The Curbsiders Addiction Medicine Podcast

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Familiarize yourself with the differences in mitragynine-derived compounds. Understand how to identify and manage kratom use disorder and withdrawal from mitragynine-derived compounds. We’re joined by Dr. Jonathan Tanawan (Profile).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Written and Produced, with Show Notes, Infographic, and Cover Art by Zina Huxley-Reicher, MD
Hosts: Carolyn Chan, MD. MHS and Zina Huxley-Reicher, MD
Reviewer: Kento Sonoda, MD, MPH
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Jonathan Tanawan, MD

Show Segments
Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week * Case from Kashlak; Definitions * Pharmacology of kratom and other mitragynine-based compounds * How to take a mitragynine-specific substance use history * Defining a use disorder * Withdrawal from kratom * Managing a use disorder with MOUD * Legal landscape and regulation * Outro

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Become the Medetomi-Dean of Admissions

Step up your hospital addiction medicine game by learning to troubleshoot methadone dose confirmations/missed doses and understanding how medetomidine’s emergency in the drug supply is impacting patients and withdrawal management. We’re joined by Dr Maggie Lowenstein (University of Pennsylvania)

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Writer, Producer, and Show Notes: Shawn Cohen MD
Infographic and Cover Art: Zoya Surani
Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD
Reviewer: Payel Jhoom Roy MD, MSc
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Maggie Lowenstein MD MPhil MSHP

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Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We’re joined by Ashish Thakrar, MD at the University of Pennsylvania.

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!
Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak; Definitions * Symptoms of opioid withdrawal * Medications for the management of opioid withdrawal * Buprenorphine precipitated withdrawal * Starting Buprenorphine: Experiences and Strategies * Titrating Methadone: Dosage and Adjuncts * Adjunctive short-acting opioids * Emerging Trends in Drug Supply: Xylazine and Medetomidine * Outro

Credits
* Producer, Show Notes: Zina Huxley-Reicher * Infographics: Zina Huxley-Reicher MD and Zoya Surani * Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD * Reviewer: Payel Jhoom Roy, MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Ashish Thakrar, MD MHSP

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In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using methamphetamines and/or living with methamphetamine use disorder. We explore the latest pharmacologic options, harm reduction strategies, contingency management, and innovative ideas for monitoring and supporting patients. Whether you’re in primary care or other subspecialty settings, this episode is packed with pearls for every clinician with our amazing guest, Dr. Phillip Coffin, Director of the Center on Substance Use and Health in the SFDPH.

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!
Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak; Definitions * Four-tier approach to taking care of patients with methamphetamine use/use disorder * Medications for treatment * Psychosocial treatment * Harm reduction * New horizons in treatment * Outro

Credits
* Producer/Script Writer/Show Notes: Era Kryzhanovskaya, MD * Infographic and Cover Art: Zoya Surani * Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD * Reviewer: Sarah Leyde MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Dr. Phillip Coffin

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Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We’re joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!
Credits
* Producer, Show Notes, Infographics: Carolyn Chan MD, MHS * Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD * Reviewer: Payel Jhoom Roy MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Jessica Merlin MD, PhD, MBA

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Level up your treatment for people with alcohol use disorder. Learn about medication options beyond the first line, when they’re appropriate and not, and how to work with your patients to set goals that fit them. We’re joined by Dr Stephen Holt (Yale University School of Medicine)

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Written, produced, show notes, cover art and infographics by: Shawn Cohen MD * Hosts: Carolyn Chan, MD. MHS, Shawn Cohen MD, and Paul Williams MD * Reviewer: Kento Sonoda MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Stephen Holt MD

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Join us to hear the latest pearls and best practices on talking to patients about vaping, if e-cigarettes can be used to stop smoking cigarettes, and every other question you hadn’t thought to ask about vaping with Drs. Pam Ling (UCSF) and Maya Vijayaraghavan (UCSF).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

We are thrilled to produce Season 3 with support and partnership from The American College of Academic Addiction Medicine (ACAAM)!

