Cracking Addiction Meducate

In this compelling episode of Cracking Addiction, Dr Ferghal Armstrong welcomes Jonathan Hunt-Glassman, an individual with lived experience of alcohol misuse and the CEO of Oar Health. Jonathan provides a raw and honest account of his struggles with alcohol, starting from high school right through to his twenties. His journey involved excessive binge drinking, blackouts, and multi-day benders, ultimately leading to the physical and mental health repercussions associated with alcohol addiction.
**Key Points Covered:**
1. **Understanding the Root Causes**:

- Jonathan delves into the social anxiety that drove his alcohol misuse. As Dr Ferghal notes, understanding the underlying pain is crucial.

2. **The Impact of Social Media and COVID-19**:

- The episode discusses how the increase in digital communication and social isolation could contribute to future spikes in alcohol use disorders.

3. **The Importance of Support Systems**:

- Jonathan highlights how a supportive healthcare practitioner, empathic friends, and a loving partner were instrumental in his recovery.

4. **Tools for Recovery**:

- Jonathan shares the multifaceted toolkit that helped him, including goal-setting, medication, therapy, and lifestyle changes.

**Learning Outcomes:**

1. **Identifying Root Causes**:

- By listening to Jonathan's experiences, you will learn how social anxiety and feelings of insecurity can lead to problematic drinking. Understanding these root causes can help in seeking appropriate therapies to address them.

2. **The Role of Support Systems**:

- This episode underscores the importance of having a reliable support system. Friends and family play a critical role in recovery, providing non-judgmental, loving support that can significantly impact an individual's journey towards sobriety.

3. **Utilising Healthcare Professionals**:

- The value of a compassionate healthcare provider cannot be overstated. As Jonathan explains, a simple phrase like "We can work with that" can break down barriers of fear and shame, making the initial steps to recovery much more manageable.

4. **Building a Toolkit for Recovery**:

- Jonathan discusses the various tools that worked for him, including medication, therapy, and personal strategies like avoiding drinking on an empty stomach. Assembling a similar toolkit can provide a structured and effective approach to managing alcohol use disorder.

**Actionable Takeaways:**

1. **Address Social Anxiety**:

- Seek professional help to address any underlying social anxiety or insecurity. Therapies such as Cognitive Behavioural Therapy (CBT) can be incredibly effective in mitigating these triggers.

2. **Establish Clear Goals**:

- Set clear, achievable goals for your alcohol consumption. For Jonathan, a key goal was never to blackout again; similar concrete objectives can provide direction and motivation.

3. **Engage with Health Practitioners**:

- Don’t hesitate to consult with healthcare professionals. A supportive and understanding medical practitioner can offer crucial guidance and prescribe helpful medications if necessary.

4. **Rely on a Support Network**:

- Lean on your friends and family. Their support can provide emotional resilience and practical help, such as non-judgemental feedback or participating in healthier, sober activities.

**Quote:**

"We can work with that."

This phrase, used by Jonathan's healthcare provider, signifies the power of empathy, understanding, and collaboration in the recovery journey.

Are you curious about the hidden dangers lurking in the world of synthetic opioids? In this episode of "Cracking Addiction," Dr Ferghal Armstrong sits down with the incredible Prof. Suzanne Neilsen, Deputy Director of the Monash Addiction Research Centre, to dive deep into the chilling rise of nitazenes in Australia. As high-potency synthetic opioids, nitazenes are causing waves of concern, and their impact could be closer to home than you think.
What's a nitazene, you ask? These potent synthetic opioids came into existence through pharmaceutical research in the 1950s but are now making a perilous comeback in the illicit drug scene. As Suzanne and I chat, we unravel why these forgotten compounds are suddenly re-emerging and the harrowing effects they have, particularly respiratory depression. Also, did you know that nitazine contamination could be lurking in various recreational drugs like MDMA or ketamine, posing a lethal threat unexpectedly?

But don't just take my word for it—watch the video and have your questions answered by one of Australia’s leading experts in addiction research. Prof. Neilsen steps us through the nuances of these dangerous compounds, their presence in recreational drugs, and the life-saving importance of naloxone for overdose reversals.

**Learning Outcomes:**

1. **Understanding Nitazines:**

- Learn about Nitazenes, their chemical structure, and why they are considered highly potent opioids.
- Suzanne reveals that although they were initially developed for potential therapeutic uses, their severe side effects, including significant respiratory depression, halted their progress.
- Discover the historical context that has led to their re-emergence in the illicit drug scene.
- Recognise the distinction between different types of Nitazenes and their varying potencies and half-lives.

2. **Risk Awareness and Harm Reduction:**
- Understand the risks associated with Nitazene contamination in various illicit drugs, such as MDMA, ketamine, and cocaine.
- Gain insights into how synthetic opioids like Nitazenes and fentanyl increase the danger of overdose due to their potency and rapid onset.
- Develop awareness of the “sloppy drug dealer” theory and its implications for contamination.
- Learn about the broadening need for harm reduction initiatives that address not just opioid users but anyone using illicit drugs.

