Cracking Addiction (Meducate)

Join Dr. Ferghal Armstrong and Dr. Laura Petracek as they delve into the transformative O-M-A-N (Observation, Measuring, Asserting, and Not) framework for negotiating with friends, partners, colleagues, and others. In this enlightening discussion, Dr. Armstrong emphasises the power of observation and creating healthy boundaries without jeopardising relationships.

Discover how being a disinterested observer and practicing mindfulness can keep emotions in check during negotiations. Explore practical techniques like body scans and taking timeouts to defuse potential conflicts and facilitate open dialogue. Say goodbye to unnecessary apologies and discover the linguistic alternative, "ology," to express disagreement respectfully.

Gain valuable insights into the importance of ego detachment and anacostics for problem resolution. Discover how removing ego-driven dynamics leads to more harmonious relationships and a more fulfilling life. Don't miss out on this invaluable wisdom and effective negotiating techniques for building stronger connections with those around you.

Cracking Addiction 104 offers listeners invaluable insights into the art of setting boundaries, observing patterns, and understanding the role of ego in relationships. By recognizing the importance of self-reflection, assertiveness, and the impact of excessive apologizing, we can navigate conflicts with grace, preserve the dynamics of our relationships, and prioritize our well-being. Remember, true growth and freedom lie in finding a balance between asserting oneself and maintaining strong, respectful connections with others.

Subscribe to Cracking Addiction for more thought-provoking discussions that explore strategies for overcoming addiction and building healthier, more fulfilling lives.

In this episode, Dr. Ferghal Armstrong and guest Dr. Manu Bhatnagar explore the treatment principles underlying the management of ADHD. If you want to gain valuable insights into the use of stimulant medication and non-stimulant pharmacology in addressing ADHD, this episode is a must-listen.

The focus keyword for this episode is "ADHD management." Dr. Armstrong and Dr. Bhatnagar provide in-depth analysis of the use of stimulant medications, such as dexamphetamine and lisdexamfetamine, as well as non-stimulant medications like atomoxetine, in the treatment of ADHD. They shed light on the difference between dexamphetamine and amphetamine, the safety concerns associated with stimulant therapy, and the role of non-stimulant pharmacology in ADHD management.

Learning outcomes:

1. Understanding the nuances of stimulant medications: Dr. Armstrong and Dr. Bhatnagar explain the mechanism of action and differences between amphetamines, including dexamphetamine, lisdexamfetamine, and methylphenidate, helping listeners grasp the key factors to consider when prescribing and using these medications.

2. Safety considerations and risk management: The episode delves into the potential risks associated with stimulant therapy, such as psychosis and substance use disorder, while also addressing the assessment and management of these risks to ensure safe and effective treatment for individuals with ADHD.

3. Exploring non-stimulant pharmacology: Listeners will gain insights into the role of atomoxetine as a non-stimulant medication for ADHD management. The episode highlights the considerations and scenarios where non-stimulant pharmacology might be preferred or necessary, providing a comprehensive view of treatment options.

Actionable takeaways:

1. Informed decision-making: Gain an understanding of the specific characteristics of different stimulant medications and how they impact dopamine release, enabling more informed decisions when prescribing medications for ADHD management.

2. Risk assessment and mitigation: Learn about the potential risks, such as psychosis and substance use disorder, associated with stimulant therapy, and discover strategies for assessing and managing these risks to ensure patient safety and treatment effectiveness.

3. Consideration of non-stimulant options: Explore the role of non-stimulant pharmacology, particularly atomoxetine, in the management of ADHD, and understand the scenarios where non-stimulant medications may be beneficial, providing a holistic approach to treatment.

Quote or insight:

"Every now and then, if you have that propensity to have a psychotic episode, [stimulant medication] might be the thing that adds another notch to your likelihood meter."

#ADHDmanagement #StimulantMedication #NonStimulantPharmacology #PatientSafety #RiskAssessment #Atomoxetine #InformedPrescribing #SubstanceUseDisorder #PsychosisRisk #CrackingAddiction

Thank you for tuning in to this episode of Cracking Addiction. For more insightful content, be sure to like and subscribe to our channel. You can find more information and episodes on our Meducate website: https://meducate.com.au.

Recovery isn’t just about stopping substance use; it’s about transforming your life. This episode covers key points like the idea of “white knuckling” versus a more holistic approach to sobriety, and how hitting rock bottom can be a powerful catalyst for change. Jesse, a former addict turned lived experience peer worker, shares his own journey, revealing how finding your authentic self can turn recovery into an exciting, fulfilling process.

**Learning Outcomes:**

1. **Understanding the True Nature of Recovery:** It’s crucial to understand that recovery is far more than just abstaining from harmful substances. Jesse highlights that true recovery is about discovering and connecting with your authentic self. This shift in perspective can turn what seems like a daunting process into an attractive and fulfilling journey. By acknowledging that recovery involves reconnecting with your real self, you can focus on the long-term benefits rather than short-term sacrifices.

2. **Recovery vs. White Knuckling:** Jesse discusses the exhausting and often unsuccessful method known as "white knuckling"—relying solely on willpower to refrain from substance use. He outlines how this is not sustainable for those deeply entrenched in addiction. Instead, a structured recovery programme alongside community support can offer a more sustainable and fulfilling path to sobriety. Recognising this can help you align your recovery efforts more effectively and avoid the burnout associated with sheer willpower.

3. **The Role of Hitting Rock Bottom:** Ferghal and Jesse delve into the importance of hitting rock bottom as a catalyst for embracing recovery. Jesse explains how the sheer misery of his lowest point opened his eyes to the necessity of change. This realisation can act as a turning point, making the attractions of a clean, healthy life more apparent. This insight can be both a wake-up call and a motivator for those reluctant to embark on their recovery journey.

4. **The Concept of Self Care in Recovery:** One of the standout themes is the idea that recovery demands rigorous self-care. Jesse’s tale of prioritising diet, exercise, and mental wellness paints a vivid picture of how taking care of oneself daily is not a luxury but a necessity. This actionable takeaway can help you build a solid foundation for long-term sobriety by instilling habits that support both your physical and emotional well-being.

**Actionable Takeaways:**

1. **Engage with Recovery Communities:** Jesse highlights how seeing others with qualities he admired—patience, calmness, wisdom—made recovery appealing for him. This underscores the importance of surrounding yourself with supportive individuals who inspire you. Seek out local or online recovery support groups; these communities can be invaluable in offering the encouragement and motivation you need to stay on track.

2. **Explore New Hobbies and Interests:** Breaking free from the cycle of addiction often requires filling your life with new, healthy activities. Jesse mentions trying ultra running, hiking, and even yoga retreats to fulfil his need for excitement. Make a list of activities you’ve always wanted to try and commit to exploring at least one new interest a month. This approach not only keeps you engaged but also helps in building a new identity beyond addiction.

3. **Prioritise Self-care:** A recurring theme in this episode is the crucial role of self-care in recovery. Jesse’s disciplined routine, including meditation, yoga, and maintaining a balanced lifestyle, serves as a powerful model. Develop a daily self-care regimen that includes physical, mental, and emotional health practices. Prioritising self-care helps prevent relapse and promotes overall well-being.

4. **Shift Your Perspective on Fun:** One of the most profound insights Jesse shares is how his...

Dr Ferghal Armstrong addresses the often-underestimated influence of diet on addiction recovery and mental health. By contrasting Australian Dietary guidelines with the detriments of ultra-processed "junk" food, Ferghal uncovers the profound impact that food choices have on our overall health and capacity to overcome addiction.

Exploring various diets, such as the Mediterranean, DASH, and MIND diets, Ferghal emphasizes the benefits of whole foods and the avoidance of high saturated fat, sodium, and processed sugars.

Crucial connections between diet and risk of diseases, including cardiovascular issues, cancer, metabolic syndrome, and mental health disorders, are highlighted, making a strong case for the fork's role in lifestyle medicine.

00:00 Dr. Fergal Armstrong discusses lifestyle medicine in addiction.

03:49 Junk food linked to metabolic diseases, mental health.

08:16 MIND diet reduces Alzheimer's risk, benefits mental health.

Welcome to the 100th episode of Cracking Addiction. In this milestone episode, we delve deep into the assessment of dependency, comparing home-based detox with inpatient detox, and explore the fundamental principles of managing withdrawals for alcohol, cannabis, methamphetamine, and opioids.

We examine the important decision of choosing between home-based detox and inpatient detox. We also explore the advantages and challenges of both approaches, considering factors such as the level of support, medical supervision, and individual needs.

Withdrawal symptoms can be one of the most challenging aspects of addiction recovery. We tackle this topic head-on by providing a comprehensive overview of the management of withdrawals for alcohol, cannabis, methamphetamine, and opioids.

In this episode, Dr Ferghal Armstrong and Dr Richard Bradlow unpack the complex relationship between alcohol, thiamine deficiency, and the severe neurological condition Wernicke’s encephalopathy. Ferghal opens by questioning long-held beliefs about alcohol’s direct effects on thiamine absorption, while Richard provides a contextual understanding of the symptomatic manifestations. The discussion touches on the practicalities of diagnosing and treating thiamine deficiency, focusing particularly on clinical scenarios where immediate action can prevent irreversible damage.

**Learning Outcomes**

1. **Understanding Thiamine Deficiency and Alcohol Use**

- Thiamine deficiency is commonly seen in individuals with alcohol use disorders due to poor diet, liver damage, and compromised gut integrity. Ferghal emphasises that alcohol does not directly reduce thiamine but affects its absorption and storage indirectly.

- Recognise the critical symptoms of thiamine deficiency: Ataxia, ophthalmoplegia, and confusion. Richard shares that only 10% of individuals present with the classic triad, stressing the need for a low threshold in administering thiamine.

- Ferghal reveals that thiamine is stored in the liver, with approximately 20-30 milligrams available. Without replenishment, these levels deplete quickly, making regular intake essential.

2. **Diagnosis and Management**

- Learn to assess risk factors beyond alcohol consumption. Richard suggests evaluating diet, liver health, and any conditions that hamper gut absorption.

- Understand the importance of high-dose, parenteral thiamine administration in suspected cases of Wernicke’s encephalopathy. This prevents irreversible neuronal damage, particularly in the cerebellum and midbrain.

- Find out why rapid thiamine delivery is critical. Ferghal explains that alcohol withdrawal demands a higher energy output, which depletes thiamine stores faster, precipitating encephalopathy.

3. **Preventative Measures and Harm Reduction**

- Recognise the importance of thiamine supplements for those engaging in hazardous drinking, even if not experiencing withdrawal. Richard advocates for over-the-counter vitamin B1 tablets, taken multiple times daily for optimal absorption.

- Explore how diet can play a crucial role in preventing thiamine deficiency. Liver, cereals, and fortified foods are excellent sources of thiamine, as Ferghal points out.

- Koraskoff’s syndrome is an irreversible consequence of untreated thiamine deficiency. It leads to significant memory deficits and an ataxic gait, which underscores the need for timely intervention.

**Actionable Takeaways**

1. **Routine Screening for Thiamine Deficiency**

- Incorporate routine screening for thiamine deficiency in patients with alcohol use disorder. Ferghal and Richard highlight this as a vital practice to prevent conditions like Wernicke’s encephalopathy and Korsakoff syndrome.

- Develop a checklist for evaluating risk factors, including dietary patterns, liver function, and gut health issues.

- Push for early intervention even with subclinical symptoms. Ferghal stresses the colossal benefits of early detection and treatment.

2. **Educate on Thiamine Supplementation**

- Ensure patients receive clear instructions on thiamine supplementation. Richard recommends oral vitamin B1, taken in divided doses throughout the day.

- Cultural and dietary recommendations should include foods rich in thiamine, like liver and fortified cereals.

- Advocate for harm reduction strategies that include vitamin supplements. Ferghal points out this can significantly reduce the risk of severe neurological...

In this episode of "Cracking Addiction," we dive deep into the concept of "resilience" and its critical role in addiction recovery. I'm Dr. Ferghal Armstrong, and joining me is the insightful Dr. Richard Bradlow. Together, we unravel the layers of how resilience can make or break the recovery process for individuals battling addiction.

Resilience in addiction recovery is more than just a buzzword; it's the lifeline that enables one to bounce back amidst life’s hardships. Dr. Richard Bradlow and I discuss how resilience helps manage both the impulsivity and compulsivity associated with substance use disorders. How can we bolster this resilience in recovery? By mastering small, achievable goals, creating positive habits, and saying 'no' to cravings, of course!

Are you or someone you know struggling with recovery? This episode is tailored for you. Tune in to discover practical tips, backed by real-life experiences and professional insights, to enhance your journey towards a substance-free life.

In episode 69 of Cracking Addiction we discuss the difference and similarities between general practice and Addiction Medicine. We discuss Addiction Medicine consultation liaison services in hospital, inpatient and community management options with regards to Addiction Medicine. Lastly we discuss the role general practitioners play in managing patients with substance use disorders within the community and the breadth of community presentations and continuity of care that they provide their patients.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In this episode of Cracking Addiction we discuss relapse prevention strategies with regards to methamphetamine use and discuss harm reduction strategies, how to avoid a lapse becoming a relapse, the Matrix Model, motivational intervention and contingency management.

