Let’s Talk About Meth

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Description

Overdose deaths from methamphetamine use have been surging in the US, not unlike opioids. But meth isn’t talked about as much. In this episode, Nzinga brings on Eleanor Health Clinic Manager Jack Register to talk about why meth has been prominent in certain communities and why there is less publicity over the rise in numbers. Plus, Nzinga lays the groundwork on how meth impacts our brains, behaviors, and bodies.

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Transcript

SPEAKERS:

Dr. Nzinga Harrison, Jack Register, Claire Jones

Dr. Nzinga Harrison 

Happy Monday, all this is Nzinga and you’re listening to IN RECOVERY. This week we’re going to talk about meth. If you’re new to the IN RECOVERY community, welcome. Just a quick blurb. This show is about all things addiction. So not just substances, although we definitely talk quite a bit about that. But other things that we’re all experiencing. So, bingeing election coverage, technology, exercise, sex. And it’s really about breaking down this idea that there are those people who are addicted to things and the rest of us, because in reality, all of us have something we would lay down. If it were that easy. We are a question and answer show. And so we need your questions, you can submit them by calling 8334-LEMONADA. That’s 833-453-6662. Or you can fill out our contact form at bit.ly/inrecoveryquestions. The last thing I’m going to say is, I’m your host, because I have a little bit of street cred in this space. I’m a doctor, physician, I’ve been practicing Addiction Medicine for almost two decades, it is my life work, I co-founded and I’m Chief Medical Officer at Eleanor Health where we are trying to be compassionate every single day and change the way we treat people with addiction in this country. So with that, we can dive in and talk about meth.

Claire Jones 

We have a guest coming on to talk about meth specifically in the LGBTQ community. But I first want to ask some basic questions to you and Nzinga because I have the immense privilege of not actually knowing that much about meth and not interacting that much with meth. So the first thing that I’m interested in is what is the difference between an opioid and an amphetamine.

Dr. Nzinga Harrison  02:05

So we categorize substances by where they act in the brain, or the effect that they have in the brain and the body. And so an opioid is a substance that binds to the opioid receptors in your brain and your body. And those receptors send messages like don’t have any pain, no physical pain, don’t have any emotional pain, calm down, relax, get sleepy, stop breathing. Those are the opioid messages. On the other hand, stimulants, which is the bigger category that methamphetamine belongs to, along with amphetamine, and prescription medications that we use for ADHD like Ritalin, Adderall, Concerta, etc, they actually bind a different receptor in the brain. And that receptor leads to an increase in what we call Monoamine Neurotransmitter. So that’s your dopamine, your norepinephrine, which is adrenaline, and serotonin. And so the difference is where they work in the brain and the message that they sent. And so methamphetamine and other stimulants send an adrenaline message. Whereas opioids send a be calm, slow down, don’t have pain message.

Claire Jones  

And it also sounds like meth and other stimulants send like a, I mean, if their serotonin and dopamine, it’s like a happy, it’s like a happy adrenaline.

Dr. Nzinga Harrison 

It can be yes. And you know, the dopamine is the main thing that’s driving the addiction, the reinforcement to keep coming back and back. But yeah, you’re exactly right about the seratonin. Adding that additional piece that like this is pleasurable. The reason I hesitated on it can be is because methamphetamine intoxication can be like a really, really intense negative agitation, paranoid type of intoxication, that can also happen. So I just wanted to put a little caveat there.

Claire Jones  04:09

That’s good, because it actually goes to my next question. So a listener wrote in to us and asked about the long-term effects on the brain. What are some of those effects on the brain? And how is that different?

Dr. Nzinga Harrison 

Our brains are naturally manufacturing, dopamine, norepinephrine and serotonin based on what’s going on right now, in this very moment. When you’re using an external drug like a methamphetamine that is increasing dopamine, increasing norepinephrine, which is basically adrenaline, increasing serotonin, then your receptors are like what the HE- double-hockey-sticks. And they actually start to down regulate the number of receptors that can accept dopamine, the number of receptors that can accept norepinephrine, the number of receptors that can exact serotonin. So whereas before methamphetamine, a hook from your child used to generate a dopamine signal that was reinforcing. But now that you’re down regulated, those things don’t bring enough reinforcement. The only thing that can bring enough dopamine signal is methamphetamine.

