The Saving Dose

John Hsu & William Pedranti
  • 5.0 (4)
  • Medicine

The podcast for those building the future of healthcare. A clinician, a healthcare attorney, and a behavioral health executive on what's actually working in addiction, adherence, and the capital reshaping both.75% of patients do not take medications as prescribed. 125,000 Americans die from it every year. $528 billion in preventable costs trace directly to a gap the healthcare system has known about for decades and never closed: what happens after the prescription is written. The Saving Dose is a podcast about that gap, the space between the clinic visit and the outcome, between the evidence-based treatment and the patient who never receives it, between the innovation that works and the reimbursement system that decides whether anyone can afford to deliver it. Hosted by Dr. John Hsu, and William Pedranti, the show brings together a behavioral health revenue strategist, an addiction medicine physician, and a biotech entrepreneur to go inside the clinical, operational, and commercial realities of addiction recovery, medication adherence, opioid use disorder (OUD), and behavioral health. Three different vantage points on the same broken system. Honest about what fails, specific about why, and direct about what a real fix requires. Topics include: addiction, addiction recovery, MOUD and MAT clinic operations, medication-assisted treatment adherence, behavioral health reimbursement, opioid use disorder treatment, payer contracting, DEA compliance, FFS-to-value-based care transitions, and the patient adherence gap in controlled substance prescribing. The Saving Dose is for investors evaluating the addiction recovery and behavioral health infrastructure market. For clinic operators and executives running opioid treatment programs, MOUD practices, and behavioral health facilities. For clinicians in addiction medicine and pain management. For payers and administrators navigating the cost and risk of behavioral health coverage. New episodes every two weeks. Available on Spotify, Apple Podcasts, YouTube, and wherever you listen.058171

