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Addiction Medicine Made Easy | Fighting back against addiction
An OB Addiction Specialist Explains Why Marijuana Is Not Benign In Pregnancy
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THC isn’t the same drug it was 20 years ago, and pregnancy counseling hasn’t caught up. We sit down with Dr. Nazanin Amadieh, a board-certified OBGYN who also trained in addiction medicine, to map what today’s high-potency cannabis means for conception, the placenta, fetal development, and the newborn period. If you’ve heard “it’s legal” or “it’s just a plant” as proof of safety, this conversation offers a clearer, evidence-informed way to think about marijuana during pregnancy without stigma and without hand-waving.
We dig into the endocannabinoid system, why fetal receptors show up as early as five to six weeks, and how cannabis exposure may affect implantation, placenta formation, and early brain development. Then we get practical about the outcomes clinicians track: miscarriage risk signals, the stronger association with low birth weight or small for gestational age babies, and what NICU admission can mean for families. Because so much research is dated and modern THC concentrations can reach levels older studies never measured, we also talk openly about uncertainty and why “no proof of harm” is not the same as “safe.”
Nausea and vomiting gets its own spotlight, including the tricky overlap between hyperemesis gravidarum and cannabinoid hyperemesis syndrome, plus the hot shower clue that can point toward CHS. We also cover breastfeeding and THC in breast milk, what parents should watch for, and why postpartum relapse to cannabis is common when anxiety and overwhelm hit after the first few months. If you care about maternal health, prenatal care, addiction medicine, or harm reduction, you’ll leave with better questions and clearer next steps.
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To contact Dr. Grover: ammadeeasy@fastmail.com
Welcome And Show Purpose
SPEAKER_00Hi, I'm Dr. Casey Grove. I spent years practicing emergency medicine for shifting my focus to addiction medicine. This podcast grew out of characteristics, doing their stories and wanting to do better. Here we talk about recovery, medicine, and passion. This is addiction medicine maybe. She is an addiction medicine doctor who trained as an OBGYN before her addiction medicine fellowship. How cool is that? Well, if you don't think it's cool, I sure do. And you'll hear me talk about how unique her training and background is during this episode. And what's even cooler is that she practices medicine in my community. Our community is so lucky to have her as a resource. So given her unique training and background, she is the perfect person for us to learn from about the effects of cannabis on pregnancy. So with that, let's get started. All right, good evening. Welcome to the podcast. Let's just start with you telling us who you are and what you do.
SPEAKER_02Good evening. Thank you so much for having me, Dr. Grover. My name is NASA. I usually go with Nas and I am a board certified OBGYN and also addiction medicine, working in central coast and specifically Salinas, California.
SPEAKER_00Let's go with Casey and Nas for this interview because I feel like that feels nice and casual. Okay. OBGYN addiction? I didn't know this was a thing.
SPEAKER_02Yeah, I myself didn't know it's a thing. And I always, since medical school, I knew I wanted to do something with women's health. Definitely was thinking about family medicine and fell in love with surgeries. I went into OBGYN and I've really been a fan of psychiatry too, but never wanted to leave the OR operating room. So really loved the surgery. So I went to OBGYN and after graduation, I ended up in a very niche place in the east of Seattle, a little city called Renton, Washington. And I ended up practicing next to this amazing math program or MAT program and inherited a lot of pregnant patients who were on suboxin or methadone and definitely helped with dosing of suboxin. That's when I fell in love with working with patients with substance use disorder. And then also took a break for a year, went back to addiction medicine fellowship at UC Davis. Amazing people, learned a lot, and then graduated. Currently I'm working at the Kaiser Northern California doing both.
SPEAKER_00So you must know Dr. Amy Mulin.
SPEAKER_01Yes. Amazing woman. She does a lot. She does a lot.
SPEAKER_00Yeah, she's one of our colleagues in the ED addiction space.
SPEAKER_01Yeah, yeah. I think that was the good thing about that program was ED and addiction.
SPEAKER_00Yeah. No, I'm gonna try to make a joke here. I my humor's not that good. You can ask my daughter. No. So I'm gonna try to make a joke here. So if doctors are like horses, there's so few addiction medicine doctors that we're more like zebras, but an OBGY and addiction, you're like a unicorn. This is so cool. I'll take that compliment for sure. This is amazing. So, yes, let's dig into what you do. What percentage of your work is OB, GYN, addiction?
