Addiction Medicine Made Easy | Fighting back against addiction

What It’s Really Like To Practice Addiction Medicine

• Casey Grover, MD, FACEP, FASAM

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Have you ever wondered what it's like to practice Addiction Medicine? In this episode I speak about what we do in Addiction Medicine - both generally as well as how we do things in our practice on the Central Coast of California. 

I share how our clinic treats substance use with low‑barrier access, kind care, peer support, and long‑acting injectables while partnering with therapists to address trauma and ADHD that often drive relapse. 

I also review two cases that reveal how PTSD and undiagnosed ADHD change the treatment plan and the outcome.

Topics Discussed:

• What an addiction medicine visit includes  
• Medications for alcohol and opioid use disorder  
• The "three‑legged stool" of meds, therapy, and groups to treat addiction
• Levels of care and smooth transitions  
• Dual diagnosis as the rule, not the exception  
• Low‑barrier access through walk‑ins and telemedicine  
• Person‑first language to reduce stigma  
• Peer support as lived‑experience expertise  
• Long‑acting injectables to boost adherence  
• Mobile street medicine and carceral care partnerships

To contact Dr. Grover: ammadeeasy@fastmail.com

SPEAKER_00:

Welcome to the Addiction Medicine Made Easy podcast. Hey there, I'm Dr. Casey Grover, an addiction medicine doctor based on California's Central Coast. For 14 years, I worked in the emergency department, seeing countless patients struggling with addiction. Now I'm on the other side of the fight, helping people rebuild their lives when drugs and alcohol take control. Thanks for tuning in. Let's get started. This episode is an overview of what it is like practicing addiction medicine. My practice is always trying to partner with other local organizations so as to be able to offer more treatment options and referrals to our patients. And so we connected with a local practice that offers counseling and therapy. And they asked me to speak about what we do in our addiction medicine practice here on the central coast of California. And so if you've ever wondered what it is like being a doctor that practices addiction medicine, this episode is for you. I speak about what we do as addiction medicine doctors in general, and I also speak about what we do in our specific practice, including the four attributes of our practice that we believe make us successful. And with that, here we go. Okay, so first of all, so nice to meet all of you. I'm sure we have plenty of plenty of clients that we've shared. And I'm just gonna give you an overview of what I do. And if anything is too basic, I apologize. But not everyone has a sense of really what addiction medicine does. And yes, let me start with just who we are in my practice. So our name is Pacific Rehabilitation and Pain. And the practice offers both pain medicine and addiction medicine. And in addiction medicine, we treat any and all substances and also some behavioral addictions. So I've got a couple of folks I treat for binge eating, but we'll see cannabis use, alcohol use, nicotine use, ketamine, GHB, methamphetamine. If people can take it, we're happy to treat it. Most of our patients use some combination of opiates, cannabis, stimulants, and alcohol, which is probably pretty standard. The other thing is if any of your clients use Kratom. Kratom is, I think, very poorly understood by medical providers. And we've got a couple of us, including myself, that have some expertise in Kratom. And we actually are growing. So we started the practice two and a half years ago with myself and the incredibly beautiful and extraordinarily intelligent Dr. Reb Close, who happens to be my spouse. So we've been married for 18 years. We both practiced in the emergency department initially. And it's really been a labor of love, pun intended, as we've tried to create a safe space for people to come in and get care. And we are so excited that we now have three other physicians in the practice. We have lots of availability. And right now, if people want to come in, we can almost always get them in within a week. Now, just to really zoom out a little bit, and if you know all this, I apologize, but addiction medicine's a new specialty. We weren't even recognized as a medical specialty by the American Board of Medical Specialties until 2015. So addiction medicine was the stepchild of medicine, and it had to create its own board because it wasn't recognized as a specialty. So it used to be there was the American Board of Addiction Medicine. Now, thank goodness we're finally recognized as a specialty by the American Board of Medical Specialties. And there are two ways to become an addiction medicine doctor. One is you do basically a general type of residency. So things like pediatrics, internal medicine, family medicine, emergency medicine, where you see a wide breadth of things. And then you go back and you do a year of addiction medicine and you're board certified in addiction medicine. As we'll talk about, there's very few addiction medicine doctors. So because of the shortage, the American Board of Preventative Medicine allowed for what's called a practice pathway, where if you can show that you've been doing addiction medicine because you were meeting a need, they'll allow you to sit for the boards. And so of the five doctors in our practice, four of us went through the practice pathway. Just we were seeing addiction patients, we