  1. 4d ago

    What the UK Got Right About Addiction | The Saving Dose Ep. 14 Ft. Mark Gilman

    Mark Gilman has worked inside the opioid crisis from every angle for more than 40 years: as a researcher, a policy architect, a commissioner, a clinician, and a patient. He designed the Through the Gate program for NHS England, which put medication-assisted treatment inside prisons and continued it through release. He helped build the harm reduction infrastructure that prevented the UK's HIV response from becoming a second catastrophe. He started self-medicating at 12 after his father's death, spent years navigating addiction before going to university, and built a career dedicated to fixing the systems that had failed him. In this conversation with Dr. John Hsu, Mark makes the case that the United States already has the evidence it needs. The question is whether it will use it. What they cover: The UK's 1981 brown powder heroin epidemic and why unemployment, displacement, and loss of identity drove addiction rates more than drug availabilityWhy policing a drug market is like standing on a balloon: push it down in one place, it pops up somewhere else, because the markets are demand-ledHow harm reduction began as a peer-led self-help movement with no government support and became national policy when Margaret Thatcher's government decided HIV was a greater threat than drug misuseThe abstinence-without-medication success rate: 2 to 7 percentWhy people are 129 times more likely to die in the two weeks after prison release in the US, and 25 times more likely in the UK, and what the Through the Gate program does to close that windowThe Retox concept: stabilizing people on MOUD inside prison so medication continues seamlessly from the prison gate into the communityHeroin-assisted therapy and the Basel model: patients in Switzerland can choose between injectable diamorphine, a nasal spray, or a 200mg tablet, and early observations show a shift toward the tablet because what people actually want is jobs, homes, and friendsThe subset of patients, less than 10%, with severe trauma histories for whom buprenorphine doesn't work because greater cognitive clarity brings the trauma backStigma inside the recovery community itself, including 12-step fundamentalists who tell people taking ADHD medication that they've relapsed, and why Mark argues that internal cultural stigma causes more damage than state stigmaVietnam veterans: 25% of soldiers became heroin addicts during the war; 85 to 90% simply stopped when they came home to jobs, homes, and a sense of purposeThe biopsychosocial model and the case for adding a fourth dimension: spiritual, meaning a sense of meaning and purpose, not religion specificallyChapters: [00:00] Introduction and Mark's background [01:01] Self-medicating at 12 after his father's death [01:42] University, two degrees, and entering the field [02:09] The six elements of OUD: research, policy, practice, commissioning, providers, and patient [03:22] The UK's 1981 brown powder heroin epidemic [05:26] Pain, unemployment, and displacement as the drivers of addiction [06:48] Why policing drug markets is like standing on a balloon [08:52] Harm reduction as a peer-led self-help movement [10:07] How Thatcher's Conservative government pragmatically backed harm reduction [13:36] Recovery requires more than medication: jobs, friends, and houses [15:30] The abstinence-without-medication success rate: 2 to 7% [17:59] The history of diamorphine prescribing in the UK since 1926 [19:59] Buprenorphine and the subset it doesn't serve [21:11] Heroin-assisted therapy and the Basel model [23:05] Stigma from OUD's history as a moral or criminal failing [24:31] NIMBY: why clinics end up on the wrong side of town [25:02] Stigma inside recovery communities: ADHD medication and 12-step fundamentalism [27:01] Four decades of the US opioid epidemic and the case for looking outward [28:43] Prison, recidivism, and the 75% three-month return rate [31:22] The two-week death window after prison release: 25x in the UK, 129x in the US [32:32] Through the Gate: seamless handover at the prison gate [33:04] The two pathways in prison: abstinence-based or MOUD stabilization [36:01] Why short sentences create a revolving door of detoxification and death [39:08] The growing crisis of meaning and ketamine among young people [40:00] Vietnam veterans: most stopped using when they came home to a life [42:27] Dignity, the diversion concern, and the Basel diamorphine tablet options [46:21] The final question: what would you change from your early career? [47:27] The biopsychosocial model and the case for a fourth dimension: spiritual [48:15] John's patient who found meaning in a peer support group at a church [49:51] Closing Connect with Mark Gilman: LinkedIn: https://www.linkedin.com/in/mark-gilman-0597012b/ About The Saving Dose: The Saving Dose is a podcast about what it actually takes to close the gap between the medication adherence crisis and the patients who need care. Hosted by Dr. John Hsu, an anesthesiologist and pain management physician with 25 years of experience, and William Pedranti, a healthcare attorney and biotech operator who has taken companies from founding through FDA approval and commercial exit. New episodes every Tuesday. Subscribe on Spotify, Apple Podcasts, and YouTube. The Saving Dose is produced by iPill Adherence Tech Services. All content is for educational and informational purposes only and does not constitute medical advice.

  2. Sep 29

    How Stigma Keeps People from Getting Help | The Saving Dose Ep. 13 Ft. Melissa Shackleford

