The Transformed Minds Pod

In this episode, Dr. O examines how self-harm, substance use, and emotional dysregulation interact to increase risk in adolescents and young adults.Drawing on the Global Burden of Disease Study 2025, this discussion highlights how mental disorders, substance use, and self-harm are leading contributors to disability in ages 10–24.Key topics include:Substance use as a major risk factor for suicidal thoughts and behaviorsEmotional dysregulation and impulsivitySocial media and behavioral risk patternsClinical implications for screening and early interventionFeatured research includes:Xu et al., Translational Psychiatry 2025Jones et al., Substance Abuse 2023López-Martínez et al., Behavioral Sciences 2025RESOURCES:If you or someone you know is in immediate danger, call emergency services (911 in the U.S.) right away.*U.S.: Call or text 988 (Suicide and Crisis Lifeline) OR Chat via 988lifeline.org*International: Visit findahelpline.com to find local resourcesYou are not alone. Help is available.

Are dose caps on buprenorphine costing lives? In this episode of the Transform Mind Podcast, Dr. O and Dr. Drits dig into the evidence and the gaps around buprenorphine dosing for opioid use disorder In the fentanyl era, drawing on a 2023 narrative review by Grande and colleagues published in the Journal of Addiction Medicine.Higher doses are consistently linked to better treatment retention. Yet dose caps persist in clinical practice and insurance policy, even as the opioid supply has fundamentally shifted. Dr. O and Dr. Drits break down why, and what clinicians and patients can do about it.In this episode:→ Why the "ceiling effect" applies to respiratory depression not to craving or withdrawal relief→ What the evidence says about retention, fentanyl, and dosing→ How to advocate for patients within institutional and insurance constraints→ Common myths about diversion and high-dose buprenorphine→ Shared decision-making in practiceLearning ObjectivesBy the end of this episode, listeners will be able to:Describe the evidence base regarding buprenorphine dose limits and clinical outcomes.Explain how buprenorphine pharmacology informs safety at higher doses.Identify policy and systemic factors that influence dosing practices.Apply evidence-based reasoning to clinical and systems-level decision-making in opioid use disorder care.Chapters:00:00 High Dose Benefits 01:23 Podcast Intro Format02:34 Why Dose Caps Matter07:48 Guest Perspective Policy Lag11:27 Dose Limits Today14:44 Buprenorphine Pharmacology18:07 Retention Saves Lives20:31 Fentanyl Needs Higher Doses22:25 Advocacy Under Limits24:53 Training And Myths28:38 Case Dosing Decisions34:38 Shared Decision Making37:34 Ceiling Effect Explained39:24 Key Takeaways Reference: Grande LA et al. "High-dose buprenorphine for the treatment of opioid use disorder in the context of fentanyl exposure." Journal of Addiction Medicine, 2023.⚠️ This podcast is for educational purposes only and does not constitute medical advice. Clinical decisions should be made in consultation with a qualified healthcare provider.#BuprenorphineTreatment #OpioidUseDisorder #MOUD #FentanylCrisis #AddictionMedicine #HarmReduction #TransformMindPodcast

Why does mental health care stay fragmented when the evidence for effective treatment already exists? In this Host Rx episode, Dr. O argues that persistent treatment gaps are a structural problem, not a knowledge problem.Drawing on a 2023 Lancet Psychiatry paper, Dr. O breaks down what's actually driving fragmentation:Insurance design and weak parity enforcementPrior authorization delays blocking time-sensitive careScope-of-practice restrictions and workforce shortagesEHR silos and reimbursement models that don't support collaborative careShe maps the problem across clinical, organizational, and policy levels, and makes the case for structural literacy as the foundation for reform.00:00 Evidence Versus Architecture01:05 Podcast Welcome And Format02:19 Treatment Gaps Are System Design04:58 Why Care Stays Fragmented06:38 Insurance Shapes Clinical Care07:19 Why Pilots Fail To Scale08:14 Case Study OUD And Depression09:49 Clinician Reflection And Levers10:52 Warm Handoffs And Case Conferences13:45 Why Silos Persist In Practice15:18 What Integration Really Means15:54 Three Levels Of Architecture17:42 Advocacy And Closing MessageFeatured Studies- 2023 Article, The Lancet Psychiatry (ScienceDirect link provided)- Lagisetty PA et al., 2019. Racial disparities in buprenorphine treatment. JAMA Psychiatry.- Parity enforcement advocacy and policy statements from the American Medical AssociationTransformed Minds is hosted by Dr. O and covers addiction medicine, psychiatry, and the policy shaping mental health care delivery.