We also discuss the importance of peer support programs in aiding people on their path to recovery from substance use disorder and discuss the evidence surrounding pharmacotherapy interventions for methamphetamine use disorder.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Kamini an Ayurvedic opiate-Kamini or Kamini Vidrawan Ras is an Ayurvedic medicine containing opiates as well as some heavy metals. It is a medicine marketed for a variety of indications ranging from premature ejaculation and impotence to increased stamina. There is increased recognition and awareness of patients presenting to specialist Addiction Medicine services with opioid dependence secondary to Kamini Vidrawan Ras often requiring treatment with opioid substitution therapy.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Have you ever wondered how the quality of your sleep impacts your mental health? Or how the intricacies of sleep deprivation can influence everything from decision-making to long-term brain health? In this riveting episode of "Cracking Addiction," Dr Ferghal Armstrong and Dr Richard Bradlow dive deep into the complex, bidirectional relationship between sleep and mental health. Whether you're grappling with insomnia, curious about ADHD, or just keen to improve your sleep hygiene, this episode packs a wealth of information and actionable advice. Listen to gain valuable insights and transform how you view the power of sleep.

**Sleep and Mental Health Interlink**

In this episode, Dr Ferghal Armstrong and Dr Richard Bradlow explore various mental health disorders, such as melancholic and atypical depression, and their distinct sleep patterns. They discuss how poor sleep can aggravate existing mental illnesses and vice versa. Understand why sleep is crucial and how its deprivation can lead to cognitive and emotional impairments. Gain practical, scientific knowledge on how to enhance your sleep quality and, by extension, your mental health.

**Best Quote:**

"Sleep deprivation ultimately kills you, and it kills you quicker than starvation."

**Learning Outcomes:**

1. **Understanding the Bidirectional Relationship:** Explore the fascinating concept of the bidirectional relationship between sleep and mental health. Learn how poor sleep can precipitate mental health issues like anxiety and depression and how these conditions can further deteriorate sleep quality. Understanding this relationship can prompt more effective treatment approaches. Practising better sleep hygiene can potentially alleviate some symptoms of mental health disorders.

2. **Melancholic vs Atypical Depression:** Differentiate between melancholic and atypical depression regarding their impact on sleep. Melancholic depression is linked with early morning awakenings, while atypical depression is associated with hypersomnia. This knowledge can help you identify what type of depression may be affecting you or your loved ones. By recognizing these patterns, you can seek appropriate treatment options.

3. **Impact of Sleep Deprivation on Cognitive Function:** Realise how sleep deprivation affects cognitive functions, such as decision-making and ethical awareness. Discover that being awake for 16 hours renders cognitive impairment equivalent to a 0.05 blood alcohol level. This insight can incentivise you to prioritise sleep, especially if your day-to-day activities involve crucial decision-making. Adequate sleep can improve your productivity and emotional well-being.

In episode 28 of Cracking Addiction we discuss our practical tips, advice and experience in managing patients on LAIB and share what we have learned.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Steve Herd is an expert in the field of family violence. In our first of a series of conversations, he explains that family violence is not just physical abuse. It includes emotional, psychological and sexual abuse as well. The abuser uses various tactics to maintain control over their partner, such as isolating them from friends and family, controlling their finances, and limiting their access to information.

Herd also highlights the role of gender in family violence. He explains that men are more likely to use physical violence to control their partners. He argues that this is because society has traditionally given men more power and control over women, which has led to a sense of entitlement among some men.

Overall, our conversation with Steve Herd sheds light on the complexity of family violence and its damaging effects on individuals and families. Understanding the root causes and different forms of abuse is crucial in order to prevent and respond to this pervasive issue.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In episode 34 of Cracking Addiction we discuss how to manage some of the special circumstances in opioid substation therapy including OST in renal and hepatic impairment, managing polypharmacy complications with OST and managing acute pain whilst a patient is on OST.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

Latest Blogs

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

In today's episode, we delve into the often isolating and lonely world of motherhood. Our host, Dr. Ferghal Armstrong, is joined once again by the inspiring Celeste Yvonne, as they discuss the challenges faced by mothers in today's society.

From the impossible parenting standards set on social media to the lack of support for maternal mental health, this episode uncovers the realities that mothers often face in silence. We explore the connection between the mental load of motherhood and the rise in women's drinking, shedding light on the pressures and burdens placed upon mothers.

Additionally, we dive into the incredible work of the Sober Mom Squad, a recovery network founded by our guest, Emily Paulson, during the pandemic. Join us as we explore stories of hope, discuss the need for better support systems, and offer solutions to address the struggles faced by mothers in their journey through addiction and motherhood.

00:00:28 Alcohol and societal pressures contribute to women's drinking.

00:03:42 Alcohol narratives justify and validate risky drinking.

00:09:35 Isolation, impossible standards, lacking maternal support.

00:14:15 Postpartum depression dismissed, fear of seeking help.

00:19:08 Better support for women; distribute household labor and prioritise mental health.

00:23:34 Sober Mom Squad offers recovery support network.

00:25:04 You deserve congratulations for making an impact.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Uncovering the Power of Ibogaine: A Game-Changer for Addiction Treatment [Psychedelic Medicine, Ibogaine, Addiction Recovery]

Are you ready to revolutionise your understanding of addiction treatment? In this eye-opening episode of Cracking Addiction, I sit down with the legendary Zappy Zapolin, founder of the Mind Army and renowned as the "psychedelic concierge to the stars." Together, we delve into the transformative world of psychedelic medicine, focusing specifically on the groundbreaking potential of ibogaine in addiction recovery.

🔥 Discover how ibogaine offers a radical shift in treating heroin addiction and other substance dependencies. Zappy takes us on a journey through the cultural and historical roots of this powerful African plant, used for centuries by the Bwiti people to connect with their ancestors. With current rising addiction crises and mental health issues, could ibogaine be the miracle we’ve been waiting for?

👀 Don't miss out on this riveting conversation that promises to challenge conventional wisdom. You'll learn why Zappy and his Mind Army are advocating fiercely for the decriminalization and legalization of naturally occurring psychedelics. Tune in to understand the profound benefits and the contentious debates surrounding their use.

💬 Be part of this transformative discussion! Like, share, comment, and subscribe to MedHeads to stay updated with the latest in addiction treatment breakthroughs!

📚 [Mind Army Official Website] https://mindarmy.org

#Ibogaine #PsychedelicMedicine #AddictionRecovery #MentalHealth #CrackingAddiction

This episode is perfect for you if you're committed to exploring cutting-edge treatments and alternative solutions to addiction.

In this episode  of Cracking Addiction we discuss the effects of chronic

benzodiazepine usage and the mechanisms of which tolerance and

dependence to benzodiazepines develops and discuss the time course in

which these syndromes can occur as well as discuss the diagnostic

criteria for a benzodiazepine use disorder.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available https://www.meducate.com.au

Episode 20 of Cracking Addiction explores methadone, its origins, the pharmacology behind methadone and how to commence a patient on Methadone.

Methadone is a synthetic long acting mu receptor agonist suitable for the treatment of opioid use disorder. Methadone has a longer plasma half life than morphine (average 22 hours (15-32 hours) vs 2 hours for morphine) which permits once daily supervised dosing.

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About Meducate ®

Meducate provides online education for doctors, clinicians, health professionals and the public.

See the website to browse the many different talks and courses available

https://www.meducate.com.au

Dr. Ferghal Armstrong and Dr. Laura Petracek delve into the 11th step of the twelve-step program, discussing the significance of prayer and meditation in improving conscious contact with a higher power. The episode explores the practical ways individuals can manifest the 11th step in their daily lives and the impact of skepticism on recovery. Listeners will gain valuable insights into the role of connection in recovery, the importance of a sponsor, and the transformative potential of the 11th step prayer.

Dr. Laura Petracek and Dr. Ferghal Armstrong provide an in-depth analysis of the 11th step, emphasising the focus on conscious contact with a higher power and praying for knowledge of that power's will. The conversation also touches on the evolution of the interpretation of a higher power and the challenges of incorporating the 11th step into daily practice. The speakers shed light on the impact of skepticism on engagement with the step and the importance of sponsors and connection in recovery.

**Learning Outcomes:**

1. Understanding the 11th step: Gain insight into the significance of prayer and meditation in establishing conscious contact with a higher power as outlined in the twelve-step program.

2. Practical manifestation: Explore different methods to incorporate prayer and meditation into daily recovery practice, from reading meditation books to journaling and seeking guidance.

3. Impact of skepticism on recovery: Recognise the implications of skepticism and defiance on engagement with the twelve-step program, and the importance of empathy and exploration of alternative avenues for connection.

4. The role of sponsors and connection: Appreciate the significance of sponsors in reframing the 11th step and the transformative potential of finding connection in recovery.

**Actionable Takeaways:**

1. Start each day with a moment of prayer or meditation to establish a connection with a higher power and seek guidance on your journey of recovery.

2. Explore various methods of meditation, such as reading meditation books, journaling, or even engaging in outdoor activities, to foster a deeper spiritual and introspective practice.

3. Recognise the impact of skepticism on engagement with recovery programs and consider the role of empathy and exploration of alternative paths for connection and healing.

4. Emphasise the role of sponsors and the power of connection in finding support and reframing the 11th step, seeking guidance from those who have walked a similar path.

**Quote:**

"Getting quiet and doing meditation help facilitate the process of discerning the right choices, instead of overthinking and trying to solve problems on our own."

I chat with Dr Laura Petracek about unnecessary suffering. There is a famous saying: ”Pain is inevitable, suffering is optional”.

We all experience inevitable pain such as bereavement, separation, illness and ageing. Suffering is optional in that it is a function of how we react to the pain. Maladaptive coping strategies cause optional suffering. These include drug or alcohol misuse, or maladaptive psychological constructs such as wishing for a different outcome, anticipating the worst, ruminating on the outcome, or trying to change the outcome. Acceptance is the key to avoiding unnecessary suffering.

When we practice acceptance and focus on what we can control rather than what we can't, we can reduce our suffering and increase our resilience. This can include accepting the reality of the situation, letting go of our attachment to a specific outcome, and finding ways to move forward in a positive direction.

It's also worth noting that seeking support from others, such as friends, family, or a therapist, can be a helpful way to cope with pain and avoid unnecessary suffering. By sharing our experiences and emotions with others, we can feel less alone and gain new perspectives on our situation.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In today's episode, we will dive deep into Dr Laura's personal journey of addiction, mental health struggles, and finding a sense of belonging. From battling with substance abuse and self-destructive behaviours to overcoming societal and religious pressures, Laura's story is a testament to the power of resilience and the importance of seeking help.

We'll explore the pivotal moments that led to her recovery, the challenges she faced along the way, and the shifts in society's attitudes towards mental health and addiction.

So grab your headphones and get ready for a powerful and inspiring conversation on "Cracking Addiction."

In today's episode, we will dive deep into Dr Laura's personal journey of addiction, mental health struggles, and finding a sense of belonging. From battling with substance abuse and self-destructive behaviours to overcoming societal and religious pressures, Laura's story is a testament to the power of resilience and the importance of seeking help.

We'll explore the pivotal moments that led to her recovery, the challenges she faced along the way, and the shifts in society's attitudes towards mental health and addiction.

This episode is a must-listen if you're looking for motivation and guidance to overcome addiction. Throughout our conversation, Laura emphasizes the importance of seeking help and taking things one day at a time. Her story sheds light on the complexities of addiction and explores topics like mental illness, family dynamics, and finding a sense of belonging. By tuning in, you'll gain a deeper understanding of addiction and discover practical actions you can take to support yourself or someone you care about.

So grab your headphones and get ready for a powerful and inspiring conversation on "Cracking Addiction."

00:02:07]Teenage addiction, suicide attempt, recovery, treatment.

00:06:22] Bullied at home and school, seek refuge.

00:11:31] Struggles with identity, isolation, and belonging.

00:15:52] Finished school early in rehab, struggled without it.

00:16:58] Alcoholism, obsession, excessive drinking, financial consequences, sobriety.

00:23:03] Bipolar disorder, fear of medication, AA support.

00:29:08] Life turned better without lithium, but harder.

00:30:30] Unmedicated bipolar led to depression and instability.

00:36:51] Seek help for various issues; take it one step at a time.

In this episode of Cracking Addiction we mainly speak about

methamphetamines but also amphetamines and discuss the amphetamine class

of drugs and their physiological effects, the different types of

methamphetamines, symptoms of intoxication with amphetamines, side

effects of methamphetamine and amphetamines including the various organ

systems they impact and in particular the potential psychological and

psychiatric harms and focus on drug induced psychosis. 

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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I sit down with the inspiring Jesse Ball as we dive deep into the concept of spirituality and authenticity in recovery. The enlightening conversation reveals how Jesse transformed his life by reconnecting with his true self and breaking free from the chains of addiction. This is your opportunity to understand the profound impact of spiritual awakening and authentic living on the road to recovery.

Throughout this episode, Jesse and I unpack the disconnection that fueled his addiction and explore his journey toward understanding and embracing his authentic self. Jesse shares the revolutionary moment of spiritual realization that altered his path and offers valuable insights on maintaining that authenticity in daily life. If you're seeking practical advice on personal growth, emotional vulnerability, and authentic connection, you're in the right place.