3. **Importance of Naloxone:**
- Comprehend the role of naloxone in reversing opioid overdoses, even caused by potent synthetic opioids like Nitazenes.
- Learn about the potentially higher doses of naloxone required to reverse nitazene-induced overdoses.
- Understand the importance of having multiple doses of naloxone on hand and the implications for stocking it in harm reduction services.
- Recognise the balance needed in administering naloxone to avoid severe withdrawal symptoms in patients.

**Actionable Takeaways:**

1. **Increasing Awareness and Education:**
- Educate yourself and your community about the dangers of synthetic opioids like nitazenes.
- If you’re in a position to influence policy, advocate for expanding drug-checking services to help identify contaminants before use.
- Spread the word about the importance of having naloxone readily available, especially in communities at risk.
- Support initiatives that provide harm reduction training to a broad audience, including those who might not identify as opioid users.

2. **Advocating for Harm Reduction Services:**
- Push for the establishment and funding of drug checking services in all states and territories, not just limited areas.
- Encourage local governments and organisations to support evidence-based harm reduction services.
- Participate in or initiate community...

Dr Ferghal introduces us to Helen, a Reiki master, who delves into the origins of Reiki and its application in addiction recovery. Discover the transformative power of Reiki healing and how it can complement traditional methods of treatment for substance use disorders.
Gain insights into the emotional causes of addiction and explore how Reiki can aid in relapse prevention and detoxification. Join us as we unravel the potential of Reiki in supporting individuals on their journey to recovery from addiction.
**Focus Keyword:**
Reiki in Addiction Recovery
**Key Points:**
- Learn about the origins of Reiki and how it was discovered by Mikaya in the 18th century.

- Understand the Reiki healing process and how it can help individuals release fear and emotional traumas.

- Explore the role of Reiki in addiction recovery, including aiding in detoxification, relapse prevention, and addressing underlying emotional causes of addiction.

- Discover the levels of Reiki attunements and the benefits of each stage in personal healing and helping others.

**Quote:**
"Ask not why the drug, but why the pain." - Dr Ferghal Armstrong

**Learning Outcomes:**
1. Understand the origins of Reiki and its connection to traditional healing practices.

2. Explore the role of Reiki in releasing fear and emotional traumas in addiction recovery.

3. Learn about the levels of Reiki attunements and their significance in personal healing and growth.

4. Discover the potential benefits of Reiki in detoxification, relapse prevention, and addressing the emotional root causes of addiction.

**Actionable Takeaways:**
1. Consider incorporating Reiki as a complementary therapy in addiction recovery programmes to support emotional healing.

2. Explore the practice of Reiki for personal healing and self-care, starting with Reiki Level 1 attunement.

3. Investigate the role of Reiki in reducing fear and anxiety during the recovery process and consult with a Reiki master for guidance.

4. Reflect on the emotional causes of addiction and how Reiki may assist in addressing and releasing these underlying issues.

In this episode, Dr Ferghal Armstrong and Dr Richard Bradlow unpack the complex relationship between alcohol, thiamine deficiency, and the severe neurological condition Wernicke’s encephalopathy. Ferghal opens by questioning long-held beliefs about alcohol’s direct effects on thiamine absorption, while Richard provides a contextual understanding of the symptomatic manifestations. The discussion touches on the practicalities of diagnosing and treating thiamine deficiency, focusing particularly on clinical scenarios where immediate action can prevent irreversible damage.
**Learning Outcomes**
1. **Understanding Thiamine Deficiency and Alcohol Use**

- Thiamine deficiency is commonly seen in individuals with alcohol use disorders due to poor diet, liver damage, and compromised gut integrity. Ferghal emphasises that alcohol does not directly reduce thiamine but affects its absorption and storage indirectly.

- Recognise the critical symptoms of thiamine deficiency: Ataxia, ophthalmoplegia, and confusion. Richard shares that only 10% of individuals present with the classic triad, stressing the need for a low threshold in administering thiamine.

- Ferghal reveals that thiamine is stored in the liver, with approximately 20-30 milligrams available. Without replenishment, these levels deplete quickly, making regular intake essential.

2. **Diagnosis and Management**

- Learn to assess risk factors beyond alcohol consumption. Richard suggests evaluating diet, liver health, and any conditions that hamper gut absorption.

- Understand the importance of high-dose, parenteral thiamine administration in suspected cases of Wernicke’s encephalopathy. This prevents irreversible neuronal damage, particularly in the cerebellum and midbrain.

- Find out why rapid thiamine delivery is critical. Ferghal explains that alcohol withdrawal demands a higher energy output, which depletes thiamine stores faster, precipitating encephalopathy.

3. **Preventative Measures and Harm Reduction**

- Recognise the importance of thiamine supplements for those engaging in hazardous drinking, even if not experiencing withdrawal. Richard advocates for over-the-counter vitamin B1 tablets, taken multiple times daily for optimal absorption.