In this episode of Transformed Minds Season 2, Dr. O sits down with addiction medicine specialist Dr. Desai, a CATCH Team Lead Physician (Consult for Addiction Treatment and Care in Hospitals), for a deep clinical dive into alcohol withdrawal management in the hospital setting.Whether you're a hospitalist, internist, nurse, resident, addiction medicine clinician, or medical student, this episode gives you a practical, bedside framework you can use immediately.What You'll Learn:A practical framework for risk-stratifying alcohol withdrawal at the bedsideWhen and how to use CIWA and what most clinicians get wrongHow to choose between benzodiazepine regimens based on patient profileWhen phenobarbital enters the picture and how to use it safelyHow an interdisciplinary consult model changes outcomes for hospitalized patients with alcohol use disorderChapters00:00 Why Early Assessment Matters00:49 Welcome to Transformed Minds02:38 Meet Dr. Desai04:37 What Is the CATCH Team07:26 Alcohol Withdrawal Red Flags13:10 Bedside CIWA and Reassessment15:16 Symptom-Triggered Protocols18:10 High-Risk Withdrawal Timeline20:22 Front-Loading and Fixed Tapers25:58 Complicated Withdrawal and Phenobarbital36:54 Choosing the Right Benzo39:32 Key Takeaways and Wrap UpSubscribe to Transformed Minds for clinical education on psychiatric and addiction care, advocacy and tips.

In this Host Rx episode, Dr. O examines a critical reality in addiction care: access gaps.Medications for Opioid Use Disorder (MOUD), including buprenorphine, reduce all-cause mortality by approximately 50%. The evidence is clear. Yet in the United States, who receives these medications often depends on race, income, insurance status, and geography.What This Episode Covers- Racial disparities in buprenorphine prescribing. - Geographic inequities and treatment deserts. - Medicaid expansion and insurance barriers. - Adolescent access gaps. - Telehealth reforms and post-COVID regulatory changes. - Structural determinants driving opioid mortality.Grounded in peer-reviewed research and national policy analysis, this episode is designed for clinicians, policymakers, advocates, public health professionals, researchers, and trainees in psychiatry and addiction medicine, as well as anyone who wants to understand why zip code should not determine survival.Featured Research- Lagisetty et al., 2019. Buprenorphine Treatment Divide. JAMA Psychiatry. --Krawczyk et al., 2022. Policy Impact on Buprenorphine Access. JAMA Network Open. -Goedel et al., 2021. Structural Determinants of Treatment Access. American Journal of Psychiatry. -Samples et al., 2022. Telehealth and Buprenorphine Access. Health Affairs. -Williams et al., 2023 .Treatment Inequities and Policy Reform. Lancet Psychiatry. -Priest et al., 2022. Adolescent Treatment Access. Journal of Adolescent Health. -Clinical guidance: SAMHSA and CDC.Episode Chapters00:00 Welcome to Transformed Minds 01:27 Why Access Matters 04:11 Research on Treatment Gaps 07:07 Clinician Pipeline and Policy 11:16 Frameworks and Care Models 12:31 Buprenorphine vs Methadone Systems 16:07 Geography, Youth, and Trauma 20:04 Case Study: Marcus 22:58 How Buprenorphine Works 25:50 Access Is the Treatment 27:35 Screen for Structural Barriers 30:55 Final Call to AdvocateBecause where you live should not determine whether you survive.