Jesse's story is a beacon of hope and a testament to the power of taking responsibility for one's own life. By embracing his vulnerabilities, overcoming self-loathing, and making recovery his full-time job, Jesse discovered unimaginable strength and clarity. You'll learn how to release old narratives, confront your rock bottom, and build a life where your internal and external selves align perfectly.

In episode 58 of Cracking Addiction we discuss the pharmacology of benzodiazepines and their interaction with the GABA-A receptor, the different types of benzodiazepines and their different half lives and effects, discuss how to calculator benzodiazepine dose equivalence, the increased risks of benzodiazepine overdose when compared with other medications especially with opioid medications and the pharmacokinetics and metabolism of benzodiazepines.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Cracking Addiction discusses some of the special or difficult circumstances of prescribing LAIBs including intoxicated patients, pregnant patients, patients with chronic disease, patients with acute pain and our management strategies in these situations.

In today's episode, Dr. Ferghal Armstrong and Dr. Laura Petracek delve into the seventh step of the twelve-step program. They discuss the importance of humbly asking God to remove our character defects and how it is a continuous process rather than a one-time request. They explore the concept of progress, not perfection, and the active role we play in our personal growth. They also address the secular context of the seventh step, explaining that it can be reinterpreted to seek help from oneself, the community, therapists, or support groups. Discover how therapy can complement a twelve-step program and the importance of self-awareness in the journey of recovery

Episode 19 of Cracking Addiction explores the management of opioid use disorder in the post partum period.

Post birth the patient's usual oral methadone dose can be continued in the peripartum and post partum period. There is a theoretical concern in the postpartum period of over-sedation as methadone levels may increase as plasma volume and hepatic clearance normalise post the delivery of the child.

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Cocaine toxicity - In this episode of Cracking Addiction, we discuss the metabolites of cocaine, the different organ systems affected by cocaine, and the harms associated with cocaine use. We discuss the harms of coingestion in particular of alcohol and cocaine and the toxic metabolite cocaethylene. We also discuss the common adulterants mixed in with cocaine and the harms that can be caused by these adulterants.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Listen to this insightful episode of Cracking Addiction and unravel the complexities of substance use within the realm of professional sports, particularly the AFL.

We delve into the controversial handling of illicit drug use among players, balancing the tightrope between medical treatment and role-model expectations. This discussion is crucial for anyone looking to understand the multifaceted approach to addiction and substance use in high-pressure environments.

Join Dr. Ferghal Armstrong and guest journalist Max Laughton as they dissect the layers of policy, public perception, and personal care in the context of the AFL's recent drug use dilemma.

The focus of this episode lies in the intricate policy and personal care considerations surrounding illicit drug use among AFL players. Max helps us unfold the doctor-patient confidentiality within clubs, the allegation of deception through manufactured injuries, and the tension between medical care and punitive actions.

The conversation pivots to societal expectations of athletes as role models, the ethical conundra posed by possible performance enhancement, and the broader implications of substance use policies in sports. This episode offers a perspective shift urging compassion and understanding, instead of condemnation, in substance use management.

Learning Outcome 1:

Understanding the distinction between social substance use, addiction, and the role sports pressures play in substance use amongst AFL players. It is highlighted that not all substance use signals addiction and the pressures unique to AFL players can amplify the risks. Recognition of this nuance is crucial in addressing and managing substance use in professional sports. Ferghal articulates the importance of distinguishing occasional use from dependency and considering the broader psychosocial factors contributing to each player's situation.

Actionable Takeaway 1:

Encourage open dialogue about the psychosocial pressures associated with professional sports that could lead to substance use. Sports organizations can focus on preventive measures by fostering environments supportive of mental health and resilience training. It's essential to create an open forum for athletes to discuss their challenges without fear of punitive repercussions, cultivating a team culture that prioritizes well-being and support over punishment.

Learning Outcome 2:

The dilemma faced by AFL in balancing the medical model of substance use treatment with the expectation of punishment for 'misbehaviour'. AFL players caught using illicit substances aren't just athletes; they are individuals with complex personal circumstances and health needs. By exploring this sensitive terrain, listeners gain insight into the complexities of sports administration, ethical considerations, and the well-being of the players. Ferghal emphasizes the importance of treating substance use as a health issue rather than a criminal or purely disciplinary matter.

Actionable Takeaway 2:

Evaluate and potentially implement medical models of care for substance use amongst athletes in all sports sectors. By focusing on treatment rather than punishment, sports organizations can maintain the dignity of the player while addressing the health issue more effectively. Listeners involved in sports administration might consider advocating for or revising existing policies to integrate health-centric approaches to substance use.

**Quote or Insight:**

"AFL players caught using illicit substances aren't just athletes; they are individuals with complex personal circumstances and health needs." -

Dr. Ferghal Armstrong.

Join us in this episode as we hear from Dr. Tony Weeks, a former Director of Anaesthesia at Alfred Health, as he shares his experiences in treating doctors with addiction and working in a medically supervised injecting room. Dr. Weeks speaks candidly about the challenges of helping colleagues with substance use disorders, and the complexities of treating doctors who are also struggling with addiction.

After retiring from his work as an anesthetist, Dr. Weeks volunteered at a drug consumption room in North Richmond, Melbourne, where he helped patients find veins to inject into, assisted those who overdosed, and provided opioid substitution therapy. Through his vast and varied career, Dr. Weeks has seen firsthand the life-saving work that takes place in drug consumption rooms. He shares his insights on the evidence-based nature of harm reduction interventions, such as drug consumption rooms, and the importance of treating addiction as a public health issue.

Don't miss this thought-provoking conversation with Dr. Tony Weeks, where he sheds light on the challenges and rewards of helping those struggling with addiction, including colleagues and fellow doctors.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Are you curious about the hidden dangers lurking in the world of synthetic opioids? In this episode of "Cracking Addiction," Dr Ferghal Armstrong sits down with the incredible Prof. Suzanne Neilsen, Deputy Director of the Monash Addiction Research Centre, to dive deep into the chilling rise of nitazenes in Australia. As high-potency synthetic opioids, nitazenes are causing waves of concern, and their impact could be closer to home than you think.

What's a nitazene, you ask? These potent synthetic opioids came into existence through pharmaceutical research in the 1950s but are now making a perilous comeback in the illicit drug scene. As Suzanne and I chat, we unravel why these forgotten compounds are suddenly re-emerging and the harrowing effects they have, particularly respiratory depression. Also, did you know that nitazine contamination could be lurking in various recreational drugs like MDMA or ketamine, posing a lethal threat unexpectedly?

But don't just take my word for it—watch the video and have your questions answered by one of Australia’s leading experts in addiction research. Prof. Neilsen steps us through the nuances of these dangerous compounds, their presence in recreational drugs, and the life-saving importance of naloxone for overdose reversals.

**Learning Outcomes:**

1. **Understanding Nitazines:**

- Learn about Nitazenes, their chemical structure, and why they are considered highly potent opioids.

- Suzanne reveals that although they were initially developed for potential therapeutic uses, their severe side effects, including significant respiratory depression, halted their progress.

- Discover the historical context that has led to their re-emergence in the illicit drug scene.

- Recognise the distinction between different types of Nitazenes and their varying potencies and half-lives.

2. **Risk Awareness and Harm Reduction:**

- Understand the risks associated with Nitazene contamination in various illicit drugs, such as MDMA, ketamine, and cocaine.

- Gain insights into how synthetic opioids like Nitazenes and fentanyl increase the danger of overdose due to their potency and rapid onset.

- Develop awareness of the “sloppy drug dealer” theory and its implications for contamination.

- Learn about the broadening need for harm reduction initiatives that address not just opioid users but anyone using illicit drugs.

3. **Importance of Naloxone:**

- Comprehend the role of naloxone in reversing opioid overdoses, even caused by potent synthetic opioids like Nitazenes.

- Learn about the potentially higher doses of naloxone required to reverse nitazene-induced overdoses.

- Understand the importance of having multiple doses of naloxone on hand and the implications for stocking it in harm reduction services.

- Recognise the balance needed in administering naloxone to avoid severe withdrawal symptoms in patients.

**Actionable Takeaways:**

1. **Increasing Awareness and Education:**

- Educate yourself and your community about the dangers of synthetic opioids like nitazenes.

- If you’re in a position to influence policy, advocate for expanding drug-checking services to help identify contaminants before use.

- Spread the word about the importance of having naloxone readily available, especially in communities at risk.

- Support initiatives that provide harm reduction training to a broad audience, including those who might not identify as opioid users.

2. **Advocating for Harm Reduction Services:**

- Push for the establishment and funding of drug checking services in all states and territories, not just limited areas.

- Encourage local governments and organisations to support evidence-based harm reduction services.

- Participate in or initiate community...

Welcome to the latest instalment of the Cracking Addiction newsletter. In this episode, I dive deep into Step 10 of the twelve-step journey with Dr. Laura Petracek. We explore the ongoing process of personal inventory and prompt amends, shedding light on the critical role of self-reflection in addiction recovery.

Why Listen:

If you're looking to gain insights into maintaining sobriety and personal growth in addiction recovery, this episode is not to be missed. Step 10, addressed alongside Dr. Laura Petracek, delves into the ongoing commitment to self-reflection and the importance of making amends. It also offers valuable lessons for anyone seeking to improve their personal growth journey.

Key Points You Will Learn:

1. The 10th step involves an ongoing self-reflection process where individuals take inventory of their daily behaviours and promptly make amends when necessary.

2. Step 10 is not a formalised process like the previous steps. It represents a summary of the earlier steps, requiring individuals to take personal responsibility for their actions.

3. Dr. Laura Petracek sheds light on the challenges individuals face in staying on their side of the street and not resorting to the blame game when making amends.

4. The episode discusses how relapse is not an inevitable part of the recovery journey and explores the significance of mindset in preventing a potential relapse.

5. We delve into the analogy of recovery being akin to cycling uphill, emphasising the need for ongoing effort and growth to prevent stagnation or relapse.

Interesting Fact:

The episode highlights the concept that relapse is a process, not just a single event. Dr. Laura Petracek explains that the cognitive distortions and behaviours leading up to the actual act of picking up a drink or a drug are equally crucial and warrant attention.

Learning Outcomes and Actionable Takeaways:

1. Develop an understanding of the ongoing self-reflection process involved in Step 10 and recognize the importance of making amends promptly.

2. Gain insights into the challenges individuals face in maintaining personal accountability and learn strategies to overcome the tendency to indulge in the blame game.

3. Understand the nuanced view of relapse as a process and explore the proactive efforts that can help prevent a potential relapse.

4. Embrace the analogy of recovery being akin to cycling uphill, fostering a mindset of continuous effort and growth to sustain sobriety and personal development.

5. Gain valuable insights from Dr. Laura Petracek's personal journey and expertise, reinforcing the idea of recovery as an ongoing and transformative process.

As Dr. Laura Petracek aptly puts it, "I feel we could concentrate or bring that message. Like, that's not an option anymore. I feel there's so much permission, and that's okay. You could go out 50 million times, and I think that could be changed."

In this episode of Cracking Addiction, Dr. Ferghal Armstrong and Dr. Laura Petracek delve into the complexities of the 9th step of the addiction recovery journey, which involves making direct amends to those who have been hurt. Dr. Petracek shares insights from her personal experience, providing a deep understanding of the emotional and psychological struggles involved in this step. Listeners will gain an in-depth understanding of the 9th step, the process of making amends, the intricate dynamics involved, and the impact on recovery.

Inhalant Abuse: Understanding the Dangers of Hydrocarbon and Nitrite Inhalation - Hydrocarbon inhalants are substances that are inhaled for their intoxicating effects. They include a wide range of products, such as gasoline, paint thinner, glue, and aerosol sprays. These substances are commonly abused by inhaling the fumes, which can produce a feeling of euphoria and relaxation. However, inhaling hydrocarbon fumes can be extremely dangerous and can lead to a number of negative health effects, including respiratory problems, brain damage, and even death. Additionally, inhaling these substances can also be highly flammable and can lead to fires and explosions. It is important to avoid inhaling hydrocarbon fumes and to seek help if you or someone you know is struggling with addiction to these substances.

Additionally we discuss nitrites which are vasodilators and can create a warm rush and sensation of warmth and also can be used as a chemsex drug which can cause anal sphincter relaxation. Side effects can include headaches, hypotension, methaemoglobinaemia and can cause burns if nititres are exposed to a flame.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode Stephen Herd and I discuss the Power and Control Wheel: a widely used tool to help understand the dynamics of family violence and identify ways to address it.

The Power and Control Wheel was developed by a group of activists in Duluth, Minnesota, in the 1980s, who recognised the need for a comprehensive approach to address family violence. The Duluth Model is based on the belief that domestic violence is a result of the abuser's desire for power and control over their partner.

According to the Duluth Model, domestic violence is not caused by anger, substance abuse, or mental illness. Instead, it is a deliberate tactic used by abusers to control and dominate their partners. The Duluth Model identifies several different types of abuse, including physical abuse, sexual abuse, emotional abuse, economic abuse, and psychological abuse. These are presented in the Power and Control Wheel as a circular diagram that outlines the different tactics used by abusers.

