Have you ever wondered what it's like to practice Addiction Medicine? In this episode I speak about what we do in Addiction Medicine - both generally as well as how we do things in our practice on the Central Coast of California. 

I share how our clinic treats substance use with low‑barrier access, kind care, peer support, and long‑acting injectables while partnering with therapists to address trauma and ADHD that often drive relapse. 

I also review two cases that reveal how PTSD and undiagnosed ADHD change the treatment plan and the outcome.

Topics Discussed:

• What an addiction medicine visit includes  
• Medications for alcohol and opioid use disorder  
• The "three‑legged stool" of meds, therapy, and groups to treat addiction
• Levels of care and smooth transitions  
• Dual diagnosis as the rule, not the exception  
• Low‑barrier access through walk‑ins and telemedicine  
• Person‑first language to reduce stigma  
• Peer support as lived‑experience expertise  
• Long‑acting injectables to boost adherence  
• Mobile street medicine and carceral care partnerships

To contact Dr. Grover: [email protected]

Dr. Casey Grover welcomes Dr. Sarah Nasir, an addiction medicine specialist, for an insightful conversation about effectively communicating with patients and addressing common myths in addiction treatment.

• Personal journeys into addiction medicine that transformed both doctors' understanding of substance use disorders
• The science behind medication-assisted treatment and why it's not "trading one addiction for another"
• How the body adapts to chronic opioid use through three key mechanisms: reducing natural chemicals, decreasing receptors, and increasing metabolism
• Why recovery takes time: "It's easier to break something than to fix it"
• The critical connection between trauma, PTSD, and addiction
• Integration of life coaching principles into addiction treatment
• Creating authentic connection as a cornerstone of effective recovery
• Addressing stigma around medications in recovery communities and sober living facilities
• The difference between dependence and addiction in patient education

If you're a healthcare provider treating patients with addiction, thank you for your life-saving work. For everyone else, thank you for taking time to learn about addiction – it's a fight we cannot win without awareness and action.

To contact Dr. Grover: [email protected]

Mental health conditions and addiction are deeply intertwined, creating complex treatment challenges that require addressing both simultaneously. Dr. Mark Hrymoc, an addiction psychiatrist, shares insights on effectively treating dual diagnosis patients through parallel treatment plans that address both substance use and underlying mental health conditions.

• Dual diagnosis (co-occurring disorders) describes patients with both mental health conditions and substance use disorders
• Many patients use substances to self-medicate underlying mental health conditions rather than for euphoria
• 50-80% of patients with addiction also have PTSD or significant trauma histories
• SSRIs like Zoloft and Lexapro are first-line treatments for anxiety disorders including PTSD
• Prazosin is effective for PTSD-related nightmares
• Propranolol, clonidine, and gabapentin offer non-addictive options for anxiety management
• ADHD is a major risk factor for developing substance use disorders
• Non-stimulant options like Strattera, Qelbree, and Wellbutrin should be tried first for ADHD with comorbid addiction
• Insomnia treatment options include trazodone, mirtazapine, quetiapine, and newer DORA medications
• Ketamine therapy shows promise for treatment-resistant depression and suicidality

Remember, treating addiction saves lives.

To contact Dr. Grover: [email protected]

Dr. Casey Grover shares his personal struggle with food addiction and binge eating while exploring the science behind why certain foods trigger addictive behaviors in the brain. He examines how the food industry deliberately engineers products to maximize pleasure and consumption through carefully calibrated combinations of sugar, fat, and salt.

• Food addiction involves an intense dopamine response to certain foods that varies between individuals based on genetic predisposition
• The food industry uses "bliss point" science to make products as addictive as possible
• Ultra-processed foods make up over half the average American diet despite increasing risks of various diseases
• Eating disorders (anorexia, bulimia, binge eating) are mental health conditions where food behaviors are merely the symptoms
• Treatment options include SSRIs, topiramate, naltrexone/bupropion combinations, and potentially GLP-1 medications
• Weight loss surgery fails to address the underlying mental health aspects of food addiction
• Dr. Grover's personal experience with naltrexone showed how it made previously pleasurable foods taste "flat"

If you found this episode helpful, please consider supporting Central Coast Overdose Prevention (https://ccodp.org/) and the work we do to treat addiction and prevent overdoses. Together we can improve how addiction is treated and save lives.

To contact Dr. Grover: [email protected]

This episode is the fourth and final episode of a four part series on stigma.

This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.

First responders face unique mental health challenges due to the high-stress nature of their work, but stigma often prevents them from seeking help when they're struggling. Dr. Casey Grover, firefighter/paramedic Jesse, and firefighter/paremedic Evan discuss the psychological toll of being the ones who save lives, including PTSD, addiction, and the struggle with vulnerability.

We also hear from Dr. Reb Close, who worked as an Emergency Medicine physician for over 20 years.

• First responders naturally prioritize others over themselves, often neglecting self-care
• "Normalization of deviance" occurs when first responders gradually develop unhealthy coping mechanisms
• PTSD is a permanent brain change that many first responders experience but fear admitting
• Female first responders face additional challenges and scrutiny in male-dominated professions
• The pressure to appear perfect creates barriers to seeking help, even when struggling severely
• First responders often judge themselves more harshly than they judge others
• Addiction can develop as a way to self-medicate trauma and stress
• Recovery is possible when first responders become willing to be vulnerable and uncomfortable
• Those with established careers have the social capital to break stigma by sharing their experiences

If you're a first responder struggling with mental health or addiction issues, please know that help is available and seeking it early can prevent tremendous suffering. You are not alone, and recovery is possible.

To Contact Dr. Grover: [email protected]

This episode is the third episode of a four part series on stigma.

This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.