    Melissa Shackleford has been in addiction recovery for 37 years. She got sober as a college freshman, went on to spend a decade as SVP of Marketing at Hazelden Betty Ford, and built a career at the intersection of healthcare marketing and behavioral health. She is a TEDx speaker, Amazon #1 bestselling author of Harnessing Purpose, and founder of Shackleford Strategies. In this conversation with Dr. John Hsu and William Pedranti, Melissa breaks down why stigma is not just a cultural problem but a clinical one. She's seen it from both sides: as a person in long-term recovery and as the marketing executive who had to fight to remove stigmatizing language from Hazelden's own outreach materials. What they cover: Why the language we use determines whether someone seeks help or disappearsThe person-first language shift and why it matters beyond addictionThe Gallup and Shatterproof stigma studies and what the data reveals about how little has changedWhy doctors call OUD patients "difficult" when no one says that about diabetics who won't follow their dietThe buprenorphine shame problem inside 12-step recovery communitiesMedicaid's 8-to-9-month wait for OUD treatment and who loses their life in that windowWhy pharmacies refusing to stock MOUD medications is a form of stigma with real body countsWhat Hazelden Betty Ford got right about messaging: lead with hope, not shockJohn's La Joya house: giving six bedrooms to a sober living facility because no neighborhood wants treatment next doorThe one change Melissa asks every doctor, pharmacist, and family member to makeChapters: 00:00 Introduction and Melissa's background 02:30 Getting sober at 18: what that looked like 05:00 Why person-first language is not political, it's medical 08:00 The parking lot pill count story (and what it says about how we treat patients) 10:00 Stigma inside the recovery community: buprenorphine and 12-step 15:30 MAT stigma and the barriers it creates 17:00 Medicaid pays 80% of OUD treatment, then makes patients wait 9 months 18:40 John's sober living house and the "not in my backyard" problem 20:00 Why OUD patients are labeled "difficult" when no chronic condition patient is 22:00 Long-term MAT: the three schools of thought 24:00 How the drug supply changed: from prescription opioids to fentanyl-laced everything 25:00 Treating the body and the mind: why medication alone is not recovery 26:00 MAT and the work requirement trap: losing Medicaid means losing medication 28:00 Pharmacies that refuse to stock MOUD medications 28:44 These medications reduce overdose-related death by more than 50% 31:00 OUD providers keeping secret lists of pharmacies that will fill prescriptions 32:00 Trust as the currency of healthcare 33:00 Hazelden's messaging strategy: pull out stigmatizing imagery entirely 35:00 People call treatment centers on the worst day of their life 37:00 The one thing to change: use person-first language 40:00 Addiction is not a choice, it's not a moral failing 41:00 Cancer has pink ribbons. Why does addiction still carry shame? 43:00 About Shackleford Strategies and how to connect with Melissa 44:10 Closing Connect with Melissa Shackleford: LinkedIn: linkedin.com/in/melissashackleford Website:  https://melissaforsshackelford.com/ About The Saving Dose: The Saving Dose is a podcast about what it actually takes to close the gap between the medication adherence crisis and the patients who need care. Hosted by Dr. John Hsu, an anesthesiologist and pain management physician with 25 years of experience, and William Pedranti, a healthcare attorney and biotech operator who has taken companies from founding through FDA approval and commercial exit. New episodes every Tuesday. Subscribe on Spotify, Apple Podcasts, and YouTube. The Saving Dose is produced by iPill Adherence Tech Services. All content is for educational and informational purposes only and does not constitute medical advice.

  3. Sep 22

    The Drug That Can Make Pain Worse | The Saving Dose Ep. 12 Ft. Prof. Patrice Forget

    In the twelfth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Professor Patrice Forget, a Belgian anesthesiologist and pain researcher now based in the United Kingdom. With more than 250 peer-reviewed publications, Professor Forget chairs the PANDOS research group (Pain and Opioids After Surgery) at the European Society of Anesthesiology and Intensive Care, serves as a board member and honorary treasurer of the European Pain Federation, and is deputy editor-in-chief of the European Journal of Anesthesiology. His work bridges clinical practice, large-scale epidemiology, and policy at the intersection of post-operative pain management, opioid use, and long-term outcomes. This episode goes further into the clinical science of opioids than any conversation The Saving Dose has had. Professor Forget challenges assumptions that have shaped prescribing practice for decades, including the idea that more opioids during surgery means less pain after it. 00:00 Introduction 02:06 Professor Forget's background and path from Brussels to the UK 04:00 How fentanyl was developed in Belgium and what it was originally designed to do 07:15 Opioid-induced hyperalgesia: what it is and why it matters 10:00 The Liverpool technique and the history of balanced anesthesia 12:00 Why large doses of opioids can increase pain sensitivity rather than reduce it 16:00 The preemptive analgesia theory and why the data rejected it 20:00 How not all patients respond to opioids the same way 24:00 What European post-surgical data shows about long-term opioid outcomes 28:00 The gap between what research shows and what policy assumes 32:00 Opioid stewardship and responsible prescribing in a post-crisis environment 38:00 John on cardiac anesthesia and the clinical reality of high-dose opioid use 44:00 What the field still does not know and where research is heading 50:00 What better perioperative pain management could mean for addiction prevention About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch.  William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit.  About the Guest Professor Patrice Forget is a Belgian anesthesiologist and pain researcher based in the United Kingdom. He chairs the PANDOS (Pain and Opioids After Surgery) research group at the European Society of Anesthesiology and Intensive Care and serves as a board member and honorary treasurer of the European Pain Federation. He is deputy editor-in-chief of the European Journal of Anesthesiology and a past president of the Belgian Pain Society. He has authored more than 250 peer-reviewed publications on perioperative epidemiology, clinical pharmacology, and opioid stewardship. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. If you or someone you know is struggling with substance use disorder, contact SAMHSA's National Helpline at 1-800-662-4357. Free, confidential, 24/7. #ChronicPain #OpioidCrisis #PainManagement #AddictionRecovery #TheSavingDose #OpioidInducedHyperalgesia #Anesthesiology #PeroperativeCare #OpioidStewardship #SurgicalPain #PainMedicine #Buprenorphine #SubstanceUseDisorder #HealthcarePodcast #EuropeanPainFederation #PANDOS #OpioidPolicy #AddictionMedicine #ChronicPainManagement #PublicHealth

