The Transformed Minds Pod

thetransformedmindspod
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  • MENTAL HEALTH
  • EVERY TWO WEEKS

Transformed Minds is a podcast dedicated to reshaping how we understand and approach mental health and substance use. Through evidence-based discussions, real stories, and expert interviews, we create a space for learning, reflection, and transformation. Hosted by theprayingpsychiatrist, a physician, researcher, and advocate for community and global mental health, this platform bridges evidence-based medicine, clinical insight and lived experience. Whether you're a provider, trainer, policymaker, patient, or loved one—this podcast is for you. Let’s learn, heal and transform – together!

  1. When Policy Lags Behind Science: Buprenorphine Dosing Reconsidered with Dr. Drits | Ep 5

    7 APR

    When Policy Lags Behind Science: Buprenorphine Dosing Reconsidered with Dr. Drits | Ep 5

    Are dose caps on buprenorphine costing lives? In this episode of the Transform Mind Podcast, Dr. O and Dr. Drits dig into the evidence and the gaps around buprenorphine dosing for opioid use disorder In the fentanyl era, drawing on a 2023 narrative review by Grande and colleagues published in the Journal of Addiction Medicine. Higher doses are consistently linked to better treatment retention. Yet dose caps persist in clinical practice and insurance policy, even as the opioid supply has fundamentally shifted. Dr. O and Dr. Drits break down why, and what clinicians and patients can do about it.In this episode: → Why the "ceiling effect" applies to respiratory depression not to craving or withdrawal relief → What the evidence says about retention, fentanyl, and dosing → How to advocate for patients within institutional and insurance constraints → Common myths about diversion and high-dose buprenorphine → Shared decision-making in practice Learning Objectives By the end of this episode, listeners will be able to: Describe the evidence base regarding buprenorphine dose limits and clinical outcomes. Explain how buprenorphine pharmacology informs safety at higher doses. Identify policy and systemic factors that influence dosing practices. Apply evidence-based reasoning to clinical and systems-level decision-making in opioid use disorder care. Chapters: 00:00 High Dose Benefits 01:23 Podcast Intro Format 02:34 Why Dose Caps Matter 07:48 Guest Perspective Policy Lag 11:27 Dose Limits Today 14:44 Buprenorphine Pharmacology 18:07 Retention Saves Lives 20:31 Fentanyl Needs Higher Doses 22:25 Advocacy Under Limits 24:53 Training And Myths 28:38 Case Dosing Decisions 34:38 Shared Decision Making 37:34 Ceiling Effect Explained 39:24 Key Takeaways Reference: Grande LA et al. "High-dose buprenorphine for the treatment of opioid use disorder in the context of fentanyl exposure." Journal of Addiction Medicine, 2023. ⚠️ This podcast is for educational purposes only and does not constitute medical advice. Clinical decisions should be made in consultation with a qualified healthcare provider. #BuprenorphineTreatment #OpioidUseDisorder #MOUD #FentanylCrisis #AddictionMedicine #HarmReduction #TransformMindPodcast

    42 min
  2. The Hidden Architecture: Rethinking Mental Health System Design | Ep 3

    24 MAR

    The Hidden Architecture: Rethinking Mental Health System Design | Ep 3

    Why does mental health care stay fragmented when the evidence for effective treatment already exists? In this Host Rx episode, Dr. O argues that persistent treatment gaps are a structural problem, not a knowledge problem. Drawing on a 2023 Lancet Psychiatry paper, Dr. O breaks down what's actually driving fragmentation: Insurance design and weak parity enforcementPrior authorization delays blocking time-sensitive careScope-of-practice restrictions and workforce shortagesEHR silos and reimbursement models that don't support collaborative careShe maps the problem across clinical, organizational, and policy levels, and makes the case for structural literacy as the foundation for reform. 00:00 Evidence Versus Architecture01:05 Podcast Welcome And Format02:19 Treatment Gaps Are System Design04:58 Why Care Stays Fragmented06:38 Insurance Shapes Clinical Care07:19 Why Pilots Fail To Scale08:14 Case Study OUD And Depression09:49 Clinician Reflection And Levers10:52 Warm Handoffs And Case Conferences13:45 Why Silos Persist In Practice15:18 What Integration Really Means15:54 Three Levels Of Architecture17:42 Advocacy And Closing MessageFeatured Studies- 2023 Article, The Lancet Psychiatry (ScienceDirect link provided)- Lagisetty PA et al., 2019. Racial disparities in buprenorphine treatment. JAMA Psychiatry.- Parity enforcement advocacy and policy statements from the American Medical Association Transformed Minds is hosted by Dr. O and covers addiction medicine, psychiatry, and the policy shaping mental health care delivery.