SPEAKER_02Yeah, it is really interesting. A lot of people inspired me to go to this uh niche of OBGYN and addiction medicine. Our system is not used to it. So I'm finding my feet in the door in a really amazing medical group and trying to find that balance. And they are helping me to find my way into both. I'm doing prenatal care and clinic and gynecology and surgery, and also managing some of our prenatal care who are also on buprenorphine or have a history of substance use disorder, and some of the chronic pain in there as well, who are pregnant. So my main appointment is with OBGYN, but also now I have involvement with our addiction medicine department. So mainly the pregnancy work, but also it's really important gynecology as well, because we do surgeries, management of pain for a lot of our patients who have opiouse disorder is really important and it is ignored. So I help with that in with our gynecology colleagues as well. But it's been most rewarding has been working with the obstetrics patients, managing their biprenorphine dose, especially found a lot of patients trying to decrease their dose the minute and they find out they're pregnant, and that that's actually against what we recommend. I've had a lot of patients going from 24 to 8 to 2, and that's like really risky. So just coaching those patients through their trimester as they require more has been really gratifying and trying to decrease the stigma. And part of my job is also to educate my colleagues and just hospital staff because these patients go to deliver in those hospitals, and I don't do deliveries nowadays. So it's really important to make sure my colleagues, the staff that are there in the hospital for these patients, they make them feel welcomed as much as they feel in their prenatal care. So it's going both ways: both clinical, both education. And we have an amazing program at Kaiser called Early Start. It is extra support for patients who have had substance use disorder or currently have it, or they have some dependence on any of the substances. Generally, they don't meet the criteria for the use disorder, but they have some dependence. And we support them through our psychologist colleagues, social work, case management, and take it from there. So it's been a good mix.
Why Cannabis In Pregnancy Matters
SPEAKER_00Wow. Well done. Very cool. I was gonna make a joke about I'm assuming as an OBGY and addiction doctor, all your patients get like 80 oxycodone after surgery, right? Of course, yeah, you and I both know you don't do that. But so tonight we were going to talk about cannabis in pregnancy. Because uh there's a couple of things that are interesting about cannabis. Number one is you and I both know it's getting way stronger. I graduated high school in 2002. At that time it was 4%, now it's routinely 30%. You can get THC infused joints, 50%, waxes and gabs, just a different drug. So how does it being stronger affect pregnancy? Also, I'm the parent of a Gen Z, and Gen Z likes cannabis more than alcohol. So younger people who would be likely to get pregnant would be more likely to use cannabis than alcohol. And then the last thing is, and I love this, is cannabis can't be bad because it's just a plant. And there's this perception of cannabis being helpful. And I feel like more people are using it for that. So let's just start with what do we know about what cannabis does during pregnancy?
THC Placenta Implantation And Early Brain
SPEAKER_02Yeah, actually, people think we don't know a lot, but we've had a lot of researches more than before, more than 90s. And we've we really trying to study this more as we established a lot of different changes in how alcohol and nicotine affects the pregnancy. Now our focus is on cannabis, and being illegal in a lot of states doesn't mean it's safe, but that has increased the perception of especially our newer generation of the safety. And definitely we don't know that it's helpful in pregnancy. We can't prove the specific harms, but based on the few data we have, we counsel our patients. So, in general, the cannabis does interact with the endocannabinoid system of our body, and that's like an on-demand stress response. And the receptors for them, they're both in your brain and peripheral tissue as well. But the main important thing is the cannabis is lipophilic, it loves fat and actually crosses the brain barrier. So it makes it super potent and super important to regulating pregnancy. And fetus actually has endocannabinoid receptors as early as five to six weeks, and that's when the organogenesis usually happens. And based on our data now, we're we're seeing that it can affect implantation, it can affect the neuronal migration during the first few weeks, and we can extrapolate it to disaffecting the neurodevelopmental of the fetus in the future and the child as well. And then also it because it affects implantation, it can affect the placenta formation. And we know anything that affects the placenta formation, it can play a role in different hypertensive disorders of pregnancy, such as preclampsia, all these complications that we actively try to avoid in pregnancy to have a healthy one. So you're saying it's great in pregnancy.