  4. Sep 15

    Inside the White House Drug Policy Office | The Saving Dose Ep. 11 feat. Rob Kent

    In the eleventh episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Rob Kent, former General Counsel at the White House Office of National Drug Control Policy under the Biden administration and a 30-year veteran of New York state government drug policy. He now runs Kent Strategic Advisors, working with treatment providers, advocacy groups, and think tanks to navigate regulators and insurance companies. Rob is one of the few people in this conversation who has been inside the machinery of federal drug policy and is now free to say exactly what he thinks about how it works and where it fails. This episode is the most policy-focused conversation The Saving Dose has had, and it does not pull punches. This episode covers the X-waiver elimination and why removing the barrier did not move prescribing numbers the way anyone hoped, why harm reduction is still the third rail of drug policy, what the Biden administration actually accomplished in its first 18 months before reelection politics took over, why the opioid settlement billions are being misspent in ways Rob believes are worse than the tobacco settlement errors, and what it looks like when an insurance company tells you a person who barricaded themselves in a hotel room and drank the entire minibar did not meet the criteria for inpatient care. 00:00 Introduction and Rob Kent's background 02:06 Growing up in Syracuse, 30 years in New York state government, White House ONDCP 04:00 What the Office of National Drug Control Policy actually does 05:32 What the Biden administration focused on: harm reduction, X-waiver, jails and prisons 06:49 The biggest challenges: Congress, stigma, and the politics of harm reduction 08:33 Why the first 18 months are the window and what happened after 10:11 The X-waiver: what it was, why it mattered, and what eliminating it did and did not do 12:54 Why removing the barrier was not enough without incentivizing prescribers 14:44 John on the X-waiver limiting him to 25 patients and killing the business model 16:23 Telehealth and buprenorphine: how COVID blew the door open and what the DEA is doing now 18:36 Why too many policymakers still believe addiction is a choice 20:03 Proving it works versus winning hearts and minds: Rob's policy approach 20:40 OUD as a lifelong condition: why policy needs to treat it like high blood pressure 26:00 Medicaid work requirements and what they mean for people in recovery 28:47 The opioid settlement billions: why Rob believes the money is being wasted 30:16 The death rate dropped 37% after CDC loosened prescribing restrictions in 2022 31:14 Opioid dependency versus opioid use disorder: two diseases, one stigma 33:06 What the Biden CMS guidance on Medicaid in jails actually did 34:41 Why guards are the happiest people when MAT is offered in correctional facilities 36:33 New York's seven-day acute supply law and what happened when a pain clinic was shut down overnight 38:01 How policy swings from one extreme to the other instead of legislating in the middle 38:29 John on the 1999 pain as a fifth vital sign movement and what it started 42:01 How the Joint Commission and reimbursement incentives built the opioid crisis systemwide 43:29 Physicians stopping opioid prescribing entirely out of fear of monitoring 44:19 Tylenol and Motrin after a total knee replacement: John on the prescribing overcorrection 49:34 Insurance clawbacks: John receives a bill for a patient who died six years after treatment 50:17 Rob on insurance companies and where the money in the system actually goes 51:04 Kent Strategic Advisors: what Rob does now and who he works with 54:05 The insurance company that said a person who barricaded themselves in a hotel room did not need inpatient care 55:15 William's experience attending an addiction recovery meeting and why everyone should go About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/ William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/ Kendra Allen is the CRO of iPill with 20 years in behavioral health revenue strategy, payer contracting, and regulatory navigation. She founded and exited a national healthcare consulting firm. Connect with Kendra: https://www.linkedin.com/in/kendra-allen-cro/ About the Guest Rob Kent is a former attorney and government official with 30 years of experience in New York state drug policy and addiction recovery. He served as General Counsel at the White House Office of National Drug Control Policy under the Biden administration, where he worked on the X-waiver elimination, harm reduction policy, and expanding MAT access in jails and prisons. He now runs Kent Strategic Advisors, working with treatment providers, advocacy groups, and think tanks on drug policy, insurance disputes, and regulatory navigation. He speaks in a personal capacity. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. If you or someone you know is struggling with substance use disorder, contact SAMHSA's National Helpline at 1-800-662-4357. Free, confidential, 24/7. #OpioidPolicy #AddictionRecovery #OpioidUseDisorder #BehavioralHealth #TheSavingDose #HealthcarePodcast #DrugPolicy #HarmReduction #MOUD #Buprenorphine #OpioidSettlement #PublicHealth #AddictionMedicine #SubstanceUseDisorder #WhiteHouse #ONDCP #MedicaidPolicy #CriminalJusticeReform #OpioidCrisis #RecoveryPodcast

