Captain Hooked: The Addiction Project

A few months back we went through Matthew Perry autobiography. https://youtu.be/xBFxfMvihLY?si=qwaDkhgwvQTyv5PX It was quite a shock to hear he had passed away. In this episode, we discuss the nuances around addiction, medical treatment and the self-medication. We begin by examining the public perception of sobriety, using Matthew Perry's tragic story to illustrate the struggles of addiction under the public eye and the pressure accompanying it. The conversation then shifts to ketamine, a drug gaining attention for its potential in treating depression, while also posing risks for misuse and abuse. Table of Contents 00:00:00 - 4 clips from episode 00:00:50 - Start - Why are we taking about ketamine? 00:01:25 - Pro/cons ketamine as medicine 00:06:32 - Celebrities and addiction 00:08:26 - JP personal experience with ketamine - tolerance, heightened enjoyment 00:13:37 - Why do some people use ketamine? 00:16:41 - Can we self medicate//shame and recovery 00:22:35 - Can celebrities get good medical care? 00:25:21 - Unscheduled pause (1 of 6) - due to Premiere Pro upgrade 00:26:07 - What to do in a world with unlimited access to drugs of abuse. 00:28:10 - Public health inverted U curve on prohibition vs government regulation of drugs. A historical perspective on the use and abuse of various substances in medicine sets the context for current addiction treatment challenges. The experts caution against overlooking ketamine's abuse potential, emphasizing careful consideration in its therapeutic use. They also discuss the burgeoning interest in psychedelics for mental health treatment, stressing the need for caution and awareness. A significant part of the discussion centers on the dangers of self-titration and microdosing, especially with drugs like ketamine. Personal experiences are shared, providing insights into the use of various substances and their impact. The unpredictability of drug-induced thought patterns and the ethical dilemmas in using drugs for depression treatment are explored. Socioeconomic factors in drug accessibility and effects, along with celebrity cases like Michael Jackson and Matthew Perry, are analyzed to understand addiction treatment complexities in different social contexts. The emotional challenges of relapse, stigma, and the importance of supportive recovery environments are discussed. The podcast also delves into tolerance development in drug use, particularly with ketamine, and the cultural and recreational aspects of its use. The complex relationship between drugs and emotions is highlighted, underscoring the importance of considering these effects in treatment. This episode offers a thought-provoking exploration of addiction treatment, the balance between medication and self-medication, and the ethical considerations in mental health treatment with substances like ketamine. It's a deep dive into the delicate intricacies of addiction and recovery. Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The podcast episode primarily revolves around the complex issues of addiction medicine, with a significant focus on the concept of safer supply in drug policy. The hosts begin by discussing their recent visit to Vancouver Island for an addiction conference, leading into a conversation about the Drug User Liberation Front (DULF), an advocacy group that has been in the news. A major point of discussion is the arrest of DULF members, who were involved in efforts to provide a controlled and safer supply of drugs. This action by the police raises questions about the challenges and legalities surrounding efforts to mitigate the risks of the toxic illicit drug supply. The hosts discuss the implications of these arrests and the broader impact on harm reduction initiatives. The conversation then delves into the specifics of DULF's approach to safer supply, highlighting how the group's activities aimed to reduce harm by controlling the quality of the drug supply. This leads to a broader discussion on drug policy analysis, with references to experts like Karen Ward and the importance of studies that suggest reduced drug use and overdose risks with safer supply methods. Funding for such initiatives is another key topic. The hosts scrutinize the government's stance on funding harm reduction and safer supply programs, noting the controversy and political challenges in sustaining these programs. They emphasize the need for drug checking services and harm reduction equipment in the context of safer supply. The ethical dilemmas faced by healthcare professionals in prescribing drugs for harm reduction are discussed, particularly concerning substances like fentanyl and hydromorphone. The hosts question the traditional roles and responsibilities of healthcare providers in the context of a safer supply model. Attention is given to the impact of these policies on youth and the broader societal implications. The hosts express concerns about young people's exposure to substances under safer supply initiatives and the long-term effects on their potential and health. In the concluding segments, the hosts reflect on the need for a balanced approach that incorporates diverse perspectives in drug policy. They call for sensible and practical solutions that navigate the complexities of providing a safer supply while considering the broader societal and political implications. Overall, the podcast offers a comprehensive exploration of the safer supply concept in addiction medicine, emphasizing the need for nuanced and informed approaches in drug policy and harm reduction efforts. Table of Contents 00:00:04 - Introduction: Focus on Safer Supply in Addiction Medicine 00:00:44 - Arrests of DULF Members and Impact on Safer Supply 00:01:17 - Discussing DULF's Safer Supply Approach 00:02:09 - Controversies in Funding Safer Supply Initiatives 00:07:27 - Challenges in Drug Testing: Fentanyl and Safer Supply 00:09:33 - Ethical Considerations in Prescribing for Safer Supply 00:21:17 - The Role of Prescribing Practices in Safer Supply 00:25:52 - Youth Impact in the Context of Safer Supply Policies 00:29:07 - Societal and Political Dimensions of Safer Supply 00:37:15 - Conclusion: Future of Safer Supply in Addiction Medicine Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. #Lived experience #addiction #recovery #addiction medicine #DULF #cocaine, #Heroin, #safe supply #decriminalization

