Renegade Psych

In this series, Dr. Stephen Love, MD, and I discuss a vitally important aspect of substance use treatment that is not discussed enough as a society or in our medical training, educating users on how to reduce the harms associated with substance use. We delve into what addiction is in this episode and discuss whether the causes are biological or environmental in nature... and you guessed it, we settle on a nuanced combination of the two. We also discuss why the U.S. is particularly susceptible to addiction and has THE highest rates of addition in the developed world. Finally, we talk about the internal battle between the AA (Alcoholics Anonymous, now including Narcotics Anonymous, etc.) and MAT (Medication-Assisted Treatment), and how, again, it is so important to take helpful components of both philosophies to help guide individualizing each treatment regimen to each patient. I hope you enjoy and tune in every Tuesday for a new release!

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

In this series, Dr. Stephen Love, MD, and I discuss a vitally important aspect of substance use treatment that is not discussed enough as a society or in our medical training, educating users on how to reduce the harms associated with substance use. Just as we would not neglect treatment for an uncontrolled diabetic who refuses to comply with diet, lifestyle, and medications, we shouldn't neglect treating Substance Use Disorders just because the user does not want to be abstinent from use. We should be trying to reduce harm in every way possible... and that's what this series is all about. This episode starts out with my typical monologue rant on the topic explaining why we need to change our overall approach to addiction, and then we introduce my guest and best bud, Stephen, as we discuss his personal and professional journeys, as well as our philosophical approaches to addiction. I hope you enjoy and tune in every Tuesday for a new release!

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

Here I reveal some exciting new upcoming changes to the podcast, starting in July of 2024. Hope you enjoy.

Here, I summarize my closing thoughts, then Adam and I talk about how we fix the systemic and multifactorial problems that in the American healthcare system. As always, to bring my angst down a notch at the end of the series, I've included a local artist and song, again featuring Jared Foos inaugural solo album, Who Loves You Baby, with the song, "I know." Enjoy! I'll be back next week with more content!

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

Dr. Urato has been talking about the risks of SSRIs (Prozac, Zoloft, Lexapro, Paxil, etc.) during pregnancy for almost as long as he was talking about the risks of Makena, nearly two decades. He reveals to us the data behind the FACT that there are risks to the developing fetus of maternal SSRI use during pregnancy, starting with the common sense evidence, followed by information obtained from human research, animal randomized controlled trials, and finally and most recently, MRI and functionalMRI findings in children of mothers on antidepressants. The point of this series (or our jobs as physicians) is not to pill shame anybody or over-exaggerate the risks of SSRIs in pregnancy, it is to provide our patients with the most up-to-date and SCIENTIFIC evidence to collaborate WITH them and HELP them make the best and most informed decisions for them. I reveal to Adam some of the pharmaceutical industry's disdain for lithium, one of the oldest, cheapest, and most effectives medication in all of psychiatry, as well as some of the questionable recommendations for its use during pregnancy, especially in light of the risks of the most commonly used class, SSRIs. Lithium is by no means safe during pregnancy, especially at high doses, however, its risks may be somewhat sensationalized, and I hope to have Adam back on in the future to discuss the potential lower risk in unipolar and bipolar depressed pregnant patients.

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

In this segment, Dr. Urato and I talk about his history with getting Makena removed from the pharmaceutical market after 20 years and how the pharmaceutical industry rolls out products with a relatively consistent M.O. and playbook. Adam talks about how a lot of treatments don't 'work' from a medical standpoint, but that they 'work' from a financial standpoint... if there are enough people and/or groups profiting from their rollout, it creates a situation where those entities put in place to protect American consumers of healthcare are just too financially incentivized to do their jobs regulating pharmaceutical products and protecting Americans from undue harm. It's not just the FDA or the CDC, however, it's also the 'key opinion leaders,' doctors and scientists promoted by industry as 'experts in their field' who are paid to essentially promote pharmaceutical products, as well as the professional medical societies how oftentimes receive a large percentage of their funding from pharmaceutical companies standing to profit from their patients.