    19 min
  3. Alcohol Withdrawal in the Hospital: CIWA, Benzodiazepines & Phenobarbital Explained | S2 Ep.3

    10 MAR

    Alcohol Withdrawal in the Hospital: CIWA, Benzodiazepines & Phenobarbital Explained | S2 Ep.3

    In this episode of Transformed Minds Season 2, Dr. O sits down with addiction medicine specialist Dr. Desai, a CATCH Team Lead Physician (Consult for Addiction Treatment and Care in Hospitals), for a deep clinical dive into alcohol withdrawal management in the hospital setting. Whether you're a hospitalist, internist, nurse, resident, addiction medicine clinician, or medical student, this episode gives you a practical, bedside framework you can use immediately. What You'll Learn: A practical framework for risk-stratifying alcohol withdrawal at the bedsideWhen and how to use CIWA and what most clinicians get wrongHow to choose between benzodiazepine regimens based on patient profileWhen phenobarbital enters the picture and how to use it safelyHow an interdisciplinary consult model changes outcomes for hospitalized patients with alcohol use disorderChapters 00:00 Why Early Assessment Matters00:49 Welcome to Transformed Minds02:38 Meet Dr. Desai04:37 What Is the CATCH Team07:26 Alcohol Withdrawal Red Flags13:10 Bedside CIWA and Reassessment15:16 Symptom-Triggered Protocols18:10 High-Risk Withdrawal Timeline20:22 Front-Loading and Fixed Tapers25:58 Complicated Withdrawal and Phenobarbital36:54 Choosing the Right Benzo39:32 Key Takeaways and Wrap Up Subscribe to Transformed Minds for clinical education on psychiatric and addiction care, advocacy and tips.

    44 min
  4. Who Gets Treatment and Why? Evidence, Inequity, and Solutions in Addiction Care | S2 E2

    24 FEB

    Who Gets Treatment and Why? Evidence, Inequity, and Solutions in Addiction Care | S2 E2

    In this Host Rx episode, Dr. O examines a critical reality in addiction care: access gaps. Medications for Opioid Use Disorder (MOUD), including buprenorphine, reduce all-cause mortality by approximately 50%. The evidence is clear. Yet in the United States, who receives these medications often depends on race, income, insurance status, and geography. What This Episode Covers - Racial disparities in buprenorphine prescribing. - Geographic inequities and treatment deserts. - Medicaid expansion and insurance barriers. - Adolescent access gaps. - Telehealth reforms and post-COVID regulatory changes. - Structural determinants driving opioid mortality. Grounded in peer-reviewed research and national policy analysis, this episode is designed for clinicians, policymakers, advocates, public health professionals, researchers, and trainees in psychiatry and addiction medicine, as well as anyone who wants to understand why zip code should not determine survival. Featured Research - Lagisetty et al., 2019. Buprenorphine Treatment Divide. JAMA Psychiatry. - -Krawczyk et al., 2022. Policy Impact on Buprenorphine Access. JAMA Network Open. -Goedel et al., 2021. Structural Determinants of Treatment Access. American Journal of Psychiatry. -Samples et al., 2022. Telehealth and Buprenorphine Access. Health Affairs. -Williams et al., 2023 .Treatment Inequities and Policy Reform. Lancet Psychiatry. -Priest et al., 2022. Adolescent Treatment Access. Journal of Adolescent Health. -Clinical guidance: SAMHSA and CDC. Episode Chapters 00:00 Welcome to Transformed Minds 01:27 Why Access Matters 04:11 Research on Treatment Gaps 07:07 Clinician Pipeline and Policy 11:16 Frameworks and Care Models 12:31 Buprenorphine vs Methadone Systems 16:07 Geography, Youth, and Trauma 20:04 Case Study: Marcus 22:58 How Buprenorphine Works 25:50 Access Is the Treatment 27:35 Screen for Structural Barriers 30:55 Final Call to Advocate Because where you live should not determine whether you survive.

