A practical and evidence-based podcast on how to think about, diagnose, and treat substance use disorders in the Emergency Department and Acute Care. Why? One American dies every 6 minutes from a drug overdose, and one American dies every 5 minutes from excessive alcohol use. As many as 64% of adult Emergency Department (ED) patients meet criteria for problematic substance use. Patients with untreated substance use are 81% more likely to require admission when they come to the ED. We need to learn more and do better in treating substance use in the acute care setting.
Episode 36 - What labs can you use to assess alcohol use? (follow up to Episode #27)
A follow up to Episode #27 on labs and alcohol use disorder. So you're at work and you have a patient who you're pretty convinced has an alcohol use disorder, but you're not sure which test you should order to assess their alcohol use. LFTs? Carbohydrate deficient transferrin? Ethyl glucuronide? Phosphatidylethanol? In this episode we take another look at lab tests that can help you with your assessment of patients who use alcohol...including some lab tests that you probably have never heard of (but might find useful)
BONUS EPISODE - The Non-Opioid Management of Renal Colic
A bonus episode! This isn't really on the topic of addiction...but it does involve opioid sparing and alternative to opioid treatment protocols (and avoiding a new start of opioids may prevent someone from developing opioid dependence or opioid use disorder).
I put together a lecture on the non-opioid management of renal colic a few months back. I thought the topic was really useful, so I presented it to the docs that I work with where I practice as a part of our monthly physician education. I literally just recorded my presentation with my iPad while I was giving the lecture to my group (thus the lousy audio...my apologies). In any case - I hope you find this lecture helpful. I review non opioid pain management of renal colic in detail, including NSAIDs, lidocaine infusions, antispasmodics, and tamsulosin.
Episode 35 - Hallucinogen Intoxication
How much do you know about hallucinogens? Do you know the differences between LSD, psilocybin, and MDMA? In this episode we review hallucinogens as a general class of drugs, specific hallucinogenic drugs, and how to manage the acutely intoxicated in the ED and acute care setting.
Episode 34 - An Overview of Methamphetamine Use Disorder
Given how prevalent methamphetamine use is, this topic is WAY overdue. In this episode we take a broad look at methamphetamine use disorder - how methamphetamine affects the brain, the clinical features of methamphetamine use disorder, and how to treat methamphetamine use disorder.
Episode 33 - Methamphetamine Psychosis
You just had a patient arrive via ambulance on an involuntary hold who is clearly psychotic. As the paramedics are giving report, you hear that the patient was found using methamphetamine on scene. So...is this schizophrenia? Or is it meth psychosis? Can you tell the difference? In this episode, we do a deep dive into methamphetamine psychosis, to review the clinical features, prognosis, risk factors, and treatment - including a discussion of the differences between primary psychotic disorders and methamphetamine induced psychosis.
Episode 32 - The "Drug-Seeking" Patient and why it's time to retire the term "Drug-Seeking"
This episode is on the topic of the label "drug-seeking" that is often given to patients. Dr. Grover reviews a clinical case and reviews a perspective piece written on this topic. How would you handle a patient in pain who has an allergy to multiple medications, is refusing non-opioid options, and is asking for morphine? Is it addiction? Severe pain? Or is the patient in withdrawal? In this episode we delve into the complex and nuanced topic of the so-called "Drug-Seeking" patient.
Much needed info!
Real Life Experience
I have had the pleasure of learning from Doctor Casey Grover in person. The science behind drug addiction and the way he relays it clearly and passionately is encouraging and brings hope to a dark, dangerous epidemic. If it is possible to spread the science and knowledge to more people (like myself) who are stuck in their addiction, we may start to see them get help and get clean. I want to share what I learned here to anyone who will listen. I finally have the information I needed to fight back against my own addiction. This is a life saving podcast. A life changing Doctor. No doubt in my mind. Thank you Doctor Casey Grover.
Really great podcast. We in the EM world who are interested in substance use and addiction are few and far between, so I was quite excited to find this podcast! GREAT, evidence-based, and practical episodes. I’ve used information from this podcast in residency didactics I’ve delivered. I think this podcast will become more popular as engaging persons who use drugs and treatment of substance use disorders becomes the standard of care in the ED. Thanks for this.
- (Senior EM Resident)