Producer/Writer: Era Kryzhanovskaya, MD
Show Notes: Zina Huxley-Reicher, MD; Era Kryzhanovskaya, MD
CME: Era Kryzhanovskaya, MD
Infographic and Cover Art: Zina Huxley-Reicher, MD
Hosts: Carolyn Chan, MD, MHS and Era Kryzhanovskaya, MD
Reviewer: Kento Sonoda, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guests:. Pam Ling, MD; Maya Vijayaraghavan, MD

Show Segments
* 00:11 Intro, disclaimer * 02:22 Guest bios * 04:28 Guest one-liners * 10:28 Case from Kashlak * 11:55 Vape info and definitions * 14:32 How to discuss vaping with patients * 17:53 FDA authority over vapes * 20:37 Development of nicotine (via vaping) use disorder * 23:29 Questions to ask about use disorder * 30:53 E-cigarettes for tobacco cessation * 35:39 Exploring ways to quit smoking (+/- vapes) * 39:53 Screening for vaping use disorder; research measures * 43:10 Resources for e-cigarette cessation * 45:33 Medication approaches * 48:25 Behavioral supports for e-cigarette cessation * 1:00:31 Take Home Points * 1:05:08 Outro

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From Recreational Use to Possible Therapeutic Interventions

Learn how different hallucinogens act in the body and common dosing strategies. Appreciate the risks of use and the current state of hallucinogen research. We are joined in this episode by Dr. Albert Garcia-Romeu (Johns Hopkins Center for Psychedelic and Consciousness Research)

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Show Segments
* Intro, disclaimer, guest bio * Case from Kashlak; Definitions of hallucinogens and psychedelics * Examples of hallucinogens and mechanisms of action * Dosing strategies * Risks of Use * Psychedelic Assisted Therapy * Outro

Credits
* Producer, Writer, Show Notes, Infographic, Cover Art: Kat Mullins, MD * Hosts: Shawn Cohen, MD and Kat Mullins, MD * Reviewer: Kento Sonoda, MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Albert Garcia-Romeu, PhD

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Maximize your treatment of alcohol-associated liver disease. Learn how to evaluate liver disease in patients with alcohol use disorder (AUD), choose AUD medications that are safe and effective, and identify patients who may be eligible for early liver transplantation. We’re joined by Dr. Lamia Haque, @lykhaque (Yale School of Medicine).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Show Segments
* Intro, disclaimer, guest bio 0:00 * Guest one-liner 3:10 * Case from Kashlak 6:30 * Epidemiology of alcohol-associated liver disease (ALD) 7:40 * How does alcohol affect the liver? 11:11 * Spectrum of ALD 13:10 * Risk factors for ALD 16:13 * Evaluating for ALD 19:35 * When to refer to hepatology 33:08 * Medications for AUD in patients with ALD 37:00 * Monitoring liver tests for naltrexone 44:27 * Optimizing treatment for patients who continue drinking 47:18 * ALD and liver transplantation 50:45 * Post-transplant care 1:00:15 * Take-home points 1:02:30 * Outro 1:04:56

Credits
* Writer and Producer: Kenneth Morford, MD * Show Notes: Kenneth Morford, MD * Infographic and Cover Art: Natalie Stahl, MD, MPH * Hosts: Carolyn Chan, MD. MHS and Kenneth Morford, MD * Reviewer: Sarah Leyde, MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Lamia Haque, MD, MPH

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Spark your learning

We cover clinical pearls from graduating addiction medicine fellows by covering ACAAM’s annual lighting round presentation. Learn about tianeptine, buprenorphine starts in patients with acute hepatitis, vaccinations for persons who inject drugs, and more!

Claim CME for this episode at curbsiders.vcuhealth.org!
Listening to this episode and completing CME, can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Producer, Show Notes, Infographics: Carolyn Chan * Hosts: Carolyn Chan, MD. MHS, Shawn Cohen, MD, Kenneth Morford, MD, Natalie Stahl, MD MPHS * Reviewer: Sarah Leyde, MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste

Show Segments
* 00:00 Intro, disclaimer * 03:00 Picks of the week * 07:00 Buprenorphine and hepatitis * 16:30 Ketamine for withdrawal * 24:00 Hepatitis B * 28:20 Tianeptine * 35:30 Hepatitis C treatment * 39:00 PETH * 47:40 Unintended phenobarbital consequences * 53:40 TBI and overdose risk * 58:00 Outro

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Expand your practice to include wound care for xylazine-related wounds and learn how to talk to your patients about harm reduction for xylazine. We are joined by Dr. Raagini Jawa (@Raaginizzle, UPMC) and Tehya Johnson, NP (@TehyaRJohnson, Boston Health Care for the Homeless).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Show notes, infographics, cover art, writer and producer: Zina Huxley-Reicher, MD * Hosts: Carolyn Chan, MD. MHS, Zina Huxley-Reicher, MD and Shawn Cohen, MD * Reviewer: Payel Jhoom Roy, MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guests: Raagini Jawa, MD MPH and Tehya Johnson, NP

