All Things Substance

I had the privilege of speaking with Dr. Dave at Shrink Rap Radio. He's been podcasting for over 15 years and has interviewed hundreds of people. If you haven't had a chance to hear the interview, check this out!

I had the privilege of talking with Brian, the host of All In: An Addicted Gambler's Podcast in December of 2020. This is a re-post of that interview from his channel to mine. Gambling is a unique addiction and often called the "silent addiction." Check out his podcast for more information

What treatment options are there for opiate addiction? What's the difference between agonist, partial-agonist and antagonist options?  What is the therapist role in treating opiate addiction? The opiate epidemic is all around us. We hear about the deaths and the dangers. Most of us know a bit about it, but we may not know enough details to help our addicted clients. This is the last part of a mini...

The opiate epidemic is all around us. We hear about the deaths and the dangers. Most of us know a bit about it, but we may not know enough details to help clients who have opiate addiction.  This is the second part of a mini-series about opiates and heroin.  The goal is to help you get a clear picture of this issue, how it impacts people and what treatment looks like. 

Where do opiates and heroin come from?  What's the difference between the prescription painkillers?  How did opiate addiction get so bad? The opiate epidemic is all around us. We hear about the deaths and the dangers. Most of us know a bit about it, but we may not know enough details to help our addicted clients. This is the first part of a mini-series about opiates and heroin.  The goal is to hel...

Why is marijuana illegal anyway?  What's the difference between legalization and decriminalization? What implication does this have for therapists? The debate over legalization of marijuana is all around us. It's a complex issue and there are a lot of terms used that we should know and understand. This podcast explores the origins of the ban on marijuana and talks about the reasons for and against...

What are common things people say about marijuana?  What are the facts about those common claims?  What implication does this have in therapy? Marijuana conversations give rise to really interesting information being shared. Much of it isn't based on science or fact. It can be really hard to know what the real truth is, even if you know where to look. This week we'll be discussing the common thing...

What is marijuana and how is it used?  Why is THC potency important?  What does this have to do with therapy? Marijuana is here to stay and it looks like we're heading towards legalization. The use of marijuana comes up often in therapy circles and we need to know about it. Join me for an up-front conversation about weed.

How does alcohol work?  What long-term effects can it have?  What should therapists ask about alcohol? Alcohol is a part of most adults' lives. We might be tempted to skip over assessing someone's use of alcohol.  Someone's drinking habits don't typically just come up in conversation. If we don't ask we could be missing something. So let's talk about alcohol, its effects and implications in therap...

Is sex addiction a real thing?  What does the research say about problematic sexual behaviors? What does research say about pornography? The word addiction and the word sex are put together a lot. It's used in popular culture often, but we didn't get trained that it's an addiction. There's a reason for that, it's not an addiction. That's what science tells us. Today's episode is an interview with...

Is sex addiction a real thing? What does the research say about problematic sexual behaviors? How can we evaluate potential issues with sexual behavior? The word addiction and the word sex shouldn't be put together, at least by therapists.  It's used in popular culture often, but we didn't get trained that it's an addiction. There's a reason for that, it's not an addiction. That's what science tel...

Can you be addicted to food? Is it possible to find recovery from food addiction? What should therapists know about food addiction? Food addiction is a real thing, even if the DSM doesn't say it yet.  Food addiction is not an addiction to eating, it's an addictive reaction to types of food and ways of eating. Today is the second part of the podcast where we will examine the current science on the...

Can you be addicted to food? Is it possible to find recovery from food addiction? What should therapists know about food addiction? Food addiction is a real thing, even if the DSM doesn't say it yet.  Food addiction is not an addiction to eating, it's an addictive reaction to types of food and ways of eating. Today's podcast is part 1, our interview with Kelly Coffey. Part 2 is where we will exami...

What do mental health therapists need to know about gambling? What types of gambling are there? What's the connection to mental health? Gambling is a pretty specialized topic.  Mental health therapists are a logical place for problem gamblers to show up. I'm making the case that we should be checking in about this with each client. Even if we only find a few problem gamblers over our careers, the...

What does the  DSM V have to say about internet gaming? What types of games are part of this proposed disorder? Is internet gaming addiction a real issue? Video games are often seen as sucking away people's time and the popularity of games is at an all time high with no sign of stopping. It's hard to tell what it would look like if someone had a "problem" with video games. The DSM has a proposed d...

In the addiction treatment world, abstinence and harm reduction can often be seen as contrary to each other. We need both models available in order to truly help clients. Our goal is to meet clients where they are and help walk with them to building a life worth living sober.  In this Podcast:   Abstinence is based on the biological model of addiction that we discussed in Episode 7 (Brain Science...

What does progression mean when talking about addiction? How does progression relate to the DSM criteria? What addiction criteria shows up most often? Progression is the key to addiction. It's not about choice or willpower. It's a biologically based occurrence that is a guarantee in addiction. Progression moves people along the stages of use into addiction, unless they are able to stop using befor...

What levels of use are there? How do I know which level of use my client is in? Do people bounce around in use stages or move in a linear fashion? Stages of use are helpful in assessing your client's use and  determining when you should be concerned about someone's use. It also helps direct our interventions so that we can tailor them more effectively.  In this Podcast:   The stages of use are no...

What reduces the risk of addiction? Will changing environmental factors help or is it just up to genetics? Is prevention only for kids? This episode looks at the protective factors for addiction. Genetics isn't the only factor and much can be done to help improve people's chances of avoiding addiction. Addicts can tell you what they didn't get that they needed and perhaps unsurprisingly it's reinf...

What makes one person become addicted  to drugs and alcohol and another person doesn't? Does genetics have a lot to do with addiction? Is environment more important than genetics? There are many factors that influence the development of an addiction. There are complex risk factors at play for each person. Genetics are a big deal, but the risk is more than just our biology. This episode focuses on...

What role does the brain play in addiction?  Is addiction a matter of willpower and choice or is it about biology? Addiction is a hard thing for many people to talk about. Either their own addiction or their loved one's addiction. This is because addiction is destructive and it leaves people wondering "why" a person does this to themselves.  In this episode we talk about what is happening in the b...

What exactly is addiction?  Is addiction a choice or are addicted people victims of circumstance? Episode 6 is the first part of a series about addiction. This episode defines the components of addiction according to generally recognized authorities like the American Society of Addiction Medicine. It also begins to address the question of whether or not addiction is a choice or a disease with a me...

What do I need to be able to work with substance use?  What role do specialized substance abuse programs do and how can we work together? This is the last installment of the five-part discussion about why substance use is absolutely our business and why we all need to know how to assess and treat substance use in our mental health clients.  In this Podcast  Substance abuse is the business of the m...

Why is substance abuse important for you to know?  How will it help you better serve your clients? This is part 4 of the  five-part discussion about why substance use is absolutely our business and why we all need to know how to assess and treat substance use in our mental health clients.  In this Podcast: Some people aren't sure substance abuse is our business. I maintain that it is completely ou...

What is being a licensed therapist like?  What challenges exist that we didn't anticipate?  This is part 3 of a five-part discussion about why substance use is absolutely our business and why we all need to know how to assess and treat substance use in our mental health clients.  In this Podcast  One of the first things a new therapist notices is the difficulty with managing all the new clients at...