  5. Sep 8

    What Actually Happens After Rehab | The Saving Dose Ep. 10 ft Frank Galimidi

    In the tenth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Frank Galimidi, CEO of Sunview Wellness in West Palm Beach, Florida, a veteran clinical leader with 23 years in addiction treatment and substance use disorder who entered the field himself in recovery at 22 years old. Frank runs one of the most honest extended outpatient programs in the country. Average length of stay at Sunview Wellness is 130 days. He believes the addiction treatment industry has made enormous scientific progress and almost none of it has moved the relapse needle, and he is direct about why: short-term treatment, insurance-driven discharge, and a cultural belief that stabilization equals recovery are producing a predictable failure rate that the industry keeps misreading as patient noncompliance. This episode covers why 40 to 60% of OUD patients relapse within 90 days of leaving residential treatment, what consequence fade is and why it hits hardest at exactly the moment insurance companies decide to cut patients off, why Frank scholars patients out of his own pocket rather than discharge them mid-treatment cycle, and the one line that stopped William cold: connection is the opposite of addiction. You cannot connect with a pill and you cannot connect with artificial intelligence. 00:00 Introduction and Frank's background 02:08 23 years in addiction treatment: from Phoenix House Brooklyn to CEO 04:27 Why the relapse rate has not moved despite decades of scientific progress 06:13 Counselor burnout, workforce collapse, and who is leaving the field 08:35 Holistic OUD treatment: why medication without therapy is not enough 12:09 What AMA blocking is and why patients leave treatment before it works 13:07 Consequence fade: why patients stop doing what is working at 90 days 15:30 Why Frank's average length of stay is 130 days and what that changes 16:34 The statistics: 27% relapse the day of discharge, 90% within a year 19:00 In vivo treatment: doing recovery in real life, not inside a facility 26:00 Insurance companies cutting patients at exactly the wrong moment 32:00 Frank scholarships patients to finish treatment when insurance pulls out 35:00 Medicaid, work requirements, and the socioeconomic reality of OUD 38:00 Why Europe is trialing an oral heroin pill and what that means for harm reduction 38:53 OUD as a chronic condition: why John compares it to cancer surveillance 41:40 Longer duration, decreasing intensity: what the research actually supports 42:02 What the perfect OUD treatment center looks like 43:03 Detox alone without step-down care is setting patients up to fail 45:28 The future of addiction treatment if the therapist workforce keeps shrinking 46:05 Connection is the opposite of addiction 47:49 Your addiction is constantly telling you you're okay 49:15 Closing and how to find Sunview Wellness About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/ William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/ About the Guest Frank Galimidi is the CEO of Sunview Wellness, an extended outpatient addiction treatment program based in West Palm Beach, Florida. He has 23 years of experience in substance use disorder and mental health treatment, beginning at Phoenix House in Brooklyn at age 22. He has held senior executive roles at Sunset House and the Meadows Counseling Center and is a recognized expert in program development, clinical frameworks, and continuum of care. He speaks from both professional expertise and personal experience in recovery. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. If you or someone you know is struggling with substance use disorder, contact SAMHSA's National Helpline at 1-800-662-4357. Free, confidential, 24/7. #OpioidUseDisorder #AddictionRecovery #BehavioralHealth #TheSavingDose #HealthcarePodcast #AddictionTreatment #SubstanceUseDisorder #MOUD #RehabReality #PatientRetention #MentalHealth #RecoveryPodcast #OpioidCrisis #AddictionMedicine #SoberLiving #ContinuumOfCare #PublicHealth #OutpatientTreatment