were learning as we went, and so now we're board certified. And then the other, which we don't have any of, is addiction psychiatry. So you do four years of psychiatry and then a year of addiction psychiatry. And it's a really fun job. You can do all sorts of stuff. So our practice is focused on outpatient, meaning we see people in our office and I can talk about what it looks like, but people come in and their appointment is focused on their substance use. I would like to see the doctor to talk about my alcohol use. We can also work with narcotic treatment programs to do methadone. I'm personally a medical director for Sun Street. Since you all practice in this area, I'm the medical director for outpatient services for Sun Street and also the women's residential in Hollister. At some point, we'd love to have an addiction consult service at the hospitals in Monterey County. So if your patient gets admitted and they've got problems with alcohol, the internist admits them and they can get a consult. We're trying to build that. And then, as we'll talk about in a little bit, we have a street team. And then just so you know, again, there's not a ton of addiction doctors nationwide. So if you think about it, problematic substance use may affect as many as one in seven Americans in their lifetime. And yet there's maybe 3,000 of us. So very under-resourced. We are so proud of our little fledgling five-doctor practice because we feel like we're a little stronghold of addiction medicine on the Central Coast. Okay. Here's what's really funny about being an addiction medicine doctor our focus is medication management around addiction. But there's only five medicines that we get, right? For opioids, naltrexone, methadone, buprenorphine, and for alcohol, naltrexone, accampersate, and disulfurate. Think about a cancer doctor. They literally have like thousands of different chemotherapies that they have access to. We only get five. So what we end up doing a lot of is using meds off label, meaning that we found that tapiramate or topomax can suppress cravings for alcohol, so we'll use it off label. Or tapiramate can suppress cravings for cocaine or methamphetamine, so we'll use it off label. And a lot of what we do is mental health management because most of these patients are dual diagnosis, which we'll talk about in just a sec. So, what does it look like if you send a client to our practice? We sit down with them, do the standard doctor thing, take a history, ask the questions, what meds are you on? What other comorbidities do you have? And just like if you go see the cardiologist for your high blood pressure, we come up with a treatment plan. And usually it's some medication that we're going to prescribe. And then we try to get everyone into therapy, and then we try to find patients a meeting where they feel like that's their tribe and they feel good. And some patients come to me and they're like, Doctor, I don't want any medications. And I'm like, great. You see your therapist, you go to meetings. And if you change your mind, we can talk about the meds. And then a follow-up is not that different. Are you craving? How did the meds work? Are there side effects? Do we need to increase the dose, decrease the dose? And then it's really all about the other services on top of the medicine. Trying to get people into therapy, finding them a place where they feel safe. Okay, I know you all know this, but just to level set, there are really three basic treatments for addiction, right? Medications, counseling or therapy, and mutual support groups. And the way I explain it to my patients is it's like a stool. And if you have all three, the stool is very stable. If you take one away, the stool starts to teeter on two legs. And if you only do one, you're really having a balancing act. And so I try to give everybody all three. And our practice really takes a harm reduction approach, is we really want to engage them. And even if we can reduce their drinking, that's a win. And we'll talk about the four basic things my practice does that has made us, we think, successful. But we really try to make it a safe place to land because if they're willing to come once and they have a good experience, hopefully they're willing to come twice, three times, four times, etc. So if somebody comes in and like, I am not going to see a therapist, I'm like, great, no problem. Let's bring you back for a follow-up visit and let's revisit it. Okay, something again that all of you know, but just in case you didn't, the American Society of Addiction Medicine breaks up addiction care by levels of care. So it's fairly similar to behavioral health, right? You have outpatient, intensive outpatient, partial hospitalization, residential, and then hospitalization. And what's cool is we follow these patients throughout the journey. So let's say somebody comes to us, they've never had any treatment before, they're like, I would like to quit drinking. Great. Let's get you in with one of our docs. Let's get you on the schedule. Hey, doc, I want to go to IOP. Perfect. We will see you, and you can go to your IOP. Oh, Doc, I've got to go to residential. Great. We will come visit you in residential. Okay. Now I don't need to tell a group of therapists about dual diagnosis, but this is really my niche personally. I'll share with all of you my first career before I was an addiction medicine doctor is I did 14 years as an emergency medicine doctor and I got diagnosed with PTSD last year. I had no idea why I couldn't emote on shift and I was