Addiction Medicine Made Easy | Fighting back against addiction

Casey Grover, MD, FACEP, FASAM
  • 4.9 (57)
  • MEDICINE
  • UPDATED MONTHLY

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. 3D AGO

    Wait… Weed Does That??? The Cannabis Side Effects Nobody Warned You About

    The story we’ve been told about cannabis—safe, simple, and mostly benign—doesn’t match what we’re seeing at the bedside. Two ER-turned-addiction doctors pull back the curtain on how high-potency products can quietly undercut psychiatric meds, complicate procedural sedation, and nudge recovery off course even when everything else looks better. This isn’t a panic piece; it’s a practical guide to staying safer and getting more from treatment. We start with psychiatry and a pattern that’s easy to miss: chronic cannabis use can upregulate ABC transporters along the gut, liver, and blood-brain barrier, pushing certain antipsychotics and mood meds out of cells faster and blunting their effect. What looks like “noncompliance” may be pharmacology. We talk through which agents lean on these transporters, which alternatives may perform better, and how to have a stigma-free conversation that protects trust while fixing the plan. Then we roll into the procedure room. Heavy cannabis use can decrease sensitivity to propofol and other sedatives by altering GABA activity and endocannabinoid tone, often requiring higher doses and tighter monitoring. Add a lesser-known risk—post-propofol hypersalivation in frequent users—and disclosure becomes a safety tool. We share exactly what to tell anesthesia, what clinicians can prepare for, and how to keep airways protected without surprises. Finally, we examine the “Cali sober” idea through data, not dogma. Large cohort studies link cannabis use to higher rates of alcohol recurrence and new substance use disorders over time, especially with potent concentrates. We cover why potency and pattern matter, how cannabis can dampen the gains of CBT, MI, and contingency management, and what a realistic harm reduction path looks like when abstinence isn’t the first stop. Throughout, we keep language careful—reported use, not admitted; return to use, not relapse—because words shape trust. If you care for patients, care about someone in recovery, or care about your own health, this conversation offers a clear framework: ask better questions, match meds to biology, and align goals to protect progress. Subscribe, share with a colleague or friend, and leave a quick rating to help others find the show. What did you learn that changes your practice—or your plan—today? Link to State by State Alternatives to California Sober: https://www.mcsweeneys.net/articles/local-alternatives-to-california-sober To contact Dr. Grover: ammadeeasy@fastmail.com

    53 min

  2. FEB 9

    Up All Night: How Drugs, Alcohol, and Recovery Disrupt Sleep—and How to Fix It

    Sleep doesn’t break because you forgot how to close your eyes. It breaks when anxiety trains your brain to stay on guard, and when quick fixes like alcohol, cannabis, or OTC sleep aids sedate you without restoring you. We team up with Australian psychologist and author Helen Dugdale to unpack how insomnia forms, why 3 a.m. wakeups become a habit loop, and the practical, evidence‑based steps that rebuild real rest—especially for people in recovery. Helen shares how anxiety sits at the core of most sleep problems and why the brain’s plasticity is our greatest ally. We dig into Cognitive Behavioral Therapy for Insomnia (CBT‑I) basics—aligning with circadian rhythm, setting simple pre‑bed routines, and replacing catastrophic thoughts with repeatable behaviors—and explore how Eye Movement Desensitization and Reprocessing (EMDR) calms trauma so sleep skills can finally land. Expect concrete tactics: caffeine cutoffs tied to bedtime, screen boundaries that don’t feel punitive, mantras that redirect attention, breathing and counting that occupy mental space, and progressive muscle relaxation you can run anywhere, even in a noisy room with the lights on. We also address the realities people with addiction face: unstable housing, tight budgets, caregiving, and long days that drain executive function. You’ll hear how to build micro‑habits that fit into crowded lives—thirty seconds while the kettle boils, one minute before starting the car, seven minutes as “0.5% of your day.” We talk timelines for progress, what to do on rough days when HALT hits, and how to bounce back from relapse without shame. The throughline is hope: you are worth the effort, and repetition rewires nights. If you’re ready to trade quick fixes for deep, durable rest, this conversation gives you a blueprint you can start tonight. Subscribe, share with a friend who needs better sleep, and leave a review with the one habit you’ll try first. Your feedback helps others find the show. To learn more about Helen's work: https://australianbraincoaching.com.au To contact Dr. Grover: ammadeeasy@fastmail.com

    47 min

  3. FEB 2

    Could This Device Change the Future of Addiction Treatment???