SPEAKER_00Good heavens. For sure. This is there's so much here. Let's stop unpack. Some of my audience are healthcare providers, some are not. So what I heard is it crosses the placenta into the baby, the growing fetus, and changes various organs developing, specifically the brain. And then it also changes how the pregnancy and the placenta that's around the pregnancy grows as well. Because it affects implantation where the pregnancy starts growing, is maternal cannabis use associated with miscarriage?
SPEAKER_02Yeah. So we've seen in some data, even though we don't have the greatest data on this, but we've seen that it can just like alcohol and also the nicotine use, it can lead to miscarriages. But main data that we have on cannabis use in pregnancy is showing us that increases the low birth weight or the babies being small for gestation. And then the next level of evidence we have that we see a correlation between the babies staying longer in NICU or having NICU admission compared to moms who never used cannabis in their pregnancy. So low birth weight usually determines the nutritional status of the baby and also how the baby is gonna respond to the different stresses in the world. So it is a marker that we always measure, we always try to follow in our fetuses and also when they come out, babies. And also if a baby has low birth weight or small for gestational age, then we worry about blood supply, we worry about neurodevelopmental. They usually have to stay in a NICU, they are more uh prone to getting infections because of their immune system not being that as strong. So the resiliency of these babies decreases compared to the other ones that are not as small for their gestational age or they don't have a low birth weight.
SPEAKER_00So you and I both know that cannabis, as it's gotten stronger, has a withdrawal syndrome. Is there a cannabis abstinence syndrome for baby exposed cannabis?
SPEAKER_02So that's something that hasn't come up in a lot of studies, unfortunately. But just extrapolating from a lot of other substance use misorders, we can definitely establish that relationship. And it definitely is something that in postpartum we always counsel our patients who had cannabis use to look for. And a fussy baby is always a fussy baby, right? Is it withdrawal or a fussy baby? And we see that in opious disorder too, but mainly we urge all our moms that who use cannabis in pregnancy to make sure they are monitoring the weight of the baby and also watching for the yellow nest or the jaundist, and also looking for the cues, as you said, the withdrawal can be irritability for the baby. But there's not much of studies that has been done on that, unfortunately, because we are now focusing on in the pregnancy and the postpartum will come soon. So hopefully there's the research that we can help the babies with that too. Like having a medication for them, such as morphine for opiouse disorder. Unfortunately, we haven't focused on that in cannabis use. But another thing is our a lot of our researchers are from 1990s, where, as you mentioned, the cannabis was 4%. I think that was the highest, 4 to 5% was the highest. And then now I've had patients because we do calculation together with my patients about the concentration and especially in the vape as well. So I've seen up to 80% also, which is really shocking to me. So we can't really depend on the most of the research that we have for cannabis either. Only can depend on the very, very newer ones right now.
SPEAKER_00How does maternal cannabis use affect symptoms of morning sickness like nausea, vomiting? And then have you ever had anyone get cannabinoid hyperemesis syndrome and hyperemesis gravitarm at the same time?
SPEAKER_02That's where it gets really tricky. But yeah, a lot of a lot of patients that I see in the clinic, they have been using cannabis in the form of THC or CPD in the past. And then especially they bring that thought into the pregnancy that because it's legal, again, it is safe in pregnancy, which is not correct. And they start using that for morning sickness, not knowing that it can really put them in this vicious cycle of more nausea and vomiting, versus we have antonause medication with amazing medicinal studies and evidence that it's safe in pregnancy. So we really prefer those over the even the CBD, because as we know, we think that CBD is safer than THC. It doesn't have the psychoactive characteristic of THC, but it can be contaminated with a lot of heavy metals, but with other THC that we're not testing for it, right? We're not regulating those, it's not FDA regulated. So yeah, I definitely see all these patients that do get that vicious cycle. And now is it hypermesis gravidorum, or is it because of the THC they were using? And sometimes when it's really bad, I use the hot shower test. So if they get better with a hot shower, it's not hyperamesis gravidorum. So it is definitely because of the THC. So I always ask them, like, how about a hot shower? And if they didn't try it, and sometimes some of our patients are in a hospital, I'm like, how about taking a hot shower and see how you feel? And then come to check on them and they feel amazing. They some of sometimes they don't even want to come out of shower. Like they're not, I just have to talk to them from the door and be like, Are you coming out? That's the other thing that we can see the difference between them. But it's been really challenging for OGYN to try to navigate this because hyperimesis graviderum is such a tough subject for us to actually battle. And it goes on sometimes for such a long time. Most of the pregnancy I'm talking about more than three or four months. I've had doctors or the patient have considered the termination because the hyperimesis graviderm was so bad. So with this THC coming on and the effect of it, it's really has made it such a challenging part of our daily practice.