CSAM (Canadian Society of Addiction Medicine) has extended an invitation to our very own Dr. Wip to present their 2023 Lifetime Achievement Award to his mentor, Dr. Shelby. Dr. Wip elucidates the profound influence and enduring impact that Dr. Shelby has had on his journey. Dr. Peter Selby is a Clinician Scientist and Senior Medical Consultant at CAMH. He is the Interim Vice-Chair of Research for the Department of Family and Community Medicine and holds the Dr. Barnett & Beverley Giblon Professorship in Family Medicine Research at the University of Toronto. He is a Clinician Scientist and Director of the Mental Health and Addictions Division in the Department of Family and Community Medicine. He is also a Professor in the Department of Psychiatry and in the Dalla Lana School of Public Health at the University of Toronto. He is also a full member of the School of Graduate Studies through the Dalla Lana School of Public Health and the Institute of Medical Sciences at the University of Toronto. Areas of Research Dr. Selby's research focus is innovative methods to understand and treat addictive behaviours and their comorbidities. He also uses technology to combine clinical medicine and public health methods to scale up and test health interventions. His cohort of 280,000+ treated smokers in Ontario is an example. His most recent program of research utilizes a Learning Health Systems approach to investigate how technology enabled collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying experience of care for both patient and provider. Dr. Selby has received grant funding totaling over 100 million dollars from CIHR, NIH, and Ministry of Health, and has published 38 research reports prepared for the government. Dr. Selby mentors residents and faculty from a variety of disciplines. He is a sought after speaker for various topics including addictive disorders, motivational interviewing, and health behavior change at individual and system levels. Publications Dr. Selby has published over 150 peer-reviewed articles, 37 books or book chapters, and 125 international presentations. https://csamconference.org/ Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. The content should not be taken as direct medical advice or clinical instruction.

In the recent episode of ‘Captain Hooked: The Addiction Podcast’, addiction case manager Jean-Paul Michael and addiction psychiatrist Dr. Wip, share insights from their attendance at the CSAM 2023 conference held in Victoria, British Columbia. The episode unfolds the nuances of integrating peer support in addiction treatment, contrasting the traditional healthcare setups with innovative, peer-led organizations like the Umbrella Society. We speak about Alex Caudarella, of the CCSA, Chris Cull and his new series and the rest of the CSAM family. The conversation broached the disparities in employment and support structures between hospital-employed individuals and those engaged through community organizations, underscoring the necessity for well-supported, sustainable peer support systems within the conventional healthcare framework. Wip loves this conference. When he started doing addiction medicine, he felt like he was in a bubble. Providing psychiatric care to people who use drugs or addiction medicine care to psychiatric patients may seem like commonplace, but usually those two fields are siloed. CSAM connected Wip to a community of health care providers that were really trying to figure out how to best serve people who use drugs. For those of you in health care, it may be worth considering joining as well. Table of Contents 00:00:15 Introduction and Initial Thoughts 00:02:40 Involuntary care symposium 00:04:10 CCSA - Alex Caudarella 00:05:35 Umbrella Society LLE Challenges 00:07:15 Are LLE staff treated well? 00:16:55 Chris Cull Video Premiere https://csamconference.org/ inspirebyexample.ca https://www.umbrellasociety.ca/ Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. The content should not be taken as direct medical advice or clinical instruction.

In this episode, Dr. Wip extends his gratitude towards Drs Hugo Faria, Carolina Marquez, Cláudia Pereira, Gonçalo Henriques and Roberta Reis for their hospitality during his visit to Portugal. All of them are psychologists that oversee different areas of this non-profit in a both a leadership and direct clinical role. This episode serves as a follow-up to our previous discussion in episode 141 about Portuguese drug policy. Dr. Wip and Addiction Case Manager Jean-Paul Michael engage in a fascinating dialogue about addiction medicine, comparing the strategies employed in Canada and Portugal. The discussion brings to light a unique 'bus service' in Lisbon acting as a mobile clinic for substance users, which significantly lowers the threshold for individuals seeking help, as they require no appointment to access the services. The episode delves into the notable distinctions in drug policy, particularly highlighting the decriminalization model adopted by Portugal in contrast to Canada's approach of legalization and taxation. This disparity paves the way for an enriching discussion on the availability and efficacy of addiction services in both nations. They explore the comprehensive wraparound services offered in Lisbon which include showers, fresh clothing, and counseling, facilitating a more holistic approach to addiction management. The dialogue also touches on the hurdles faced in accessing medical detoxification services in Toronto, drawing a stark contrast to the integrated approach witnessed in Lisbon. They further discuss the Pathways Clinic in Canada, which caters to individuals referred from Rapid Access Addiction Medicine (RAAM) clinics. Despite its advantages, it's apparent that the accessibility to such pivotal services is more limited in Canada as compared to Lisbon. Moreover, the conversation appreciates the artwork created by the clients of the Lisbon service, recognizing not only the talent but also the potential therapeutic value of art in the recovery process. The hosts delve into the perception and reality surrounding 'education' in addiction management, discussing the efficacy and safety of detoxification processes. Through this insightful discussion, the hosts underscore the significance of compassionate, patient-centered approaches in addiction medicine. They advocate for the integration of such methodologies in the Canadian healthcare system for enhanced addiction management and recovery. This episode emphatically supports the broader objectives of promoting recovery, reducing stigma, and alleviating the societal burden associated with addiction. #addiction #recovery #wiplove lamba #jean-paul michael, #addiction medicine #Portugal #Decriminalization #Drug policy

Join us as we delve into a pre-conference discussion on the intriguing topic of involuntary addiction care, a focal point of an upcoming symposium at the CSAM-SMCA 2023 Scientific Conference in Victoria, BC. I will be in discussion with Dr. Wip, reflecting on the anticipated dialogues at the conference where I will serve as the moderator of the symposium. The symposium will feature esteemed participants, Dr. Dave Crockford and Dr. Rob Tanguay, who will explore the ethical and practical dimensions of involuntary addiction care. Our podcast aims to set the stage for the conference, offering a glimpse into the vital discussions expected to unfold. We'll touch on our hopes for the symposium, the importance of dialogues surrounding involuntary care in addiction medicine, and the impact it has on the broader community. We extend our gratitude to Nicole Bootsman, the dedicated pharmacist behind the organization of this symposium, as well as the co-chairperson of the conference for creating a conducive platform for such crucial discussions in addiction medicine. This episode is a precursor to the in-depth explorations awaiting attendees at the CSAM-SMCA 2023, shedding light on the multifaceted nature of involuntary addiction care in modern healthcare settings. https://csamconference.org/ Table of Contents 00:00:15 Introduction to the Symposium and Moderation Role 00:00:43 Discussion on Involuntary Care Symposium 00:02:16 Defining Involuntary Treatment and Scope 00:04:05 Mention of Legal System and Provincial Mental Health Acts 00:05:17 Discussion on Interpretation and Resource Allocation 00:07:29 Debating Decision-Making and Consent in Treatment 00:11:27 Community Treatment Orders and Implementation 00:14:11 Comparing Residential Treatment and Incarceration Risks 00:14:53 Symposium Structure and Time Management 00:16:38 Emphasizing Dialogue and Conclusion ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours. #Involuntary Addiction Care #Addiction Medicine #CSAM, #Scientific Conference #Addiction Care #Legal System #Addiction Treatment #Mental Health Act