  6. Sep 1

    Managing Chronic Pain with Fear of Addiction | The Saving Dose Ep. 09 Ft. Sandy Eulitt

    In the ninth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Sandy Eulitt, a software engineer, data architect, and technology professional based in Southern California who has lived with chronic pain since 1986 and undergone 17 surgeries, including 7 spine surgeries and bilateral total knee replacement. Sandy is not a clinician, a researcher, or a policy expert. She is a patient who made a deliberate, decades-long decision to manage severe chronic pain without opioids, and who built an entire system of ice packs, CBD, prehab, physical therapy, and community research to do it. This episode is the patient's side of the conversation that John and William have been having from inside the clinic. This episode covers what chronic pain actually looks like from inside a life, why fear of addiction shapes treatment decisions in ways providers rarely see, what patients do when the healthcare system tells them there is nothing more it can offer, and what Sandy built when she realized no one had given her a plan. In this episode: How four car accidents beginning in 1986 set Sandy on a 40-year journey through chronic pain, 17 surgeries, and a determination to manage her condition without becoming dependent on prescription opioids. Why hearing Rush Limbaugh admit to opioid addiction in the early 1990s became the defining moment that shaped every treatment decision Sandy made for the next three decades. What Sandy actually used instead of opioids: ice packs, CBD cream, THC gummies, TENS units, acupuncture, massage tables, a mini bike for prehab, and a carefully researched list of which specific medications she would and would not accept. How she drove a stick shift convertible 17 days after bilateral total knee replacement, what she did in the weeks before surgery to make that possible, and what her surgeon thought about it. What multimodal pain therapy is, why Sandy had never heard of it despite 17 surgeries, and what it says about the gap between clinical best practice and what patients are actually told. Why fear of addiction causes some patients to undertreat pain in ways that create their own health consequences, and what John sees in his Asian patients who tell him they cannot become an addict because it would shame their family. The Life Backup Plan: what Sandy built, who it is for, and why she believes every person managing a chronic condition needs a documented plan for what happens when things go wrong. What Facebook groups for surgery patients taught Sandy that her doctors, hospitals, and nurses never told her, and why patient communities are filling a gap that the clinical system is not. Sandy's advice to anyone living with chronic pain and afraid of opioids: what to ask your doctor, how to research your options, and why being prepared going into surgery changes everything about recovery. About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/ William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/ About the Guest Sandy Eulitt is a software engineer, data architect, and technical project manager with four decades in technology. A Southern California resident and chronic pain patient since 1986, she has undergone 17 surgeries and developed a personal framework for managing severe chronic pain without opioid dependence. She is the creator of the Life Backup Plan app, designed to help people manage health crises and chronic conditions. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. #ChronicPain #OpioidUseDisorder #PainManagement #AddictionMedicine #TheSavingDose #HealthcarePodcast #ChronicPainAwareness #PatientAdvocacy #OpioidCrisis #SpineSurgery #MOUD #BehavioralHealth #SubstanceUseDisorder #PublicHealth #PainPatient #MultimodalPain #RecoveryPodcast #HealthcareInnovation