having all these weird emotions and I would be really emotionally flat the day of my ER shifts. And so I saw a therapist and I learned I had PTSD. And it's given me a lot of lived experience to be able to be like, I am so sorry you're really triggered. We need to get you in to your therapist so you can work on finding your triggers. I had this conversation with one of my patients yesterday. He's former active gang. He's been in prison. And he was like, Dr. Grover, why am I so emotionally reactive all the time? I was like, has anyone talked to you about PTSD? So we went through the DSM 5 criteria. He met criteria. I made the diagnosis, and he's going to meet with his therapist next week with his new diagnosis to try to understand his triggering. Okay. In my humble opinion, we have four things about our addiction medicine practice that has made us so far able to provide really good care to patients. We're low barrier to access us. Kindness and respect are our core values. We really integrate peer support and we use long-acting injectable medications whenever we can. So low barrier. I know you all know roughly what that means, but what does that look like? It's easy to see us, right? I don't know how many of you have had to get medical care yourselves, but medical care is so unfriendly, right? You got to figure out who's in network. Okay, my primary is not available for three months, and oh gosh, and then I saw the doctor, and then the pharmacy was out of stock, and oops, they needed prior authorization. And it is just barrier after barrier after barrier. Honestly, for us, it's like walk in. So we have somebody literally walks in off the street, we will connect them with one of our peer support specialists, do an initial intake, figure out do they just need behavioral interventions? Do they need to see one of the doctors? And then we'll start plugging them in to the practice. What's really amazing, thank you, Central California Alliance for Health. That's our local Medi-Cal HMO. They waived the referral authorization for addiction medicine. So normally people have to go to their primary and then get referred for all other services. The Alliance has been amazing. They waived any referral. So people can literally walk in off the street, want to get help, and were able to build their insurance without issues. So thank you to whoever in the Alliance is listening. But it's great because people have really low barrier access to get to us and they don't have to worry about getting medical bills. We can even see people like day after hospitalization, after an emergency department visit. The other thank you is to COVID, right? Telemedicine was super restricted before COVID. And thank you, COVID. Now people realize that telemedicine is great. So we have a lot of telemedicine services. And if people are remote, that's how they get to us initially. So of our five doctors, four of us are in Monterey County. And then one of them is in Los Angeles. She practices remotely. And so yesterday I got a call from a drug and alcohol counselor in Hollister. Dr. Grover, this patient needs to be seen. So I did a telemedicine visit yesterday afternoon. We're going to get him started on some meds while he gets plugged into behavioral health services. And then you all know this, right? When there's a small window of opportunity for change, we want to capitalize on it, which is really why we try to make ourselves as accessible as possible. Okay, kindness and respect. You all know this. Our patients face so much stigma. In fact, I actually lecture professionally on stigma. And of all of the different conditions, I think addiction is the most stigmatized. Schizophrenia is pretty high up there, but addiction, I think, really faces the most stigma. But there's stigma against all sorts of conditions: epilepsy, psoriasis, urinary incontinence. So we really try to use person-first language, right? It's not an alcoholic, it's a person with alcohol use disorder. We want to avoid terms with inherent judgment. No one's urine is ever dirty. That's such a judgmental term. No patient with a mental health condition is ever crazy. Come on, we know what to diagnose them with. And then we really try to create a welcoming space. And the peer support specialists make that possible, which I'll share in just a sec. But yeah, sometimes my patients come in and their home environment is just brutal. Their significant other also has an addiction and there's complex family dynamics. And I'll be like, you know what? Just come have a seat in the waiting room. Like, you'll be safe with us. And we really try to make it a place where people feel safe and respected. We literally have signs on the walls that say your urine test results are confidential. We will never judge you for them. Just thank you for being here. Peer support. So I don't know how much of this is happening in the behavioral health world, but I am what I understand is there's a movement generally in all of healthcare to do more peer support, meaning that when a person has lived with a particular condition, they have wisdom that can help others. So when we started, it was just two doctors and one peer support specialist. And we found that a lot of times our patients needed the peer support specialist more. They're like, what do I do with this? And how do I talk to my dad? And I've never lived with addictions. So I was like, this is some structured, scripted language you can use, but why don't you go talk with our peer support person? And they'd sit down, talk it through. And