The Power and Control Wheel helps to illustrate the cyclical nature of family violence. The abuser may use a combination of different tactics to gain control over their partner, and the victim may respond with different coping strategies, such as walking on eggshells or trying to appease the abuser. Over time, the abuse can escalate, and the victim may feel trapped and unable to escape the cycle of violence.

The Duluth Model and Power and Control Wheel are useful tools for understanding the dynamics of family violence and identifying ways to address it. They help to shift the focus away from the victim and onto the abuser, recognizing that family violence is a result of a deliberate choice made by the abuser to maintain power and control.

There are several different approaches to addressing family violence, including criminal justice interventions, civil protective orders, and community-based interventions. The Duluth Model emphasizes the need for a coordinated community response to address family violence, including law enforcement, the court system, and community-based organizations.

One of the strengths of the Duluth Model and Power and Control Wheel is that they recognize the importance of a multi-disciplinary approach to addressing family violence. Family violence is a complex issue that requires a coordinated response from multiple sectors, including the criminal justice system, social services, healthcare, and education.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Cocaine, Crack and Freebase -In this episode of Cracking Addiction we

explore cocaine, it's origins, the difference between powder cocaine and

crack and freebase and the effects of cocaine on various organ systems

and in pregnancy.

Cocaine is a stimulant drug that is made from the leaves of the coca plant. It is a powerful psychoactive substance that is commonly used for recreational purposes. When ingested, cocaine produces feelings of increased energy, alertness, and euphoria. It is also a potent anesthetic and can be used medically to numb tissues and decrease bleeding during surgery.

Crack is a form of cocaine that has been processed to create a rock crystal, which can be smoked. Crack cocaine is highly addictive and produces a strong, immediate high that lasts for only a few minutes. The high is followed by a crash that leaves the user feeling exhausted and depressed.

Freebase is another form of cocaine that has been processed to create a more pure, potent form of the drug. It is made by mixing cocaine with ammonia or sodium bicarbonate and heating the mixture to remove the hydrochloride salt, which makes the cocaine more soluble in water. This allows the drug to be smoked, producing an intense, short-lived high. Freebase cocaine is extremely potent and can be very dangerous due to the high risk of overdose.

It is important to note that all forms of cocaine are potentially harmful and can have serious short-term and long-term health effects. Regular use of cocaine can lead to addiction and can have detrimental effects on mental and physical health.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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The Sensory Awareness Rule of Five is a technique that involves shifting one's focus from distressing thoughts or emotions to neutral sensory input. By focusing on what we can see, hear, feel, smell, and taste, we can ground ourselves in the present moment and reduce the intensity of our distress. This technique can be particularly helpful for individuals who experience re-experiencing symptoms associated with PTSD. By focusing on neutral stimuli, we can shift our attention away from distressing memories or flashbacks and regain a sense of control.

To use this technique, you can start by taking a few deep breaths and then focus on the present moment. What can you see around you? What sounds can you hear? What sensations can you feel in your body? What smells can you detect? What tastes can you identify? Take a few moments to observe these neutral sensory inputs and allow yourself to become fully present in the moment. This can help you to calm down and reduce the intensity of your distress.

Improve the Day Mnemonic

The "Improve" the day system is a useful intervention for managing distress that involves focusing on six areas of our lives that can improve our overall well-being and reduce distress. By implementing small changes in these areas, we can improve our mood, reduce distress, and enhance our overall well-being.

The acronym "Improve" stands for:

1. Imagery: This involves using visualization techniques to imagine positive outcomes or situations. By visualizing positive outcomes, we can create a sense of hope and optimism. For example, if we are feeling distressed about an upcoming presentation, we can visualize ourselves giving a successful presentation and receiving positive feedback from our audience. This can help us feel more confident and less anxious about the upcoming event.
2. Meaning: This involves identifying activities or experiences that give our lives meaning and purpose. When we engage in activities that are aligned with our values and beliefs, we experience a sense of fulfillment and satisfaction. For example, if we value helping others, we can engage in volunteer work or donate to a charitable organization. This can give us a sense of purpose and meaning, which can help reduce distress.
3. Prayer: This involves engaging in spiritual or religious practices that provide comfort and support. For individuals who have a spiritual or religious practice, engaging in prayer or meditation can provide a sense of comfort and support. This can help reduce distress and provide a sense of connection to something larger than ourselves.
4. Relaxation: This involves engaging in activities that promote relaxation and reduce stress, such as deep breathing, meditation, or yoga. When we are stressed or anxious, our body responds by releasing stress hormones, such as cortisol and adrenaline. By engaging in relaxation techniques, we can reduce the amount of stress hormones in our body and promote a sense of calm and relaxation.
5. One thing: This involves identifying one small thing we can do each day to improve our mood or well-being. This can be something as simple as taking a few minutes to listen to our favorite song, going for a walk, or calling a friend. By focusing on one small thing each day, we can create a sense of accomplishment and positivity, which can help reduce distress.
6. Vacation: This involves taking time off from work or other responsibilities to engage in enjoyable activities or travel. Vacations provide an opportunity to relax, recharge, and engage in activities that bring us joy and fulfillment. By taking time off from our regular routine, we can reduce stress and improve our overall well-being.

In conclusion, the "Improve" the day system is a useful intervention for managing distress that involves focusing on six areas of our lives that can improve our overall well-being and reduce distress. By implementing small changes in...

In this episode of Cracking Addiction, I sit down with Jesse Ball to explore the profound journey of breaking free from addiction and embracing a fulfilling life in recovery. If you're looking for motivation and real-life insights on addiction, recovery, and maintaining sobriety, this video is just for you! Keywords: addiction, recovery, sobriety.

We dive deep into Jesse's personal experiences, from the pivotal moments that made recovery attractive to the ongoing practices that help him stay clean. You'll hear about the power of accountability, the journey through the twelve-step program, and how even salsa dancing can play a role in the path to a new life. Jesse’s story resonates with the struggles many face, and his tips on fitness, diet, and mental health are invaluable for anyone navigating their own recovery or supporting someone in theirs. Keywords: addiction, recovery, sobriety.

Trigger for Change: A realisation by the age of 25 that continuing to use drugs over a past breakup was no longer a valid reason.

Trauma and Substance Use: Emphasised the importance of not validating a victim mindset to avoid feeling disempowered and reinforcing the ability to change one's life.

Power and Accountability: Recognising powerlessness over addiction paradoxically empowers individuals to actively seek help and make lifestyle changes.

Sustaining Recovery: Success in early recovery involved following advice from experienced individuals in recovery, engaging in therapy, fitness, and building accountability through relationships and activities.

Maintaining Recovery: Continuously engaging in healthy habits such as regular exercise, meditation, and diet, while exploring new interests and remaining accountable to oneself and others.

TIPP is a simple and effective acronym that stands for Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation. Each component of TIPP is designed to help us manage acute distress in a different way.

Temperature: Exposure to cold temperatures has been shown to reduce sympathetic nervous system tone and increase parasympathetic nervous system tone. This means that cold exposure can help us calm down and feel more relaxed. To use this technique, you can try putting your face into a bucket of iced water for 30-60 seconds. While this may sound unpleasant, it can be a powerful tool for managing acute distress.

Intense Exercise: Intense exercise can help disperse the adrenaline rush associated with acute distress. When we experience distress, our body releases adrenaline, which prepares us for fight or flight. However, if we do not use this adrenaline, it can build up and cause us to feel more anxious or agitated. Intense exercise can help us burn off this adrenaline and feel more calm and relaxed. To get the most benefit from intense exercise, it is important to reach our maximal heart rate. Our maximal heart rate is calculated as 220 minus our age. For example, if you are 30 years old, your maximal heart rate would be 190 (220-30=190). To get the most benefit from exercise, we should aim to achieve 90% of our maximal heart rate for 30-second bursts. This can increase our fitness and also reduce our emotional distress.

Paced Breathing: Paced breathing is a technique that involves slowing down our breathing to help us feel more calm and relaxed. To use this technique, we should inhale for 4 seconds, hold our breath for 4 seconds, and then exhale for 4 seconds. This can be repeated for several minutes until we feel more calm and relaxed.

Progressive Muscle Relaxation: Progressive muscle relaxation is a technique that involves tensing and then relaxing different muscle groups in our body. This can help us release tension and feel more relaxed. To use this technique, we should tense our muscles for 5-10 seconds and then relax them for 10-20 seconds. This can be repeated for several minutes until we feel more relaxed.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Medicinal Cannabis Part 1– In this episode of Cracking Addiction, we are joined by Dr. Jim Connell, a GP and medicinal cannabis prescriber and the founder and chief medical officer of Heyday Medical. In this episode of Cracking Addiction, we discuss the endocannabinoid system, cannabis, and the cannabinoids that comprise cannabis, the history of medicinal cannabis, the current indications for medicinal cannabis, the evidence for cannabis for anxiety, depression, chronic pain, and sleep, and whether there is a role or any evidence for medicinal cannabis as an opioid-sparing agent, as well as how to select patients appropriately for a trial of medicinal cannabis.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Welcome to another episode of Cracking Addiction! I'm your host, Dr. Ferghal Armstrong, and the brilliant Dr. Laura Petracek is joining me today.

In this episode, we dive deep into the topic of why some patients feel they don't need to achieve abstinence and believe they can control their substance use or drinking.

We explore the psychological aspects at play, including cognitive distortions and denial. We also discuss the underlying reasons behind this cognitive distortion, such as the enjoyment and positive effects of alcohol and using it to suppress negative emotions.

But how do we approach treatment for patients who are engaged but not acknowledging the need for abstinence?

Dr. Petracek shares her insights on using a harm reduction approach and motivational interviewing to meet the clients where they are. We also touch upon the fear associated with contemplating a life without alcohol and the importance of shifting negative goals to positive ones.

Lastly, we examine the impact of trauma and impulse control disorders on substance use and how to address trauma in this context.

So grab a cup of coffee, sit back, and join us as we unlock the complexities of addiction on Cracking Addiction.

00:00:04 Discuss the patient's reluctance to achieve abstinence.

00:06:15 Tracking alcohol consumption to break denial promotes self-reflection.

00:09:04 Commit to engagement, reduce consumption, and seek support.

00:13:32 Trauma is a key driver for addiction.

00:17:58 Some people can control their drinking.

00:20:43 Consequences of risking sober successes for a thrill.

In this episode of Cracking Addiction we discuss various smoking cessation interventions including behavioural interventions, nicotine replacement therapy, varenicline, bupropion and nortriptyline to aid patients in stopping smoking.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Episode 21 of Cracking Addiction explores methadone pharmacokinetics, breakdown and interactions within the body and interactions with other drugs.

Methadone is a drug with a wide variability in its absorption with oral bio-availability ranges from 35% to 100%. This is a significant amount of variability and explains why the same dose of Methadone can impact different patients differently.

Methadone is metabolised within the liver by the cytochrome P450 enzymes but mainly 3A4. There is a 17-fold inter-individual variation of methadone blood concentration for a given dosage and variations in metabolism account for a large part of this variation. Kinetic interactions influenced by the CYP 450 enzyme can affect plasma methadone levels.

• Inducers of CYP450 can

• Accelerate the metabolism of methadone

• lower methadone plasma levels

• Precipitate opioid withdrawal

• Inhibitors of CYP450 can

• Slow the metabolism of methadone

• Increase plasma levels

• Produce opioid toxicity (sedation, overdose)

Methadone is excreted renally with approximately 10% of drug renally eliminated unchanged. Renal excretion of methadone urinary pH dependent with increased Methadone excretion noted at pH less than 6 and decreased Methadone excretion at higher pH levels.

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In episode 29 of Cracking Addiction we discuss Suboxone and talk about the components of Suboxone as well as the pharmacology and pharmacokinetics of Suboxone.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Dr. Ferghal Armstrong and Dr. Manu Bhatnagar delve into the complex and often misunderstood topic of adult ADHD. They discuss the prevalence of ADHD in adults, the potential role of environmental factors in its development, and the challenges in diagnosing and treating this condition in adulthood. Listeners will gain valuable insights into the differential diagnosis of ADHD, the potential impact of trauma and substance use on inattention, and the nuances of medication management for individuals with ADHD.

Keywords: Adult ADHD, diagnosis, differential diagnosis, trauma, substance use, medication management.

Learning outcomes:

1. Understanding the prevalence and presentation of adult ADHD: The episode sheds light on the prevalence of adult ADHD and how the symptoms may manifest differently in adults compared to children. Listeners will learn about the challenges in accurately diagnosing adult ADHD and the potential impact of environmental factors on its development.

2. Exploring differential diagnoses: The speakers discuss the importance of exploring differential diagnoses for acquired inattention syndrome, including substance use, PTSD, and borderline personality disorder. Listeners will gain insights into how these conditions may present similarly to ADHD but require distinct diagnostic and treatment approaches.

3. Examining the impact of trauma and substance use: The episode addresses the role of trauma and substance use in exacerbating inattention and emotional dysregulation. Listeners will understand the complex interplay between trauma, substance use, and the development of inattention symptoms, particularly in the context of ADHD.

