Cracking Addiction

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 supervi...

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 chi...

Episode 18 of Cracking Addiction explores the management of opioid use disorder in pregnancy. Most women presenting with opioid dependence are of child-bearing age with chaotic drug use predisposes to amenorrhoea. The initiation of opioid substitution therapy (OST) facilitates stability and reinstatement of regular menstrual cycles and thus OST is a risk factor for unplanned pregnancy.  About...

Episode 17 of Cracking Addiction explores the range of drugs one can become dependent upon or addicted to and how to identify someone at risk of prescription drug aberrancy. 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

How to take an accurate substance use history. Taking an accurate substance use history is of great importance in the management of addiction. There are a number of strategies that one could use but the most important part of history taking is that of demeanour and empathy. The best results and most accurate information are often obtained when one treats one’s patients with human empathy and in a...

Cracking Addiction explores the social and societal benefits of Methadone.  Methadone has a number of benefits that extend from not only the person taking it but also society as a whole. Methadone decreases criminality with the overall reduction in convictions and cautions estimated to be at 10% for each six months enrolled in methadone maintenance therapy with patients in continuous treatment rec...

Ferghal & Thileepan explore the role of Methadone in opioid agonist therapy.

Episode 13 of Cracking Addiction covers opioid replacement therapy (ORT) and the philosophy and evidence behind this highly effective treatment for patients with opioid use disorder.

In this episode of Cracking Addiction we cover the difference between dependence and addiction, the intricacies of addiction and provide a definition of opioid use disorder

Cracking Addiction covers the OPQRST framework and how to use this framework to prescribe safely to patients on opioid medications.

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.

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 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 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. Blog available

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 comor...

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 withd...

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

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.

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...

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 addict...