is board-certified in psychiatry, addiction psychiatry, and addiction medicine, and he has previously served on the board of GLMA: Health Professionals Advancing LGBT Equality and as the chair of the LGBT Advisory Committee to the American Medical Association’s Board of Trustees.Learn more about Dr. Hurley at https://www.asam.org/about-us/leadership/board-of-directors/biography-brian-hurleyIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

Medical professionals bear an enormous responsibility taking care of patients and are often held to a higher standard than other members of society. However, they are human and are therefore also susceptible to the development of addiction, especially given the stresses they are placed under. In this episode, I speak with Dr. Michael Sprintz about substance use disorders in healthcare professionals. Dr. Sprintz is triple board-certified in anesthesiology, pain medicine, and addiction medicine and has struggled with addiction himself, giving him a unique understanding of this topic. He talks about why he first started using substances and how accepting who he was and being authentic was key to his long-term recovery.Dr. Michael Sprintz is a physician, entrepreneur, author, consultant, public speaker and a national expert on the intersection of chronic pain and addiction. He received training at top tier institutions including Johns Hopkins Hospital and MD Anderson Cancer Center. Dr. Sprintz founded the Sprintz Center for Pain and Recovery, located in Texas, in 2013 and at the same time started a software company, Cellarian, which automates medical documentation to give providers more quality time for their patients. Dr. Sprintz has consulted for organizations in the pharmacology, biotechnology, and medical device spaces. He is currently on an FDA advisory committee and is also active in local and national medical societies, working to create and support policies that help patients and providers become their own best advocates and re-engage and protect their healthcare relationships.Learn more about Dr. Sprintz at https://drsprintz.com/Learn about the Sprintz Center for Pain at https://www.sprintzcenter.comIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, Colonel Christopher Perry, M.D. discusses the prevalence of substance use disorders in military personnel, which substances are most commonly misused, and how addiction is managed in those actively serving. He reviews the importance of screening for and treating use disorders, especially given the high rates of suicide in this population.Dr. Perry is the Chief Medical Officer for Madigan Army Medical Center on Joint-Base Lewis McChord, Washington. He has extensive experience in treating addiction in military personnel and was a member of the VA/DoD Work Group, which established comprehensive guidelines for the management of substance use disorders in military personnel and in veterans. Learn more about Colonel Perry at https://www.linkedin.com/in/christopher-perry-a1298321/Access the VA/DoD Clinical Practice Guidelines at https://www.healthquality.va.gov/guidelines/MH/sud/VADoDSUDCPGProviderSummary.pdfIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

An estimated 50 million adults suffer from chronic pain in the U.S., which can interfere with their ability to work, take part in normal activities, or enjoy life. The treatment of chronic pain is complex, even more so if a person struggles with a coexisting substance use disorder. In this episode, I speak with Dr. Gregory Rudolf about the various treatment options for chronic pain, the problem of opioid-induced hyperalgesia in patients on long-term opioids, and how a holistic approach with active patient participation yields the best results. Dr. Rudolf works in a multidisciplinary pain management specialty clinic at Swedish Health Services in Seattle. He is board certified in pain medicine, addiction medicine, and medical acupuncture. He is also certified and residency-trained in family medicine and brings a longitudinal, whole-person perspective to his work with patients who suffer from chronic pain and substance use disorders. He is the current chair of the American Society of Addiction Medicine Pain and Addiction Committee and the President of the Washington Society of Addiction Medicine. He is also on the clinical faculty of the University of Washington School of Medicine. Learn more about Dr. Rudolf at https://schedule.swedish.org/doctors/pain-medicine/wa/seattle/gregory-rudolf-1871524728If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, Dr. Jadene Wong discusses Neonatal Abstinence Syndrome, also  commonly referred to as Neonatal Opioid Withdrawal Syndrome (NOWS), which describes the withdrawal symptoms an infant experiences after exposure to opioids in the uterus. Dr. Wong reviews which factors increase