4. Navigating medication management for ADHD: The speakers provide valuable insights into the complexities of medication management for individuals with ADHD, including potential comorbidities such as substance use disorders. Listeners will learn about the need for comprehensive treatment approaches that go beyond pharmacotherapy to address the functional impairments associated with ADHD.

Actionable takeaways:

1. Conduct a thorough differential diagnosis: When evaluating patients for suspected adult ADHD, consider a comprehensive differential diagnosis that encompasses trauma, substance use, and other mental health conditions that may present similarly to ADHD. This approach can ensure accurate diagnosis and tailored treatment plans.

2. Consider the impact of trauma and substance use: Take into account the potential impact of trauma and substance use on inattention and emotional dysregulation when assessing individuals for ADHD. By addressing underlying trauma and substance use issues, healthcare providers can better support individuals with ADHD.

3. Incorporate non-pharmacological interventions: Recognize the importance of incorporating non-pharmacological interventions, such as ADHD coaching and psychosocial support, alongside medication management for individuals with ADHD. This comprehensive approach can address the long-term functional impairments associated with the condition.

4. Advocate for comprehensive care: Encourage a multidisciplinary approach to the management of adult ADHD, involving collaboration between mental health professionals, addiction specialists, and primary care providers. By advocating for comprehensive care, healthcare providers can address the diverse needs of individuals with ADHD.

Insight: "All roads lead to Rome. So really, the inattentive prefrontal cortex is the final common pathway of the vast majority of mental health disorders, including substance use disorders." - Dr. Ferghal Armstrong

Hashtags: #ADHD #AdultADHD #MentalHealth #SubstanceUse #Trauma #Diagnosis #DifferentialDiagnosis #MedicationManagement #PsychosocialSupport #ComprehensiveCare

In episode 35 of Cracking Addiction we discuss in detail some of the psychiatric comorbidities associated with substance use disorders and what to screen for, be aware of and some management techniques.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction, Scot Aitken and Dr Ferghal Armstrong chat about Johan Hari’s book, Chasing The Scream. We explore some of themes of the book including the motivations that underpin the war on drugs, the economic factors that affect the war on drugs and the role of decriminalization of drug use.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction we discuss the harms associated with tobacco use, the health benefits of tobacco cessation, briefly discuss smoking cessation interventions and highlight the importance of brief interventions in eliciting behaviour change.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction we are again joined by Dr Colin Mendelsohn to discuss the controversies around vaping including the risks around vaping, the thoughts of vaping being a gateway to smoking cigarettes, the risks of EVALI, the role of 'Big Tobacco' in vaping, looking at the evidence around vaping and challenging some of the latest reviews around vaping

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this riveting episode of Cracking Addiction, Dr Ferghal Armstrong and Dr Richard Bradlow shed light on the complex issue of alcohol use and withdrawal, providing critical insights and practical guidance for individuals and healthcare professionals alike. The duo explores detailed diagnostic criteria and the implications of daily alcohol consumption and addresses the signs that might indicate a move towards severe withdrawal symptoms. Learn about the societal impacts of drinking norms and the misconceptions that might be putting individuals at risk without them even realising it. This episode uncovers the stark differences between casual drinking and potential alcohol dependence that could lead to serious health consequences.

**Learning Outcomes:**

1. Understand the varied patterns of alcohol withdrawal and how personal history affects its likelihood. Richard emphasizes the importance of individual patient history in predicting withdrawal symptoms such as seizures.

2. Discover the guidelines for safe alcohol consumption set by different governments and how they compare, highlighting discrepancies that might affect public health advice. Particularly, the comparison between Australian, Canadian, and American standards provides a global view of alcohol consumption benchmarks.

3. Recognize the clinical signs of alcohol withdrawal, applying both psychological and physiological markers, including the mnemonic PAST NIGHT (Psychomotor Agitation, Anxiety, Seizures, Terrors, etc.) proposed by Ferghal for easier recall during assessments.

4. Learn about the significant risks associated with ignoring other potential diagnoses when a patient presents symptoms similar to alcohol withdrawal, underscoring the necessity of comprehensive medical evaluation.

In this episode of Cracking Addiction we discuss the variety within the

class of synthetic cannabinoids, symptoms of synthetic cannabis

intoxications, side effects and complication of synthetic cannabis usage

and specific considerations in withdrawal management.

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In this episode of Cracking Addiction we discuss tobacco use in

pregnancy and the those with mental health disorders and the evidence

around smoking cessation in these special population groups.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction, Dr. Ferghal Armstrong and Dr. Manu Bhatnagar delve into the complexities of screening for ADHD in both children and adults. They break down the core concepts of inattention, impulsivity, and hyperkinesis, providing valuable insights into the often-misunderstood symptoms of this condition. Understanding how ADHD presents in children and adults, as well as the differential diagnosis considerations, can be crucial for parents, educators, and healthcare professionals. This episode offers valuable information for anyone navigating the challenges of identifying and understanding ADHD.

Focus Keyword: ADHD Screening

Dr. Manu Bhatnagar provides an in-depth understanding of inattention, explaining that ADHD doesn't necessarily equate to a deficiency in attention, but rather an inability to focus on a particular task for an extended period. He clarifies the distinction between concentration and attention, shedding light on the struggles individuals with ADHD face in prioritizing tasks and maintaining focus.

Learning Outcomes:

1. Understanding the Complexities of ADHD Presentation: Dr. Bhatnagar's insights highlight the multifaceted nature of ADHD symptoms, providing a clearer understanding of the challenges individuals face in managing their attention and impulsivity.

2. Differential Diagnosis Considerations: By exploring alternative diagnoses such as anxiety and autistic spectrum disorder, listeners gain an understanding of the importance of comprehensive assessments in ruling out other potential conditions before reaching an ADHD diagnosis.

3. The Impact of ADHD on Children: The episode delves into the potential repercussions of undiagnosed ADHD in children, offering valuable insights for parents and educators to recognize and address symptoms early on.

4. Utilising Screening Tools and Collateral Interviews: The discussion emphasises the significance of structured screening tools and obtaining collateral information from multiple sources to achieve a robust ADHD diagnosis.

Actionable Takeaways:

1. Encourage Collaborative Approach: Healthcare professionals, educators, and parents are encouraged to collaborate in providing comprehensive insights into a child's behaviour, ensuring all facets are considered when assessing ADHD.

2. Early Intervention: Recognising and addressing symptoms of ADHD in children early on can help prevent potential emotional and psychological impacts, emphasising the need for proactive intervention and support.

3. Comprehensive Assessments: Consider a holistic approach to diagnosis, including screening tools, collateral interviews, and comprehensive assessments, ensuring a thorough evaluation to capture the complexities of ADHD symptoms.

4. Seeking Support and Understanding: Individuals with ADHD may benefit from tailored support and understanding, emphasizing the importance of creating an environment that accommodates neurodiversity.

Quote:

Dr. Bhatnagar highlights the impact of undiagnosed ADHD, stating, "You can treat ADHD with a pill, you can't undo years of having undiagnosed ADHD and what that might do to someone's sense of self."

keywords

ADHD, prevalence, mental disorder, neurodevelopmental, screening, impulsivity, inattention, hyperkinesis, concentration, dopamine, norepinephrine, hyperfocus, success, expert, myth, functional, diagnostic criteria, sex gender, subtype, fidgeting, impulsivity, hyperactivity, angry outbursts, anxiety, sensitivity, specificity, differential diagnosis, language disorder, autism spectrum disorder, social services, psychosocial interventions

Welcome to another episode of Cracking Addiction, where we delve into the world of addiction and recovery. In this episode, Dr. Ferghal Armstrong and guest Dr. Laura Petracek explore the third step in the twelve-step process. They discuss the concept of turning our will and our lives over to a higher power, exploring different interpretations of what that higher power may be. Dr. Petracek shares her insights on the challenges of surrendering oneself to the unknown and the importance of accountability in the recovery process. They also discuss the Serenity Prayer and its role in understanding the third step. If you're interested in addiction recovery and understanding the power of surrender, this episode is a must-listen.

Key Points and Learning Outcomes:

1. Understanding the Concept of Higher Power: The third step involves making a conscious decision to turn our will and our lives over to the care of a higher power as we understand it. This concept varies for each individual, and it can include religious beliefs, nature, support groups, or even a sponsor. By exploring different interpretations, we can personalize our recovery journey and find a source of accountability and support.

2. Accountability and the Need for Human Connection: Surrendering to a higher power alone may not provide enough accountability in recovery. Dr. Petracek highlights the importance of involving real people, such as sponsors or support groups, in our commitment to abstain from addictive substances. This external accountability helps to overcome denial and provides a stronger foundation for long-term recovery.

3. Surrendering Self-Control and Willpower: The idea of surrendering our self-control, willpower, and identity can be daunting for many individuals. Particularly for those who have relied on drugs or alcohol as a coping mechanism, letting go of familiar habits may feel like stepping into the unknown. However, surrendering the things we cannot change is a crucial step towards personal growth and finding serenity in recovery.

4. Addressing Doubts and Skepticism: Some individuals may find difficulty with the third step due to its traditional association with a white Christian God. To overcome this barrier, reframing the concept of a higher power is vital. Books such as "Twelve Steps a Woman's Way" or using therapy approaches like dialectical behavior therapy can help individuals find a more inclusive interpretation that aligns with their personal beliefs and culture.

Actionable Takeaways:

1. Explore Your Understanding of Higher Power: Take time to reflect on your own understanding of a higher power. Consider what brings you a sense of peace, support, and guidance. It doesn't have to conform to traditional notions; it should be a source of strength that resonates with you.

2. Seek Accountability in Human Connections: Find someone you trust, such as a sponsor or a support group, to hold you accountable in your recovery journey. Sharing your commitments and struggles with others can significantly enhance your chances of maintaining sobriety.

3. Embrace Surrender and Letting Go: Recognize the limitations of your control over certain aspects of life. Embrace the idea of surrendering the things you cannot change and focusing your energy on the areas where you can make a difference.

4. Challenge Traditional Notions: If you struggle with the concept of a higher power due to cultural or religious differences, explore alternative perspectives and resources that align with your beliefs. Look for books, communities, or therapists who can help you reframe the concept to make it more inclusive and meaningful for you.

Quote:

"It's like you're asking them to go off a cliff without a parachute. It's very scary. But not drinking or drugging is scary because you don't know what's going to happen. But if I wake up and have a beer, I know exactly what's going to happen and it's not...

In this episode of Cracking Addiction, we are again joined by addiction psychiatrist Dr Dan Pham and discuss how to take a trauma history without further traumatising or triggering a patient. We also discuss the diagnostic criteria for PTSD and how to formulate this condition. In this episode, we discuss trauma-informed care and how to treat and manage trauma and PTSD, and what psychological and medical therapies may be useful to manage this condition, and briefly touch on some of the emerging research surrounding psychedelic-assisted psychotherapy in PTSD.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Are you curious about how alcohol really affects your heart health? In this eye-opening episode of "Cracking Addiction," Dr. Richard Bradlow and I, Dr. Ferghal Armstrong, dive deep into the science behind alcohol consumption and its impacts on diseases like high blood pressure and heart disease. This video is packed with insights that you won't want to miss!

Alcohol and heart health are two critical subjects that often spark extensive debates. In today's discussion, we'll explore the common questions that many people have about alcohol and its relationship with high blood pressure and heart disease. We'll debunk myths, reveal surprising facts, and help you understand the intricate balance between potential benefits and significant risks.

We start with the famous debate on whether alcohol, especially red wine, can be good for your heart. While resveratrol in wine does have some health benefits, I explain how the harmful effects of excessive alcohol consumption far outweigh these perks. Dr. Bradlow and I cover topics like alcoholic cardiomyopathy, thiamine deficiency, and the dangerous path toward cirrhosis and other liver issues. Understanding these mechanisms will give you a clearer picture of what too much alcohol can do to your body, especially your heart.

In today's episode, we have a special guest, Celeste Yvonne, sharing her personal experiences and insights on quitting alcohol and embracing a sober life.

Celeste discusses the challenges that many individuals face when attempting to break free from the clutches of addiction, particularly when it comes to alcohol. She explores the fears of not fitting in, losing friends, and the belief that without alcohol, life may not be as enjoyable. Drawing from her own journey, Celeste opens up about feeling disconnected from her own life and losing her sense of identity without alcohol.

However, she also reveals the incredible transformation and self-discovery that await those who embark on the path to sobriety. Celeste discovered that most things in life are actually more enjoyable without alcohol, and that those activities that may not be as enjoyable without it may not be worth pursuing in the first place.

As a mother, Celeste bravely shares the challenges she faced while dealing with hangovers and the intense anxiety, frustration, and self-doubt that consumed her ability to care for her child. This pivotal moment led her to make a choice between continuing to drink or becoming the mother she wanted to be.

Celeste also takes us on her journey of writing a book, which began as a memoir about quitting drinking and staying sober but evolved into a powerful combination of memoir, research, and inspiring stories from other women and mothers who have found strength and sobriety.

Through personal anecdotes, Celeste recounts the transformative experience of taking a sober vacation at an all-inclusive resort, where alcohol was readily available at every turn. Despite initial fear and anxiety, she embraced her sobriety and discovered a newfound sense of power, freedom, and enjoyment in waking up early, working out, and savouring moments with her husband.

