Trapped: Understanding Addiction

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-1871524728

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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-wong

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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.pdf
https://www.cdc.gov/mmwr/volumes/68/wr/mm6817a3.htm
https://opioidmisusetool.norc.org/
https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1015&context=ruhrc_reports
https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1014&context=ruhrc_reports
https://www.countyhealthrankings.org/app/colorado/2021/measure/factors/134/data

Learn more about Dr. Jackman at https://doctors.sclhealth.org/provider/Ryan+K.+Jackman/1617603

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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.

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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-fingerhood

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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.

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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-mesheriakova

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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-md

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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.html

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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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-felsher

If you enjoy what you hear, please feel free to contribute at www.trappedunderstandingaddiction.com to support harm reduction efforts.

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