  7. Aug 18

    The Pharmacist Who Became the Patient | The Saving Dose Ep. 08 ft Ernie Dole

    In the eighth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Ernie Dole, a pharmacist by training, former clinical professor at the University of New Mexico, and someone who spent decades treating opioid use disorder in patients while quietly living with it himself. Ernie had 30 years of continuous sobriety. Then he relapsed. He is now on buprenorphine, which he credits with saving his life. This episode is one of the most honest conversations The Saving Dose has had about what OUD actually looks like from inside a career built on understanding it, and why expertise and professional arrogance can be their own form of risk factor. This episode covers the relationship between adverse childhood events and OUD, why healthcare professionals develop opioid use disorder at higher rates than the general population, what it means to lose the art of medicine inside a 15-minute appointment structure, and why compassion is the single most important thing a provider can bring to a patient with OUD. In this episode: Why Ernie believes his childhood asthma hospitalizations were an adverse childhood event that shaped his relationship with substances decades before he would have admitted it, and what the connection between ACEs and OUD risk actually looks like in a real life. Why healthcare professionals, including pharmacists, anesthesiologists, and nurses, develop OUD at rates higher than the general population, and what access and professional arrogance have to do with it. How 30 years of sobriety ended with a pint of Jack Daniels one afternoon, what Ernie thinks stopped working in his recovery, and why he believes putting a time limit on buprenorphine treatment is a mistake. What the Pharmacist Clinician Act in New Mexico made possible: how collaborative practice agreements between pharmacists and physicians created a model where every provider practiced at the top of their license and opioid patients got more accountability and better care. Why fibromyalgia, chronic pain, and OUD are connected through untreated trauma, and what Ernie observed in nearly every female chronic pain patient he treated over the course of his career. What happens to the clinical relationship when a provider is stuck in a 15-minute appointment structure, and why Ernie regularly ran an hour behind because his patients needed the time. John's frustration: why physicians have lost the art of medicine, what it means to be accused of practicing Chinese medicine for using multimodal pain therapy in 1999, and how Medicare now penalizes hospitals that do not use that same approach. Ernie's closing message to every pharmacist, anesthesiologist, and nurse who is struggling: compassion, treatment works, and buprenorphine saved his life. About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/ William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/ About the Guest Ernie Dole is a pharmacist, former clinical professor, and patient advocate based in New Mexico. He developed and led the clinical pharmacy program at the University of New Mexico's outpatient chronic pain center, pioneering a collaborative practice model under New Mexico's Pharmacist Clinician Act that allowed pharmacists to manage complex opioid patients alongside physicians. He speaks from both professional expertise and lived experience with opioid use disorder and recovery. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. If you or someone you know is struggling with substance use disorder, contact SAMHSA's National Helpline at 1-800-662-4357. Free, confidential, 24/7. #OpioidUseDisorder #AddictionRecovery #BehavioralHealth #TheSavingDose #HealthcarePodcast #Buprenorphine #MOUD #AddictionMedicine #PharmacistLife #ChronicPain #SubstanceUseDisorder #MentalHealth #RecoveryPodcast #OpioidCrisis #ACEs #TraumaInformedCare #PublicHealth #HealthcareProfessionals

  8. Aug 4

    Investigative Reporter on How Opioid Settlement Funds Are Spent | The Saving Dose Ep. 07 ft. Ed Mahon