Claire Jones 

Is that different than other drugs? 

Dr. Nzinga Harrison 

That is the same. 

Claire Jones 

Yeah. Okay. That’s like what makes some addictive.

Dr. Nzinga Harrison

And also what creates withdrawal syndromes. And what drives cravings. What is different about methamphetamine is less than the brain and more throughout the rest of the body. Norepinephrine is like the main neurotransmitter that methamphetamine is increasing. That puts a lot of load on your cardiovascular system. So the risk for heart attacks, the risk for stress induced heart disease, cardiovascular disease, is significantly higher, and methamphetamine because the load on those in organs is like causing long term changes that your body can’t really recover from the same is true in the brain. So when you take methamphetamine or any other stimulant, it constricts your blood vessels and makes them smaller, reduces blood flow to all of your in organs. And so you’re in organs cumulatively over time, bear that burden, which is why we see so much premature death and people that have methamphetamine addiction,

Claire Jones  06:35

Gotcha. And then what about the psychological effects like paranoia or people who end up, I mean, for this listener who wrote in their cousin died by suicide, and they attribute it a lot to the way that meth affected their mental health.

Dr. Nzinga Harrison 

Yeah. And so this is a chicken and egg question, definitely. So we know, preexisting depression, anxiety, psychotic disorders like schizophrenia, schizoaffective disorder, bipolar disorder, personality disorders, anxiety, we know that the presence of any of those increases the chance that a person develops an addiction to something, methamphetamine included. We also know that even if those illnesses were not preexisting, methamphetamine is mucking up your neuro transmitters. And your neurotransmitters are the biological basis for depression, anxiety, ADHD, PTSD, and more. And so we know that methamphetamine can drive the development of those illnesses.

Claire Jones 

So then why is it that this only happens with methamphetamine but not necessarily with opioids or not even with cocaine.

Dr. Nzinga Harrison 

It does the only difference that would be here on opioids. So think about methamphetamine is increasing adrenaline. Adrenaline is fight or flight. Adrenaline is being keyed up, and being aware of every single stimulus in the environment so that you don’t get eaten by whatever is coming to eat you like you got to see the zombie and outrun it before it takes a bite. You can easily see how pouring that signal dialing that signal up to 100 can lead to paranoia, and hallucinations. Opioids are not binding to a receptor that sends that message. opioids are sending a message that’s like, have no pain, be numb, calm down, don’t breathe. The PTSD, the trauma-based disorders, some of that is input, but a lot of that is active addiction results in people being in a lot of environments in situations where trauma is a significant risk. So that signal is also coming from both directions. That makes sense?

Claire Jones  08:57

Yeah.

Claire Jones 

So the opioid epidemic has gone so much coverage, but underneath that, meth use and meth overdose have also been on the increase sort of at the same time as the opioid epidemic has happened. Yep. And as states have started to take action on opioids, meth use still continues to grow, and yet there’s way less coverage on it. So why is that?

Dr. Nzinga Harrison 

I think there are a lot of different factors for why this isn’t being talked about as much one. Like I said, the proximal connection between methamphetamine intoxication and death is not as closest opioid overdose and death. Like literally people are watching their loved ones die right in front of them from an opioid overdose. And that’s not typically going to be the experience for methamphetamine overdose. The other I think  while there’s a lot of methamphetamine use, everywhere, our rural communities are particularly devastated. And I mean, let’s be honest, we don’t value our rural community members the way that we should. I think the third thing I’ll say here, why methamphetamine crisis is not getting as much public attention is also because a great portion of the opioid crisis is driven by prescribing. So we hardcore normalized opioid use through pain pills. And that same normalization has not happened, although we’re treating ADHD that same normalization has not happened on the stimulant side. And so, you know, when there is an industry to blame, like the medical industry, then public attention peaks

Claire Jones  10:48

A lot higher. Yeah, that makes sense.

Dr. Nzinga Harrison 

So those are my three hypotheses.

Claire Jones 

Okay, great.

Dr. Nzinga Harrison 

That was a long answer. I think we could probably use a break.

Claire Jones 

Yeah, definitely use a break.

Dr. Nzinga Harrison 

So we’re bringing on my friend and colleague Jack Register, who is our clinic manager in our High Point clinic at Eleanor Health. If you’ve listened to the LAST DAY podcast when they came to visit us at Eleanor health, in Episode 23. Jack was that smooth velvet voice that you heard guiding the LAST DAY folks around the Eleanor Health Clinic. So super excited to be bringing you on Jack, thank you for joining me.