Fictional Patient Information Medical History: • Hypertension: Under treatment • Depression: Under treatment • Diabetes: Under management • Substance Use: Intoxicated upon arrival but denies substance use • Speech: Slurred • Injuries: Result of fall, unknown severity Current Medications: • Hypertension: Lisinopril 20 mg daily • Depression: Sertraline 50 mg daily Allergies: • Penicillin: Causes hives Previous Surgeries: • Hip Replacement: 10 years ago • Cataract Surgery: 5 years ago Vitals: • Blood Pressure: 160/90 mmHg • Heart Rate: 88 bpm • Respiratory Rate: 18 breaths/min • Oxygen Saturation: 95% on room air • Temperature: 98.6°F (37°C) Blood Work: • Blood Alcohol Level: 0.18% (above legal limit) • Blood Sugar: 200 mg/dL (elevated) • CBC, CMP, Other Labs: Not provided Next Steps: • Medical Evaluation: Full workup to assess injuries and intoxication level • Consult Psychiatry: For depression and potential substance use • Consult Endocrinology: For diabetes management • Social Work Consult: To explore social support and other services • Addiction Medicine Referral: Despite denial, consider further assessment for potential substance issues Table of contents DISCLAIMER: The content of this medical podcast, including all patient names, health records, and case studies, is purely fictional and has been created solely for educational purposes. Any resemblance to actual persons, living or dead, or to any real-life medical situations, is entirely coincidental. This podcast is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. The hosts and producers of this podcast disclaim any liability, loss, or risk, personal or otherwise, that may be incurred as a result, directly or indirectly, of the use or application of any of the information, advice, or discussions presented on this podcast. This is a mock patient role-play. JP is playing the case worker, and Wiplove is playing the psychiatrist, collaborating on a mock case that was presented to the emergency department. Chapters: 0:00 - Introduction 0:57 - Case Presentation: 77-Year-Old Female with Alcohol Use Disorder 2:37 - Dr. Wip’s Clinical Recommendations 5:59 - Ethical Reminder: “Do No Harm” 8:21 - Evaluating Morning Intoxication: Is it a Symptom? 10:20 - Case Manager’s Recommendations 12:59 - Resource Guide for Family, Physicians, and Elder Care Providers 15:08 - The Role of Societal Respect for Elders in Providing Candid Advice Resources https://cep.health/media/uploaded/20191003-CEP_AUD-rev.12_UPDATED.pdf https://ccsmh.ca/wp-content/uploads/2019/12/Final_Alcohol_Use_DisorderV6.pdf https://ccsmh.ca/substance-use-addiction/ ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours.

Step into the captivating world of psychedelics as they intersect with addiction medicine in this illuminating episode of the Captain Hooked Addiction Podcast. As the landscape of addiction evolves, so too does our understanding of substances like psychedelics, and their roles, risks, and rewards. Table of Contents 0:00 - Introduction: Setting the Stage for Psychedelics Discussion 1:08 - Legality: Are Psychedelics Illegal Everywhere? 2:36 - Toronto Spotlight: A Narcity Tour of Mushroom Retail Stores 4:36 - Personal Insights: Dr. Wip's Experience with Psychedelics 7:10 - Cannabis Dependence: A Reality Check on Addiction Rates 8:30 - Journey into the Unknown: Has JP Tried Psychedelics? 9:03 - Diving Deep: A First-Hand Experience with Ketamine 13:40 - Bias in Discussion: Are JP & Wip Truly Objective About Psychedelics? 15:20 - Municipal Action: How Are Retailers Being Regulated? 17:45 - Open Dialogue: Should JP & Wip Silence Discussions on Psychedelics Risks? 21:10 - Unveiling the Truth: Understanding the Actual Risks of Psychedelics 30:20 - Book Highlight: Michael Pollan's "How to Change Your Mind" 31:30 - The Role of Psychedelics in Palliative Care: A New Perspective Toronto, ever the urban trailblazer, has witnessed a surge in psychedelic retail stores. We take you inside one such establishment through a compelling @Narcity video tour, offering a firsthand glimpse into this burgeoning industry. How do these stores operate, and what does this mean for Toronto’s addiction community? Hear Dr. Wip and JP candidly discuss their personal encounters with psychedelics, providing insights into both their profound effects and the inherent risks. Amidst the discussions of potential therapeutic uses, we don’t shy away from the critical: a transparent conversation about cannabis dependence, the real risks of psychedelic use, and our responsibility in presenting this information. Our journey also touches upon the potential transformative experiences with psychedelics, as highlighted by Michael Pollan’s “How to Change Your Mind,” and concludes with a significant discourse on their role in palliative care. Join us for an episode that is as informative as it is introspective, bridging the worlds of addiction medicine and psychedelics, and offering a comprehensive perspective on a topic that resonates deeply with Toronto’s heartbeat. References How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence https://a.co/d/1rNpGEl @Narcity video on Toronto mushroom stores https://www.youtube.com/shorts/x3-zg5UcioA About the Hosts Featuring addiction psychiatrist Dr. Wip and addictions case manager JP, a former addict, this series delves into all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in the emergency room of a renowned inner-city hospital in Canada's largest city, a role separate from Wip's clinical and academic work. Please note that the content should not be taken as direct medical advice or clinical instruction.