Show Segments
* Intro, disclaimer, guest bios - 01:42 * Guest one-liners - 03:22 * Case from Kashlak - 7:56 * Definition of xylazine, overview of xylazine in the drug supply and experience of use - 08:38 * Xylazine test strips and other harm reduction strategies - 15:48 * Natural history of xylazine wounds - 19:15 * Creating a welcoming wound care environment - 21:05 * Red flag symptoms indicating need for oral antibiotics and higher levels of care - 26:18 * Steps for wound care - 33:27 * Frequency of wound care - 46:16 * Pain control in the setting of dressing changes - 51:01 * Route switching, harm reduction around injecting at the site of the wound - 52:20 * When to refer to other wound care specialists/plastic surgery - 55:00 * Take home points - 57:05 * Outro - 1:00:17

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OTP yea you know me

Make methadone a part of your practice. Learn how the methadone system in the US works and how you can play an active role in improving care for people with opioid use disorder treated with methadone. We’re joined by Dr. Ruth Potee @DrRuthPotee (website) and Dr. David Frank @highway_dave

Claim free CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Show Segments
* Intro, disclaimer, guest bio * 5:00 Guest one-liner * 10:25 Case from Kashlak; Definitions * 11:19 Methadone pharmacology and evidence * 17:08 What an OTP feels like * 20:25 OTP intake * 24:45 Talking through methadone with a patient * 28:15 Personal impact of methadone * 30:20 Requirements at an OTP * 33:43 What your patient needs to access an OTP * 37:25 The line * 39:06 Dosing/Take homes * 44:48 Loss of take homes * 48:39 How to interact with an OTP as a PCP * 52:50 Methadone at STRs * 57:03 How to clinicians use their voice to improve things * 1:00:45 Take home points * 1:03:00 Plugs * 1:04:24 Outro

Credits
* Producer, Writer, Show Notes, Infographic, Cover Art: Shawn Cohen MD * Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD * Reviewer: Payel Jhoom Roy MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Ruth Potee MD, David Frank PhD

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Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Producers: Shawn Cohen MD, Kenneth Morford MD * Writer: Carolyn Chan MD MHS * Show Notes: Shawn Cohen MD * Infographic and Cover Art: Kenneth Morford MD * Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD * Reviewer: Kento Sonoda MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Melissa Weimer DO MCR

Show Segments
* Intro, disclaimer, guest bio 00:00 * Guest one-liner 05:02 * National Addiction Treatment Week 06:00 * Case from Kashlak; Definitions 08:30 * Starting methadone 11:01 * Common methadone pitfalls 15:00 * Buprenorphine precipitated opioid withdrawal 23:50 * High-dose buprenorphine 32:20 * Treating buprenorphine precipitated withdrawal 36:50 * Low-dose buprenorphine 41:50 * Maintenance dose of buprenorphine 48:15 * ER buprenorphine 49:00 * Take home points 53:31

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Prevent opioid overdoses in your community! We discuss opioid overdose prevention and treatment so you can counsel patients who use substances on ways to decrease their risk of overdose. We discuss optimal ways to respond to hospital overdoses, ideal doses of naloxone, and how to monitor a patient experiencing an overdose clinically. We’re joined by Dr. Alex Walley, MD MsC @AlexanderWalley (Boston University School of Medicine).

Claim free CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.
Credits
* Producer: Natalie Stahl, MD, MPH * Show Notes, Infographic, Cover Art: Carolyn Chan, MD, MHS * Hosts: Carolyn Chan, MD, MHS and Natalie Stahl, MD, MPH * Reviewer: Sarah Leyde, MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: Podpaste * Guest: Dr. Alex Walley

Show Segments
* Intro, disclaimer, guest bio: 00:00 * Guest one-liner: 05:10 * Case from Kashlak: 07:20 * Overview of the Overdose Crisis: 08:13 * Changes in Messaging for Fentanyl OD Prevention: 16:10 * Naloxone formulations: 22:15 * Dose and frequency of naloxone: 24:50 * Counseling a patient on overdose response/prevention: 31:25 * Good Samaritan Laws: 38:00 * Responding to hospital overdoses: 40:45 * OTC naloxone: 51:14 * Take Home Points: 55:50 * Outro: 59:19

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Accelerate your knowledge on low-dose buprenorphine starts for individuals with opioid use disorder. We cover the physiology of how low-dose starts work, different 4-7 day protocols, and how to troubleshoot challenges patients may face. We’re joined by Dr. Eleasa Sokolski, MD (Oregon Health and Sciences University) and Amelia Goff, MSN, FNP (Oregon Health and Sciences University).