Does incarceration actually reduce substance use or does it make it worse?In this episode of The Transformed Mind, Dr. Owusu sits down with forensic and addiction psychiatrist Dr. Jason Barrett to examine the growing body of evidence showing that incarceration is not a deterrent to drug use and may actually increase risk after release, even after controlling for prior substance use.Using longitudinal research on formerly incarcerated Black Americans as a foundation, this conversation moves beyond statistics to explore the lived realities of incarceration, reentry, trauma, and gaps in addiction treatment. Together, they unpack why relapse after release is not a moral failure, but a predictable outcome of disrupted care, untreated trauma, and structural barriers like housing instability, loss of insurance, and lack of access to evidence-based treatment.This episode covers:- Why incarceration predicts drug use independent of prior useCarceral trauma, racialized trauma, and loss of autonomy- Why court-mandated treatment often fails without readiness- The role of clinicians as the “last bridge” for patients- Medication access in jails and prisons (and why continuity of care matters)- How community organizations, peer specialists, and policy reforms can reduce harm- Why addiction should be treated like diabetes, not punished like misconductThis episode is essential listening for clinicians, trainees, policymakers, community advocates, and anyone seeking a more honest, evidence-based conversation about addiction and the justice system.🎧 Listen on Spotify, Apple Podcasts, and wherever you get your podcastsFeatured resources:Rich JD, Wakeman SE, Dickman SL. Return to illicit drug use post-incarceration among formerly incarcerated Black Americans. Drug Alcohol Depend. 2018;187:77–82.Brinkley-Rubinstein L. Incarceration as a social determinant of health. Lancet Public Health. 2018;3:e165–e166.Binswanger IA, et al. Mortality after prison release. N Engl J Med. 2007;356:157–165.National Academies of Sciences. Medications for Opioid Use Disorder Save Lives. 2019.Subscribe for weekly conversations on psychiatry, addiction, and structural health00:00 – Welcome & episode overview02:10 – Why this conversation matters right now04:40 – Intergenerational incarceration, foster care, and homelessness07:30 – Lack of treatment inside jails and prisons10:15 – Why incarceration predicts drug use even after prior use is controlled14:20 – “What does the substance do for you?”18:45 – Trauma, PTSD, ADHD, and untreated psychiatric drivers23:10 – The myth that incarceration stops drug use27:30 – Court-mandated treatment vs readiness for change32:40 – Stages of change and why forced care often fails37:15 – Being the only bridge left for a patient41:50 – Carceral trauma and racialized trauma47:10 – What forensic psychiatry actually is51:30 – How clinicians should assess incarceration history56:20 – Addiction treatment during incarceration: what the evidence shows1:01:10 – Medicaid gaps, reentry, and continuity of care1:07:30 – Community organizations, peer specialists, and rehabilitation1:14:40 – Addiction vs diabetes: dismantling stigma1:21:10 – Case presentation: post-release escalation explained1:28:50 – Evidence-based interventions before release1:35:30 – Final reflections and key takeaways

In the season finale of The Transformed Minds, Dr. O brings the series full circle, reflecting on the season’s core lessons around evidence-based, humane, and equitable care in substance use and psychiatric treatment.This episode focuses on the heightened risks of the holiday season, a time when emotional stress, trauma activation, social isolation, and structural inequities often collide. Dr. O explores how holiday pressures can exacerbate substance use and psychiatric symptoms, while also highlighting concrete, actionable strategies to promote safety, continuity of care, and recovery.Drawing on clinical insight and real-world examples, the episode examines:The psychology of stress and trauma during the holidaysStructural vulnerabilities that increase risk for relapse, overdose, and psychiatric crisesPractical interventions for clinicians, caregivers, policymakers, and communitiesFrom anticipatory care planning and medication continuity to community-level harm reduction strategies such as naloxone distribution and syringe services, this finale underscores a central message of the season: support saves lives.Join us for a thoughtful, grounded discussion on how to build recovery-friendly environments and reduce harm during one of the most challenging and meaningful times of the year.Learning ObjectivesBy the end of this episode, listeners will be able to:Identify evidence-based risk factors for substance use recurrence during the holiday season.Apply practical, anticipatory strategies to reduce relapse and overdose risk.Understand how trauma, social determinants, and system-level gaps shape holiday outcomes.Translate research into actionable steps for clinicians, patients, communities, and policymakers.Reframe holiday substance use risk as predictable and therefore preventable.

Tackling Addiction and Homelessness with Dr. Fabiola Arbelo CruzIn this episode of the Transformed Minds Podcast, Dr. Owusu speaks with Dr. Fabiola Arbelo Cruz, Addiction Psychiatrist at the Connecticut Mental Health Center and Yale School of Medicine. They explore how mental health, addiction, and homelessness intersect, the barriers unhoused individuals face, and the innovative approaches used by Yale’s Street Psychiatry team.Dr. Arbelo Cruz discusses treatment engagement, long-acting buprenorphine, peer support, and the policy changes needed to address social determinants of health. A powerful episode for clinicians, policymakers, and advocates seeking meaningful solutions.Episode Highlights:Understanding homelessness and addictionChallenges within emergency and street-based careCase study insightsBuilding trust with unhoused patientsEffective treatment strategiesSystem-level and policy recommendations

