Addiction Medicine Made Easy | Fighting back against addiction

Casey Grover, MD, FACEP, FASAM
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Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us. *This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*

  1. 1d ago

    Does Letting Your Teen Drink at Home Prevent Drug and Alcohol Problems?

    The idea sounds caring and practical: if my teen is going to drink anyway, I’d rather it happen at home where I can supervise it. I’m Dr. Casey Grover, and after years in emergency medicine and now addiction medicine, I keep hearing this “safe at home” approach framed as a way to teach responsible drinking and prevent future addiction. The problem is that good intentions are not the same as good outcomes, and the research on parental permission is far less comforting than most families expect.  We walk through six studies that directly test whether allowing underage alcohol use (and the same logic often applied to cannabis) provides a protective effect. Across surveys and longitudinal data, the pattern points in one direction: permissive attitudes and permission to drink at home are associated with more frequent use, higher quantities, and more alcohol-related harms later on. We dig into findings on teens drinking without parental knowledge, the risk of alcohol being taken from the home, and how early “sips” or “tastes” can predict heavier drinking in late adolescence even after controlling for other factors.  We also get practical about what helps. The evidence supports clear boundaries, consistent discipline around drinking, and direct communication about risks. One of the most sobering insights is how often parents underestimate how much teens drink, especially when parents believe that controlled access at meals is protective. If you’re a parent, caregiver, clinician, or student, you’ll leave with concrete takeaways you can use in real conversations at home and in the clinic.  If this was useful, subscribe, share it with someone raising a teen, and please leave a review so more people can find Addiction Medicine Made Easy. Huge thanks to Central Coast Overdose Prevention for supporting the show, and remember: treating addiction saves lives. To contact Dr. Grover: ammadeeasy@fastmail.com

  2. Sep 7

    Skip The Strip: Talking Direct to Inject for OUD With Dr. Reb Close

    Getting someone from fentanyl to buprenorphine can be one of the hardest transitions in addiction medicine, and not because people “don’t want it.” The pharmacology is unforgiving: start too soon and precipitated withdrawal can hit fast, loud, and memorable enough that patients never want to try bupe again. We sit down with Dr. Reb Close to talk through a newer approach that’s gaining traction, Direct To Inject (DTI), and what it looks like when you actually do it in the real world.  We explain why fentanyl’s long tail changes everything, then map the options we offer patients: macrodosing, microdosing with a cross taper, microdosing without a cross taper, and DTI. You’ll hear how DTI uses a weekly long-acting injectable buprenorphine dose that comes on over about 24 hours, effectively creating a built-in “microdose ramp” while the patient navigates that first day. We also get specific about comfort meds, safety counselling, and how we handle the common moment where someone feels terrible but hasn’t taken any of the meds meant to help.  From street-based care to clinic workflows, we share what withdrawal severity looks like across patients, when DTI is not a good option, how we think about methadone switches, and why we often push toward high-dose monthly injectable buprenorphine for a longer protective tail. If you care about practical fentanyl-era buprenorphine induction, retention, and overdose prevention, this one is for you. Subscribe, share with a colleague, and leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com

  3. Aug 31

    Sober Living Explained

    Walking out of treatment can feel like being dropped right back into the fire: the bills are higher, relationships are still strained, triggers are everywhere, and the old “solution” of numbing out is suddenly right there again. We wanted a clearer answer to a common question from patients, families, and clinicians: what is sober living, and how does it actually help? I sit down with Gerald Lott, host of the Seeds of Recovery podcast, author, and executive director of Sauk Valley Voices of Recovery in Illinois. Gerald breaks down sober living as real-life practice with guardrails: peer-led structure, house rules, curfews, chores, and meeting requirements that taper over time. We also talk about the differences between a recovery home (treatment without walls), sober living, Oxford House style models, and why it’s essential to vet programmes carefully because predatory sober homes do exist. A huge thread running through our conversation is connection. Gerald explains why recovery built only on shared trauma can fade as you stabilise, and how “tribe” and affinity groups like sports, music, fishing, running, art, and service can keep connection growing in long-term recovery. We get practical about life skills too: budgeting, work routines, repairing relationships, and how recovery coaching turns big goals into weekly steps. If you care about addiction recovery, relapse prevention, sober living programmes, or how peer recovery specialists support lasting change, this one is for you. Subscribe, share with someone who needs a next step after treatment, and leave a review so more people can find the show. * Note * - there is some adult language in this episode To contact Dr. Grover: ammadeeasy@fastmail.com