Jack Register 

Sure. Thank you so much for the invitation. This is great.

Claire Jones 

So we’re bringing on Jack to talk about meth use in the LGBTQ community. In our episode about supporting your loved ones we had our guests Brent on and he mentioned that meth is really prominent in this community. And so we wanted to know a little bit more about it. And Nzinga with her Rolodex had the perfect person, Jack.

Dr. Nzinga Harrison  12:06

Jack, introduce yourself to our IN RECOVERY listeners, help us get to know you.

Jack Register 

Sure. So my name is Jack Register. I’m a clinical social worker and clinical addiction specialist. I have been in the field for just over 20 years, I am openly queer. But I’ve done a lot of work in the coalition of communities because LGBTQIA+++ is not one monolithic community. And many folks out there try and lump us all together under the gay community. And that’s actually a term that many people find really disparaging. So I have a lot of experience treating folks who have this kind of co-occurring experience of a relationship with methamphetamines, and being identified in this coalition of communities and some of the issues that come up with that. So I’m really excited to be here to talk about that with you all today.

Dr. Nzinga Harrison  12:55

So okay, Jack, I can tell you are about to take us to school, and I’m here for it. So let’s start with the alphabet.

Jack Register

The issue is, is that many folks say that the term gay refers to men, particularly white men. And the term that gets held up because gay white faces, particularly male faces and cisgendered folks get presented as the sort of ultimate What is this community experiencing? And many of us in my coalition of communities get seen as who we are in terms of the label before we get seen as a person. So the thing that we always say to folks is, if you want to know how to identify, just ask me.

Dr. Nzinga Harrison

So I usually will say LGBTQIA+ I heard you say plus, plus plus. So I want to adopt that language too, because I hear you saying so loudly, to just say, the gay population is invisiblelising, the diversity that all of those letters and plus plus plus represent. And it is so important to be shining a light on people who are made to be invisible by our social cultural political constructs.

Jack Register  14:08

So for young people, the thing that’s the struggle is how do I find safe spaces? Because when you’re a young person, the first place you might want to go would be a club, right? Well, that’s substance induced. One of the reasons why methamphetamines in particular is such a huge thing in this coalition of communities. It’s a club drug, you’re up for about 12 hours, right? It kind of gives you a little bit of fearlessness, a little bit of invulnerability. So you see that other person across the way and they cute and you be cute, you want to be cute together, and you’ve got a little more juice in you to be able to go over and say hey, then you would ordinarily. So the other thing that’s interesting is just consider this right? You find somebody cute, you’re cute and you want to be cute together and you’re in that initial warm fuzzy phase of dating, right? Valentine’s Day comes up or your two-month anniversary comes up and you want to buy them a card. 

Jack Register

Hallmark has plenty of cards for cisgendered heterosexual folk. I have to go to a sex shop to find a card of two dudes, right? And if I say to somebody, you know, I want to buy a ring for my partner, they’re like, What is she looking for? I’m like, well, he’s about six foot four. He’s a big bear. And I’ve actually had people say, You’re not welcome to shop here. Right? And I’m a white guy who is cisgender. Right? So I kind of I have all kinds of other privilege that go on the disconnect here is is that when you add in issues, particularly around substances, substances become a way for some folks to find that out that little bit of space where they feel okay, again, and methamphetamine is so easy to get at clubs, and sex shops, and all of the places where folks who are marginalized from society and they can’t be who they really are, are going to get pushed.

Claire Jones 

The main question that comes up for me, is why meth in particular?

Jack Register 

I would say that because it has this notion of this arc of keeping you up, right? I mean, you crash, of course, but it keeps you up. And it can be up to 12 hours. It gives you this sense of fierceness, right? So you have the ability to kind of push back against the world and say, You know what, I’m gonna do what I want to do damn it.

Claire Jones  16:13

Yeah. But is it something that’s just more available than other drugs that you would find in clubs that give you a similar like, confidence and ability to stay awake for a long time?

Jack Register 

Because it’s one of those things that, you know, cocaine can be harder to get than methamphetamines because you can make methamphetamines a little bit easier. So the notion is, is that for a lot of folks, there’s a sort of ripple effects.