We also delve into Celeste's moments of doubt and her decision to quit drinking after experiencing a panic attack at work, fearing that she would follow in her father's footsteps of addiction. Her upbringing in a home with addiction and her mother's constant weight obsession played a significant role in shaping her relationship with alcohol and food.

Join us as we explore Celeste's journey of self-discovery, resilience, and the power of breaking free from addiction. This episode of Medheads will inspire, educate, and provide hope to those who are facing their own battles with addiction.

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Episode 27 of Cracking Addiction discusses the patient journey on LAIB and how to adequately deal with and manage adjusting doses of LAIB, commencing and ceasing LAIB and ensuring that patients are maintained on LAIB therapy

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction, Dr. Ferghal Armstrong and Dr. Manu Bhatnagar delve into the complex issue of psychosis in the context of withdrawal treatment or when withdrawing from stimulants such as methamphetamine. They explore the challenges of distinguishing between drug-induced psychosis and primary psychotic disorders, and discuss the intricacies of treatment options, including the use of benzodiazepines and antipsychotics. With valuable insights and clinical expertise, this episode provides a deep understanding of the management of psychosis in the context of substance withdrawal.

Key Points:

- Differentiating between drug-induced psychosis and primary psychotic disorders is a challenging yet crucial aspect of patient care in the context of substance withdrawal.

- Understanding the neurochemical impact of stimulants on the brain and the implications for treatment is essential for managing psychotic symptoms effectively.

- The role of benzodiazepines and antipsychotics in controlling agitation and psychotic symptoms during withdrawal and the potential transition to more long-term antipsychotic therapy in cases of persistent symptoms.

- The importance of comprehensive and integrated psychosocial support alongside medication in ensuring long-term recovery and abstinence.

Insightful Quote:

"The best amount of medication is the least effective dose. My role is to say, how much support can we put around you? So I can bring this dose down to a level where it's causing the least amount of side effects, but it's just enough to prevent the next episode happening." - Dr. Manu Bhatnagar

Learning Outcomes:

1. Gain insights into the complexities of distinguishing between drug-induced psychosis and primary psychotic disorders, and the implications for treatment decisions.

2. Understand the neurochemical basis of stimulant-induced psychosis and the role of medications such as benzodiazepines and antipsychotics in managing psychotic symptoms during withdrawal.

3. Appreciate the significance of longitudinal assessment and psychosocial support in the overall management of psychosis in the context of substance withdrawal.

4. Explore the potential transition to long-term antipsychotic therapy and the importance of holistic approaches to supporting recovery and abstinence.

Actionable Takeaways:

1. When managing patients undergoing withdrawal from stimulants, establish a timeline of substance use and psychotic symptoms to differentiate between drug-induced psychosis and primary psychotic disorders.

2. Consider the neurochemical impact of stimulants and the mechanisms of action of benzodiazepines and antipsychotics to tailor treatment for psychotic symptoms during withdrawal.

3. Emphasize the role of comprehensive psychosocial support and longitudinal assessment in ensuring successful recovery and abstinence post-withdrawal.

4. Strive for a balanced approach to medication, aiming for the least effective dose while providing adequate support to prevent future episodes of psychosis.

Dr. Ferghal Armstrong and Jesse Ball explore the foundational aspects of early recovery from addiction, highlighting the roles of honesty, support systems, and effective routines. Jesse shares how a no-nonsense, empathetic counsellor with lived experience catalysed his transformation. This episode delves deep into practical strategies to navigate the vulnerable early stages of sobriety and sustain long-term recovery. Listen in for invaluable lessons that go beyond recovery—these are life skills everyone should possess.

**Learning Outcomes and Actionable Takeaways:**

1. **Honesty and Vulnerability in Recovery:**

Jesse emphasises the pivotal role of being completely honest with his counsellor. The absence of judgement and the presence of lived experience created a safe space for Jesse to be vulnerable. By being open about his behaviours and feelings, Jesse was able to receive tailored, effective advice, which was instrumental in his recovery. Honesty not only builds trust but also catalyses tailored interventions essential for overcoming addiction.

2. **The Power of Support Systems:**

One of the most significant aspects of Jesse’s recovery was his willingness to listen to others who had walked the same path. Building relationships with those who have lived experience can provide crucial support and inspiration. During weak moments, reaching out to someone who understands your struggle can make all the difference. Jesse's experience underscores the importance of having a robust support network ready to offer reasoning when self-delusion creeps in.

3. **Establishing a Routine:**

Jesse’s disciplined approach to his daily routine played a critical role in his recovery. From morning walks to regular therapy sessions and meetings, a structured day helped him stay focused and avoid relapse. Incorporating simple, healthy habits like exercising, eating well, and staying occupied can support mental clarity and emotional stability. A consistent routine creates a sense of normalcy and purpose, essential in the tumultuous early stages of recovery.

4. **Cutting Ties with Negative Influences:**

Jesse made the tough but necessary decision to distance himself from his old friendship group, realising the importance of eliminating risky environments. This bold choice was driven by understanding that his life depended on his recovery. By only engaging in safe social interactions, Jesse minimised triggers and maximised his chances of staying sober. This teaches us the crucial lesson that prioritising health sometimes means making difficult choices about relationships.

5. **Proactive Planning for Crises:**

Jesse's proactive strategy to pre-empt and address moments of weakness was another key to his success. Knowing the likelihood of temptation, he ensured he had trusted individuals to call when those 'mind worms' started speaking. This preparedness to seek external voices of reason is critical in averting relapse. Planning for crises is an actionable step everyone in recovery should adopt, recognising that the path is fraught with moments requiring external reinforcement.

**Quote:**

*"Often, it's someone else's voice of reasoning during those really weak, vulnerable moments that can be the difference between success and failure."* – Jesse Ball.

We delve into the fascinating realm of cognitive distortions and the powerlessness individuals with addiction often face. Dr. Petracek shares her experiences and insights, highlighting the importance of motivational interviewing and the dangers of attempting to control drinking habits. We'll also explore the concept of hitting rock bottom and societal pressures that prevent individuals from seeking help.

Timestamped Overview

00:01:15 Inability to control substance consumption, cognitive distortions.

00:05:53 Motivational interviewing is a helpful intervention strategy.

00:07:20 Alcohol breaks out in handcuffs, problem.

00:12:59 Outpatient approach: journal, assess, suggest, increase care.

00:17:20 Challenges in seeking help, redefining rock bottom.

00:21:50 Sometimes people need a push to seek help for mental health and addiction.

00:23:29 Thanks for your insights, Laura. Let's reconnect soon.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In the latest episode of "Cracking Addiction," Dr Ferghal continues the journey with Dr Richard, exploring the critical subject of alcohol withdrawal. This episode is particularly focused on the timings, the natural history of withdrawal symptoms, and the potential complications faced during alcohol detoxification. The discourse provides key insights on when symptoms typically appear, ranging from mild to severe cases, and discusses methods of intervention based on the severity of withdrawal symptoms.

**Learning Outcomes:**

1. **Understanding the Onset of Alcohol Withdrawal:** This episode helps listeners grasp the variable onset of alcohol withdrawal symptoms which can appear from 12 to 24 hours after the last drink. Ferghal and Richard explain the concept of 'day two' of withdrawal, enhancing understanding of the physiological changes happening in the body during this time.

2. **Risk Factors and Complications:** The conversation thoroughly covers potential complications, such as seizures and delirium tremens. It emphasizes the importance of recognizing past withdrawal histories and comorbidities that heighten withdrawal complications, which proves crucial for healthcare providers in assessing risk.

3. **Ethical and Effective Treatment Strategies:** Highlighting the dangers of protocol-driven approaches in detoxification settings, Richard points out the importance of tailored treatment plans. They discuss the use of diazepam to manage symptoms effectively and the strategies to mitigate risks such as 'kindling.'

4. **Proper Management of Seizures and Delirium:** Key strategies for managing severe withdrawal symptoms like seizures and delirium tremens (DTs) are elaborated on, including the avoidance of certain medications and the focus on benzodiazepine regulation.

**Actionable Takeaways:**

1. **Recognise the Early Signs:** Listeners are encouraged to identify early withdrawal symptoms to initiate timely treatment, potentially preventing the escalation towards more severe complications such as DTs.

2. **Avoid High-Protocol Rigidity:** The importance of flexibility in treatment protocols was underscored, stressing individual patient needs over rigid guidelines, which might prevent effective symptom management.

3. **Prepare For Seizure Management:** Understanding that alcohol withdrawal seizures could peak around 24 hours post-last ingestion, healthcare providers should monitor and adjust benzodiazepine dosages accordingly.

4. **Psychosocial Aspects of Withdrawal:** Addressing withdrawal is not just about managing physical symptoms but also involves supporting the patient’s psychological well-being to enhance recovery success rates.

In this episode Stephen Herd and I continue our discussion on the power and control wheel.

The Power and Control Wheel was developed by a group of activists in

Duluth, Minnesota, in the 1980s, who recognised the need for a

comprehensive approach to address family violence. The Duluth Model is

based on the belief that domestic violence is a result of the abuser's

desire for power and control over their partner.

According to the Duluth Model, domestic violence is not caused by anger,

substance abuse, or mental illness. Instead, it is a deliberate tactic

used by abusers to control and dominate their partners. The Duluth Model

identifies several different types of abuse, including physical abuse,

sexual abuse, emotional abuse, economic abuse, and psychological abuse.

These are presented in the Power and Control Wheel as a circular diagram

that outlines the different tactics used by abusers.

The Power and Control Wheel helps to illustrate the cyclical nature of

family violence. The abuser may use a combination of different tactics

to gain control over their partner, and the victim may respond with

different coping strategies, such as walking on eggshells or trying to

appease the abuser. Over time, the abuse can escalate, and the victim

may feel trapped and unable to escape the cycle of violence.

The Duluth Model and Power and Control Wheel are useful tools for

understanding the dynamics of family violence and identifying ways to

address it. They help to shift the focus away from the victim and onto

the abuser, recognizing that family violence is a result of a deliberate

choice made by the abuser to maintain power and control.

There are several different approaches to addressing family violence,

including criminal justice interventions, civil protective orders, and

community-based interventions. The Duluth Model emphasizes the need for a

coordinated community response to address family violence, including

law enforcement, the court system, and community-based organizations.

One of the strengths of the Duluth Model and Power and Control Wheel is

that they recognise the importance of a multi-disciplinary approach to

addressing family violence. Family violence is a complex issue that

requires a coordinated response from multiple sectors, including the

criminal justice system, social services, healthcare, and education

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction, Dr. Fergal Armstrong and Dr. Laura Petracek discuss the challenging 8th step in addiction recovery – making a list of persons who have been harmed and becoming willing to make amends to them.

The conversation delves into the emotional and practical complexities of this step, offering invaluable insights into the process of self-reflection, making amends, and navigating the internal and external obstacles in the recovery journey.

Listeners will gain a deeper understanding of the 8th step and its significance in the recovery process, as well as practical strategies for approaching this crucial aspect of addiction rehabilitation.

Join us in this informative episode as we dive into the topic of urine drug tests in Addiction Medicine. We will discuss the purpose and importance of these tests and the circumstances in which they are performed. We will also touch on the key indications that may lead to a urine drug screen being administered during addiction treatment.

Patients can often have concerns and feel stigma surrounding urine drug testing. We will address these issues and offer ways to mitigate any negative feelings that may arise. Additionally, we will provide guidance on how to interpret the results of a urine drug screen, including what they mean and what actions can be taken based on the results.

Whether you are a healthcare provider, a patient, or simply curious about this topic, this show is a must-listen.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In Episode 38 of Cracking Addiction we summarise the previous episodes regarding opioid use disorder and discuss a framework on the safe management of patients with opioid use disorder.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction we are privileged to have Steven

McDonald who discusses his lived experience with addiction and his path

towards recovery. Steven speaks openly and honestly about his past

history and his experiences. Steven has written a book 'Thanks for

Letting Me Share' which is a book of 368 quotes that have helped him

along his journey. The book is available on Amazon https://www.amazon.com/dp/B09BCG67JK/ and Facebook https://www.facebook.com/Thanks-for-Letting-Me-Share-book-102078078856382

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this thought-provoking episode of Cracking Addiction, Dr Ferghal Armstrong and Steve Herd delve into the complex intersection between AOD (alcohol and other drugs) use and family violence. The duo challenges the common misconception that stopping AOD use would automatically eliminate family violence. According to Armstrong and Herd, family violence is a long-term set of behaviours that require a comprehensive approach to tackle effectively.

The discussion also covers the broader picture of family violence, including the personality traits and skills of the perpetrator, such as narcissism, lack of empathy, and cognitive ability. While Armstrong suggests that IQ does not increase or decrease the risk of family violence, Herd argues that people with disabilities have a greater chance of experiencing and using family violence.

The episode also touches on the issue of gender inequality as a risk factor for using violence, as well as why people choose to stay in abusive relationships. Armstrong and Herd emphasise that the perpetrator is solely responsible for family violence, and supporting the situation better involves identifying and focusing on the perpetrator's behaviours.

