Drs. DeVine and Bell bring up a common yet infrequently discussed topic: the overlap of alcohol and opioids in older adults. This is a topic with high risk and significant complications that isn’t discussed, screened for, or understood. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine return to finish (for now) common pearls in buprenorphine practice. In Part 4 we will discuss co-occurring mental health diagnosis with opioid use disorder and when to treat it.  Also, what about those urine drugs screens?  Which meds cause false positives and which false positives should we be most aware of - especially in a patient on MOUD? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with...

Drs. Bell and DeVine return to the common pearls in buprenorphine practice.  Part 3 will bring to you the discussion on false negatives UDAS (what substances could patients be on that are not in their urine that you need to be aware of). We spend much of the discussion also discussing inductions in the fentanyl era. How we do it and why! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback:...

Drs. Bell and DeVine are back with part 3 of "Sugar Addiction."  What is it that makes us feel full; what is it that makes us want more; how do these same feeding behaviors - both adaptive and maladaptive - compare to drugs of abuse?  To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine are back with part 2 of ‘Sugar Addiction’. We will dive deeper into the evolution of genetics and how this has impacted how and what we eat. By the end, we will tie it back to the pleasure center of the brain, the limbic system, and continue the pathway into the “addiction” debate over sugar. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback:...

Drs. Bell and DeVine start with part 1 of "sugar addiction." Although not truly classified on the DSM-V, we will spend several podcasts breaking down all aspects of it and how it ‘could’ meet many criteria. This episode focuses on the overview of sugar consumption as well as the evolution of obesity and finishes with the first theory into why many consider sugar to be addictive - the Nutrition Transition Theory. To learn more about the doctors as well as keep up with current happenings follow...

Drs. Bell and DeVine have a discussion about the common questions that come up in the day-to-day management of patients on buprenorphine products. In Part 2, we have a discussion about where to do inductions on to buprenorphine (home vs clinic) and how that has changed over time and then we discuss UDAS. Do you get a UDAS every time? When do you/should you get a confirmatory UDAS? More parts to come! To learn more about the doctors as well as keep up with current happenings follow us on...

Drs. Bell and DeVine have a discussion about the common questions that come up in the day-to-day management of patients on buprenorphine products. In Part 1, we discuss ‘firing’ of patients, urine drug screens, and treatment. More parts to come! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell PROMISE you this will be the last (at least for awhile) episode on off-label use of medications for the treatment of alcohol use disorder. This episode will surprise you as to what all makes the list both in studies and anecdotally.  Do we have a new ‘favorite’ off-label treatment now? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine with Dr. Charlie Reznikoff, organically fell into this very interesting, anecdotal experience, real-life and clinical practice discussion on the whys and hows of methadone to buprenorphine transitions. What are the pitfalls? Should it even be done? How do you stay patient focused? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell, with Dr. Charlie Reznikoff, address the changes that one particular methadone clinic (OTP) made during the COVID pandemic. From crowded clinics to social distancing, how was it even possible? And then in follow up, how has that changed since? Are patients being cared for in a patient centered manner or are they overly monitored for other reasons? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with...

Drs. DeVine and Bell, with Dr. Charlie Reznikoff, explain a methadone clinic (OTP)- what does a clinic ‘look like’, what is the work flow, and what are the logistics? We will describe one methadone clinic with the understanding they are not all required to be the same. This episode will set the stage for what resulted when the pandemic happened. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback:...

Drs. Bell and DeVine describe how opioids have been used as weapons. It is very well known that opioids can cause significant morbidity and mortality, but how can this be preyed upon intentionally? And why? We will also tangent into describing other chemical weapons examples. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell, again joined by Dr. Reznikoff, finalize the ‘off-label’ medications for alcohol use disorder (AUD). This episode will highlight a couple anti-anxiety/anti-depressant medications, a medication typically used to treat ADHD and a final medication, one which happens to be tried as a treatment for nearly everything! This is a fantastic way to wrap up AUD [medication] treatment options! To learn more about the doctors as well as keep up with current happenings follow us on...

Drs. Bell and DeVine highlight XYLAZINE, the ‘new player on the street.’ A non-opioid, with similar pharmacology as clonidine, it is easy to purchase in bulk and is often added to opioids to extend the ‘high;’ but like most substances, it can have very dire consequences. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell now bring you a few antipsychotics that are, at times, used to treat alcohol use disorder (AUD). Joined by THE Dr. Charles Reznikoff, we not only bring you the mechanisms of action of how and why they “work” but also give you our clinical experience and thoughts! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell review THREE current non–FDA approved medications for alcohol use disorder. All in the anticonvulsant category, we describe the mechanism of action in relation to alcohol use disorder, side effects, and why would you choose an anticonvulsant as a treatment option? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine explore the use of varenicline (Chantix) for the treatment of cocaine dependence. There are no current FDA approved medications for the treatment of cocaine dependence and several smaller studies have reviewed varenicline as a possible treatment. What does this most recent article, published April 2022, show? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback:...

Drs. DeVine and Bell review the THREE current FDA approved medications for alcohol use disorder. They explain each one’s mechanism of action, indications [why you would consider choosing one over the other], common and rare side effects, and can they be combined for a ‘better’ response? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell highlight another group of patients that all providers need to be aware of: patients with a history of gastric bypass or weight loss surgery. Is it physiology, psychology, or something else? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine walk you through the barriers, the whys and the hows of “capturing the patients at the biggest impact” - the Emergency Room. Why is this standard of care not seen this way and not already happening? To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine, on episode 100 (:-) (-:) Fill you in on the current projects and passions they are working on and in! They also discuss their “lessons learned”, why they tend towards certain use disorders to care for (trauma differences between the two), and finally, what defines “success”?! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. DeVine and Bell answer the age old question, “what is the ceiling effect?” Buprenorphine has such a high morphine equivalent, but why don’t patients overdose on it via respiratory depression? This is sometimes a difficult thing to explain to patients or healthcare professionals, but we bring you the data! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine, back in episode 34, discussed the impact of chronic opioids on testosterone. Now, they discuss how medications for opioid use disorder (Methadone, buprenorphine) impact testosterone levels. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback: [email protected]

Drs. Bell and DeVine discuss a case study on a patient who had anaphylaxis to opioid products, including buprenorphine, who also had severe opioid use disorder. Seriously, how these allergists were able to desensitize this patient in order for her to maintain recovery is remarkable, especially since the mechanism is not what you’d think! To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct or email us with questions or feedback:...