  4. Aug 24

    Ozempic Goes to Rehab: GLP-1s for Addiction

    GLP-1 medications are everywhere right now, and not just because people are losing weight. We’re starting to see something far more interesting for addiction medicine: semaglutide may reduce alcohol cravings and heavy drinking, and early data hints it could influence other compulsive behaviors too. I recorded this talk after giving it as a lecture to my colleagues, and it’s one I’ve wanted to share for a long time because the science is moving fast and the clinical questions are piling up. We walk through what GLP-1 drugs actually are, how gut hormones like GLP-1 and GIP shape appetite, digestion, and glycaemic control, and why side effects like nausea and bloating are so common. I also clear up the most confusing practical point patients run into: Ozempic versus Wegovy and Mounjaro versus Zepbound are often the same molecules labelled for different indications, and insurance coverage usually follows those rules. Then we get into the addiction evidence. I review three recent randomized controlled trials from 2025 to 2026 studying semaglutide for alcohol use disorder, including injectable and oral versions. The results aren’t magic, but they’re meaningful: fewer drinks on drinking days, fewer heavy drinking days, and lower craving scores compared with placebo, plus secondary findings that raise new research questions about nicotine and cannabis. Finally, I share two de-identified patient cases that show why GLP-1s can be a game-changer for some people and only a small nudge for others, especially when depression, grief, anxiety, or PTSD is the true engine behind drinking. If this helped you think differently about recovery tools, subscribe, share the show with a colleague or friend, and leave a review so more people can find it. To contact Dr. Grover: ammadeeasy@fastmail.com

  5. Aug 17

    The Most Effective Stress Relief You Should Never Use

    In this episode, Dr. Grover sits down with his daughter to discuss some of the more subtle aspects of quitting smoking. If you're wondering why it was his daughter, well - she was home when the recording was happening and it just felt right.  Smoking isn’t just nicotine, it’s a whole stress ritual hiding in plain sight. We’ve both seen it: someone can do the brutal work of getting sober from alcohol or stopping opioids, yet cigarettes or vaping stay glued to their day. So we slow down and ask a more honest question: if nicotine gum, lozenges, and patches can cover withdrawal, why does quitting smoking still take so many serious attempts? We break nicotine dependence down in plain language, including why nicotine can feel like both an upper and a downer, what nicotine withdrawal looks like, and how nicotine replacement therapy fits into a real smoking cessation plan. Then we get into the part people rarely name: the behavioral addiction. The hand-to-mouth routine becomes automatic, and the body starts craving the motion and timing just as much as the chemical. From there we lay out three hidden reinforcers that make smoking and vaping feel calming: paced breathing that works like an anxiety exercise, the built-in permission of a smoke break, and the walk away from people that restrictions and stigma often force. We also connect this to early recovery and post-acute withdrawal syndrome (PAWS), when the brain is already dysregulated and anxiety can run high at work. If quitting removes your breathing, breaks, and escape all at once, of course cravings surge. Listen for practical ways to replace the ritual without keeping the smoke: schedule breaks on purpose, keep the walk, practice box breathing, and use evidence-based supports when needed. If this helps you or someone you love, subscribe, share the episode, and leave a review so more people can find it. To contact Dr. Grover: ammadeeasy@fastmail.com

  6. Aug 11

    What Do You Do With the Patient Using Everything? (Rebroadcast)