all of our peer support specialists, we have seven of them, have completed some level of training. Just in case you didn't know, the main criteria to be a peer support specialist is to have lived with addiction and now you're in recovery. And the course is only like 80 hours. So it's fairly easy for someone to get sober and want to switch from their say grocery store job to being in the treatment space to go back into a peer support course as opposed to going back and get an MSW or a KDAC, right? And I'm I always get emotional when I say this. Addiction is a disease of shame and stigma and people's darkest secrets. But when they transition to being peer support specialists, all those horrible things that they live through is now their superpower. And they are able to connect with people in ways I never can. Ooh, sorry, I just got goosebumps. I get so emotional when I do this. To see people who used to be homeless that I took care of as an ER doctor now work with me and are using their lived experience of those the horrible things they lived through to help others is just off the charts. And what's really cool is it's self-perpetuating. Some of my peer support specialists went through the county jail system. And I have clients come in and they're like, is that Bob? And I'm like, yeah, that's Bob. And they're like, whoa, I did time with Bob. And they'll want to sit down and be like, Bob, you look so good. Like, how did this happen? And they're like, talk to Bob about being a peer support. You're a year sober. You could do it too. So a number of my patients have started to take peer support classes because they're inspired by their peers. It's really cool. And I'm gonna be a little bit funny here. Addiction oftentimes involves taking care of people who have shattered lives and they have a lot of problems. And they come in and man, they hot offload dump their problems. And peer support really helps to just give them a safe space to get out a lot of their frustrations. And then they come into me and they're like, okay, doc, I talked to Bob, I feel better. Let's talk about the naltrexon. Okay. The last thing is long-acting injectable medications. These are amazing. I love them. I would give every one of my patients them if I could. So let's imagine you guys refer a patient to me and I put them on Suboxo three times a day. That involves a decision to be compliant with medication, to stay in treatment, or even just to remember their medication three times a day, 365 days a year. That's over a thousand decisions that they have to make. When I put them on a long-acting injectable, they just come see me 12 times a year. They can come more if they want. But it really improves compliance. And I don't know how much your patients experience this, but a lot of my patients feel really judged by the pharmacist and the pharmacy staff when they have addiction. They're like, oh, I don't want them to find out I'm on Suboxone. They're gonna know what I'm here for. So a lot of my patients love the fact that we are one-stop shopping. You come in, you see peer support, you come to a group meeting, you get your shot. It's all you need. So, Sublicade is one brand. That's for buprenorphine. That's the medicine in Suboxone. And this is a picture of just it comes in a box, it gets shipped to our office, and they work fantastic. This is a slide from the manufacturer of Sublicade. Quick disclosure: I have nothing to disclose. No one pays me. I teach a lot about this, and Sublicade works great. So I'm gonna use their slides. So essentially, when you take an oral medication, and I know you all know this, but just a level set, the drug levels have peaks and troughs during the day as you take your medicine. And once you're on a long-acting injectable, it's just a simple, steady state. It works great. And if you didn't know, you can take a long-acting injectable on top of the medicine in its oral form. So you can be on sublicade or brixadi and take suboxo. A lot of my patients feel like it's either or. For alcohol, you can be on the long-acting injectable naltrexone and still take oral naltrexone when you have breakthrough cravings. They are amazing. And what's really cool is we're actually able to give them on the street, which we'll talk about at the end. Okay. For alcohol use disorder, we have naltrexone. The brand name of the long-acting injectable is vivitrol. For opioid use disorder, we have buprenorphine. The two brands are Brixati and Sublicade. You can also give Naltrexone for opioid use disorder, but it doesn't really work because it doesn't really treat cravings. It's just enforced sobriety. But I do have one patient on Vivitrol for opiate use disorder. Okay. Hopefully you all will find this funny given what you do professionally. But every last one of my patients says, Dr. Grover, can you please be my therapist? And I tell them all, I really wish. I just don't have time to go back to school. And I think that's because they feel safe in our practice and they're ready to unload some of their deepest, darkest secrets. It usually doesn't come up on the first visit, but once they start, this is what I did. And I was trafficked when I was younger, and my mom used to beat me. Once that really negative stuff starts coming out, they're like, okay, this person knows my secrets. I want to confide in them. I personally try to refer 100% of my patients to therapy. Some of them are not willing. We always revisit. I have sent some clients to therapists who send them back saying, I don't really have expertise in