    What if opioid withdrawal could visibly ease in 20 minutes and cravings could drop to near zero within days? We sit down with Net Recovery CEO Joe Winston to unpack a wearable neuromodulation device, FDA-cleared for managing opioid withdrawal, that adapts to real-world drug trends and may restore a person’s ability to choose. Joe traces an unexpected journey from aerospace and AI to building a handheld system that translates complex waveform expertise into accessible care—and shares how rigorous trials and peer-reviewed data convinced skeptics. We dive into how the device works: gel electrodes behind the ears deliver patterned stimulation that dynamically shifts based on daily assessments of opioid, sedative, and stimulant withdrawal. As supplies change—think xylazine-adulterated fentanyl or emerging veterinary sedatives—the team retools waveforms to meet the moment. The results are striking: measurable relief within an hour, average treatment of three to four days, and early evidence that many patients reduce use of opioids and psychostimulants for months post-treatment, even without medication. That renewed agency becomes the catalyst for aftercare, longer residential stays, and more consistent engagement. Access and scale matter as much as science. We explore delivery in jails where Medicaid interruptions worsen withdrawal, residential programs, and new office-based addiction treatment designed for privacy and minimal life disruption. We also tackle safety and harm reduction—falling tolerance raises overdose risk if someone returns to old doses—and clarify patterns of lapse versus relapse observed in follow-ups. Beyond clinics, Joe lays out a bold public-health vision: statewide jail deployments measured against overdoses, all-cause mortality, and re-arrest. It’s a practical, humane plan to meet people where they are and move addiction care forward with data, transparency, and stories of real recovery. If this conversation resonates, follow the show, share it with a colleague, and leave a quick rating. Your support helps more people find evidence-based paths out of addiction. To Learn More about Net Recovery: https://www.netrecovery.net One of the studies Joe referenced in our interview: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1510428/full To contact Dr. Grover: ammadeeasy@fastmail.com

    44 min

  4. JAN 26

    How Ketamine Treats Depression, Anxiety, And PTSD

    Join us for this episode which is a fast, honest tour through what ketamine can actually do for mental health—without the hype. We sit down with addiction psychiatrist Dr. Mark Hrymoc to unpack where the evidence is strongest, who qualifies, and why IV ketamine often produces quicker relief than nasal esketamine when depression won’t budge. From treatment-resistant depression and acute suicidality to anxiety and PTSD, we dig into the protocols that matter: six-session inductions, customized maintenance, and practical strategies for measuring progress with tools like the PHQ-9. We pull back the curtain on how ketamine works at the receptor level—NMDA antagonism, downstream dopamine effects, and BDNF-driven neuroplasticity—and explain why dissociation may help some patients but isn’t required for benefit. You’ll hear how we screen candidates, manage blood pressure, reduce nausea, and set up sessions with eye masks, ambient music, and a nurse at the bedside so the experience is safe, focused, and grounded. We also get real about addiction risk, clarifying the difference between recreational use and a carefully monitored medical protocol, and how stable recovery timelines factor into clinical decision-making. For PTSD and anxiety, we explore pairing ketamine with psychotherapy and post-session integration to turn insights into change. We compare IV ketamine’s dosing flexibility with Spravato’s structured pathway, talk costs and coverage, and outline how to taper other meds only after sustained stability. Looking ahead, we spotlight promising research directions—from extending response with adjuncts to early signals for substance use disorders—and why interventional psychiatry is opening a much-needed chapter beyond traditional antidepressants. If you’ve wondered whether ketamine is a bridge or a destination, this conversation gives you a clear, practical map. Subscribe, share with a clinician friend, and leave a review to help others find evidence-based mental health care. To contact Dr. Grover - ammadeasy@fastmail.com

    45 min

  5. JAN 19

    Parents in Recovery: Navigating Sobriety While Raising a Family

    Parenting can sharpen joy and stress at the same time—and for moms and dads in recovery, that edge can test every habit that keeps sobriety strong. We sit down with Sarah Benton, licensed counselor, addiction specialist, and author of Parents in Recovery, to unpack how families can protect recovery without sacrificing the warmth and wonder of raising kids. From morning routines to packed weekends to those birthday parties where wine shows up next to the cupcakes, we get practical about limits, language, and the lifestyle choices that prevent burnout. Sarah explains why “recovery first” isn’t selfish—it’s the foundation that keeps everything else standing. We explore the high-functioning myth, where substances quietly enable overloaded schedules, and what happens when you remove the “checkout” at day’s end. Expect candid talk on right-sizing commitments, navigating the dip of post-acute withdrawal, and building a toolbox that actually works: therapy, meetings, peer support, and simple rituals for rest. We also dive into partner dynamics, from two parents in recovery to mixed households, and the education and respect that make those setups sustainable. Prevention gets the spotlight too. Genetics raise the stakes, and delaying a teen’s first drink past 15 meaningfully lowers risk. We share how to start honest conversations by middle school, present family history without shame, and set boundaries around alcohol and cannabis in social spaces. You’ll hear real-world scripts, ways to model “social battery” limits at home, and strategies to swap FOMO for intention. By the end, you’ll have a clear map for turning recovery into a steady family culture—one that keeps parents connected and kids grounded. If this conversation helped, follow the show, leave a quick review, and share it with someone who needs a practical, hopeful roadmap for parenting in recovery. To learn more about Sarah's work: www.bentonbhc.com www.waterviewbh.com To contact Dr. Grover: ammmadeeasy@fastmail.com

    39 min

  6. JAN 12

    Parallel Recovery: What If Helping Your Loved One With Addiction Begins With Healing You?