In this compact, informal episode, Dr. Wip and addictions case manager JP tackle a couple of big myths they've faced in their various educational endeavours within addiction medicine. Together, they explore questions like whether Fentanyl is found in pharmaceutical-grade medications and what harm reduction kits contain. Through a candid and hopefully engaging conversation, they delve into the challenges and commonalities in addiction care. Table of Contents 0:00 - Introduction 0:28 - Is Fentanyl Present in Pharmaceutical-Grade Medications? 1:32 - Do Harm Reduction Kits Include Narcotics? 3:30 - Are We Closer in Understanding Than We Think? 4:38 - How to Create a Baseline Understanding? References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034966/ https://ohrdp.ca/supplies/ About the Hosts Featuring addiction psychiatrist Dr. Wip and addictions case manager JP, a former addict, this series delves into all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in the emergency room of a renowned inner-city hospital in Canada's largest city, a role separate from Wip's clinical and academic work. Please note that the content should not be taken as direct medical advice or clinical instruction.

In today's podcast, we explore the urgent issue of substance misuse and addiction, focusing on the heartrending loss of Leonardo De Niro Rodriguez. We consider the criminal allegations against Sophia Marks and why some individuals seek substances like fentanyl. We also offer a comparative analysis of drug charges and sentencing in the USA vs Canada. We delve into the narrative of a former drug trafficker and clarify common misconceptions about fentanyl contamination in the drug supply, sharing anecdotes from our own experiences. Reflecting on the 'War on Drugs,' we propose potential solutions to the ongoing drug crisis. Please find our references in the description below. Our discussion aims to educate, not exploit, sparking conversations to prevent further tragedies like Leonardo's. Table of Contents 0:00 Introduction 1:02 Discussion on the Criminal Allegations Against Sophia Marks 2:10 Examining Why Some Individuals Seek Fentanyl 3:56 Case Studies of Medical Practitioners Charged for Overprescribing 4:50 USA vs Canada: A Comparative Analysis of Drug Charges and Sentencing 6:35 Drug Traffickers or Drug Users? A Closer Look 7:01 Insight into a Former Drug Trafficker’s Story and Dr. Wip’s Ethical Concerns 13:35 Why Addiction Medicine is not a Participant in the ‘War on Drugs’ 14:25 Debunking Misconceptions about Fentanyl Contamination in Drug Supply 15:59 Dr. Wip’s Anecdote from a 2014 Medical Conference 19:20 Is Heroin a Thing of the Past? 20:10 Evaluating the ‘War on Drugs’: Has it Been Lost? 24:00 Proposed Solutions to the Current Drug Crisis: Our Perspectives References More Than 80% of People Who Inject Drugs Test Positive for Fentanyl—But Only 18% Intend to Take It (https://www.nyu.edu/about/news-publications/news/2023/may/fentanyl-new-york-city.html) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252037/ A Summary from the charging document. https://www.justice.gov/media/1305851/dl?inline ‘Detective Joseph Aliberti from the NYPD has charged Sophia Marks for knowingly distributing and possessing narcotics in violation of Title 21, United States Code, Section 841. The narcotics included fentanyl and alprazolam. Aliberti's knowledge comes from personal investigation, examination of reports and records, and conversations with other law enforcement officers. The main evidence is a text conversation between Marks and a victim, in which Marks discusses selling counterfeit oxycodone pills and Xanax. After purchasing these drugs, the victim was found dead of a suspected overdose. Further evidence includes surveillance video of the drug delivery, and lab tests confirming the presence of fentanyl and alprazolam in the drugs found at the victim's death scene. The victim's toxicology screen was positive for cocaine, fentanyl, and benzodiazepines. Another sale of fentanyl to an undercover officer was also documented.’ Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. The content should not be taken as direct medical advice or clinical instruction. #Drug Decriminalization #Ethical Questions #Addiction Treatment #Addiction Debate #Addiction Is Treatable #Hope In Recovery #Substance Use #Harm Reduction #Drug Policy #Addiction Treatment #Robert De Niro #Leonardo De Niro Rodriguez #Sophie Marks #Drug Trafficking #War On Drugs

The allure of the Kennedy dynasty continues to capture global interest. Robert Kennedy Jr.'s entry into the 2024 presidential race signals an exciting era of potential political innovation and change true to the Kennedy legacy. Recently @TeamKennedy24 sat down with @NewsNation, providing insights into his strategy to combat the persistent issue of drug addiction, including proposals such as cannabis and psychedelic decriminalization. What caught our attention, however, was his reference to Italy's San Patrignano recovery community. Described by RFK Jr. as a beautiful place, we felt compelled to delve deeper into this topic, shedding light on the unique challenges and triumphs that have characterized this community's journey over the years. This episode owes its foundations to the content produced by @NewsNation (https://youtu.be/8fyetO18FlM) and @Netflix's "SANPA: Sins of Our Saviour". Join us for this comprehensive exploration into the recovery strategies suggested by a potential future leader and how these could shape the war on drugs. TABLE OF CONTENTS: 0:00 - Introduction 1:48 - RFK First Interview Clip: Insights from a significant political figure running for the presidency. 3:03 - A Novel Concept: The First Recovery-Focused President 3:40 - Is the Current Addiction Treatment Model Predatory? 4:39 - RFK's 2nd Clip: RFK says, "this beautiful model... called San Patrignano" 7:02 - Unveiling the Dual Facets of San Patrignano Recovery Community 9:24 - Rolling Hills, Vineyards, and Rose Gardens: The captivating backdrop 11:11 - San Patrignano's Past: Leg Irons and Shackles: A historical perspective on some of the severe methods used during the 80s and 90s. 14:46 - Reflection on Caged Treatment 16:01 - Highlighting @Netflix's "SANPA: Sins of Our Saviour": An insightful documentary exploring the complex and at times dark history of addiction care. 16:27 - Involuntary Addiction Care DISCLAIMER: This podcast is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. REFERENCES: https://youtu.be/t9zJbcdJ2rU https://youtu.be/8fyetO18FlM ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove's clinical and academic endeavours.