SPEAKER_00Your colleagues must love you when there's someone using THC that they can't get to stop vomiting. They're like, Where's Nas? We need we need her to come in.
SPEAKER_02That's the thing that that that makes it really hard because also we are giving a lot of medication that we usually use for hyperemesis gravidarium. But honestly, it's just as somebody had a cold, supportive medications, right? Like just make the patient feel better. And also in the early days, I usually recommend hot showers, but to a point that they do get out, hopefully. But we've we don't have amazing data on this, but galopentin is uh a medication that I usually use for craving, and I've had a great anecdotal success with it in patients who've had the hyperamesis because of the THC. And I've used that for patients who want to not smoke or not use any THC, but they're stable. So both ways, I think it has helped a lot. Again, I hope there is uh research that can come and randomize a study that can help us have more evidence for it. But anecdotally, I've I've had great experience with it.
SPEAKER_00Mine's the same. Gabapentin's my go-to. I don't know if you've used much N-acetylcysteine for cannabis use disorder, but I was just curious: is that safe in pregnancy?
SPEAKER_02No, that's not safe in pregnancy. That's why. Bummer. Yeah. That's why I haven't been uh used to it. I trained with a bunch of toxicologists, and I know that's their go-to throughout everything. So that was the first thing.
SPEAKER_01And I was like, oh, never mind, just gallop engine.
SPEAKER_00Bummer. So we're still on the first trimester here. What are other first trimester complications from cannabis use that we have to worry about?
SPEAKER_02Besides we know that unlike alcohol, it's not tartogenic. So we don't have a specific malformation. But one thing that we just worry about is miscarriage hyperamesis that can muddy the water of is it because of pregnancy or not. So those are the ones that we mainly look at in the first trimester. But there is not a malformation that we would be looking out, especially in the first trimester. And but we do recommend to people the minute they know to stop it, because the organogenesis really happens within the first eight weeks. And most of my patients don't know that they are pregnant at that time either. So that makes it really tough.
SPEAKER_00Again, I'm gonna embarrass myself because it's been a few years since I followed someone through a pregnancy. But I remember the first trimester was pretty rocky and the third trimester was pretty rocky, but that second trimester was pretty nice. Yeah. Any issues or specific complications from cannabis use in the second trimester?
SPEAKER_02Again, it's like data is really lacking in second trimester and third trimester as well. I've had a lot of hyperemes just continuing it to the second trimester, and that's what makes it really difficult. And sometimes I've had patients that, especially in fellowship, that were taking an edible, and in that way we had to decrease the edible strength to get them to a point that we could help them with the gabopentin. But usually, as with any other medication that you require more in pregnancy, I've seen that the need for T C goes higher. And that can be also related to the stress from pregnancy mentally and physically as a growing baby, right? That is another thing that we usually notice, but not a specific side effect beside the hypermesis that we usually continue to see.
SPEAKER_00So as we transition into the third trimester, is there any data that cannabis withdrawal is associated with preterm labor the way opioid withdrawal is?
SPEAKER_02So that that is a really touchy subject because even with opioid use disorder and when we are looking at that, it there is a relation to preterm labor. But preterm labor is such a heavy subject. A lot of research that we extrapolated this was not randomized and also wasn't basically amazing, amazing structured research that we can say this is definitely the risk of preterm labor is due to opioid use disorder or cannabis use or the withdrawal. And it is really tough to even extrapolate it for opioid use and opioid withdrawal. And then we get to cannabis that we don't even have that much data. We usually, I counsel my patients on, you know, we've seen that in opioid withdrawal, and we it can happen with any substance. And I usually tell them, like with any substance, if you're not feeling great, your body's not gonna feel great. And there's always a preterm labor rest. And we'd recommend everybody get dentist appointments. Before their pregnancy, because we've seen three-term labor with our gum diseases. So it is really possible, but at the same time, I don't have clear data to counsel my patient on it. But I do extrapolate a little bit from opioid withdrawal. But even in opioid withdrawal, our evidence is it's a little bit rocky. They're not randomized to study. There's so many, the people they studied, they have other comorbidities as well. But that's something that we really look for in the patients with substance use.