Dr. Nzinga Harrison  16:36

And the addict ability, yes, made it up. But the risk of developing addiction to methamphetamine is really significantly higher than say, for example, marijuana. This is not a drug that most people can use recreationally, purely as a result of the impact that it makes in the brain. And so then you have our young people, right, like you said, 23 getting addicted so early. And stimulants are actually the fastest growing substance of abuse. People die of methamphetamine overdose, but it’s not right there at the party, in your face, dead. It’s like you went to the ER with a crisis, and probably had a two or three day like you don’t drop dead from the methamphetamine overdose right there. And so it’s harder for people to make the connection. But it’s actually very, very dangerous.

Jack Register

And then the other piece is really odd, right? If your only experience of seeing other folks who are like you is a club scene in a substance scene, you start to get this sort of self-hatred of my own folk. I have heard many folks say, Well, you know, all queer and trans folk, they’re all just like, you know, drunks, and they all using substances. And so I can’t even be around those folks. Because it’s not even healthy. It’s not like you can go out, you know, into a bowling league or to, you know, all kinds of other places. So the notion is, is that the only spaces that ever get talked about in this coalition of communities, right? If you look at lesbian bars in particular, right, most of them are like huge amounts of alcoholism. Most of them are wearing cowboy boots and playing pool, when I know a ton of lesbians, they don’t do any of that stuff, right? And it’s this idea of we marginalize folks into these really narrow areas of where they can be identified and where they cannot be identified. And it creates even less community for folks to find whenever they’re searching for it.

Dr. Nzinga Harrison  18:36

Oh, and less community leads to more addiction, less connection, I can identify with that. The images you see of yourself, driving internalized self-hatred, like for black folks, is a lot better now. But literally the only black people used to see on TV or either drug dealers getting arrested on the news or actors playing drug dealers in movies. Like that phenomenon. When you said that jack that really resonated. I felt that one.

Claire Jones 

So it seems like one of the biggest root causes here is that there’s a lack of safe spaces for people that identify in these what was the term you used?

Jack Register  

Coalition of communities

Claire Jones  

Coalition of communities.

Dr. Nzinga Harrison  

I love it. 

Claire Jones  

And one of the safest spaces that many people can find are clubs and when they go to clubs, there’s this availability of meth that helps to boost your confidence. It helps to keep you in a safe space for a long time by staying up all night for 12 hours. So what are some other safe spaces that you tell people about?

Jack Register 

The idea is is that the first thing we have to do is to help folks understand the past that can come from even if that past is your family of origin and your face background. You may have to sever that connection to survive. The grief involved in that is profound. So part of what we do at Eleanor’s, we try and create those spaces. We have an LGBTQIA, dot, dot dot dot plus plus, plus group. We have a space for folks to come who are like my head’s exploding. I have no earthly idea. We’re like, Look, you’re a rainbow kid, I’m a rainbow kid you can be a rainbow kid. And we can talk about it, right? But that’s the thing is, this is the first time in my professional career where I can talk about these things, where all of me gets to show up and say, Look, this is an issue for folks out there. And we can help you deal with that.

Claire Jones  20:38

What other communities do we see large numbers of meth use?

Jack Register 

Well, homelessness is a big, it’s a big piece, right? And all of these other communities are affected by homelessness, because that’s one of the things that happens when systemic discrimination pushes you to the margin really far. People who are black indigenous people of color across the spectrum that happens a lot there too. Right? So the thing is, there is no one particular demographic who sort of has the market on methamphetamine use, it’s out there.

Dr. Nzinga Harrison

The other thing, Claire’s, if you look at the relative cost of methamphetamine, it’s relatively cheap. So like jack is telling you, one hit of methamphetamine can last you 12 hours, even 24. If you really stretch it, that’s like 20 bucks, whereas you’re paying 20 bucks for other drugs that you have to use multiple times per day. And so that also makes it more accessible.

Jack Register 

So consider this, if you’re a trans identified person, and you get picked up by law enforcement for some whatever reason, right? It’s a substance related charge. You go to the jail of your birth, not the jail of your presentation. It could be a death sentence to be arrested for this. And for some folks if they have to get their meds on the street for their hormones, right? We’ve even seen folks in my career that actually were mixing hormones with substances and mixed testosterone, with methamphetamine. Holy guacamole.