the risk for developing withdrawal, how to diagnose NOWS, and why avoiding bias while maintaining the mother-infant dyad is essential in treatment. Dr. Wong is a Clinical Associate Professor of Pediatrics at Stanford University School of Medicine and Neonatal Hospitalist at Lucile Packard Children’s Hospital. She served as the Newborn Clinical Lead on the task force for the joint CMQCC/CPQCC Mother & Baby Substance Exposure Initiative.Learn more about Dr. Wong at https://profiles.stanford.edu/jadene-wongIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, Dr. Ryan Jackman gives us an overview of addiction in Rural America. He compares the rates of substance use and overdose deaths between urban and rural areas and reviews what factors might contribute to the development of use disorders in rural communities. Dr. Jackman also discusses the unique challenges rural areas face in obtaining treatment and how we can draw upon the strength and resiliency of their people to overcome some of these barriers. Dr. Ryan Jackman is a board-certified family medicine and addiction medicine physician who practices in Grand Junction, Colorado. He is the medical director of St. Mary’s Integrated Addiction Medicine clinic and the project director for a HRSA funded Rural Communities Opioid Response Program serving Western Colorado. He has special interests in graduate medical education and increasing access to medical care in rural locations has received training awards from the National Institute on Drug Abuse (NIDA) in 2016 and the Colorado Health Foundation and Denver Foundation in 2017 to implement tele-addiction medicine in Western Colorado.Take a look at some of resources Dr. Jackman referenced:https://www.cdc.gov/nchs/data/databriefs/db403-H.pdfhttps://www.cdc.gov/mmwr/volumes/68/wr/mm6817a3.htmhttps://opioidmisusetool.norc.org/https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1015&context=ruhrc_reportshttps://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1014&context=ruhrc_reportshttps://www.countyhealthrankings.org/app/colorado/2021/measure/factors/134/dataLearn more about Dr. Jackman at https://doctors.sclhealth.org/provider/Ryan+K.+Jackman/1617603If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, Dr. Helena Hansen talks about how she became involved in researching the role of race in addiction and drug policy. She discusses the impact of unequal drug criminalization and mass incarceration on communities of color and how media portrayal and treatment of use disorders have differed between racial groups. She also explains the importance of a comprehensive, culturally responsive treatment approach to addiction.Dr. Hansen is a psychiatrist and anthropologist and serves as Co-Chair of the Research Theme in Translational Social Science and Health Equity at the David Geffen School of Medicine at UCLA. She has published widely in clinical and social science journals and is the recipient of several awards. In addition, she has written two books with one forthcoming and co-developed the concept of structural competency.Learn more about Dr. Hansen at https://socialmedicine.semel.ucla.edu/helena-hansen/If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I am joined by Dr. Michael Fingerhood, Associate Professor of Medicine and Public Health at Johns Hopkins University and Chief of the Division of Addiction Medicine at Johns Hopkins Bayview Medical Center. Dr. Fingerhood explains why older individuals may develop a use disorder and how it can go unrecognized due to preconceived impressions of the elderly. He also reviews how to screen patients in a nonjudgmental way to identify individuals who use substances but may not be aware of the risks or may be ashamed to talk about their use.  Dr. Fingerhood has created multiple community programs for the treatment of opioid use disorder and is currently serving on the Board of Directors for the American Society of Addiction Medicine. He has also received the Health Equity Leadership Award from the Baltimore City Health Department and has co-authored over 60 research papers.Learn more about Dr. Fingerhood at https://www.hopkinsmedicine.org/profiles/details/michael-fingerhoodIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, Dr. Mishka Terplan gives an in-depth review of the most commonly used substances during pregnancy and their effects on the expectant mother and fetus. He explains how to screen for addiction during prenatal visits and stresses the importance of treating addiction as a disease, with medication if needed, to improve health outcomes for both mother and baby. Dr. Terplan is a Distinguished Fellow of the American Society of Addiction Medicine who works at the Friends Research Institute. He is double board-certified in obstetrics and gynecology and addiction medicine. His primary clinical, research and