The Curbsiders Addiction Medicine Podcast

S2 Ep19: #30 Blazing Hot Takes: The Latest in Vaping With Drs. Ling and Vijayaraghavan Aug 22, 2024

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)!
Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

Credits

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

S2 Ep18: #29 Hallucinogens with Dr. Al Garcia-Romeu Aug 15, 2024

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

S2 Ep17: #28 Alcohol-Associated Liver Disease with Dr. Lamia Haque Helping Patients Liver Longer Aug 08, 2024

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

S2 Ep16: #27- Recap: ACAAM Lightning Round Aug 01, 2024

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

S2 Ep15: #26 Addressing adulterants (xylazine) in the drug supply with Dr. Raagini Jawa and Tehya Johnson, NP Jul 25, 2024

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

S2 Ep14: #25 Methadone in the Clinic with Dr Ruth Potee and Dr David Frank Jul 17, 2024

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

S2 Ep13: #24 Treating OUD in the Fentanyl Era: ASAM Treatment Week with Dr. Melissa Weimer Oct 17, 2023

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

S2 Ep12: #23 Opioid Overdose Treatment and Prevention with Dr. Alex Walley Sep 21, 2023

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

S2 Ep11: #22 Low Key Pearls for Low Dose Bup With Amelia Goff FNP and Eleasa Sokolski, MD Sep 14, 2023

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

S2 Ep10: #21 Racism and Inequities in Addiction Medicine with Dr. Myra Mathis Sep 07, 2023

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)
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: 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

S2 Ep9: #20 Extending Knowledge of LAI Buprenorphine with Dr. Ken Lee Aug 31, 2023

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.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S2 Ep8: #19 Return to Use Prevention Counseling with Dr. Eve Lasswell, PsyD Aug 24, 2023

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.
Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S2 Ep7: #18 Urine Drug Testing with Dr. Timothy Wiegand Aug 17, 2023

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.
Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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: 05:17
Case from Kashlak: 09:42
Types of Urine Drug Testing (UDT): 10:37
Detection Window 22:07
Interpreting Opiates and Opioids UDT 25:26
Resources to Interpret UDT 39:20
False Positives 43:29
Discussing Results with a Patient 45:52
Interpreting UDT - Buprenorphine 48:47
Specimen Validity Testing 50:22
Saliva Testing 54:56
Outro 1:01:28

S2 Ep6: #17 Caring for People with Criminal Legal Involvement and SUDs with Dr. Lisa Puglisi Aug 10, 2023

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.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S2 Ep5: #16 Distilling Inpatient Alcohol Withdrawal with Dr. Shawn Cohen Aug 03, 2023

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.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S2 Ep4: #15 Buprenorphine for Chronic Pain with Dr. Will Becker Jul 27, 2023

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.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S2 Ep3: #14 Getting to the Heart of Injection Drug Use Associated Infectious Endocarditis with Dr. Ayesha Appa Jul 20, 2023

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!

S2 Ep2: #13 What to Expect: Managing Opioid Use Disorder in Pregnancy with Dr. Terplan Jul 14, 2023

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

S2 Ep1: #12 Listener Q & A on Substance Use Disorders Jul 06, 2023

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.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

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

S1 Ep11: #11 Smoking Cessation: It’s Not a Drag with Dr. Panagis Galiatsatos Sep 15, 2022

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).

S1 Ep10: #10 The ABCs of CBT: Psychosocial Interventions 101 with Dr. Carla Marienfeld Sep 08, 2022

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.

S1 Ep9: #9 A Joint Conversation: Cannabis Use Disorder with Dr Deepika Slawek Sep 01, 2022

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!

S1 Ep8: #8 Back to Basics: A Stigma-Free History with Dr. Jeanette Tetrault Aug 25, 2022

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).

S1 Ep7: #7 Do the OBOT: Buprenorphine for OUD in the Clinic with Dr. Christy Soran Aug 18, 2022

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.

S1 Ep6: #6 Get Hip to Sedative-Hypnotic Use Disorders with Dr. Ximena Levander Aug 11, 2022

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).

S1 Ep5: #5 Amp Up Your Treatment of Stimulant Use Disorder with Dr. Paxton Bach Aug 04, 2022

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!

S1 Ep4: #4 Wrapping Our Heads Around Alcohol Use Disorder Meds w/Dr. Alyssa Peterkin Jul 28, 2022

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!

S1 Ep3: #3 Harm Reduction: Partnering with Patients w/Dr. Kim Sue Jul 21, 2022

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!

S1 Ep2: #2 Get in the Spirit of Ambulatory Alcohol Withdrawal Jul 14, 2022

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!

S1 Ep1: #1 Methadone for Opioid Use Disorder - Find Your Rage with Dr. Ruth Potee Jul 07, 2022

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.

S1 Ep1: Trailer - The Cursbiders Addiction Medicine Jun 21, 2022

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!

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