Welcome to Episode 145, 'Beyond Redemption: Unraveling the Controversy of Euthanasia for Addiction.' In this episode, we're exploring an emergent and potentially contentious issue: the possibility of Medical Assistance in Dying (MAiD) for addiction. This exploration takes us to a crossroads of recovery, life-preservation, and assisted death, raising profound moral, ethical, and legal questions. Our discussion is informed by Tristan Hopper's thought-provoking piece in the National Post, titled 'One third of Canadians fine with prescribing assisted suicide for homelessness.' Join us as we probe the complexities of this nascent topic, which might significantly shape the future of addiction treatment. In our roles as addiction medicine professionals, we often grapple with the reality that our best efforts may not always yield the desired outcomes for some individuals. This only bolsters our commitment to relentlessly push for improvement and innovation in our approaches. The concept of introducing MAiD into these challenging circumstances opens up a whole new realm of debate. It presents an ethical paradox: our roles in promoting recovery and preserving life could potentially intersect with facilitating suicide. We acknowledge the deeply personal decisions some individuals make to end their own lives, and understand the enormous ethical implications of balancing the roles of recovery facilitation and potentially aiding in suicide. Our initial inclination is that MAiD should typically be linked with terminal illnesses, rather than being extended to mental health conditions like addiction. Yet, this is a budding discussion, and we're here to delve into this exploration and ongoing conversation TABLE OF CONTENTS: 0:00 - Former Addict's Thoughts on Euthanasia for Addiction 0:52 - Introduction to Topic 3:03 - Video: Tristan Hooper, National Post 4:56 - Understanding the Current MAiD Process 10:04 - Dr. Wip Addresses Limitations in Addiction Medicine 13:05 - Is Addiction a Treatable Condition? 16:21 - Maintaining Hope in Addiction Recovery 21:02 - Discussion: Slippery Slope Phenomenon and Patient Capacity 26:35 - Future Predictions: Is the Progression Unstoppable? DISCLAIMER: This podcast discusses sensitive topics including medical assistance in death. These may trigger strong reactions. If you, or someone you know, are experiencing suicidal thoughts, seek help immediately. Remember, professional help is available, and you are not alone. This podcast does not replace professional advice. In Canada, contact the Suicide Prevention Service at 1.833.456.4566 In the United States, contact the National Suicide Prevention Lifeline at 1-800-273-8255 REFERENCES: https://nationalpost.com/news/canada/canada-maid-assisted-suicide-homeless https://globalnews.ca/news/9761846/bc-diamond-family-drug-treatment-donation-20-million/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788138/pdf/10.1177_0706743717746662.pdf ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove's clinical and academic endeavours. #AddictionMedicine #EuthanasiaForAddiction #MedicalAssistanceInDying #MAiD #AddictionRecovery #LifePreservation #AssistedDeath #EthicalQuestions #TristanHopper #NationalPost #Homelessness #MentalHealth #AddictionTreatment #InnovationInMedicine #TerminalIllness #AddictionDebate #AddictionIsTreatable #HopeInRecovery #PatientCapacity #SlipperySlopePhenomenon #FuturePredictions #SubstanceUse #Psychotherapy #HarmReduction #DrWiploveLamba #JeanPaulMichael

In episode #144, we delve into an innovative approach to addiction treatment - Rapid Access Addiction Medicine (RAAM) clinics. These walk-in clinics offer low-barrier, accessible treatment for those struggling with substance use disorders, without the need for appointments or referrals. Starting at 0:15, we unpack the concept of RAAM clinics. We explore what makes these clinics unique and how they’re breaking down barriers in addiction treatment. At 1:56, we discuss why RAAM clinics are critical in the fight against addiction, highlighting their role in providing immediate care when it’s needed most. At 5:10, we journey through the history of RAAM clinics. We look at how this treatment modality has evolved over time, shedding light on its roots and progression. This leads us to 5:48, where we spotlight some of the pioneers who have led the way in this approach, shedding light on their groundbreaking work. Moving forward to 6:58, we introduce META:PHI, a progressive organization focused on the advancement of addiction treatment. Following that, at 8:45, we examine the presence of RAAM clinics, outside of Ontario, within the USA, discussing their proliferation and their overall potential. At 10:20, we address prevalent myths and misconceptions about “methadone clinics”, attempting to demystify and clarify their role within the wider sphere of addiction treatment. At 14:20, we delve into the topic of whether hospital emergency rooms are effective platforms for addiction care. Finally, at 18:50, we reveal our mission behind this podcast. We discuss our aims to educate, inform, and inspire listeners about advancements in addiction treatment, ultimately striving to promote understanding and empathy towards those battling addiction. Join us in this enlightening episode on RAAM clinics as we uncover the transformative potential of Rapid Access Addiction Medicine in the ongoing fight against addiction. DISCLAIMER: The content of this medical podcast, including all patient names, health records, and case studies, is purely fictional and has been created solely for educational purposes. Any resemblance to actual persons, living or dead, or to any real-life medical situations, is entirely coincidental. This podcast is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. REFERENCES A plain-language summary of the document “A new framework for methadone carries: A person-centered evidence-informed approach to methadone take-home “carry” dosing”. https://www.metaphi.ca/wp-content/uploads/CarryPrinciples_OnePager.pdf Comprehensive listing of all RAAM clinics in Ontario Canada https://www.metaphi.ca/raam-clinics/ A new framework for methadone carries: A person-centered evidence-informed approach to methadone take-home “carry” dosing https://www.metaphi.ca/wp-content/uploads/CarryPrinciples.pdf ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours. #Addiction #Psychotherapy #Caseworker #Healthcare provider #RAC #RAAM #recovery #METAPHI #Meldon Kahan #recovery #Vincent Lam #Rajesh Gupta #Case Management