The duo also addresses the role of alcohol in family violence, debunking the notion that alcohol fuels violence. They argue that alcohol absolves perpetrators of responsibility and gives them permission to relapse long before it occurs.

The episode concludes with a discussion of the importance of treating clients with unconditional positive regard and not laying blame on men who use family violence. Armstrong and Herd highlight the need to be more agile in the delivery of services to victims of family violence and the importance of believing their stories. This insightful video offers a fresh perspective on the intersection between AOD use and family violence and offers practical solutions for addressing this pressing issue.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Join Dr. Ferghal Armstrong, Dr. Laura Petracek, and Kate Butler in this insightful discussion about using Dialectical Behavior Therapy (DBT) and mindfulness techniques to aid individuals with chronic pain. Chronic pain, persisting beyond three months with no apparent pathology, can be exacerbated by various psychological factors, such as trauma, mental health disorders, and catastrophization. In this talk, they shed light on the groundbreaking eight-week mindfulness-based stress reduction program designed by psychologist John from About Zen, which has shown remarkable success in alleviating chronic pain.

Dr. Laura Petracek emphasizes the significance of addressing stress and fear of judgment, and the importance of somatic therapy connecting emotional and physical pain. The pain-insensitive warrior concept is explored, highlighting the role of emotions in pain perception. Learn how DBT skills like ACCEPTS and thought record, along with Viktor Frankl's meaning-based approach, can improve coping mechanisms and overall well-being for individuals living with chronic pain. Don't miss this enlightening conversation that offers hope and support to those seeking relief from chronic pain.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In part 2 of 3 episodes. In this episode of Cracking Addiction we are again joined by Dr Colin Mendelsohn to discuss the different types of vaping products on the market, the different types of nicotine e-liquids available, how to source vaping products, how to prescribe nicotine and how to vape safely.

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Are you looking to deepen your understanding of the AA 12-Step Program and peer support in addiction recovery? You've found the perfect video! In this engaging chat, I sit down with Jesse Ball to uncover the transformative power of peer support and the truths behind the AA 12-Step Program.

We dive right in by explaining the fundamental structure of Alcoholics Anonymous and other 12-Step groups like Narcotics Anonymous, Gamblers Anonymous, and so on, breaking down the processes that make these meetings so effective. Our conversation tackles common objections, debunking the myth that the 12-Step Program is a cult and addressing concerns around spirituality and belief systems.

As a bonus, Jesse shares his own journey from addiction to becoming a recovery support worker, highlighting the significance of having a sponsor to guide you through the 12 steps. Whether you're skeptical about needing a sponsor or simply curious about how to choose one, this video answers all your questions.

So, if you're in recovery, considering joining a peer support group, or just eager to learn more about the AA 12-Step Program, hit play and join us on this enlightening journey!

Bullet Points

Peer support groups like Alcoholics Anonymous (AA) and their variants are essential for recovery, offering a structured twelve-step program based on spiritual principles.

The twelve-step philosophy holds that human willpower alone cannot overcome addiction, emphasizing a spiritual approach to recovery.

Common criticisms of the twelve-step program include perceptions of it being a cult; however, the program is decentralised and members can leave freely at any time.

Sponsors within these programs guide newcomers through the twelve steps, and selecting a sponsor involves finding someone you understand and can connect with, often recommended to have at least one year of sobriety.

The actual work and transformation in the twelve-step program happen largely outside meetings, through the guidance of sponsors who help members adopt new ways of thinking.

Dr. Ferghal Armstrong and Dr. Laura Petracek delve deep into the 12th step of the twelve-step program, exploring the impact of spirituality, the importance of service to others, growth, and relapse prevention. In this episode, the discussion revolves around the psychological, emotional, and practical aspects of the final step, offering valuable insights for both individuals struggling with addiction and those supporting them on their recovery journey.

Focus Keyword: Twelve-Step Program

This episode provides a comprehensive exploration of the 12th step of the twelve-step program, shedding light on its significance and practical implications in aiding recovery from addiction. The insights shared by Dr. Ferghal Armstrong and Dr. Laura Petracek provide a holistic understanding of the program's spiritual elements, the role of service in recovery, addressing relapse, and the importance of personal growth.

Learning Outcomes:

1. Importance of Service: Dr. Ferghal and Dr. Laura articulate the pivotal role of service to others in the recovery journey. By engaging in service and helping fellow strugglers, individuals not only offer support but also find purpose and a sense of fulfilment.

2. Relapse Management: The discussion candidly addresses the possibility of relapse in the recovery journey and highlights practical approaches to deal with setbacks. Understanding that relapse is a part of the journey, the episode provides valuable insights on how to navigate relapse with compassion and practical support.

3. Spiritual Awakening: Delving into the spiritual aspect, the episode explores the concept of spiritual awakening as a result of the twelve steps and its role in fostering personal growth and contributing to the journey towards recovery.

4. Medication in Recovery: Dr. Laura confronts the topic of medication in recovery, advocating for a deeper understanding and acceptance of its role in aiding sobriety. By destigmatizing medication as part of the recovery journey, individuals struggling with addiction can access comprehensive support.

Actionable Takeaways:

1. Embracing Service: Incorporate acts of service into your recovery journey, whether through supporting fellow strugglers or contributing to the wider community. Engaging in service can offer a sense of purpose and fulfillment, aiding in personal growth.

2. Relapse Preparedness: Acknowledge the possibility of relapse and create a support network to address setbacks with compassion and understanding. By approaching relapse preparedness proactively, individuals can navigate challenging moments on their recovery journey.

3. Spiritual Reflection: Reflect on the concept of spiritual awakening as a result of the twelve steps and its potential impact on personal growth. Exploring spirituality can offer a deeper understanding of oneself and the journey towards recovery.

4. Destigmatizing Medication: Engage in open conversations about the role of medication in recovery. By destigmatizing the use of medication as part of the recovery journey, individuals can access comprehensive support tailored to their needs.

Quote:

"It's always darkest before the dawn. There's hope, and there will be another day. Hang in there." - Dr. Laura Petracek

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#RecoveryJourney #TwelveStepProgram #ServiceToOthers #RelapsePrevention #SpiritualAwakening #MedicationInRecovery #MentalWellness #AddictionSupport #PersonalGrowth #CrackingAddiction

Join Dr. Ferghal Armstrong and Dr. Laura Petracek in this enlightening discussion about Radical Acceptance—a powerful concept that can lead us towards healing and empowerment. Radical acceptance is the process of acknowledging that we have the resources to move forward despite life's challenges. By embracing this mindset, we can alleviate suffering, reduce substance use, and foster healthier relationships.

In this video, Dr. Armstrong and Dr. Petracek delve into the key steps of radical acceptance. The first step involves recognising the difference between acceptable and unacceptable behaviour, empowering us to set boundaries. Next, they explore how clients can change their lives by seeking support, such as counselling services or shelters for those in abusive situations.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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Drawing inspiration from Viktor Frankl's wisdom, the speakers discuss how suffering is often caused by our reactions to life events. Through radical acceptance, individuals can make more conscious choices to respond to challenges with a willingness to grow and heal.

In this episode of Cracking Addiction we speak to Professor Peg O'Connor, a professor of moral philosophy who is in recovery from alcohol use disorder and who addresses an audience much like herself: those in recovery who have struggled with the Christian-centric God at the heart of Alcoholics Anonymous. She brings our attention to a little-known fact: the term “higher power,” a touchstone in the twelve steps of Alcoholics Anonymous, was coined by William James, philosopher, psychologist, and intellectual giant of the early 20th century. 

In this book Professor O'Connor addresses concepts such as:

• Understanding the Concept of “Higher Power” at the Heart of the 12-Step Program 
• Why There Must Be Multiple Paths out of Addiction and No One is the Best or Right
• Why Needs in Recovery Change over Time
• Undertaking Spiritual Recovery in AA without a Religious Denomination

Professor O'Connor's book 'Higher and Friendly Powers: Transforming Addiction and Suffering' can be ordered from her website: https://pegoconnorauthor.com/ as well as Amazon, Barnes and Noble and Wildhouse Publications.

Cracking Addiction discusses Sublocade one of the LAIB preparations available and how to commence, maintain and manage any dose changes or complications associated with Sublocade.

Sublocade is a long acting injectable buprenorphine (LAIB) manufactured by Invidior that uses the “Atrigel” system to provide for a sustained and prolonged delivery of buprenorphine into the systemic circulation after subcutaneous injection.

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In this serious and thought-provoking episode of "Cracking Addiction," Dr. Ferghal Armstrong and Mr. Stephen Heard shed light on evidence-based risk factors for lethality in family violence. They address the complexities faced by clinicians when dealing with female victims and emphasise the importance of understanding their resilience strategies.

The episode explores the heightened risks during separation, with violence often escalating afterward. Herd stresses the need to prioritise safety by connecting victims with the police and relevant support services. They discuss the legal obligations associated with intervention orders, aiming to make clients aware of the protection they provide.

The conversation delves into self-harm and suicide attempts by perpetrators, highlighting their controlling behaviours and the potential for murder-suicide. They caution against underestimating the significance of access to weapons in assessing risk. The discussion also touches upon factors like unemployment and drug misuse, which can amplify the severity and frequency of family violence. The episode concludes with a reminder to clinicians about the importance of planning for family violence and the role of distractions in reducing risk.

Dr. Armstrong expresses gratitude to Steve Herd for his insights, leaving viewers with a deep understanding of the urgent need for proactive interventions. Content Warning: The episode contains discussions on sensitive topics such as domestic violence, self-harm, suicide, and murder-suicide. Viewer discretion is advised.

Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in the care and management of clinicians who find themselves struggling with addictions.

Clinicians face significant stigma when dealing with their own illnesses, and even more so in the situation of mental illness and substance use disorder. An additional barrier to accessing treatment is the regulatory environment within which clinicians must access care. This includes the potential for mandatory reporting to AHPRA. For these reasons clinicians tend to present late for help. The good news is however that clinicians are more likely to make a recovery from addiction, in that they are, as Dr Frei states, “overrepresented in success stories”.

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The distress that individuals undergoing opioid withdrawal can experience can range from mild to severe, depending on the type and duration of opioid use, as well as the individual's overall physical and mental health. Different opioids can cause slightly different withdrawal symptoms, which can include physical symptoms such as muscle aches, sweating, and insomnia, as well as psychological symptoms such as anxiety, depression, and irritability.

One of the most challenging aspects of opioid withdrawal is the phenomena of precipitated withdrawal, which occurs when an individual is given a medication that binds to the same receptors as the opioid they are dependent on, which can cause an intense and sudden onset of withdrawal symptoms. Precipitated withdrawal can be incredibly distressing, and it is important for individuals to be aware of this potential outcome if they are considering using medications to help manage their withdrawal symptoms.

Managing the symptoms of opioid withdrawal can be a complex process, and it is important for individuals to work with medical professionals to develop a plan that is tailored to their specific needs. This may include the use of medications such as methadone or buprenorphine to help ease withdrawal symptoms, as well as counseling and support services to address the psychological aspects of addiction.

It is important to note that an isolated opioid withdrawal without a plan for using opioid substitution therapy can increase the risk of relapse and overdose. When an individual is no longer opioid tolerant post opioid withdrawal, they are at a higher risk of an overdose if they do relapse, which is why it is essential to have a plan in place for opioid substitution therapy and ongoing support for addiction recovery.

In summary, opioid withdrawal is a complex and challenging process that can cause a range of physical and psychological symptoms. Precipitated withdrawal can be particularly distressing, and it is important to work with medical professionals to develop an individualized plan for managing withdrawal symptoms. Additionally, it is important to have a plan for opioid substitution therapy and ongoing support for addiction recovery to avoid the risks of relapse and opioid overdose.

Opioid withdrawal is a complex phenomenon.

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Cracking Addiction discusses Buvidal one of the LAIB preparations available and how to commence, maintain and manage any dose changes or complications associated with Buvidal.

Buvidal is a long acting injectable buprenorphine (LAIB) preparation manufactured by Camurus and uses “FluidCrystal” technology to provide for a sustained and prolonged delivery of buprenorphine into the systemic circulation after subcutaneous injection.

An Introduction to Long Acting Injectable Buprenorphine (LAIB)

Long acting injectable buprenorphine (LAIB) are long acting buprenorphine depot preparations that are injected subcutaneously and provide patients with a sustained release of buprenorphine for the duration of the depot preparation. Currently, two LAIB products are available for the Australian market. They differ in their formulations, administration and pharmacology.

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Are you concerned about the dangers of benzodiazepines and opioids? Curious about how these medications impact individuals with substance use disorders? In this episode of Cracking Addiction, Dr. Ferghal Armstrong and Dr. Richard Bradlow tackle the pressing issues surrounding the prescription of benzodiazepines and opioids. This is essential viewing for anyone interested in the complex dynamics of medication management and opioid stewardship.

From the outset, we delve into the rising legal and ethical concerns GPs face when prescribing these medications. We discuss the escalated risks of co-prescribing benzodiazepines with other sedatives, including alcohol and opioids, which can be life-threatening. Our experts explain why saying no to persistent medication requests is difficult but sometimes necessary to uphold the principle of "primum non nocere" — do not harm.