Claim free CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Producer: Era Kryzhanovskaya, MD * Show Notes, Infographic, Cover Art: Carolyn Chan, MD, MHS & Kenny Morford, MD * Hosts: Carolyn Chan, MD, MHS and Era Kryzhanovskaya, MD * Reviewer: Sarah Leyde, MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Dr. Eleasa Sokolski, MD and Amelia Goff, MSN, FNP

Show Segments
* Intro, disclaimer, guest bio: 0:55 * Guest one-liner: 5:10 * Case from Kashlak: 9:05 * Buprenorphine and fentanyl: 10:20 * Methods to start buprenorphine: 16:00 * 4-day low-dose buprenorphine protocol: 18:20 * Buprenorphine formulations: 22:30 * Counseling patients on low dose start: 26:10 * Patient population considerations: 28:20 * Troubleshooting; 30:15 * Outpatient low dose starts: 36:55 * Take Home Points: 45:14 * Outro: 50:48

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Gain insight into how racialized US drug policies, the War on Drugs, and media portrayals of substance use impact our patients in ongoing ways. Learn how you can take action and intentionally promote equity as a clinician! We’re joined by Dr Myra Mathis, @DrMyraMathis (University of Rochester Medical Center)

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By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer, Writer, Show notes, Infographic, Cover Art: Katherine Mullins, MD
Hosts: Carolyn Chan, MD, MHS and Katherine Mullins, MD
Reviewer: Kento Sonoda, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Myra Mathis, MD

Show Segments

Intro 0:00
Disclaimer 2:00
Guest bio 3:30
Episode Pearls 4:36
Guest One-Liner and Intro 5:15
Definitions (race and racism) 7:13
The War on Drugs 9:09
AntiDrug Abuse Act of 1986 11:47
Fair Sentencing Act of 2010 14:10
Policy in the Fentanyl Era 15:15
Mass Incarceration + Downstream Effects 17:30
Media Portrayals 19:24
Current Treatment Landscape 23:29
Disparities in Overdose Deaths 25:50
The Parallel System of White Supremacy 26:41
The Clinician’s Role: Advocacy on the Policy Level 27:40
The Clinician’s Role: Advocacy on the Clinic Level 29:22
Harm reduction 30:25 - 32:44

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Learn about long-acting injectable (LAI) buprenorphine for the treatment of opioid use disorder with Dr. Ken Lee, an addiction medicine provider in Canada. We go over the basics of using LAI buprenorphine, tips and tricks for troubleshooting with patients as well as newer protocols that Dr. Lee and his colleagues use.

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Show Notes, Cover Art, Infographics, Producer: Zina Huxley-Reicher, MD
Hosts: Carolyn Chan, MD, MHS and Zina Huxley-Reicher, MD
Reviewer: Payel Jhoom Roy, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Dr. Ken Lee

Show Segments

Intro, disclaimer, guest bio - 1:58
Guest one-liner - 4:15
Case from Kashlak; Definitions - 5:27
Injectable MOUD - 6:14
Plasma levels of buprenorphine - 7:14
Relative contraindications to LAI buprenorphine- 8:51
Tips for Patient Counseling - 12:28
Starting LAI buprenorphine - 16:01
Side effects of LAI bup - 25:45
Administering LAI bup - 29:06
Dosing Interval - 31:53
Other LAI considerations - 42:19
Take home points - 47:24
Outro - 49:18

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Jumpstart your knowledge on how to counsel patients in primary care to help decrease their risk of returning to substance use! Learn how to help patients identify triggers, develop plans on how to navigate high-risk situations & so much more! We are joined by psychologist Dr. Eve Lasswell PsyD at the University of California San Diego!