Dive into an enlightening 30-minute journey as we unearth the paradigm shift in Portugal's drug policy - a revolution that radically challenged global drug norms over two decades ago. In a world grappling with the adverse effects of drug prohibition, Portugal courageously paved a new path, decriminalizing all drugs and pivoting to a public health approach. In this deep-dive episode, we uncover the layers of Portugal's innovative strategy. From its commitment to harm reduction to its groundbreaking shift away from criminal punishment, we assess the real-world outcomes of such an approach. Has drug decriminalization led to rampant drug use, or has it produced a decline in drug-related deaths and HIV rates? How have Portugal's bold measures influenced its social fabric and public health outcomes? We further explore the often contentious yet vital subjects of safer supply, involuntary treatment, and drug legalization - topics making waves in North America's current policy debates. Safer supply initiatives are being implemented in various jurisdictions, providing regulated and less harmful substances as an alternative to dangerous street drugs. Involuntary drug treatment programs, which compel individuals into treatment against their will, are a controversial strategy being contemplated by several jurisdictions. And then there's the ultimate frontier - drug legalization, a step further from Portugal's decriminalization model and an option being seriously considered in some North American regions. Join us as we reflect on the lessons from Portugal's pioneering journey and discuss their potential application in the North American context. Our mission? To foster an informed dialogue that could shape the future of drug policy across continents. Let's challenge the status quo together. DISCLAIMER: This podcast is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. The hosts and producers of this podcast disclaim any liability, loss, or risk, personal or otherwise, that may be incurred as a result, directly or indirectly, of the use or application of any of the information, advice, or discussions presented on this podcast. Chapters: 0:00 - Introduction 2:11 - Dr. Wip Discusses Previous Policy Development Processes 4:45 - The Arrival of Fentanyl and Its Impact 7:10 - Understanding Decriminalization 12:35 - How Can One Obtain Drugs Under Decriminalization? 14:30 - The Influence of Portugal's Policies on Decriminalization 15:22 - Comparing Canadian and Portuguese Drug Policy Models 19:43 - Is Fentanyl Present in Portugal? REFERENCES 1. Hughes and Stevens 2017 https://kar.kent.ac.uk/13325/1/BFDPP_BP_14_EffectsOfDecriminalisation_EN.pdf.pdf 2. Drug Policy in Portugal: The Benefits of Decriminalizing Drug Use is the second in a series of reports by the Open Society Global Drug Policy Program https://www.opensocietyfoundations.org/uploads/52ff6eb9-76c9-44a5-bc37-857fbbfedbdd/drug-policy-in-portugal-english-20120814.pdf 3. Greenways - white paper Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies https://www.tni.org/files/publication-downloads/greenwald_whitepaper.pdf ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours.

Fictional Patient Information Name: Jeremy Whitter Date of Birth: 01/20/1995 Sex: Male Sexual Orientation: Bisexual Occupation: Unemployed Address: No fixed address Marital Status: Separated Chief Complaint Chest pain and insomnia; patient reports not having slept for three days. Social History 1. Crystal methamphetamine (meth) user: Reports smoking meth approximately 6 days a week 2. GHB user: Reports using GHB 2-3 days a week, mainly in the context of having sex with other men 3. Separated from wife due to intimate partner violence on three occasions 4. Child: 4-year-old daughter named Christina; currently not allowed contact with her due to pending criminal matters and involvement with child protective services 5. No reported alcohol or tobacco use Physical Examination 1. Vital signs: Blood pressure: 155/100 mmHg, Heart rate: 120 bpm, Respiratory rate: 26 breaths/min, Temperature: 98.4°F (36.9°C), Oxygen saturation: 94% on room air 2. General: Alert, agitated, and appears exhausted 3. HEENT: Pupils equal, round, and reactive to light; no icterus; oral mucosa dry 4. Lymph nodes: No cervical, axillary, or inguinal lymphadenopathy 5. Chest: Bilateral crackles in lower lung fields 6. Cardiovascular: Tachycardic, regular rhythm, no murmurs or gallops 7. Abdomen: Soft, non-tender, no organomegaly or masses 8. Extremities: No edema or cyanosis 9. Neurological: Normal strength and sensation in all extremities, no focal deficits 10. Skin: Scattered excoriations and scabs on arms and legs, consistent with "meth sores" DISCLAIMER: The content of this medical podcast, including all patient names, health records, and case studies, is purely fictional and has been created solely for educational purposes. Any resemblance to actual persons, living or dead, or to any real-life medical situations, is entirely coincidental. This podcast is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. The hosts and producers of this podcast disclaim any liability, loss, or risk, personal or otherwise, that may be incurred as a result, directly or indirectly, of the use or application of any of the information, advice, or discussions presented on this podcast. This is a mock patient role-play. JP is playing the case worker, and Wiplove is playing the psychiatrist, collaborating on a mock case that was presented to the emergency department. Chapters: 0:00 Introduction 1:10 Case manager presents the case 2:23 Patient's unmet needs 4:17 Dr. Wip gives an overview 6:50 Dr. Wip reviews the medical chart 8:40 JP asks Dr. Wip for advice on the next steps 13:58 Dr. Wip provides guidance on the best way to interview 17:48 Dr. Wip summarizes the case 22:10 Dr. Wip demonstrates how motivational interviewing can be effective 27:10 Helping your patient become the best individual they can be 28:15 What happens in the shadows 32:55 Why JP brought this case forward for review 37:30 Hear your patient's plan first 38:40 The disappearing drugs ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours. #Addiction #Psychotherapy #Caseworker #Healthcare provider #education #Psychiatry #recovery #Crystal meth #GHB #Addiction case review #Party and play #Children's aid society #Motivational interviewing #Case Management