In this episode, Wendy Solorio shares her raw, emotional journey as a mother supporting her daughter Gabrielle through addiction and into recovery, highlighting the often-overlooked impact on families and caregivers.

• First recognizing her daughter's addiction during high school while dealing with guilt and shame as a parent
• Reaching emotional breaking points while preparing for the worst possible outcomes
• Navigating the healthcare system and waiting for treatment beds during crisis moments
• Facing financial devastation with treatment costs of $40,000 and maxing out multiple credit cards
• Experiencing stigma from coworkers, friends, and even law enforcement
• Dealing with the trauma that remains even after 2.5 years of her daughter's sobriety
• Finding support through therapy, medication, and select family members
• Advocating for better education among first responders and healthcare providers
• Emphasizing the critical role of substance use navigators in emergency departments
• Offering advice to other parents: "Care for the caregiver, never stop self-educating, have tough conversations"

To contact Dr. Grover: [email protected]

This episode is the second episode of a four part series on stigma.

This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.

In this episode, Gabrielle shares her powerful journey from fentanyl addiction to recovery, highlighting the unexpected moment of compassion from a correctional officer that changed everything. Her story reveals how respect and dignity can transform recovery outcomes, while exploring the deep impact of self-stigma and family support.

She shares her experience:

• Hitting rock bottom on Christmas Eve 2022 after stealing her mother's car during active fentanyl addiction
• Experiencing six overdoses, with each one bringing her closer to death
• Finding transformation through a year-long program at Teen Challenge
• Encountering a correctional officer who showed unexpected compassion and dignity
• Battling intense self-stigma despite having family who never gave up on her
• Receiving an ultimatum from her pregnant sister that became a powerful motivator
• Learning that recovery meant becoming a different person, not just the same person without drugs
• Moving from shame about her addiction to being open about her recovery journey
• Finding ways to help others by showing kindness and treating "humans like humans"
• Building a life she couldn't have imagined three years ago, working six days a week and helping with her sister's child

If you or someone you know is struggling with addiction, remember you don't have to do it alone. There are many avenues to recovery, and compassion can make all the difference.

To Contact Dr. Grover: [email protected]

This episode is the first episode of a four part series on stigma.

This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.

In this episode, Ana Alamo shares her powerful journey from addiction to recovery, revealing how her personal struggles now help her connect with clients as a peer support specialist.

• Born and raised in Salinas, Anna experienced childhood trauma at age five that shaped her early years
• She started using cannabis in middle school and developed a pattern of fighting and substance use
• Her use progressed to using pills including Norcos and Xanax from age 20-25
• Legal trouble became her wake-up call after being involved with fentanyl-laced pills that caused someone's death
• She now works as a peer support specialist and recently graduated with an Associate's degree in Addiction Studies
• She uses her lived experience to connect authentically with clients, especially teenage girls
• She does her best to balance accountability with compassion 
• Family took approximately four years to fully trust her again
• Therapy helped her develop vulnerability and begin the ongoing process of self-forgiveness
• She plans to continue her education at CSUMB pursuing psychology

We discuss the stigma and judgement that she felt along the journey through her addiction

And we also discuss how she makes sure her clients with addiction don't feel judgment or stigma from her now that she is a peer support specialist

If you're struggling with addiction, know that recovery is possible. Ana's story shows how our darkest moments can become our greatest strengths in helping others.

To contact Dr. Grover: [email protected]

Dr. Casey Grover explores the challenging world of benzodiazepines, explaining why these commonly prescribed medications can create more problems than they solve for patients struggling with anxiety and other conditions.

• Benzodiazepines work like alcohol in pill form, enhancing the brain's natural "downer" chemical GABA
• Long-term use leads to tolerance, dependence, and potentially Benzodiazepine-Induced Neurological Dysfunction (BIND)
• The four most commonly prescribed benzos are diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax)
• Benzodiazepine withdrawal can cause seizures months after the last dose, making it particularly dangerous
• Unlike opioid addiction, there are no specialized medications to treat benzodiazepine addiction
• Tapering from benzodiazepines is extremely challenging, often taking months or years with patients experiencing severe rebound symptoms
• Modern medical understanding now recognizes benzos as inappropriate for long-term anxiety treatment
• Case studies demonstrate how patients prescribed benzos for anxiety often never learn proper coping skills and suffer increasingly worse symptoms

Thanks for listening and remember treating addiction saves lives.

To contact Dr. Grover: [email protected]

This is a joint episode between the Addiction Medicine Made Easy Podcast and the Kratom Sobriety Podcast

Check out the Kratom Sobriety Podcast: https://kratomsobriety.com/

Trauma and addiction are deeply intertwined, with unresolved PTSD often driving substance use as people attempt to manage overwhelming emotions and physical sensations.

• Understanding PTSD beyond combat veterans—recognizing both "big T" traumas and accumulated "little t" stressors
• Dr. Grover shares his personal journey with PTSD from emergency medicine and the stigma he faced
• The Adverse Childhood Experiences (ACE) scale reveals how early trauma predicts addiction risk
• Multiple diagnoses often overlap—ADHD, PTSD, and addiction create complex treatment challenges
• Medication options for PTSD include prazosin for nightmares, propranolol for triggering, antidepressants, and more
• Innovative treatments like stellate ganglion blocks can reduce physiological reactivity from trauma
• Trauma-informed care requires providers to create safety and understand the person beyond their addiction
• Breaking stigma requires vulnerability—sharing our stories helps others recognize they're not alone

Visit mdcalc.com to check out the Adverse Childhood Experiences score, and listen to the Last Day podcast episode with Dr. Gabor Maté for more insights on trauma and addiction.

To contact Dr. Grover: [email protected]