    Polysubstance use is where addiction medicine stops being a single-problem visit and becomes real clinical triage. When someone is using alcohol, fentanyl, methamphetamine, benzodiazepines, cannabis, nicotine, and whatever else is in the supply, the hardest part is not naming the diagnosis, it’s deciding what to treat first and how to do it safely. We brought back a remastered conversation with Monterey addiction physician Dr Lee Goldman to walk through the thinking that keeps patients alive and keeps clinicians from getting lost in overlapping symptoms. We talk through how we build the “priority list” using the patient’s own reason for coming in, the dysfunction the substance is causing, and objective tools like urine toxicology while remembering that some sedatives may not show up. Dr Goldman explains why alcohol withdrawal risk often rises to the top, how fentanyl changes buprenorphine inductions through precipitated withdrawal, and why unknown medications like Soma or unmentioned methadone can derail an otherwise solid plan. You’ll hear why many clinicians stabilise one withdrawal syndrome at a time, and what harm reduction looks like when “stop everything today” is not realistic. We also get honest about the messy questions: what does sobriety mean when someone says they’re “sober” but still using cannabis, benzodiazepines, or kratom? How do residential, partial hospital, IOP, and outpatient settings change what we can require and what we can monitor? Why is nicotine so normalised in recovery spaces, and when is the right time to address it? Dr Goldman makes a strong case that benzodiazepines may be the toughest substance to treat, especially with anxiety and PTSD in the background, and we close with what’s changing in drug mixes and where behavioural addictions may be heading next. Subscribe to Addiction Medicine Made Easy, share this with a colleague, and leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com

  7. Aug 3

    Ibogaine: A Miracle Cure for Addiction?

    Ibogaine is being talked about like a moonshot for addiction treatment and mental health. But when a substance is powerful enough to reshape cravings, mood, and perception, it is also powerful enough to hurt people when the science and safety systems lag behind. This is Dr. Casey Grover and Addiction Medicine Made Easy, and this is a recording of a lecture that digs into what ibogaine is, why it’s back in US headlines, and how real people are already accessing ibogaine clinics just across the border. We walk through a cautionary story of a patient told she was “cured,” only to relapse immediately, and use that to underline a central point: no single intervention replaces a durable recovery plan. You’ll hear a clear, clinician-friendly breakdown of ibogaine’s proposed mechanisms across multiple brain pathways (dopamine, serotonin, NMDA, opioid receptors, and more), what the ibogaine experience is typically like across its phases, and why this psychedelic therapy is not “benign.” We spend serious time on ibogaine safety, including QT prolongation, torsades de pointes, ventricular tachycardia, and how underlying heart conditions or mixing substances can turn treatment into tragedy. Finally, we get geeky about evidence. We explain the different types of research studies, why “the plural of anecdote is not data,” and what the best available studies actually show for cravings, opioid withdrawal, PTSD, depression, and cocaine use. If you’re considering ibogaine for opioid addiction, ibogaine detox, or ibogaine for PTSD, we close with practical guidance on what we recommend today: medication assisted treatment like buprenorphine, methadone, or naltrexone, plus groups and individual therapy, with any experimental route followed by standard recovery work. Subscribe, share this with someone who’s curious about ibogaine, and leave a review so more people can find careful, compassionate addiction medicine.  To contact Dr. Grover: ammadeeasy@fastmail.com

  8. Jul 27

    Getting Sober Is Hard. Bipolar Disorder Makes It Harder

    You can look put-together, build a big career, and still be drowning the moment the door closes. That tension sits at the heart of our conversation with Louise Barnett, host of the Unmasking Sobriety and Mental Health Podcast and author of Tainted Love: A Bipolar Memoir. She walks us through what it feels like when bipolar I disorder first shows up, why it can take years to get the right diagnosis, and how shame quietly pushes people toward secrecy, self-harm, and substance use. We talk honestly about addiction and bipolar disorder as a linked story, not two separate problems. Louise explains how alcohol and drugs played different roles across the mood spectrum: amplifying the invincible energy of mania, then numbing the crash of depression. She also shares what it meant to be “high functioning” in public while blacking out at night, and why appearance and performance can accidentally protect the illness from being seen. The most practical part of this conversation is what stability looks like now. Louise breaks down the pillars that keep her regulated, including medication, therapy, lifestyle, sobriety, nervous system regulation, and emotional regulation, plus the boundaries that protect her energy as a parent and a creator. She leaves us with a simple, powerful invitation: find your people and start telling the truth, one safe step at a time. Subscribe for more conversations at the intersection of mental health and addiction recovery, and if this resonates, share it with a friend and leave a rating or review. To learn more about Louise's work: https://www.louisebarnett.com/ To contact Dr. Grover: ammadeeasy@fastmail.com To learn more about the podcast: https://www.addictionmedicinemadeeasy.com/

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Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us. *This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*

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