Welcome to the Transform Mind Podcast with Dr. O. In today's episode, we delve into the joint clinical practice guidelines for benzodiazepine tapering released in June 2025. Dr. O breaks down the essential principles, patient-centered approaches, and key recommendations to ensure safe and effective benzodiazepine tapers. Learn why slow and supported tapering, shared decision making, and harm reduction are critical for patient safety. We also discuss special populations, psychosocial interventions, and practical case studies. Stay tuned to explore this vital topic in psychiatric and addiction care.00:00 Welcome to Transform Mind Podcast01:22 Introduction to Today's Topic: Benzo Use Tapering Guidelines01:51 Overview of the Joint Clinical Practice Guideline03:37 Key Recommendations and Classifications05:03 Guiding Principles for Implementation08:01 Detailed Tapering Strategies13:52 Special Populations and Considerations16:50 Case Study: Applying the Guidelines19:34 Conclusion and Key TakeawaysFeatured Resources🧾 Joint Clinical Practice Guideline on Benzodiazepine Tapering (ASAM, 2025)Read the full text or download the clinician summary.

What happens when life-saving anxiety medication becomes a system-wide challenge?In this episode of The Transformed Minds, host Dr. O, unpacks the clinical, systemic, and human dimensions of benzodiazepine use disorder; where relief meets risk. Drawing from evidence-based literature and the 2025 Joint Clinical Practice Guideline on Benzodiazepine Tapering, we explore how dependence develops, why abrupt discontinuation can be dangerous, and what clinicians, patients, and policymakers can do to build safer, more compassionate systems of care.You’ll learn:- How to distinguish dependence from substance use disorder- The science behind benzodiazepine tapering and withdrawal- How fragmented healthcare systems complicate deprescribing- What patient-centered and trauma-informed care looks like in real practiceListen now, subscribe for future deep dives, and join the conversation at  ⁨@thetransformedmindspod⁩ 

In Part 2 of our conversation with Dr. Chapman, we continue exploring the wholistic approach to Opioid Use Disorder (OUD), diving deep into how economics, genetics, and the state of American healthcare shape treatment and recovery.From the science of addiction to the social systems that sustain it, Dr. Chapman offers valuable insight into building a more compassionate and effective framework for healing.🔗 Subscribe and turn on notifications so you don’t miss it on new episodes every other Tuesday at 11am!

In this episode, we explore how the renowed Dr. Edwin Chapman, a leading physician and researcher, is redefining the treatment of opioid use disorder (OUD) by integrating housing, social determinants of health (SDOH), and genetics into a groundbreaking model of care.From the streets of Washington, D.C. to advocacy and the latest advances in addiction treatment, Dr. Chapman’s Urban Health Model addresses more than addiction, it treats the whole person. We discuss the role of stable housing and how precision medicine is reshaping addiction care.Topics Covered:Social determinants of health and addictionWhy housing matters in recoveryVulnerability to opioid misuseCongressional testimonyListen now on Spotify, Apple Podcasts, Amazon music and wherever you get your podcasts.Subscribe for biweekly episodes on health equity, addiction science, and innovation in care.#OpioidRecovery #DrEdwinChapman #AddictionPsychiatry #AddictionMedicine #SDOH #PublicHealth #UrbanHealthModel #PrecisionMedicine #OUD #HealthEquity #HousingIsHealthcare

In this Host Rx episode, Dr. O explores both sides of kratom.We break down:A 2025 meta-analysis linking long-term kratom use to improved metabolic health.A 2021 case series documenting kratom use disorder and its treatment with buprenorphine/naloxone.Kratom may offer benefits — but it also carries real risks. Join us as we ask what the science actually says and what it means for clinicians, patients, and communities.Don’t forget to follow for more evidence-informed conversations at the intersection of mental health, addiction, and transformative care.