    32 min
  5. The Revolving Door: Illicit Drug Use After Incarceration with Dr. Barrett | Season 2 Premier

    10 FEB

    The Revolving Door: Illicit Drug Use After Incarceration with Dr. Barrett | Season 2 Premier

    Does incarceration actually reduce substance use or does it make it worse?In this episode of The Transformed Mind, Dr. Owusu sits down with forensic and addiction psychiatrist Dr. Jason Barrett to examine the growing body of evidence showing that incarceration is not a deterrent to drug use and may actually increase risk after release, even after controlling for prior substance use.Using longitudinal research on formerly incarcerated Black Americans as a foundation, this conversation moves beyond statistics to explore the lived realities of incarceration, reentry, trauma, and gaps in addiction treatment. Together, they unpack why relapse after release is not a moral failure, but a predictable outcome of disrupted care, untreated trauma, and structural barriers like housing instability, loss of insurance, and lack of access to evidence-based treatment.This episode covers:- Why incarceration predicts drug use independent of prior useCarceral trauma, racialized trauma, and loss of autonomy- Why court-mandated treatment often fails without readiness- The role of clinicians as the “last bridge” for patients- Medication access in jails and prisons (and why continuity of care matters)- How community organizations, peer specialists, and policy reforms can reduce harm- Why addiction should be treated like diabetes, not punished like misconductThis episode is essential listening for clinicians, trainees, policymakers, community advocates, and anyone seeking a more honest, evidence-based conversation about addiction and the justice system.🎧 Listen on Spotify, Apple Podcasts, and wherever you get your podcastsFeatured resources:Rich JD, Wakeman SE, Dickman SL. Return to illicit drug use post-incarceration among formerly incarcerated Black Americans. Drug Alcohol Depend. 2018;187:77–82.Brinkley-Rubinstein L. Incarceration as a social determinant of health. Lancet Public Health. 2018;3:e165–e166.Binswanger IA, et al. Mortality after prison release. N Engl J Med. 2007;356:157–165.National Academies of Sciences. Medications for Opioid Use Disorder Save Lives. 2019.Subscribe for weekly conversations on psychiatry, addiction, and structural health00:00 – Welcome & episode overview02:10 – Why this conversation matters right now04:40 – Intergenerational incarceration, foster care, and homelessness07:30 – Lack of treatment inside jails and prisons10:15 – Why incarceration predicts drug use even after prior use is controlled14:20 – “What does the substance do for you?”18:45 – Trauma, PTSD, ADHD, and untreated psychiatric drivers23:10 – The myth that incarceration stops drug use27:30 – Court-mandated treatment vs readiness for change32:40 – Stages of change and why forced care often fails37:15 – Being the only bridge left for a patient41:50 – Carceral trauma and racialized trauma47:10 – What forensic psychiatry actually is51:30 – How clinicians should assess incarceration history56:20 – Addiction treatment during incarceration: what the evidence shows1:01:10 – Medicaid gaps, reentry, and continuity of care1:07:30 – Community organizations, peer specialists, and rehabilitation1:14:40 – Addiction vs diabetes: dismantling stigma1:21:10 – Case presentation: post-release escalation explained1:28:50 – Evidence-based interventions before release1:35:30 – Final reflections and key takeaways

    1hr 2min
  6. When Triggers Are Everywhere: Holiday Survival and Substance Use | Season Finale