    What if helping someone you love through addiction starts with healing yourself? That single shift reframes everything—your boundaries, your tone, your scripts, and the way your home holds stress. Dr. Casey Grover sits down with family coach and author Lisa Katona Smith to unpack Parallel Recovery, a values-driven approach that gives families actionable tools and a steady process for change without the burnout of fixing or the coldness of detachment. Lisa shares how a personal crisis led her to blend educator skills, CRAFT principles, motivational interviewing, and trauma-informed strategies into a practical toolkit. We explore values and their shadow sides—how devotion without limits becomes resentment, and humor under pressure turns into sarcasm—and why clarity about who you want to be drives better boundaries. You’ll hear the “hamburger boundary” story, a low-stakes, high-impact example of retraining family dynamics; a phone-blocking repair script that turns punishment into invitation; and simple ways to separate the person from the behavior so conversations stay human. We also look at the reality of nervous systems under stress and why sustainable change means concepts over checklists: consistent limits you can keep, language that calms, and agreements on how to raise concerns after treatment so families don’t slip back into super-sleuth mode. Lisa explains why families are the first and final connection in recovery and how parallel support—one guide for the family, one for the person—reduces conflict and opens the door to readiness. If you’ve felt stuck between carrot and stick, this conversation offers a third path: redesign the relationship so change has room to grow. To learn more about Lisa and her work: https://lisakatonasmith.com/ To contact Dr. Grover: ammadeeasy@fastmail.com

    39 min

  7. JAN 5

    How Cold Immersion, Breath Work, Yoga, And Meditation Can Build Lasting Sobriety

    Cravings don’t wait for perfect conditions, so we need plans that work in real life. I sit down with coach Jason Lyle to unpack a grounded, nontraditional approach to addiction treatment that starts with the body and rewires the brain: cold water immersion, breath work, meditation, and yoga. This is recovery as nervous system training—practical tools that widen the gap between urge and action and put your prefrontal cortex back in the driver’s seat. Jason shares his path from ministry through sex addiction and despair to a repeatable method that helps men regulate first, then choose. We break down the science in plain language: why ice baths create a safe, high‑intensity rehearsal for impulse control; how Wim Hof‑style breathing builds micro‑seconds of space during cravings; and how a five‑minute, no‑frills meditation practice teaches you to see thoughts and let them go. We also show where yoga fits in—not acrobatics, but simple positions that let the body signal the brain and release tension before it becomes a decision you regret. Across the hour, we map a daily stack that takes 20–30 minutes and delivers fast results, plus what to expect at the two‑month plateau when the “new normal” feels unfamiliar. You’ll learn the three pillars Jason uses—honesty, curiosity, and self‑love—along with on‑demand regulation moves: a ten‑second breath reset, when to grab a cold shower, and why hard exercise can dump stress hormones when grounding isn’t enough. We also talk identity shifts, rewriting shame narratives with simple journaling and affirmations, and how small choices compound into a life you actually want to defend. If you’re a clinician, coach, or anyone navigating addiction, this conversation offers concrete steps and clear language to share with patients and peers. Explore Jason’s resources at thesacredgrit.com and his Sacred Grit Podcast for guided practices. If this resonated, follow the show, leave a review, and share it with someone who could use a stronger toolkit for recovery. Your next calm breath might be the start of a different day. To contact Dr. Grover: ammadeeasy@fastmail.com

    37 min

  8. 12/29/2025

    Quaalude, Black Beauties, and More: A History of Misused Prescriptions

    Vintage drug ads promised calm mornings, slimmer silhouettes, and instant relief from restless nights. We dig beneath the glossy slogans to unpack how Black Beauties, Quaaludes, Miltown, Barbiturates, and Purple Hearts shaped the path to today’s mediations—and what that history teaches us about safety, dependence, and withdrawal. With clear explanations of GABA, tolerance, and cross‑tapering, we connect old “uppers and downers” to modern clinical practice and the real risks people still face. I share why amphetamines jumped from diet pills to productivity boosters, how tranquilizers won hearts and airwaves, and why barbiturates’ direct receptor action made them both effective and uniquely lethal. We explore the strange logic of combining a stimulant with a sedative in a single pill, the concept of the therapeutic index that flipped prescribing habits, and the cultural pressure—often aimed at women—that fueled demand for daily sedation. You’ll hear how benzos improved the safety margin, where they still go wrong, and how clinicians now use careful tapers, screen for polysubstance use, and apply harm‑reduction strategies to prevent overdose. If you’ve ever wondered why some drugs vanished and others became standard, this deep dive brings context, clarity, and practical takeaways. You’ll walk away able to explain the difference between narrow and wide therapeutic indexes, why withdrawal from certain depressants is so dangerous, and how our field balances relief with risk. Subscribe, share with a colleague who treats anxiety or addiction, and leave a review with the one historical ad or insight that surprised you most. To contact Dr. Grover: ammadeasy@fastmail.com

    31 min
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About

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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