- Explore how diet can play a crucial role in preventing thiamine deficiency. Liver, cereals, and fortified foods are excellent sources of thiamine, as Ferghal points out.

- Koraskoff’s syndrome is an irreversible consequence of untreated thiamine deficiency. It leads to significant memory deficits and an ataxic gait, which underscores the need for timely intervention.

**Actionable Takeaways**

1. **Routine Screening for Thiamine Deficiency**

- Incorporate routine screening for thiamine deficiency in patients with alcohol use disorder. Ferghal and Richard highlight this as a vital practice to prevent conditions like Wernicke’s encephalopathy and Korsakoff syndrome.

- Develop a checklist for evaluating risk factors, including dietary patterns, liver function, and gut health issues.

- Push for early intervention even with subclinical symptoms. Ferghal stresses the colossal benefits of early detection and treatment.

2. **Educate on Thiamine Supplementation**

- Ensure patients receive clear instructions on thiamine supplementation. Richard recommends oral vitamin B1, taken in divided doses throughout the day.

- Cultural and dietary recommendations should include foods rich in thiamine, like liver and fortified cereals.

- Advocate for harm reduction strategies that include vitamin supplements. Ferghal points out this can significantly reduce the risk of severe neurological...

In the latest episode of "Cracking Addiction," Dr Ferghal continues the journey with Dr Richard, exploring the critical subject of alcohol withdrawal. This episode is particularly focused on the timings, the natural history of withdrawal symptoms, and the potential complications faced during alcohol detoxification. The discourse provides key insights on when symptoms typically appear, ranging from mild to severe cases, and discusses methods of intervention based on the severity of withdrawal symptoms.
**Learning Outcomes:**
1. **Understanding the Onset of Alcohol Withdrawal:** This episode helps listeners grasp the variable onset of alcohol withdrawal symptoms which can appear from 12 to 24 hours after the last drink. Ferghal and Richard explain the concept of 'day two' of withdrawal, enhancing understanding of the physiological changes happening in the body during this time.

2. **Risk Factors and Complications:** The conversation thoroughly covers potential complications, such as seizures and delirium tremens. It emphasizes the importance of recognizing past withdrawal histories and comorbidities that heighten withdrawal complications, which proves crucial for healthcare providers in assessing risk.

3. **Ethical and Effective Treatment Strategies:** Highlighting the dangers of protocol-driven approaches in detoxification settings, Richard points out the importance of tailored treatment plans. They discuss the use of diazepam to manage symptoms effectively and the strategies to mitigate risks such as 'kindling.'

4. **Proper Management of Seizures and Delirium:** Key strategies for managing severe withdrawal symptoms like seizures and delirium tremens (DTs) are elaborated on, including the avoidance of certain medications and the focus on benzodiazepine regulation.

**Actionable Takeaways:**

1. **Recognise the Early Signs:** Listeners are encouraged to identify early withdrawal symptoms to initiate timely treatment, potentially preventing the escalation towards more severe complications such as DTs.

2. **Avoid High-Protocol Rigidity:** The importance of flexibility in treatment protocols was underscored, stressing individual patient needs over rigid guidelines, which might prevent effective symptom management.

3. **Prepare For Seizure Management:** Understanding that alcohol withdrawal seizures could peak around 24 hours post-last ingestion, healthcare providers should monitor and adjust benzodiazepine dosages accordingly.

4. **Psychosocial Aspects of Withdrawal:** Addressing withdrawal is not just about managing physical symptoms but also involves supporting the patient’s psychological well-being to enhance recovery success rates.

In this riveting episode of Cracking Addiction, Dr Ferghal Armstrong and Dr Richard Bradlow shed light on the complex issue of alcohol use and withdrawal, providing critical insights and practical guidance for individuals and healthcare professionals alike. The duo explores detailed diagnostic criteria and the implications of daily alcohol consumption and addresses the signs that might indicate a move towards severe withdrawal symptoms. Learn about the societal impacts of drinking norms and the misconceptions that might be putting individuals at risk without them even realising it. This episode uncovers the stark differences between casual drinking and potential alcohol dependence that could lead to serious health consequences.
**Learning Outcomes:**
1. Understand the varied patterns of alcohol withdrawal and how personal history affects its likelihood. Richard emphasizes the importance of individual patient history in predicting withdrawal symptoms such as seizures.

2. Discover the guidelines for safe alcohol consumption set by different governments and how they compare, highlighting discrepancies that might affect public health advice. Particularly, the comparison between Australian, Canadian, and American standards provides a global view of alcohol consumption benchmarks.

3. Recognize the clinical signs of alcohol withdrawal, applying both psychological and physiological markers, including the mnemonic PAST NIGHT (Psychomotor Agitation, Anxiety, Seizures, Terrors, etc.) proposed by Ferghal for easier recall during assessments.

4. Learn about the significant risks associated with ignoring other potential diagnoses when a patient presents symptoms similar to alcohol withdrawal, underscoring the necessity of comprehensive medical evaluation.