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer: Era Kryzhanovskaya, MD
Show Notes, Infographics, Cover Art: Carolyn Chan, MD, MHS
Hosts: Carolyn Chan, MD, MHS and Era Kryzhanovskaya, MD
Reviewer: Kento Sonoda, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Dr. Eve Lasswell, PsyD

Show Segments

Intro, disclaimer, guest bio 00:00
Guest one-liner 5:30
Case from Kashlak 8:25
Preparing for a visit 9:22
Pre - Planning At Risk Scenarios 17:25
Marlatt’s Framework 18:50
People, places, and things 22:55
Pearls and Pitfalls 27:30
Virtual Visits 31:50
Time Limited Visits 35:20
Mutual Support Groups 38:35
Sustained Remission 45:50
Substance Specific Tips 47:15
Take Home Points 49:20
Outro 53:30

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Interpret urine drug tests (UDT) like a toxicologist! Learn how to approach interpreting positive opiates, opioids, and benzodiazepines in UDT. We discuss the nuances of interpreting UDT, false positives, and how to counsel a patient prior to ordering the test. We’re joined by Dr. Timothy Weigand @TwToxMD (University of Rochester Medical Center).

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer: Natalie Stahl, MD, MPH
Show Notes, Cover Art, Infographic: Carolyn Chan, MD, MHS
Hosts: Carolyn Chan, MD, MHS, and Natalie Stahl MD, MPH
Reviewer: Kento Sonoda, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Dr. Timothy Wiegand

Show Segments

Intro, disclaimer, guest bio 00:00
Guest one-liner: 04:15
Case from Kashlak: 08:40
Types of Urine Drug Testing (UDT): 9:35
Detection Window 21:05
Interpreting Opiates and Opioids UDT 24:24
Resources to Interpret UDT 38:18
False Positives 42:27
Discussing Results with a Patient 44:50
Interpreting UDT - Buprenorphine 47:45
Specimen Validity Testing 49:20
Saliva Testing 53:54
Outro 1:00:26

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Learn to take a trauma-informed criminal legal history, tailor your MOUD prescribing to meet the needs of patients impacted by the criminal legal system, and advocate for high-quality care in the carceral system and the community. We’re joined by Dr. Lisa Puglisi, @pugleesa (Yale University)

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer, writer, show notes, infographic, cover art: Shawn Cohen MD
Hosts: Carolyn Chan, MD and Shawn Cohen MD
Reviewer: Sarah Leyde MD
Showrunner: Carolyn Chan, MD
Technical Production: Podpaste
Guest: Lisa Puglisi MD

Show Segments

Intro, disclaimer, guest bio 0-3:50
Learning points 3:50-4:40
Case from Kashlak 4:40-5:51
Mass incarceration as context 5:51-7:45
Taking a criminal legal history 7:45-16:27
Addressing law enforcement in the hospital 16:27-18:00
Health risks of incarceration 18:00-24:39
Opioid Use Disorder and the criminal legal system 24:39-36:00
Documentation 36:00-39:53
Parole, probation, and advocacy 39:53-43:10
Transitioning home 43:10-46:42
Addressing law enforcement in the hospital part 2 46:42-49:45
MOUD when leaving the hospital 49:45-57:28
Take homes 57:28-59:05
Plugs 59:05-1:01:15
Guest one-liner, Picks of the Week* 1:01:15-1:03:43
Outro 1:03:43-1:04:54

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Distill the management of inpatient alcohol withdrawal down to its core with Dr. Shawn Cohen (@ShawnCohen_MD, Yale University). This episode is full of practical pearls, and we discuss the ins and outs of managing alcohol withdrawal in the hospital setting. Learn how to triage patients in the hospital, which benzodiazepines to select, the pathophysiology of alcohol withdrawal, and phenobarbital for the management of alcohol withdrawal.

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer, writer, show notes, cover art, and infographic: Zina Huxley-Reicher, MD
Hosts: Carolyn Chan, MD and Zina Huxley-Reicher, MD
Reviewer: Payel Jhoom Roy, MD, MSc
Showrunner: Carolyn Chan, MD
Technical Production: Podpaste
Guest: Dr. Shawn Cohen

Show Segments

Intro 0:00
Guest bio - 3:17
Case 1- 5:20
Alcohol withdrawal pathophysiology - 6:10
Kindling effect - 9:05
Diagnosing alcohol withdrawal and clinical withdrawal scales - 10:12
Severe alcohol withdrawal definition - 15:26
Triaging a patient - 16:50
Medication management for alcohol withdrawal syndrome- 19:37
Decisions between benzodiazepines and phenobarbital and formulation - 23:47
Choices of benzodiazepines in hepatic impairment - 26:30
Symptom triggered vs. fixed protocol - 28:10
Benzodiazepine resistant alcohol withdrawal - 33:33
Timeline of alcohol withdrawal syndrome symptoms - 42:38
ICU management of alcohol withdrawal - 46:27
Discharge planning and management of alcohol use disorder - 48:50
Take home points - 51:45
Lightning round- 53:43
Outro - 56:01

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Crush chronic pain with buprenorphine. Learn how to assess chronic pain and opioid use disorder (OUD) in patients on long-term opioid therapy, when to consider buprenorphine, and how to make the switch. We’re joined by addiction medicine and pain management expert, Dr. William Becker (Yale School of Medicine).

