Cracking Addiction

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 respo...

In this thought-provoking Cracking Addiction episode, Dr Ferghal Armstrong and Steve Herd delve into the complex issue of how alcohol intersects with family violence. From the perspective of both the perpetrator and the victim of family violence, they explore the use of victim blaming and victim numbing to justify drinking in a family violence context. They also discuss the use of alcohol and drug...

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...

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 as...

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 exp...

Dr. Laura explains in more detail about Dialectical Behavior Therapy (DBT) and its four core components: distress tolerance, interpersonal effectiveness training, mindfulness, and emotional regulation. DBT is a type of therapy that helps people regulate their emotions and develop coping skills. Dialectics is a key concept that runs through each of the modules of DBT. It involves accepting both sid...

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 maladaptiv...

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 t...

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 th...

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...

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 m...

In the episode of Cracking Addiction, we are joined by Dr Daniel Pham an Addiction Psychiatrist working at Turning Point who discusses with us the differences and similarities between Addiction Medicine and Addiction Psychiatry. We discuss the term dual diagnosis and the interplay between mental health and substance use disorders. This episode focuses mainly on trauma, PTSD and its interplay with...

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 addict...

This week on Cracking Addiction we talk with Psycologist and Author Dr Laura Petracek. We explore the principles of Dialectical Behavior Therapy (DBT) and how they can be applied to the 12 Steps of addiction recovery. Recovering from addiction and managing a mental illness can be challenging and often feels like they take over your life. However, with the right tools and strategies, you can regula...

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...

In this episode, the focus is on the complicated issue of "takeaway doses" in opioid substitution therapy. Opioid substitution therapy is a treatment program that aims to help people overcome opioid addiction by substituting their drug of abuse with a safer and more controlled opioid, such as methadone or buprenorphine. One aspect of opioid substitution therapy is the use of "takeaway doses." This...

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...

Medicinal Cannabis Part 2 – In this episode of Cracking Addiction, Dr. Jim Connel joins us again and we discuss the side effects of cannabis, in particular psychiatric side effects, harms that may be associated with medicinal cannabis, the current regulations with regard to driving and medicinal cannabis, the experiences in other countries where medicinal cannabis has a longer history than in Aust...

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 medi...

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 sympto...

In the 75th episode of Cracking Addiction we discuss nitrous oxide or nangs and their medical uses and indications and the use of nitrous oxide as a euphorigenic and sedative substance of abuse. We discuss the side effects and harms associated with nitrous oxide use and emphasise in particular the functional B12 deficiency that can be associated with nitrous oxide use and in particular the neurolo...

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 th...

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. Whe...

Dr Ferghal speaks with Dr Matthew Frei, an addiction medicine specialist who specialises in providing written reports in the field of addiction medicine. There are many agencies or entities that might request a formal opinion from an addiction medicine specialist. These include Vic Roads, insurance companies, AHPRA and the coroner’s court. When writing reports for Vic roads one must bear in mind t...

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 envir...