Claire Jones  22:10

People who are selling or people who are buying?

Jack Register 

Both ends. So part of my job as a helper is to consistently be putting this out there to folks who will listen and to take the time to say to folks, you’re safe here, we will make sure you’re safe here.

Dr. Nzinga Harrison

Even I’m gonna push you one step further, Jack, because I know this is what you do. But being proactive. 

Jack Register

Oh, yeah. 

Dr. Nzinga Harrison

Right? Like not being passive and leaving it for our LGBTQIA+++ coalition of community members to have to somehow find us the safe place in the haystack. That is a world of danger. But like making it known to people were a safe place. And these are other safe places that we found.

Claire Jones

Yeah, that I mean, that was sort of my last question, like getting the word out, so to speak. I mean, I don’t know what it’s I have no idea what that experience is like, and what the access information is like. And so I just, that’s just something I’m curious about.

Jack Register

I talk to folks about this idea of common sense, right? Because many people will say, well, it’s just common sense. Boys marry girls. And many folks like me, whenever we come out first thing that somebody says, Well, how do you know? Right? And I’ve actually looked at folks and say, How do you know? I’m like I’ve never seen after school special romance, a 14-year-old folks having their first love, right? I didn’t get to have all that normative stuff. But this idea is, is that there’s actually within the world of psychology, this notion of minority stress complex, that some folks may not be able to see what they’re experiencing, because they’re drowning, because they’ve been pushed so far to the margin. They don’t even know where the lines are anymore of where they want to be or how they’re supposed to be because they’ve never seen anything more than with addiction and all of this in general. Our job is to start with that normalization and connect with folks before we even talk about sobriety.

Dr. Nzinga Harrison  24:04

I remember, Jack, when I was a Psyche second year resident, the first patient I had was a lesbian woman. That’s how she identified herself. She had just gotten married to her wife. And she said, she had no idea growing up, that there were lesbians. It just it was 100% not part of her experience. Like she said, I just knew I was different from everybody else around me. And so she didn’t have to know it was because she was lesbian. She couldn’t even like that wasn’t even part of what she even knew. She just knew that she fell on an island by herself disconnected, and that is like the importance of representation. So then when she went away to college, she had a broader experience and got her first girlfriend and the rest is beautiful story that ends in love and babies. But for her whole all the way up to 18, before she went to college, she just really struggled because it was like, I don’t know what it is. But I can’t connect. That’s the importance of having after school special where two boys have their first date, or two girls fall in love, where you can see normal affection between same sex partners and transgender partners. So that these kids can know like, there is someone like me, that people love.

Claire Jones 

We usually ask people to give us some words of wisdom or parting thoughts, what’s something that you sort of want to leave listeners with?

Jack Register 

So I really believe that we all want more than anything else in the world to be seen, be heard, be known and be loved. But the idea of just simply connecting with folk, yeah, however it works, if it’s through story, if it’s through reminding people that they are that they are alone, and they are okay, just the way that they are and that they can grow and change even through the most horrific of circumstances. My job as a helper and as a person on the planet is to remind folks that is capable and possible.

Dr. Nzinga Harrison  26:23

I love it. I love having you in the Eleanor family, Jack.

Jack Register 

Thanks. Love it.

Dr. Nzinga Harrison  

Thank you for coming on IN RECOVERY.

Jack Register 

Thanks, everybody.

Dr. Nzinga Harrison  26:33

Bye.

Dr. Nzinga Harrison 

All right. I know we have some amazing sponsors. Should we take a listen to who they are? 

Claire Jones 

Yes.

Claire Jones 

I think that we should start off with you. And Nzinga, what are your initial thoughts after this conversation?

Dr. Nzinga Harrison 

Yeah, I mean, Jack was natural like getting to the bio, psycho social, cultural, political root cause we were talking about the overlap of methamphetamine and LGBTQIA plus, plus plus dot, dot dot communities. But also, I wanted to make sure even for folks who are not identifying in that coalition of community, so even if you’re cisgendered, or straight, he really put a big emphasis on the risk for young people, period. And so methamphetamine is super risky for young people, period, because it is a club drug. And because it is affordable, and because it does give you courage to overcome what is very often the awkwardness and lack of self-assuredness, that is just the natural state of adolescence regardless of gender identity or sexual orientation. And so for people who don’t see themselves specifically in the LGBTQIA plus conversation, this still applies to young people, this risk still applies.

