Addiction Medicine Made Easy | Fighting back against addiction

Casey Grover, MD, FACEP, FASAM
  • 4.9 (80)
  • Medicine
  • Updated Weekly

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. 6d ago

    Is Pure, High Dose, CBD Ready for the Prescription Pad?

    Most CBD products leave clinicians and patients guessing: unclear labels, inconsistent dosing, and the lingering worry of THC exposure. I’m Dr. Casey Grover, and as an addiction medicine physician I came into this conversation skeptical because I treat cannabis use disorder and I’ve seen how “cannabis-adjacent” products can go sideways in real life. Then I sat down with Pulak Sharma, founder and CEO of Kazmira Therapeutics, and Dr. Marwaha, an internal medicine physician, to dig into what changes when CBD is treated like a true medical therapy rather than a supplement. We talk about what “prescription-grade” CBD actually means, including 503A compounding standards, a vertically integrated process, and why THC-free purity matters for prescribing, drug testing concerns, and patient safety. Dr. Marwaha shares how he’s using high-dose pure cannabidiol as an adjunct for generalized anxiety and chronic pain, especially in older adults who can’t tolerate NSAIDs or who become confused or sedated on typical options like gabapentin or muscle relaxers. We also get practical about what to monitor: medication interactions, liver function tests, and the real-world side effects he sees most often, like drowsiness and nausea. We don’t dodge the evidence gaps. Instead, we discuss how structured outcomes tracking (think GAD-7 and PHQ-9) could build credible data around reduced reliance on benzodiazepines, opioids, and other higher-risk meds, and how telemedicine may expand access while keeping protocols consistent. We even explore what’s next, from nanoemulsion tech for faster onset to endometriosis pain and veterinary use where THC can be toxic to pets. Subscribe, share this with a skeptical friend, and leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com To learn more about Kazmira's work: https://www.kazmiratx.com/

  2. Sep 28

    We Use More Than One Medication To Treat Diabetes and Hypertension - Let's Do The Same for Alcohol Use Disorder!

    One-med-at-a-time sounds tidy on paper, but alcohol use disorder rarely behaves like a tidy problem. Dr. Reb Close and I sat down to discuss treating alcohol use disorder, and we’ve learned that many patients do better when we treat AUD the way we treat other chronic conditions: with a multimodal plan that targets more than one pathway and stays anchored to the person’s real reason for drinking.  We walk through how we think about combination medication strategies for alcohol cravings, including naltrexone, acamprosate, gabapentin, baclofen, and topiramate. You’ll hear the practical “why” behind pairing meds, how we set expectations for naltrexone response, and how targeted dosing can give patients more control during high-risk moments. We also talk about monthly extended-release naltrexone (Vivitrol) and how we approach add-on oral dosing without overdoing it.  Just as important, we keep coming back to the central clinical question: what does alcohol do for you? If drinking is driven by anxiety, insomnia, or trauma, the best AUD treatment may start with sleep, PTSD symptoms, nightmares, or triggers rather than another anti-craving pill. We close by zooming out to what best practice really looks like: therapy or groups, good sleep, nutrition, exercise, treatment of co-occurring mental health conditions, and more than one medication when it fits.  Subscribe for more practical addiction medicine, share this with a clinician or friend who cares about recovery, and please leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmailcom

  3. Sep 21

    We Didn't Start the Fire — But We're Burning Out

    Burnout doesn’t always announce itself with a crash. Sometimes it creeps in while you’re still achieving, still leading, still doing “all the right things” until you notice you’re dreading shifts, snapping at people you love, or feeling numb with patients. That’s where our conversation goes, with James Maskalyk, an emergency physician in downtown Toronto, the first wellness director in his division, and someone who has helped bring emergency medicine training and wellness thinking to Ethiopia. We get honest about what high-stress healthcare work does to the body and mind: shift work, chronic cortisol, trauma exposure, PTSD, and the subtle slide into depersonalisation. We also talk about the system problem, not just the individual problem, when pay and performance are tied to throughput instead of the quality of care and the humanity of the clinician. Along the way, we share the moments that changed how we see “wellness,” including the realization that medicine is an act of empathy and you can’t pour from an empty cup. Then we move into practical, real-world tools: taking meaningful time away (including month-long sabbaticals), creating space inside the ER for small moments of connection, building peer support, and doing debriefs that help teams process what they just lived through. We also discuss journaling, creative work, and therapy as ways to build vocabulary for what you’re carrying so you can make changes earlier, not years later. If this resonates, subscribe, share it with a colleague, and leave a review so more healthcare workers can find it. To contact Dr. Grover: ammadeeasy@fastmail.com Dr. Maskalyk's substack: https://jamesmaskalyk.substack.com/

  4. Sep 14

    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

  5. 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

  6. 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

  7. 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

  8. 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

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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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