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

Benzodiazepines can feel like flipping a switch: panic quiets, sleep finally comes, your body unclenches. But what happens when that “off switch” starts rewiring the system you rely on to stay calm in the first place? Dr Andrew Rizzo joins me to dig into the biology behind chronic benzodiazepine use and why so many clinicians now recognize benzodiazepine-induced neurological dysfunction (BIND) as a real, patient-altering condition rather than a vague catch-all for “rebound anxiety.”

We walk through the GABA receptor in plain language, including why benzodiazepines act as positive allosteric modulators, how the brain chases homeostasis by downregulating inhibition and upregulating glutamate, and why tolerance is structural not moral. Then we connect the molecular story to the clinical reality: why abrupt benzo cessation can be life-threatening, how seizure risk emerges, what “kindling” means for repeat withdrawal attempts, and why a slow benzodiazepine taper often takes months, not weeks.

We also spend time on what patients and families actually need during recovery: validation, steady follow-up, and a plan that treats this like a fragile neurobiological injury. If you’re a clinician, a patient, or someone supporting a loved one, you’ll leave with clearer language, sharper warning signs, and a better mental model for why symptoms like photophobia, tinnitus, tremor, and cognitive fog can persist long after the last pill.

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To contact Dr. Grover: ammadeeasy@fastmail.com

Fentanyl changed the playbook for starting buprenorphine, and we’re tired of watching people suffer through days of withdrawal just to “earn” their first dose. So we break down a cleaner, faster on-ramp: direct-to-inject. Think of weekly Brixadi as an automatic microdose that builds buprenorphine levels over 24 hours, cuts out guesswork, and sets up a smooth handoff to a monthly injection that actually sticks.

We start by demystifying precipitated withdrawal with simple, memorable analogies—the “100 mph to 60 mph” shift explains why heroin-era inductions no longer work when fentanyl lingers like THC. From there, we map the current options: long waits with comfort meds, meticulous sublingual microdosing, short-acting opioid bridges, and why DTI often outperforms them in the real world. You’ll hear our step-by-step protocol for week one: when to keep using, when to stop, how to layer sublingual buprenorphine, and which comfort meds reliably blunt symptoms without fogging people out.

Then we get tactical. We compare Sublocade and Brixadi in plain English—needle size, injection sites, refrigeration, and the “tail” that can protect patients who miss appointments or face custody interruptions. We explain why some teams favor weekly Brixadi for the bridge and monthly Sublocade for its long half-life, while others choose monthly Brixadi for logistics and patient comfort. We also clear up a big myth: yes, you can supplement injectables with sublingual buprenorphine when needed.

What matters most is the outcome. DTI compresses complexity into a single, supported action and replaces fear with momentum. Patients report fewer false starts, less chaos, and a quicker path to cravings control and stability. For clinicians and outreach teams, it’s a protocol that works on the street and in clinic, with clear timing, meds, and contingencies that honor how people actually live.

If this helped you rethink induction in the fentanyl era, follow the show, share it with a colleague, and leave a quick review so more clinicians and families can find it. Treating addiction saves lives—let’s make the first step easier.

To contact Dr. Grover: ammadeeasy@fastmail.com