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Show Segments

Disclaimer 0:52
Intro, guest bio 1:18
Case from Kashlak; Definitions 4:22
Assessing chronic pain and long-term opioid use 5:22
Treatment options when patients are not benefitting from opioids 11:55
Buprenorphine for chronic pain 14:28
Assessing OUD in patients on long-term opioid therapy 15:54
Buprenorphine mechanism of action 19:17
When to consider buprenorphine for chronic pain 21:12
Buprenorphine formulations 24:25
Switching from full agonist opioids to buprenorphine 29:02
Adding full agonists to buprenorphine 39:30
Take Home Points 46:07
Plug 47:38
Lightning round 48:32
Outro 50:20

Credits

Show Notes, Writer, Producer, Cover Art, Infographics: Kenneth Morford, MD
Hosts: Carolyn Chan, MD and Kenneth Morford, MD
Reviewer: Payel Jhoom Roy, MD, MSc
Showrunner: Carolyn Chan, MD
Technical Production: Podpaste
Guest: Dr. William Becker

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Bring some heart to the care of people with IDU-IE. Learn how to provide person-centered care addressing both the acute infection and SUD and when/how to advocate for surgical treatment. We’re joined by Dr. Ayesha Appa @AyeshaAppaMD, (UCSF)

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Manage opioid use disorder in pregnancy. Learn how to counsel patients about the importance of medication and medication options, how to think about neonatal abstinence syndrome and recommendations for the postpartum period. We are joined by Dr. Mishka Terplan, on Twitter @do_less_harm (Friends Research Institute).

Segments

Intro, disclaimer: 0:00
Guest bio: 3:00
Case from Kashlak: 5:28
Opioid Use in Pregnancy: 6:17
Approach to a patient: 12:21
Medication Options for OUD During Pregnancy: 13:09
Neonatal Abstinence Syndrome: 25:46
Dosing Considerations: 29:28
Psychosocial Interventions: 38:02
Reporting / Notification Requirements: 39:32
Postpartum care: breastfeeding: 48:04
Take home: 52:12
Lightning Round: 55:22
Outro: 57:39

Claim free CME for this episode at curbsiders.vcuhealth.org!

Writer, Producer, Show Notes, Infographic, Cover Art: Kat Mullins, MD

Hosts: Carolyn Chan, MD, MHS and Kat Mullins, MD

Reviewer: Kento Sonoda, MD

Showrunner and CME: Carolyn Chan, MD, MHS

Technical Production: Podpaste

Guest: Mishka Terplan, MD

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Manage opioid use disorder in pregnancy. Learn how to counsel patients about the importance of medication and medication options, how to think about neonatal abstinence syndrome and recommendations for the postpartum period. We are joined by Dr. Mishka Terplan, on Twitter @do_less_harm (Friends Research Institute).

Claim free CME for this episode at curbsiders.vcuhealth.org**!

Credits**

Writer, Producer, Show Notes, Infographic, Cover Art: Kat Mullins, MD
Hosts: Carolyn Chan, MD, MHS and Kat Mullins, MD
Reviewer: Kento Sonoda, MD
Showrunner and CME: Carolyn Chan, MD, MHS
Technical Production: Podpaste
Guest: Mishka Terplan, MD

Show Segments

Intro, disclaimer: 0:00
Guest bio: 3:08
Case from Kashlak: 5:30
Opioid Use in Pregnancy: 6:25
Approach to a patient: 12:29
Medication Options for OUD During Pregnancy: 13:17
Neonatal Abstinence Syndrome: 25:54
Dosing Considerations: 29:30
Psychosocial Interventions: 38:10
Reporting / Notification Requirements: 39:40
Postpartum care: breastfeeding: 48:12
Take home: 52:20
Lightning Round: 55:30
Outro: 57:47

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Put on your Primary Care Cat-Hat

We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Credits

Producer, Show Notes: Kenneth Morford, MD
Infographic and Cover Art: Carolyn Chan, MD, MHS
Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH
Reviewer: Payel Jhoom Roy, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste

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Tackle smoking cessation by offering your patients evidence-based treatment options. We discuss pharmacotherapy, mindfulness, and practical tips on how to manage short-acting nicotine replacement therapy to help your patient stop smoking. We are joined by Dr. Panagis Galiatsatos from Hopkins (@Panagis21).