Claire Jones  28:04

Yeah. So aside from therapy, and other parts of the magic formula that we talked about, so therapy community trying to find community connection purpose. What are some other options for people who find themselves having a meth addiction? There’s no medication, is that right?

Dr. Nzinga Harrison 

So there’s no FDA approved medication for meth addiction. That’s right. And that’s true for any stimulant. But, you know, I’m always like, get a full evaluation, see a psychiatric practitioner, because untreated depression, anxiety, PTSD, all of these will drive a methamphetamine addiction. And so what we know is that treating with an antidepressant, if there’s depression or anxiety or PTSD, can help increase our chances that a stimulant use disorder stays in remission. Also, there are some medications that there’s early evidence for so Wellbutrin is a specific medication. Desipramine is a tricyclic antidepressant, a super old one Citalopram is an SSRI. And so there’s some evidence that treatment with those can improve outcome for methamphetamine addiction. And then the last is we’re seeing a lot of comorbid methamphetamine plus opioid addiction. And so we know if we see the opioid use there, and some of that is I’m intentionally using the two substances. Some of that is my methamphetamine has been cut with opioids. So then when I stopped using methamphetamine, I get opioid withdrawal. Suboxone and Buprenorphine then definitely helps when we have that combo presentation. 

Claire Jones 

And wait so the word you use was morbid.

Dr. Nzinga Harrison 

Co-morbid, so co-meaning at the same time morbid is the medical word we use for illness.

Claire Jones  30:01

Okay.

Dr. Nzinga Harrison 

Yeah, the affective illness, not more, but like death. So morbidity is like negative effect on health and mortality is the ultimate negative effect.

Claire Jones 

Right. So you’re seeing a lot of people using opioids and methamphetamine at the same time?

Dr. Nzinga Harrison 

I mentioned it when we were talking to jack, which is that methamphetamine use is definitely on the rise. It’s one of the less expensive drugs that we have, which makes it very, very risky. It increases confidence, which makes it very, very risky. The other thing that’s making it very risky is that it is being cut with everything, specifically Fentanyl. phenol is the deadliest opioid we have. And you may not know that your methamphetamine is cut with Fentanyl, just because you’re using it with methamphetamine. Some people think like, oh, methamphetamines are upper, opioids or a downer. If I take them together that’s reducing my chance of dying from an opioid overdose. No. So if you’re using methamphetamine, you know someone who is using methamphetamine, you need to have Narcan kits. Any of the clubs and the clubs. You know it, this is not an accusation. If you’re a club, where people are using a lot of methamphetamine and other club drugs, you know it stock with Narcan kits. Okay? You can save lives.

Claire Jones 

What are your words of wisdom?

Dr. Nzinga Harrison 

Yeah, I want to echo Jack’s words of wisdom. So because we especially see the risk for what we call initiation. So the first time a person uses a drug, and then the risk for developing addiction thereafter, initiation risk for methamphetamine is around the time kids start going to clubs. And so as parents, we need to make sure we’re having the conversation before need to be talking to our kids, if we have any addictive risk in our families that all need to be letting them know your friends might be able to do a bar, you might not be able to do a bomb based on your DNA, helping them understand this is what it looks like when it’s no longer just a party. So they can be identifying that early. And then you can come to me, I know you don’t want to come to me and say you feel like you’re hooked on anything. But please, just come to me and we’ll figure it out. So just as parents like laying that foundation very early, but then also just letting people know how dangerous methamphetamine is. So methamphetamine, we should have the same level of urgency around methamphetamine deaths that we do around opioid deaths. That was a whole lot of words of wisdom. Just to say, we need to put an eye on this ball.

CREDITS

IN RECOVERY is a Lemonada Media Original. The show is produced by Claire Jones and edited by Ivan Kuraev. Jackie Danziger is our supervising producer. Our theme was composed by Dan Milad with additional music by Ivan Kuraev. Stephanie Wittels Wachs and Jessica Cordova Kramer are our executive producers. Rate us review us and say nice things follow us at @lemonadamedia across all social platforms, or find me on Twitter at @naharrisonmd. If you’ve learned from us, share the show with your others. Let’s help this stigmatize addiction together.

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