    In the seventh episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Ed Mahon, an investigative journalist at Spotlight PA who has spent years covering how opioid settlement funds are being allocated across Pennsylvania and who actually has a say in those decisions. The opioid epidemic has generated one of the largest legal settlements in American history. Billions of dollars have been distributed to states and counties with the stated purpose of funding addiction treatment, recovery services, and prevention programs. What is actually happening with that money, and whether the communities most affected by the crisis have a seat at the table when spending decisions are made, is a question most media coverage has not answered. That is what Ed covers. This episode goes inside the accountability gap at the center of the settlement distribution process, why the voices of people directly affected by addiction are still being left out of policy decisions, and what investigative journalism is doing to close that gap in Pennsylvania. In this episode: What the opioid settlement funds are, where they came from, and why the distribution of billions of dollars to states and counties has not automatically translated into better treatment access for the people who need it most. Who is making the decisions about how settlement money gets spent, why those decision-making bodies often do not include people with lived experience of addiction or recovery, and what that absence costs in terms of policy effectiveness. What Spotlight PA's Voices of the Epidemic series uncovered about the gap between how officials describe the settlement spending and what is actually happening on the ground in affected communities. Why Pennsylvania is a useful lens for the national picture: what the state's experience with the opioid crisis, from rural counties to Philadelphia, reveals about the structural challenges that no amount of settlement money fixes on its own. The intersection of chronic pain and addiction: why 25% of Americans living with chronic pain and nearly 50 million Americans with some form of substance use disorder are not entirely separate populations, and what treating both in the same patient requires. John's multimodal pain treatment approach: ultrasound-guided pain blocks, anti-seizure medications, acupuncture, TENS units, and physical therapy — a framework he has been using since 1999 when a colleague accused him of practicing Chinese medicine on American patients. Why 75% of patients do not take their medications correctly, why complete medication transparency is essential to individualizing care, and what happens to treatment outcomes when that transparency is missing. What people who want to make a difference on the opioid crisis can do, and where to follow Ed's ongoing investigative coverage. About the Hosts John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/ William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/ About the Guest Ed Mahon is an investigative journalist at Spotlight PA covering opioid settlement accountability and addiction policy in Pennsylvania. His work focuses on how settlement funds are allocated, who has a voice in those spending decisions, and elevating the perspectives of people directly affected by the opioid crisis. Follow his work at spotlightpa.org. Website: thesavingdose.com This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions. #OpioidSettlement #OpioidCrisis #AddictionRecovery #BehavioralHealth #PublicHealth #TheSavingDose #HealthcarePodcast #OpioidUseDisorder #InvestigativeJournalism #DrugPolicy #AddictionMedicine #ChronicPain #PainManagement #SubstanceUseDisorder #Pennsylvania #OpioidFunding #RecoveryPodcast #MOUD

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5
out of 5
4 Ratings

About

The podcast for those building the future of healthcare. A clinician, a healthcare attorney, and a behavioral health executive on what's actually working in addiction, adherence, and the capital reshaping both.75% of patients do not take medications as prescribed. 125,000 Americans die from it every year. $528 billion in preventable costs trace directly to a gap the healthcare system has known about for decades and never closed: what happens after the prescription is written. The Saving Dose is a podcast about that gap, the space between the clinic visit and the outcome, between the evidence-based treatment and the patient who never receives it, between the innovation that works and the reimbursement system that decides whether anyone can afford to deliver it. Hosted by Dr. John Hsu, and William Pedranti, the show brings together a behavioral health revenue strategist, an addiction medicine physician, and a biotech entrepreneur to go inside the clinical, operational, and commercial realities of addiction recovery, medication adherence, opioid use disorder (OUD), and behavioral health. Three different vantage points on the same broken system. Honest about what fails, specific about why, and direct about what a real fix requires. Topics include: addiction, addiction recovery, MOUD and MAT clinic operations, medication-assisted treatment adherence, behavioral health reimbursement, opioid use disorder treatment, payer contracting, DEA compliance, FFS-to-value-based care transitions, and the patient adherence gap in controlled substance prescribing. The Saving Dose is for investors evaluating the addiction recovery and behavioral health infrastructure market. For clinic operators and executives running opioid treatment programs, MOUD practices, and behavioral health facilities. For clinicians in addiction medicine and pain management. For payers and administrators navigating the cost and risk of behavioral health coverage. New episodes every two weeks. Available on Spotify, Apple Podcasts, YouTube, and wherever you listen.058171

Information

  • Creator
    John Hsu & William Pedranti
  • Years Active
    2026
  • Episodes
    14
  • Rating
    Clean
  • Copyright
    © 2026 The Saving Dose
  • Show Website
    The Saving Dose