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Integrate motivational interviewing into your busy practice, and learn the basic principles of cognitive behavioral therapy. This episode highlights common psychosocial interventions for individuals with substance use disorders. After this episode, you will feel empowered to connect patients to these evidence-based resources. We’re joined by Dr. Carla Marienfeld, MD from UCSD, @DrMarienfeld who gives us practical ways to counsel patients on these interventions, as well as bring them into the busy clinic setting.

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Partner with your patients to address cannabis use disorder. Learn how to talk through someone's motivations for cannabis use, treat cannabis withdrawal, address cannabis use disorder, and the eternal importance of harm reduction in cannabis use. Dr. Deepika Slawek @DeepikaSlawekMD (Einstein Medicine Bio) joins us on this can't miss episode!

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Challenge stigmatizing terms and level up your patient-centered language! Learn how to create an inviting environment to discuss substance use and substance use disorders (SUDs), how our word choices directly affect patient care and a three-step approach to taking a comprehensive SUD History. Let’s RIP-TEAR it up with our expert, Dr. Jeanette Tetrault from Yale University (@jtetrault17).

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With this buprenor-FINE episode, you’ll become a master at office-based treatment of opioid use disorder with buprenorphine. We’ll cover the efficacy of buprenorphine, a guide to starting it, and what to think about when continuing therapy in a person-centered way. We’re joined by Dr Christine Soran, (UCSF) the medical director of the oldest buprenorphine clinic in the country - The OBIC in San Francisco.

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Decrease your anxiety managing sedative-hypnotic use disorders! By the end of this episode, you will have practical tips on how to discuss benzodiazepine use, plan a taper, and support your patient throughout the process. We’re joined by Dr. Ximena Levander, @XimenaLevander (OHSU).

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Amp up your learning on stimulant use disorder! We are joined by Dr. Paxton Bach (@PaxBach) who is the Co-Medical Director for the British Columbia Centre on Substance Use and Director of their Clinical Addiction Medicine Fellowship Program. We discuss commonly used stimulants, how to recognize when someone is “overamping,” different treatment options, and so much more!

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Get comfortable treating alcohol use disorder (AUD). In this episode, we discuss the diagnosis of AUD strategies to help patients develop therapeutic goals and options for pharmacotherapy. We are joined for this episode by Dr. Alyssa Peterkin (BU), an internal medicine and addiction medicine physician who encourages us to venture into offering pharmacotherapy for AUD as it is vastly undertreated. By the end of this episode, you will be naltrex-owning meds for AUD!

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Step up harm reduction strategies in your clinical practice! We discuss partnering with patients who use substances and methods to keep patients safe and healthy. Dr. Kim Sue (@DrKimSue, Yale University), the National Harm Reduction Coalition Medical Director, joins us. We discuss safer injection practices, stimulants, alcohol, nicotine use, and more!

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Master the management of ambulatory alcohol withdrawal! We discuss the pathophysiology of alcohol withdrawal as well as the triage and treatment of this disease in the ambulatory setting. We’re joined by our bird-loving guest Dr. Stephen Holt (Yale University), an addiction medicine and internal medicine doc who teaches us a set of practical pearls that you won’t want to miss out on!

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Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital. We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter. She inspires us to be strong advocates for our patients.

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Curbsiders Addiction Medicine is THE podcast for all things addiction medicine. This series will discuss the ins and outs of caring for patients who have substance use disorders. We want to reduce the stigma around substance use as well as myth-bust and demystify common addiction medicine topics. We use expert interviews to cover core addiction med topics such as harm reduction, stimulant use disorder, methadone and so much more! We wanted to create a podcast that will help inspire others to join us in this field and create fierce advocates for all patients who use substances!

Season 1 kicks off July 7th, 2022 wherever you get your podcasts!

The Curbsiders Addiction Medicine Podcast: Recent Episodes

The Curbsiders Addiction Medicine Podcast