What sets this episode apart is its insightful historical context. We explore tranquilizers from the first minor tranquilizer, Milltown, to the development of major tranquilizers alongside antipsychotics and antidepressants. Dr. Bradlow’s analysis is both rich and engaging, providing a broader understanding of how these medications evolved and why benzodiazepines, despite their therapeutic window, are fraught with dependency issues.

Discover the nuanced strategies for managing long-term benzodiazepine and opioid prescriptions, especially in cases involving chronic pain and opioid use disorder. Learn about the importance of clear communication and shared decision-making between doctors and patients, which is crucial for safe prescribing practices.

Feel empowered in your knowledge and join the conversation on how we can navigate these challenging waters responsibly. Whether you're a healthcare professional, educator, or someone affected by substance use disorders, this video provides the insights you need.

Join Dr. Ferghal Armstrong and Dr. Laura Petracek in this insightful discussion on self-respect as a fundamental aspect of how we relate to others. Discover effective techniques, including the FAST approach (Be Fair to Yourself and Others, No Apologies, Stick to Values, Be Truthful), that can help you cultivate self-respect and self-esteem. Gain valuable insights into the concept of fairness and its impact on relationships, as well as the distinction between equity and equality.

Explore the ongoing debate in the Supreme Court regarding admissions standards and fairness for people of color. Dr. Armstrong underscores the importance of fairness in fostering self-respect and self-esteem, while Dr. Petracek highlights the significance of boundaries and core values. Learn how aligning with your values and setting boundaries can enhance decision-making and empower you to navigate life's challenges with integrity.

Don't miss this transformative discussion on developing self-respect and living authentically.

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In this episode, we have the privilege of hearing from Jesse Ball, a courageous individual with lived experience in the realm of addiction and recovery.

Jesse takes us on an intimate journey through his turbulent past, sharing candidly about his use of various substances starting from his early teens, driven by the desire to fit in and cope with life’s challenges. He opens up about the harrowing depths of his addiction, the disconnection from self, and the mental and physical toll it took on him.

Most importantly, Jesse delves into the pivotal moments that spurred him toward recovery, revealing the internal battles and the persistent voice of hope that eventually led him to seek help. Through his story, we gain invaluable insights into the complexities of addiction and the therapeutic processes that can make a difference.

Join us as Jesse shares his profound wisdom on the importance of meeting people where they are in their journey, the role of spirituality in healing, and the transformative power of genuine human connection. Whether you’re struggling with addiction, a healthcare provider, or simply looking to understand more about this challenging issue, Jesse’s story is sure to inspire and enlighten.

In this episode of Cracking Addiction I speak with Associate Professor Suzanne Nielsen about the opioid epidemic and what we can do about it.

In the USA there seems to be more a problem with heroin whereas in Australia we are struggling with prescription opioid dependence. Even though a doctor may be prescribing your pain killers, it is still possible to become addicted to pain killers. The traditional treatments we have for opioid dependence in general include methadone and buprenorphine based opioid replacement therapy.

A recent addition to the family includes the Long -Acting Injectable Buprenorphine therapies, commonly referred to as “the Injection”. Patients who struggle with prescription opioid use disorder (which has been referred to as “pain killer addiction”) also benefit from opioid replacement therapy.

Suzanne’s research over the last ten years has proven that the same therapies that work for heroin dependency, also work for prescription opioid dependency.

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Dr Ferghal Armstrong explores the profound impact of lifestyle interventions on addiction recovery, focusing on the crucial role of tobacco cessation within the addiction and mental health treatment spaces. Dr Armstrong discusses recent AOD (Alcohol and Other Drugs) guidelines that integrate lifestyle medicine, highlighting how these can dramatically improve patient outcomes. The discussion extends to the implications of smoking on the efficacy of psychiatric medications and overall prognosis for individuals with mood disorders.

**Learning Outcomes:**

1. Understand the six pillars of lifestyle medicine as detailed by Dr Armstrong, which include the feet, the fork, the fingers, sleep, stress management, and social connection. The episode elucidates how each pillar contributes to comprehensive addiction recovery and overall mental health enhancement, emphasising the multifaceted approach required for effective treatment.

2. Gain insights into the interactions between tobacco use and psychiatric medications, learning why smoking cessation is not merely beneficial but essential for patients undergoing treatment for mood disorders and other mental health issues. Dr Armstrong explains how smoking can alter medication efficacy and overall treatment trajectories.

3. Explore the impact of the latest AOD guidelines, which advocate for lifestyle interventions during withdrawal periods. These guidelines offer a new perspective on managing withdrawal by integrating lifestyle improvements that can lead to more successful recovery outcomes.

4. Recognise the broader implications of alcohol consumption as discussed by Dr Armstrong, including detailed comparisons of standard drink measurements and guidelines in different regions, which underline the global variations in alcohol consumption recommendations.

Dr. Ferghal Armstrong and Steve Herd delve into the grim reality of family violence, exposing its potential for lethality. They focus on key risk factors, including the perpetrators' behaviour towards pets and their use of jealousy as a tool for control. The discussion begins by highlighting the alarming connection between the mistreatment of animals and domestic violence.

Steve Herd emphasises that harm to pets serves as a significant risk factor, revealing the narcissism and psychopathy behind the abusers' actions. Animals and people become pawns in their need for dominance, erasing any notion of respect for their victims. Dr. Armstrong further elucidates how the mistreatment of pets reflects the perpetrators' hunger for control. Their narrative of blame and avoidance of responsibility sets the stage for further violence. Dr. Armstrong chillingly suggests that targeting and harming pets often precede the escalation to harming a partner, indicating the dire situation at hand.

The conversation then delves into the risk factors associated with lethality in family violence. Jealousy emerges as a toxic and obsessive behaviour, capable of being misinterpreted as an expression of love. Steve Herd and Dr. Armstrong explore the concept of Othello syndrome, characterised by delusional jealousy that can lead to tragic consequences, as seen in the Shakespearean play. Sexual violence takes centre stage as another high-risk factor for lethality. Steve Herd highlights the historical context surrounding marital rape, with its criminalisation only occurring in the 1990s.

Dr. Armstrong challenges outdated beliefs, expressing concern over the perception of sexual violence as a right and the role of a submissive spouse. They emphasise that sexual violence stems from a desire for dominance and control rather than any biological need. The discussion concludes by reinforcing that the risk factors discussed are not isolated incidents but rather pervasive patterns within family violence. It is stressed that family violence is a gendered behaviour, driven by choices and a hunger for power. Steve Herd and Dr. Armstrong highlight the importance of addressing these issues comprehensively to effect meaningful change. In the final moments, Steve Herd and Dr. Armstrong emphasise the need to evaluate risk levels in cases of family violence.

By critically assessing the identified risk factors, they can develop effective intervention strategies to protect potential victims. Join Dr. Ferghal Armstrong and Steve Herd in this revealing episode of Cracking Addiction, where they unravel the dark truths behind family violence, unmasking its potential for lethality and offering insights into the path to intervention.

In this episode of Cracking Addiction we discuss the timeframe and symptoms of benzodiazepine withdrawal, how to stabilise a patient on benzodiazepines and weaning and tapering of benzodiazepines within a community setting. We also discuss and highlight the importance of psychosocial support and lifestyle interventions in managing benzodiazepine dependence and withdrawal.

Discussions and comments in our videos are for informational purposes only and should not replace the advice of your medical professional. Please consult with your doctor before making any changes to your medical treatment or lifestyle.

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In this episode of Cracking Addiction we discuss cannabis hyperemesis

syndrome, the various theories surrounding the pathophysiology of

cannabis hyperemesis, treatment of cannabis hyperemesis syndrome,

diagnostic criteria for cannabis hyperemesis syndrome and discuss the

other potential differential diagnoses of cyclic vomiting symptoms and

how cannabis hyperemesis syndrome is often a diagnosis of exclusion.

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In this episode of Cracking Addition, Dr. Ferghal Armstrong and Dr. Laura J. Petracek discuss the important topic of managing emotional distress through reality acceptance and mindfulness skills. They delve into the concept of reality acceptance and explain how it involves accepting the situation for what it is, which ultimately causes less suffering. They also stress the importance of being responsive rather than reactive, and the space between event and response where a choice can be made.

Furthermore, they highlight the significance of mindfulness and meditation in helping to build the pause button and respond instead of reacting. Through their discussion, they emphasise how reality acceptance can help people cope with adversity and lessen their suffering. They caution against beating oneself up and hating oneself into acceptance, as this can lead to depression and feeling stuck.

Dr Armstrong shares some interesting quotes from literature and pop culture that suggest anxiety is a necessary part of life. Dr. Petracek encourages Dr. Armstrong to practice reality acceptance skills as a way of retraining the brain. They share personal examples of reality acceptance and being present in the current moment.

This episode provides valuable insights into how to manage emotional distress through reality acceptance and mindfulness skills. Don't miss out on this informative and thought-provoking discussion.

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Welcome to "Cracking Addiction." In this episode, Dr. Fergal Armstrong and Dr. Laura Petracek dive into the second step of the twelve-step program: "Came to believe that a power greater than ourselves can restore us to sanity." They explore the meaning of each element of this step and provide valuable insights on attending meetings, belief in a higher power, and the restoration of sanity in recovery. Join them as they discuss the importance of accountability and the misconception of just stopping drinking without addressing the necessary changes for lasting recovery.

Learning Outcomes:

1. Understand the concept of "came to believe" in the context of recovery, which includes attending meetings, waking up to the need for change, and developing a belief in a power greater than oneself.

2. Explore the idea of a higher power beyond traditional religious connotations, emphasizing the importance of accountability and support from others in the recovery journey.

3. Recognize the limitations of simply abstaining from alcohol without engaging in the complete process of personal growth and transformation.

4. Reframe the notion of "restoration of sanity" to focus on soundness of mind and personal well-being, rather than perpetuating stigma around mental health issues.

Actionable Takeaways:

1. Engage actively in your recovery journey by attending meetings and actively participating in the process, rather than just showing up without commitment.

2. Embrace the idea of a higher power or accountability beyond yourself, whether it's through a group, sponsor, or personal belief system.

3. Recognize that simply abstaining from alcohol is just the first step, and be willing to delve into the deeper aspects of personal change and growth outlined in the twelve-step program.

4. Challenge the traditional understanding of sanity by reframing it as a state of soundness of mind and overall well-being, allowing for a more inclusive and compassionate perspective on mental health.

Quote:

"The steps don't work you, you have to work the steps." - Dr. Laura Petracek

#CrackingAddiction #RecoveryJourney #HigherPower #Accountability #MentalHealthMatters #PersonalGrowth #WellBeing #Transformation #AlcoholRecovery #SoundnessOfMind

Addiction Medicine is a speciality of medicine shrouding in mystery and disinformation, as is addiction and substance use disorder. In this introductory episode, Dr Ferghal Armstrong and Dr Thileepan Naren explain their interests in Addiction Medicine, what motivated this interest in Addiction Medicine and the benefits they have seen when engaging, empathising and listening to patients with addiction issues.

Alcohol is a common and ubiquitous part of our lives.  It is widely consumed, portrayed and advertised in the media and consuming alcohol is an acceptable part of adult life.  However, there are significant harms associated with alcohol consumption and in this episode of Cracking Addiction we explore some of the data around alcohol, the harms it causes within society, what a standard drink is and how much alcohol it is safe to drink.

In this episode of Cracking Addiction, we continue our deep dive into alcohol. We define alcohol use disorder, the definitions of dependence and addiction, the harms related to alcohol and the natural progression of alcohol use disorder and how to screen for people who might be at risk of alcohol use disorder and the importance of brief interventions.

Chronic alcohol use can lead to physical dependence. In this episode of Cracking Addiction we talk about the physiology of alcohol withdrawal, complications of alcohol withdrawal including delirium tremens and Wernicke’s encephalopathy and we discuss some of the simple interventions that can be used to guard against these complications

The safe management of alcohol withdrawal is a fundamental skill that medical practitioners should be aware to perform. It is a protocol driven management and needs to be to ensure patient safety. In this episode of Cracking Addiction we explore home based or outpatient alcohol withdrawal and how to select the appropriate people for home based alcohol withdrawal management, how to manage the withdrawal symptoms and how to safely follow up patients.

In this episode of Cracking Addiction we explore the intricacies of residential or inpatient alcohol withdrawal management including how to manage patients in a residential setting, complications that can arise and how to management then during alcohol withdrawal, medications and potential dosages of medications uses as well as how to manage patients with pre-existing medical and psychiatric comorbidities.

In this episode of Cracking Addiction we explore the common anti-craving medications used in alcohol use disorder and explain what the choices are, what the indications for these medications are, how they work as well as the common side effects and interactions.

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In this episode of Cracking Addiction we discuss both Alcoholics Anonymous and SMART recovery programs and review the evidence base behind each of these interventions and how to help patients choose the best behavioural management program to help manage relapse prevention.

In this episode of Cracking Addiction we summarise the previous episodes detailing alcohol use disorder, alcohol withdrawal management, rationale for anti-craving medications and how to assist our patients in a safe, ethical and humane manner.

In this episode of Cracking Addiction we provide an introduction to opioids, how they work what receptors they act upon and some of the harms associated with opioids.