A huge thank you to the Nash Family and @ @KliqThis Podcast for their incredible efforts in raising awareness about the dangers of alcohol withdrawal. Despite their immense grief, they have selflessly dedicated their time to helping others. https://youtu.be/mMA4beCxR8w CHAPTERS: 0:02 Loss of son to alcohol withdrawal 2:55 Detox history 4:15 Medical clearance explained 6:32 Risk factors for alcohol seizures 8:02 Kevin Nash's story 10:10 Tristan Nash's role in @kliqthis podcast 11:25 High-risk factors for seizures 12:33 PAWSS (Predictor of Alcohol Withdrawal Severity Scale) 16:05 Alcohol seizures from reducing drinking 17:55 José R. Maldonado on withdrawal symptom severity 19:50 Tristan Nash's history with alcohol complications 21:20 Kevin Nash's decision to quit drinking 24:14 Awareness of addiction medicine 26:45 Gabapentin in alcohol withdrawal management 29:20 Kevin Nash's take on clonazepam 30:52 CIWA Scale 36:30 Kevin Nash on society's portrayal of alcohol 42:50 Dr. Wip's summary SUMMARY: In this video, we discuss the heartbreaking impact of alcohol withdrawal complications on the Nash family and explore safe, medically supervised detox methods. As we share the Nash family's story, we also cover general information about alcohol withdrawal, including risk factors, symptom timelines, treatments, and the unpredictability of symptoms for those dependent on alcohol and benzodiazepines. REFERENCES: Robert Meyers' book on helping a loved one quit drinking: https://www.smartrecovery.org/get-your-loved-one-sober-alternatives-to-nagging-pleading-and-threatening/ Clinical guide for primary care providers on alcohol use disorder: https://cep.health/clinical-products/alcohol-use-disorder/ Comprehensive clinical guide to alcohol use and withdrawal: https://www.bccsu.ca/wp-content/uploads/2021/01/AUD-Guideline.pdf, https://www.bccsu.ca/alcohol-use-disorder/ UpToDate on alcohol withdrawal management: https://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes PAWSS literature: https://www.psychdb.com/_media/addictions/etoh_pawss_score_maldonando_.pdf, https://academic.oup.com/alcalc/article/50/5/509/198370?login=false Alcohol withdrawal timeline article: https://onlinelibrary.wiley.com/share/CIIRKMK7DIVBFJK5PW42?target=10.1111/ane.12671 DISCLAIMER: This video is for informational purposes only and is not medical advice. Consult your healthcare provider or visit the nearest emergency department for clinical guidance. ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic endeavours.

With the Surge in ChatGPT-4 AI Popularity, We Put It to the Test Against Our Resident Expert, Dr. Wiplove Lamba: Discover Who Emerges as the Ultimate Medical Authority! In light of the recent exponential growth in interest surrounding ChatGPT-4 AI technology, we have embarked on an exciting experiment, pitting this groundbreaking technology against our esteemed resident expert, Dr. Wiplove Lamba, a board-certified addiction medicine physician. To ensure a fair and well-structured discussion, Jean-Paul Michael will be moderating and refereeing this extraordinary event. Please be advised that the content of this video is not meant to be taken as direct medical advice or clinical instruction. Rather, our goal is to increase awareness and stimulate conversation around the field of addiction medicine. This episode, like all the content on our channel, is designed to inform, educate, and inspire dialogue on this critical subject, ultimately benefiting both healthcare professionals and the general public. Join us for this thrilling exploration into the realm of AI and human expertise, as we uncover the strengths and limitations of each in the world of addiction medicine. CHAPTERS: 0:00 Introduction 2:05 1st Question ‘as of September 2021, is there a FDA-approved medication specifically for the treatment of cocaine use disorder?’ 6:05 2nd Question, ‘Why is it dangerous to inject tap water into your veins?’ 8:55 3rd Question, ‘Is there evidence that addiction can be genetic?’ 12:07 4th Question, ‘Can methadone be addicting?’ 16:10 5th Question, ‘Can Warnicke syndrome be cured?’ 22:20 6th Question, ‘For elderly patients going through alcohol withdrawal, which is safer, Valium, or lorazepam, and why?’ 25:54 7th Question, ‘Why is opiate withdrawal, so problematic for expecting mothers?’ 27:25 8th Question, ‘Which medication has a higher likelihood of overdose, Methadone or Suboxone?’ 29:46 9th Question, ‘Does the overdose reversing drug naloxone, provide any benefit to patients that are overdosing from crystal meth or benzodiazepines?’ Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

Dr. Wiplove Lamba and Case Manager Jean-Paul (JP) Michael review a video from Vice Media (https://youtu.be/D-THhAW4MWk), which focuses on the fentanyl-related overdose deaths in North America and one possible solution. The video explores compassion clubs, particularly DULF (Drug User Liberation Front), and its co-founder Eris Nyx (dulf.ca). Please note that the content of this video should not be taken as direct medical advice or clinical instruction. CHAPTERS: 0:00 Introduction 0:45 Why this video is important 2:16 Clip 1: Overdoses and Fentanyl 3:15 Narcan at the shelter 4:26 Clip 2: Free Heroin and Meth Overdose Risk from Fentanyl 6:20 Benefits of predictable Fentanyl concentrations 8:13 The role of addiction medicine 9:40 Worries about unintended consequences 10:40 Figure: Public Health U 11:50 Who can join the compassion club 12:30 Harm reduction, safer supply, and palliative care 15:14 Managed Alcohol Program (MAP) 17:50 Legal substances are the most deadly 19:05 Clip 3: This S*!t is Real 24:45 Clip 4: The Future - A Liquor Store for Drugs? 26:30 Addiction medicine works 27:52 Latest DULF press release from Jan 30, 2023. Special thanks to VICE for all the amazing content !!! Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. #Addiction #Psychotherapy #Caseworker #Healthcare provider #education #Psychiatry #recovery #DULF #cocaine #methamphetamine #Heroin #safe supply #Vice #decriminalization