    18/12/2025

    When Triggers Are Everywhere: Holiday Survival and Substance Use | Season Finale

    In the season finale of The Transformed Minds, Dr. O brings the series full circle, reflecting on the season’s core lessons around evidence-based, humane, and equitable care in substance use and psychiatric treatment. This episode focuses on the heightened risks of the holiday season, a time when emotional stress, trauma activation, social isolation, and structural inequities often collide. Dr. O explores how holiday pressures can exacerbate substance use and psychiatric symptoms, while also highlighting concrete, actionable strategies to promote safety, continuity of care, and recovery. Drawing on clinical insight and real-world examples, the episode examines: The psychology of stress and trauma during the holidays Structural vulnerabilities that increase risk for relapse, overdose, and psychiatric crises Practical interventions for clinicians, caregivers, policymakers, and communities From anticipatory care planning and medication continuity to community-level harm reduction strategies such as naloxone distribution and syringe services, this finale underscores a central message of the season: support saves lives. Join us for a thoughtful, grounded discussion on how to build recovery-friendly environments and reduce harm during one of the most challenging and meaningful times of the year. Learning Objectives By the end of this episode, listeners will be able to: Identify evidence-based risk factors for substance use recurrence during the holiday season. Apply practical, anticipatory strategies to reduce relapse and overdose risk. Understand how trauma, social determinants, and system-level gaps shape holiday outcomes. Translate research into actionable steps for clinicians, patients, communities, and policymakers. Reframe holiday substance use risk as predictable and therefore preventable.

    32 min
  7. Unhoused & Untreated: Homelessness, OUD, and Systemic Barriers with Dr. Arbelo | Ep. 11

    02/12/2025

    Unhoused & Untreated: Homelessness, OUD, and Systemic Barriers with Dr. Arbelo | Ep. 11

    Tackling Addiction and Homelessness with Dr. Fabiola Arbelo Cruz In this episode of the Transformed Minds Podcast, Dr. Owusu speaks with Dr. Fabiola Arbelo Cruz, Addiction Psychiatrist at the Connecticut Mental Health Center and Yale School of Medicine. They explore how mental health, addiction, and homelessness intersect, the barriers unhoused individuals face, and the innovative approaches used by Yale’s Street Psychiatry team. Dr. Arbelo Cruz discusses treatment engagement, long-acting buprenorphine, peer support, and the policy changes needed to address social determinants of health. A powerful episode for clinicians, policymakers, and advocates seeking meaningful solutions. Episode Highlights: Understanding homelessness and addiction Challenges within emergency and street-based care Case study insights Building trust with unhoused patients Effective treatment strategies System-level and policy recommendations

    1hr 7min
  8. Safely Tapering Benzodiazepines: Key Guidelines and Practical Insights

    11/11/2025

    Safely Tapering Benzodiazepines: Key Guidelines and Practical Insights

    Welcome to the Transform Mind Podcast with Dr. O. In today's episode, we delve into the joint clinical practice guidelines for benzodiazepine tapering released in June 2025. Dr. O breaks down the essential principles, patient-centered approaches, and key recommendations to ensure safe and effective benzodiazepine tapers. Learn why slow and supported tapering, shared decision making, and harm reduction are critical for patient safety. We also discuss special populations, psychosocial interventions, and practical case studies. Stay tuned to explore this vital topic in psychiatric and addiction care. 00:00 Welcome to Transform Mind Podcast 01:22 Introduction to Today's Topic: Benzo Use Tapering Guidelines 01:51 Overview of the Joint Clinical Practice Guideline 03:37 Key Recommendations and Classifications 05:03 Guiding Principles for Implementation 08:01 Detailed Tapering Strategies 13:52 Special Populations and Considerations 16:50 Case Study: Applying the Guidelines 19:34 Conclusion and Key Takeaways Featured Resources 🧾 Joint Clinical Practice Guideline on Benzodiazepine Tapering (ASAM, 2025)Read the full text or download the clinician summary.

    21 min
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About

Transformed Minds is a podcast dedicated to reshaping how we understand and approach mental health and substance use. Through evidence-based discussions, real stories, and expert interviews, we create a space for learning, reflection, and transformation. Hosted by theprayingpsychiatrist, a physician, researcher, and advocate for community and global mental health, this platform bridges evidence-based medicine, clinical insight and lived experience. Whether you're a provider, trainer, policymaker, patient, or loved one—this podcast is for you. Let’s learn, heal and transform – together!

Information

  • Creator
    thetransformedmindspod
  • Years Active
    2025 - 2026
  • Episodes
    18
  • Rating
    Clean
  • Copyright
    © thetransformedmindspod
  • Show Website
    The Transformed Minds Pod