SPEAKER_00I'm seeing a theme on data on substance use in pregnancy. It seems like there's a lot more just in general across the board that needs to be done.
SPEAKER_02Yeah, and that's really tough because we can't have a group of pregnant patients and put them at risk of substance use, and then the other ones not. And as you've mentioned it in your podcast many times with different hosts, different guests as well, that mental health is a big part of it. And one of the most wonderful times of any in any women's life is it is a pregnancy. So a lot surface up. But especially at Kaiser, we're trying to do ACEs, adverse childhood events, screening with substance use screening. So that that has been helping to address those a lot. So I think addressing both and screening for both really helps.
SPEAKER_00So as we transition to the end of the third trimester towards labor and delivery, are there any unique issues that cannabis brings up around labor, anesthesia, and any of the actual like delivery stuff?
SPEAKER_02So with the cannabis use around anesthesia in labor, as long as we be using epidural, we haven't found any specific difference that it can make between the patients who use cannabis who uh versus who do not. But of course, it can affect your pain perceptions and sometimes it can trigger people and give them more anxiety. So we've seen that in labor a lot. So we were usually, you know, that's the same as any other substances. We usually recommend to at least decrease near the labor. So we are not expecting any possible withdrawal for the both maternal and fetal as well. But if we're using general anesthesia, they might be more sleepy and groggy. But at the same time, I haven't gotten any other update from the anesthesia societies on that. So that's something that somebody might factor be for that.
Child Development And Breastfeeding Concerns
SPEAKER_00Yeah, yeah. And I know you're not a pediatrician, but I know OBGYNs have this incredible role of helping set the stage for the family to take the baby and go do parenting things. Yeah. What do we know? And what do you counsel your patients on what happens to a baby exposed to cannabis during pregnancy? What do we know about potential adverse effects and their children, whether that is that like ADHD, is that learning disabilities? No.
SPEAKER_02Yeah, for those as well. Yeah, I do counsel them on attention deficiency, any again, ADHD or autism spectrum, to make sure they are aware of it. And in these, we are more aware of diagnosing these as doctors, but parents' role can be to not ignore it and get help as soon as possible because it's not useful when we don't get help, basically, and ignoring it. And that's what our previous generations did. And just giving these kids a lot of tools that they need and they can bloom with these tools and be very functional member of our society. It's really important. But again, that's really multifactorial. But from what we know with cannabis and how it affects the endocannabinoid system, we definitely think that it can lead to some of the behavioral disorders in the future. So I usually have our moms definitely be aware of it because whether you've used cannabis or not, it is something that we need to be careful as parents and have our eye on our kids. And in every state, I've been in practice in Washington State in California, and in every state, we have amazing free resources for kids up to five-year-old. So that's something I usually bring up with any of my patients who have had any history of substance use disorder. But at the same time, in immediate postpartum, I usually discuss breastfeeding. And breastfeeding is usually not contra-indicated in cannabis use, but usually we don't recommend breastfeeding with active substance use. But at the same time, we we found that 2.5% of the cannabis can be in mother's milk. And again, mother's milk usually grab a lot of other substances we have, a lot of cannabis, because cannabis loves fat. The milk is fat. And also we've noticed that in our newborn tissue, it can last about six days or more at least. So it's it can have a long-term effect on the babies. And what we are seeing anecdotally with patients that are using cannabis and also breastfeeding, and seeing that there is another good latch. Usually they're having a hard time breastfeeding. In my opinion, as long as babies fed, I'm fine. But breastfeeding becomes really important for a lot of our moms and their definition of among. So I don't want them to feel that they have failed or they haven't been successful. So just counseling on those points really helps our population.
SPEAKER_00We just need to take a minute and respect the latch. The latch I will never forget when our daughter was born. My wife and I are both physicians. I speak about my wife all the time on this podcast. Beautiful and amazing, intelligent Dr. Reb Close. Yeah. North year medical student and attending physician. The two of us took us like two days to get the latch down. We're both crying. Yeah. The latch is a big deal. And just in case the non-clinical audience doesn't know what we're talking about, it's initiating breastfeeding and getting baby to start sucking. Oh man. Yeah. Crazy memories.
SPEAKER_01Definitely. Yeah.