Dr. Wiplove Lamba and Jean-Paul Michael went through Matthew Perry Audiobook, ‘friends, lovers, and the big terrible thing’ on his recovery journey. It was a moving and powerful experience. They learned about early attachment trauma, substance use, and the internal and extremely dangerous life threatening struggles he has faced. They also learned about his experience in various treatment programs he attended and his near death experience.  While both Wip and JP do not work in private treatment centers, some of the items brought up were extremely interesting and relevant to addiction practice in general. We are hoping to promote discussion and bring awareness to all things relating to addiction medicine and recovery, both from the practitioner and patient perspective. While we both believe in and practice harm reduction approaches when the patient prefers or if it is indicated, it did not come up in the book or in our dialogue around these quotes. We found 8 clips from his audiobook and one text passage of his treatment with ketamine transcribed below The content should not be taken as direct medical advice or clinical instruction. CHAPTERS 0:00 What this podcast is about - matthew perry’s memoir and quality of addiction care 1:04 friends, lovers and the big terrible thing memoir. - why JP picked this book 1:55 why Wip likes memoirs 2:08 what it was like reading the book 3:43 JP and Wip as armchair clinicians 4:46 clip 1. What do you do when the patient knows more than the Counsellor 8:05 can phenobarbital help infants. 8:27 clip 2. Matthew perry and phenobarbital Wip is not a neonatologist and tried to share the answer in general terms. -phenobarbital is used in adults for medical detoxification. -phenobarbital has been and is used in neonates for some conditions but Is not currently used for Colicky infants. Wip cannot speak to the treatment MP received as an infant 10:29 - can one pill lead to an addiction? 11:07 clip 3 the first time MP took Vicodin 14:07 should doctors give 40 Vicodin to the hotel room? 16:08 what makes buprenorphine special? 17:00 is buprenorphine just good for detox? 17:30 detox is contraindicated for opioid use disorder - why. 18:48 does buprenorphine make you feel dead inside? 19:24 clip 4. Matthew perry buprenorphine quote 20:04 clip 5 MP smoking quote Context for clip 5. - if you are able to stop smoking, you are more likely to be successful with the other drugs. Here is the next paragraph “… complete rebuilding of a man. I didn't know this man, but he seemed to be a nice guy, and it looked like he had stopped beating the shit out of himself with a baseball bat finally. I was very eager to see who this man was!” 22:08 discussion about ketamine and treatment in Switzerland From page 2 of chapter “Interlude: dead” See below for quote. “So they’d give me hydrocodone-as much as I could actually feel-which turned out to be 1,800 milligrams a day. To put that in perspective, if you broke your thumb, and had a kind doctor, he or she would probably prescribe you five 0.5-milligram pills. Not enough to put a dent in this guy. ...” 27:07 clip 7 - MP’s turning point. - fear of colostomy bag. Fear and avoidance vs approach behaviour vs path to get there. 32:17 importance of hope 33:24 clip 8 Corruption of the system 35:27 final thoughts Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

A follow up to our episode #136 on ‘Alex Murdaugh: '$50,000 per week drug habit?', Addiction Professionals offer their insights’ https://youtu.be/A19RS7IOMYo We attempt to address some of our viewer’s addiction medicine related questions and comments. 0:00 Thank you for your curiosity 1:18 Why this followup podcast? 2:23 wouldn’t someone’s family know? 5:02 substance use changes the brain 6:23 does the brain recover from drug use? 7:17 when does the brain improve after using drugs 9:11 how much opioids can someone use without dying? (Depends on the persons tolerance) 12:03 let’s do the math - morphine equivalents (NOTE: we did not talk about cross tolerance or current guidelines for pain. Please consult an expert before making a switch.) 13:40 prescribed injectable hydromorphone dosing 15:50 how high doses of opioids were people prescribing for pain? 17:53 shame and addiction 20:40 can you look like a drug user 23:13 what does withdrawal look like (https://youtu.be/2M6jkWutyh0 ) 24:10 weed vs opioids 26:00 counterfeit oxycodone pills? 26:55 Where was Wiplove in his med school class? 27:40 stigma with word addiction 29:55 buprenorphine access and micro-dosing 30:38 you don’t have to stop opioids to start buprenorphine 32:19 thank you for the comments, the feedback and the views Addiction psychiatrist Dr. Wiplove (Wip) Lamba and addictions case manager and former addict Jean-Paul (JP) Michael attempt to offer their insights on Alex Murdaugh Trial, where it has been claimed that Mr. Murdaugh spends $50,000 per week on his substance use, Addiction Professionals offer their insights. (State of South Carolina v. Richard Alexander Murdaugh is an ongoing American criminal case in the South Carolina Circuit Court in which Murdaugh is accused of the murders of his wife and their 22-year-old son a year and a half earlier.) Main study for injectable hydromorphone as treatment ; https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2512237 Slow release oral morphine vs Methadone; https://bmjopen.bmj.com/content/9/4/e025799 Simple cartoon on tolerance; https://youtu.be/29Z0qLB8sEc https://youtu.be/xmLfddvdSXk https://youtu.be/2M6jkWutyh0 Website with BC guidelines for pain; https://www.bccsu.ca/opioid-use-disorder/ Morphine conversion tables; https://www.oregonpainguidance.org/opioidmedcalculator/ https://www.med.unc.edu/aging/wp-content/uploads/sites/753/2018/06/Analgesic-Equivalent-Chart.pdf https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/palliative2_-_pain_equianalgesic.pdf https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf NOTE. THE TABLES ABOVE AND IN OUR PODCAST WE DO NOT TALK ABOUT DOSE ADJUSTMENT AND CROSS TOLERANCE Microdosing buprenorphine guide https://www.metaphi.ca/wp-content/uploads/ED_OUD_MicrodosingInfo.pdf Canada overdose death rates from opioids; https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/maps Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work. The content should not be taken as direct medical advice or clinical instruction. #Lived experience #PWID #addiction #recovery #Captainhooked #wiplove lamba, #jean-paul Michael #addiction medicine, #alex murdaugh #OD #court TV #People magazine #oxycodone #opioid addiction #opioid use disorder, #Maggie murdaugh #murder #double murder #SHAME