addiction. Maybe another therapist would be a fit. I'll give you my take in a little bit when I go through some of the cases. But essentially, if I partner with a therapy practice, they can focus on the mental health diagnoses, and our practice will focus on the addiction, and we can collaborate. My niche in mental health is PTSD. I have all of these horribly traumatized people. I can start them on an SSRI. I can start them on clonidine and praisecin for triggering and nightnares, but I don't actually know how to help them to process their trauma. I can certainly share my lived experience of like, I see a therapist and this is what it looks like. But that's where we've really worked on getting people into therapy and we talk regularly about how therapy is so important to really understand triggers, your feelings, and then to really start the process of trying to heal from PTSD. Yes, we talked about that. Okay. Now I mentioned we were going to talk about dual diagnosis. I'm going to try to be a little bit funny here to make a point. So this is a graphic of dual diagnosis, which is a Venn diagram showing that substance use disorder has its population and mental health disorders have their population and they interact a little bit in the little intersection section of the Venn diagram. This is a great schematic, but in my humble opinion, the area that intersects is much larger. It should actually be like this, meaning that essentially all of my patients are dual diagnosis. Most of my patients have at least some symptoms of PTSD. And the way I explain it to my patients is trauma is like a snowball. It builds as time as it rolls down the hill. And the addiction in and of itself can be traumatizing. Where does addiction lead people? Overdose, incarceration, or treatment. A lot of my patients have legal consequences, the interpersonal dynamics with loved ones, that the family conflict, like it's just like it gets harder and harder and it builds up. So usually what I do as a doctor, and we're going to go through some cases, is when someone's doing great, yay, they're doing great. And if someone's not doing great, I need to do a better job of understanding what mental health conditions are being unmanaged. Okay, so we got a couple of cases here. So this is a this is a real case. This is one of my patients. She's a 34-year-old female, and she was referred to me for alcohol use disorder. So I took my usual history. She was using alcohol really at night and to sleep. Wasn't dependent, didn't have any history of withdrawal, doesn't use any other substances. We referred her to treatment, but it didn't really work. She had some legal consequences, so she wanted to be seen by me and no other issues. So I was a little baby addiction doctor at the time. I'd only been practicing for about a year, and I was like, great, let's focus on the meds for cravings, the so-called anti-craving meds. So I put her on some naltrexome, and then I put her on some tapirimate. And interestingly, if you didn't know, tapiramate makes the reward center of our brain less sensitive, which is why it works for stimulants, alcohol, and binge eating. So she did okay. She maybe have a month or two sober, and she kept really having recurrent relapses. And I'm like, what am I missing? So I went out on a limb and I said, Hey, maybe you've got some trauma. So I said, Can you think of anything that's contributing to relapse? And she's like, Dr. Grover, I just don't know. I'm not really sure. I said, But you know, what's your relationship with your family like? And she's like, Well, my stepfather and I really don't get along. Sometimes he triggers me. And I literally asked her, Have you ever had any traumatic experiences? And she was like, No, absolutely not. So I dug deeper. She was repeatedly subjected to verbal and physical abuse by her stepfather growing up. And she had a near-fatal car crash at 19 that resulted in a three-week hospitalization. And I said, Do you ever get flashbacks? She was like, How do you know? And then I said, Do you ever get any nightmares? And she's like, How do you know? So I made a diagnosis of PTSD. And I actually discontinued any craving medications for her. And I put her on Certrale for her PTSD. It's an SSRI, obviously. I put her on some praisosin. Some people say prazocin. I say praisosin. Maybe I'm in the wrong here. But I put her on some praisosin for nightmares and I put her on some propranolol for triggering. And in her mind, it clicked. She was like, oh my gosh, I drink because I get triggered. And so she reconnected with her therapist. And we saw some major improvement. She started to be able to go three to four months at a time between relapses, and her actual relapses on alcohol were one to two days instead of several weeks. And her therapist, I didn't, I don't know the person's name and haven't looked them up, but she says it's just a general therapist, whatever that means. This is not someone with specific addiction expertise, but she and her therapist are working on the relationship with her stepdad because that seems to be the trigger. She gets her fight or flight response. Sometimes the papranolol is enough to suppress it. Sometimes the Zoop gives her enough emotional resilience that she can tolerate it. And sometimes it just all explodes, and that's what leads to drinking. So we are really focusing on her PTSD as the reason why she drinks. Case two. Okay. A 32-year-old female was referred to me for methamphetamine use, and she started using methamphetamines in high school. She