Improving Access to Evidence-Based Medical Treatment for Opioid Use DisorderDespite proven treatments, access to care remains a major challenge for individuals with opioid use disorder. This episode dives into the barriers—stigma, policy hurdles, and system gaps—and offers strategies for creating a more equitable and effective treatment system.🎙️ Featuring Dr. Bowe | Yale and WVU-trained, board-certified in Internal Medicine, Psychiatry, and Addiction Psychiatry. Dr. Bowe brings expert insight into how the healthcare system can better respond to the opioid crisis.🔑 Key Insights:Why access to medication-assisted treatment (MAT) mattersSystemic changes needed for equitable carePractical solutions for healthcare providers and policymakersTune in to learn how we can break down barriers and save lives.#OpioidTreatment #AddictionRecovery #PublicHealth #HealthEquity

In this Host Rx episode, we unpack a Tennessee Medicaid study (2010–2021) tracking over 14,000 maternal–infant pairs. Researchers Krishnapura SR, McNeer E, Loch SF, et al. compared pregnancy outcomes for mothers with opioid use disorder who received buprenorphine versus those who didn’t. Hear what the data reveals about maternal health, newborn outcomes, and best practices for treatment during pregnancy.

What do the latest data reveal about youth substance use, mental health trends, and future challenges in addiction care? Dr. Phi Owusu sits down with Dr. Gomez to break down findings from the Monitoring the Future survey and their implications for public health, psychiatry, and harm reduction.In this episode, we cover:– Key substance use trends in the latest survey– Emerging patterns among teens and young adults– Policy and community-based strategies to address these issues🎧 Listen, learn, and join the conversation.#AddictionPsychiatry #PublicHealth #MonitoringTheFuture #TransformedMindsPodcast #youthdruguse#addiction

Xylazine, an animal tranquilizer not approved for human use, is increasingly found in street opioids, complicating overdoses and causing devastating wounds. In this episode, we unpack the evidence:– Why naloxone often fails– The unique dangers of xylazine toxicity– What the latest research reveals about toxicity, dependence, withdrawal, and treatment– Real-world evidence-based recommendations Based on the 2025 systematic review by Owusu et al.This is urgent. This is real. Listen and be informed.#TheTransformedMindsPodcast #Xylazine #HarmReduction #AddictionPsychiatryShow resource links:Owusu P, et al. Management of Xylazine Toxicity, Overdose, Dependence and Withdrawal: A Systematic Review. 2024.https://mattersnetwork.org/request-test-strips/https://mattersnetwork.org/supplies/#vendingmachineshttps://www.health.ny.gov/diseases/aids/general/opioid_overdose_prevention/training_calendar.htmhttps://providerdirectory.aidsinstituteny.org

Welcome to the premiere of The Transformed Minds Podcast. I’m your host, Dr. Owusu — psychiatrist, researcher, and advocate for equity in mental health and addiction care.Today, I’m joined by the brilliant Dr. Ayana Jordan—addiction psychiatrist, NYU researcher, and national voice for health equity.We explore her groundbreaking study, “Integrating Ambulatory Addiction Consultation Service Into a Community Mental Health Center,” and how this model transforms care for people with co-occurring mental health and substance use disorders.🎙️ In this episode:The real-world impact of dual diagnosesWhy addiction and mental health care must be integratedHow embedding addiction specialists into a CMHC improved access and outcomesA clinical case walkthrough inspired by the studyDr. Jordan’s insight on scaling this model nationallyThis is more than research—it’s a blueprint for transforming how we care for the most vulnerable among us. New episodes drop every Tuesday at 11 AM EST.Follow us @TheTransformedMindsPod on all platforms for more conversations where faith, psychiatry, and community meet.www.thetransformedminds.com#DrAyanaJordan #TransformedMindsPodcast #AddictionCare #MentalHealthPodcast #DualDiagnosis #IntegratedCare #BlackPsychiatrists #PublicPsychiatry #CommunityHealth #FaithAndHealing

TOMORROW → something powerful begins.🎙️ The Transformed Minds Podcast premieres TUESDAY, JULY 1 — and we’re starting with a conversation that could shift how we think about addiction and mental health in our communities.This podcast brings together:🧠 Clinical insight🗣️ Lived experience🙏🏾 Faith & purpose⚖️ Justice & healingIf you care about mental health, substance use, or systemic change, this one’s for you.First episode drops TOMORROW, JULY 1 at 11 AM EST, then every other Tuesday at @ 11 AM EST — don’t miss it.Follow now + turn on reminders.#TransformedMindsPodcast #MentalHealthAwareness #AddictionRecovery #FaithAndMentalHealth #PodcastPromo #BlackPsychiatrist #HealingJourney #NewPodcast #PsychiatryPodcast