Postpartum Relapse And The Plant Myth
SPEAKER_00Definitely. One thing I see, because I don't have a ton of pregnant patients in my clinic, is I see people many years after they've had children. And I usually ask in their substitute's history, let's say alcohol is a drug of choice. The mothers will often know I need to be sober during pregnancy, but they'll go back to alcohol afterwards. I don't have numbers, but I'm curious, do you have a sense of when moms do decide to quit cannabis during pregnancy? How many of them go back to cannabis after pregnancy and breastfeeding?
SPEAKER_02Um I don't have a specific number actually, but in general, what we see in practice is first of all, a lot of people do continue because again, it's legal, everybody uses it. It comes from a plant, so that everybody's perceiving the safety already. So among those people who do stop using during pregnancy, there is a high relapse rate, unfortunately, in postpartum, because at that point also they usually say we pump and dump, meaning like we can when we use the days we use, we just don't breastfeed and dump the milk so we don't get engorged. But at the same time, it can stay in the breast milk for a long time, again, because of that lipophilic characteristic. But anecdotally, I do see more than 50% of my patients go back to cannabis use afterward, especially around three months when the first three months after delivery, it's really focused on the baby. And after the three months, when they've tried different anti-anxiety and all that, they usually don't find that much of relief with those medications. So then they go back to the cannabis use. But at the same time, again, that's why we are really counting postpartum as the fourth trimester and trying to have care up to a year at least, which I think it still needs to be more than that, but up to a year for our postpartum moms. And I think supporting them with mental health really is the culprit that can help them in that uh stage of their life.
SPEAKER_00Yeah. So we're getting close to wrapping up on our time here. What else is on the list that we need to discuss regarding cannabis and pregnancy?
SPEAKER_02I guess just one thing is it's really important to consider that this is coming from a plant, but we are doing a lot of modification on that plant. So that is becoming way stronger and way different than any other marijuana ever our ancestor used. So right now, what we are doing with the cannabis plant is really different and it's not a natural thing. So I don't count it as a natural thing. I don't think we should. And then also this the difference between T C and CBD doesn't make it safer in pregnancy. So really hope that a lot of people who are hearing this as we're counseling our patients and as our as the patients or pregnant moms, to bring in your what you're using to your doctor if you're feeling comfortable, of course, uh, and show it to them and they can prove to you that they are not natural and they have a lot of other things that are attached to the edible or smoking or vaping you're doing. And lastly, if I had to pick between vaping, smoking, and edibles, I would say edibles, safer in pregnancy, just because the smoking also causes hypoxia in utero as well, just like nicotine.
SPEAKER_00Yeah. So let's unpack a few things you said. How long have you been on the Central Coast?
SPEAKER_01Oh my god, one less than a year. I just moved here.
SPEAKER_00Have you gotten poison oak yet? No.
SPEAKER_01So I haven't been here.
SPEAKER_00It's a local thing. I grew up here. I always had poison oak as a kid. People be like, oh, cannabis is a plant. I'm like, so is poison oak. Like yeah, yeah, that's true. Your point is very well taken. And I think the way I say it, because people get really defensive about their cannabis, it's different. I'm not saying it's bad, I'm not saying it was good, but I'm saying we used it for thousands of years and now it's different. And that seems to really resonate because people feel less on the defense with that.
SPEAKER_02Very true. Yeah, I like that wording. Very different. As at OBGYN, it wasn't a big deal for me. And then as an addiction fellow, we worked with the VA, and there were a lot of our patients that were trying to get of alcohol used, but then the cannabis was the main culprit in a lot of my patients. And I was a little bit nonchalant about that because we have the same perception until just you just go into more of that research, and you're like, yeah, no, not a plant, different plant. So for sure. This is really good. This hopefully it reaches a lot of people.
SPEAKER_00Well, I was gonna say, I think you survived your first podcast. How do you feel?
SPEAKER_01Oh my god. Good, a little bit sweaty, but other than that, thank you so much, Casey.
SPEAKER_00Appreciate it. Yes, I have to say, appreciate your insight. I learned a ton. I'm really grateful for your expertise, and I'm pretty sure I'll be pinging you about other substance use disorders in pregnancy.
SPEAKER_01Yeah, for sure.
SPEAKER_00Thank you so much for listening to Addiction Medicine Made Easy. If you found this helpful, please leave a review. It really helps others find the show. And a huge thank you to Central Coast Overdose Prevention for supporting this podcast. And always remember, treating addiction stays live.