used multiple substances, she experimented, she was in the party scene. But when I asked her, what's your drug of choice? She really said methamphetamine. Now I got lucky. She went to a residential treatment program. She was already working with a therapist. She came to me six months sober because she needed my help with some child protective services issues. She needed to get some help getting housing. And she was starting to have some cravings for methagain. So there are two questions that I ask as an addiction medicine doctor that are the most revealing. The first one is why do you want to get sober? If a person says, because my wife's annoying, that one's maybe not going to go so far, right? This is where we think about the carrot versus the stick. Addiction is a disease of cravings, compulsive use, and consequences. And when consequences build up, sometimes people are motivated for change. So she had lost her child due to her drug use, so she had faced consequences. And her carrot was she wanted to get her child back. Now, the next best question I ask the patient is what does the drug do for you? So if you think about it, let's look at this case. This person uses illicit methamphetamine. They have to incur the legal risk of getting it, they have to go to get it. That takes time, and they have to spend money on it. That's a lot of their limited resources to get the substance. They're very motivated to get it. So, what is it that their brain needs? So, at its core, addiction is using. Using substances to feel different. So I asked her, What does methamphetamine do for you? Is there a medicine that I can give you to give you that so you don't have to use it? And she said, Dr. Grover, it started when I was just having fun, but I was so much more productive when I used methamphetamine. And the little light goes off in my head. Adderall is amphetamine that treats ADHD. I wonder if there's more to this. So I took a detailed educational history. She never did well in school. As long as she could remember, goes before the age of 12. Math and science were her worst subjects. She actually could not finish high school due to academic challenges. And then she told me this, Dr. Grover, using methamphetamine was like putting my thinking cap on. She was literally using it to get her bills paid on time. It really wasn't a euphoria thing. So I realized that she had ADHD. And just in case you didn't know, you probably do, but untreated ADHD is a major risk factor for addiction. And it makes it so much harder to get sober. If you can't focus on your therapy appointment, or if you can't pay attention in a 12-step meeting because of your ADHD, it's harder to do the work to get sober. So I put her on some non-stimulant medications for her ADHD. I put her on stratera or atomoxetine and guanfacine. And she was like, Dr. Grover, I can focus. Thank you so much. So she's now 10 months sober. She just got her child back last month. And as a testament to all the work she's done, she's going to be getting in to supportive housing, hopefully, within the next month or so. We'll see. Now I mentioned we do some street work. And I have to be very clear about which hat I'm wearing. Our medical practice is called Pacific Rehabilitation in Pain. If you will refer to our practice, that's where the patient will be seen. But since I have nothing else to do, my doctor wife and I founded a nonprofit called Central Coast Overdose Prevention, and we actually take medicines to the street. So thank you to the Monterey County Weekly for covering the work that we do. So in the left panel, that is one of our staff handing out in a lock zone in Chinatown in Salinas. So we literally have a Ford F-150, and we put a doctor and some peer support specialists and a bunch of supplies, including medical care, into the truck and we drive all over Monterey County to be able to provide mobile addiction services. I mentioned the very lovely and very intelligent Dr. Reb Close. This is a picture of her on the left taking care of a client in a tent. We are able to take the medicine to them. And on the right, they actually got a photo of her giving a hug to one of her clients. We also practice medicine with both practices, the brick and mortar practice in Monterey and our nonprofit and the carceral setting. So we're able to work with juvenile hall and the Monterey County Jail. And we're going to start doing some re-entry services as well. Now I mentioned long-acting injectable medications. The practice and the nonprofit are essentially attached to the hip. So we are able to actually take a briefcase. It is a walking metal James Bond style briefcase. And we put the long-acting injectable medications in the briefcase so that they are secured because buprenorphine is a controlled substance. And we are able to take them all over Monterey County to be able to do injectable medications where people live. And a shout out to the nonprofit Central Coast Overdose Prevention for teaming up with me on this podcast. Our partnership helps me get the word out about how to treat addiction and prevent overdoses. To those healthcare providers out there treating patients with addiction, you're doing life-saving work and thank you for what you do. For everyone else tuning in, thank you for taking the time to learn about addiction. It's a fight we cannot win without awareness and action. There's still so much we can do to improve how addiction is treated. Together, we can make it happen. Thanks for listening. And remember, treating addiction saves lives.