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

For this series, Harvard-trained Dr. Adam Urato, MD, Maternal-Fetal-Medicine specialist joins us to discuss his experiences with Makena, a synthetic progesterone allowed to remain on the market for a convenient 20-year period despite true evidence of its safety and efficacy. His stance established intellectual clout and authority that bolsters his reputation as a harbinger of truth and makes it hard to ignore the evidence he is citing for the dangers of antidepressant use in pregnancy. He talks about how the COVID vaccine was similar to so many other historical pharmaceutical rollouts, citing all benefits with no risks, and how the industry uses its tentacles to create positive feedback cycles of profitability where the companies making new treatments, the regulatory agencies policing those companies, the corporations rolling out those treatments, and even the professional medical societies claiming to be 'there-for-patients' all benefit financially from and participate in the all-benefit-no-risk claims. Once companies lose exclusivity on their patent (typically, 20 years), the cycle runs dry and they no longer care to promote propaganda around it, and hope the memory of its empty promises and flawed trials are short-lived. Hope you enjoy!

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

Welcome to another series. This one features Dr. Adam Urato, MD, a Maternal-Fetal-Medicine specialist living and working in Framingham, MA, near where he trained at Harvard. Adam is in a unique position in medical culture because of his past experience sounding the alarm on Makena, a synthetic progesterone FDA approved for preterm labor in 2013, despite ONE shoddy clinical trial claiming it reduced the risk of preterm labor (without any impact on morbidity and mortality). Adam felt the trial was flawed and wanted to see more evidence of its safety and effectiveness before he committed to using it. However, over the next several years, others bit hook, line, and sinker on the propaganda bait put forth by the industry, those meant to regulate it, and its subsidiaries. While Adam fought to petition its removal until further evidence about safety and efficacy was completed, Hundreds of thousands of vulnerable pregnant women were injected with a synthetic hormone that, in 2019, was shown to have no evidence of efficacy, and to not be completely safe either. Unfortunately, the FDA dragged its feet for another four years (WTF!) until Makena was removed from the market (interestingly, 20 years after it emerged as a novel pharmaceutical in 2013). Long story short, THIS stance puts Adam in a unique position of scientific and moral authority and as a harbinger of truth in a growingly untrustworthy medical culture. It's hard to call Adam a conspiracy theorist when his Makena 'conspiracy theory' turned out to be completely valid... and therefore, it's hard not to take him seriously when he talks about the risks of antidepressant, specifically SSRI, use during pregnancy, as well as the uncertainty around the widespread use of the COVID vaccine and our divergence from other first-world countries in our current vaccination policies (We are a HUGE outlier in terms of recommending childhood and adolescent, and ESPECIALLY INFANT, COVID vaccination.)

Not to worry, however, Adam keeps it light while discussing really serious and important issues, and talks about the importance of fighting these fights as a happy warrior with an attitude of gratitude. I hope you enjoy.

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

Join us for this episode outlining modern medical training and discussing some of the medicine cultural issues that contribute to a lack of critical thinking, and the primary care shortage, which is the worst in the world, by a landslide. Only 11.5% of U.S. Medical graduates go into primary care, which easily ranks as the lowest in the world (Germany is ~25%), and creates a system of specialists, typically without a capable general practitioner that is able to manage the entirety of your care. As David Healy told me, if you follow the guidelines for ADHD, and you follow the guidelines for bipolar, and you follow the guidelines for hypertension and headaches, you'll end up on a countless number of medicines, and we need intelligent and conscientous primary care providers to be able to provide good counsel to patients on the interactions of all these medications, and ultimately, reduce the polypharmacy epidemic we're seeing in our country and around the world today.

Joining me for the discussion today is Ariel Blythe-Reske, MD and psychiatrist working in NYC. I trained with Ariel and she is very intelligent, a good critical thinker, and high-energy and eccentric, with a lot of passion for her patients and providing good medical and psychiatric care. Our discussion is a little more informal, so beware if you don't like cursing or sarcasm... hope you enjoy.

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

In this extra segment, recorded with Taylor Beckman, DO, from the "Inherent Problems" series, we discuss how the medical training system exploits students/residents, and acts like a monopoly, paying all residency positions nearly the same amount, with minimal pay increases each year, despite their skill level drastically improving. We give specific examples of how the financial systems integrated into healthcare benefit heavily from this exploitation, and discuss it in the context of NIL for college athletics, which seemingly should pave the way for resident unionization and the allowance of competition to drive wages up and give residents their true share of the pie, or at least a more even share of it.

Thanks for listening. For more social media content, check us out on all social media platforms @Renegadepsych. If you have any comments, questions or challenges to the information we've presented here, if you'd like to be a guest to the show, or if you have general comments, questions, or suggestions, email us at [email protected] and follow the link https://renegade-psych.podcastpage.io/ to our website for source material, transcripts, and additional links for my guests. If you feel passionate about our message and what we're trying to do, and you'd like to donate, you can also follow the link in the show notes to our website.

Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.