advocacy interests lie along the intersections of reproductive and behavioral health. Dr. Terplan is nationally recognized as an expert in the care of pregnant and parenting people with substance use disorder. He has participated in expert panels at Center for Disease Control, Office of the National Drug Control Policy, Office of Women’s Health, US Food and Drug Administration, and the National Institutes of Health and has published over 100 peer-reviewed articles.Learn more about Dr. Terplan at https://friendsresearch.org/people/mishka-terplan-m-d-m-p-h-facog-dfasam/If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In this episode, I speak with Dr. Veronika Mesheriakova, Assistant Professor in the division of Adolescent & Young Adult Medicine at UCSF and the medical director of the UCSF Youth Outpatient Substance Use Program. Dr. Mesheriakova has vast knowledge of and experience in the prevention and treatment of substance use disorders in adolescents. She lends her expertise in this interview to discuss the most commonly misused substances, the risk factors that predispose a teen to developing an addiction, and what parents and physicians can do to help adolescents fully recover and lead a healthy life.   Dr. Mesheriakova is a member of the American Academy of Pediatrics, Society for Adolescent Health and Medicine, American Society of Addiction Medicine and Association for Medical Education and Research in Substance Abuse. Learn more about Dr. Mesheriakova at https://www.ucsfhealth.org/providers/dr-veronika-mesheriakovaIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In the final installment of my drug facts series, I discuss sedative-hypnotic and anxiolytic drugs with Dr. Christopher Blazes, Director of the Addiction Psychiatry fellowship at Oregon Health and Science University. Dr. Blazes is triple board-certified in psychiatry, addiction psychiatry, and emergency medicine and has published and lectured extensively on benzodiazepine use. In this episode, he reviews the most commonly used drugs in the sedative-hypnotic class of medications, the risks associated with benzodiazepine dependence and addiction, and how patients who have a use disorder are treated. Learn more about Dr. Blazes at https://www.ohsu.edu/people/christopher-blazes-mdIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

For the sixth part of my drug facts series, I speak with Dr. Itai Danovitch, Professor and Chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai. Dr. Danovitch provides an in-depth summary of the physiology of cannabis and reviews both its beneficial and harmful effects (including use disorder), and how these effects differ based on the population using. He also discusses the different state policies regarding legalization of cannabis and why it might be time to reconsider federal drug scheduling so that this substance can be better researched.Dr. Danovitch has authored over 70 articles and book chapters and is the co-editor of two books on substance use disorders. He is a Distinguished Fellow of the American Society of Addiction Medicine, Fellow of the American Psychiatric Association, Past President of the California Society of Addiction Medicine, and a recipient of the Golden Apple Award for Excellence in Teaching. He also serves as a Governor-appointed Commissioner on the California Mental Health Services Commission.Learn more about Dr. Danovitch at https://bio.cedars-sinai.org/danovitchi/index.htmlIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/

In the fifth installment of my drug facts series, I speak with Dr. Bonnie Halpern-Felsher, Professor of Pediatrics in adolescent medicine at Stanford University and the founder of the Tobacco Prevention Toolkit, an online curricular aimed at reducing and preventing youth tobacco use. Dr. Halpern-Felsher discusses the unique harm nicotine poses to teenagers, especially in the era of electronic cigarettes. She reviews the different methods of nicotine delivery, the available treatment options for nicotine addiction, and why quitting is always possible and beneficial.Dr. Halpern-Felsher is a developmental psychologist who has researched the cognitive and psychosocial factors involved in adolescents’ and young adults’ health-related decision-making, perceptions of risk and vulnerability, health communication, and risk behavior. Her research has focused on understanding and reducing health risk behaviors such as tobacco use, alcohol and marijuana use, risky driving, and risky sexual behavior and has influenced national policies regulating adolescent and young adult tobacco use.Learn more about Dr. Halpern-Felsher at https://profiles.stanford.edu/bonnie-halpern-felsherIf you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts. Social media:https://twitter.com/trappedcasthttps://www.instagram.com/trappedcast/