In this episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Dr. Michael Genovese, a board-certified psychiatrist and attorney whose rare dual training gives him an unusually clear view of both the clinical and legal dimensions of behavioral health. As Chief Medical Officer of Behavioral Health at Access Telecare, he leads the nation’s largest acute specialty telemedicine platform, helping hospitals deliver psychiatric and addiction care where it’s needed most. He previously served as Chief Medical Officer at Acadia Healthcare, the largest standalone behavioral health provider in the United States, and brings more than two decades of hands-on experience as an addiction specialist. He is a longtime advocate for first responders and attorneys in recovery, and recently joined the boards of the National Eating Disorders Association and Banyan Treatment Centers.

This conversation covers the clinical and legal realities that shape how addiction is treated in America and why nearly two-thirds of people who need treatment for substance use disorders never receive it. Dr. Genovese and the hosts examine how stigma distorts clinical decision-making, what the medical community still gets wrong about opioid use disorder, and why treating the whole patient, not just the disorder, is the only approach that holds.

00:00 Introduction
02:01 Dr. Genovese’s path from law to medicine
05:46 Why psychiatry captured a doctor trained for cardiology
08:23 From one patient at a time to a facility of people
10:16 How telemedicine reaches patients no specialist could otherwise see
12:01 How a law degree changes the way a doctor practices medicine
16:14 What doctors still get wrong about addiction and stigma
18:58 When stigma becomes malpractice: cases where bias caused harm
22:41 The CDC’s 90 MME guideline and what it actually did to patients
23:48 Telehealth for opioid use disorder: better or worse?
26:10 Only 15 to 20 percent of OUD patients get treatment, and we know how to change that
28:20 First responders, the FBI National Academy, and the stigma that runs deepest
31:16 Veterans, VR treatment, and 44 deaths a day
37:31 Is buprenorphine trading one addiction for another?
38:41 Why psychosocial support cannot be separated from medication
40:11 Multidisciplinary pain treatment and why it collapsed
41:02 What it will actually take to solve the opioid crisis
43:37 Ignorance is not an excuse: 5,000 addictionologists for 48 million people
46:12 One legal or regulatory change to unlock mental health and addiction care

About the Hosts

John Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch.

William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit.

About the Guest

Dr. Michael Genovese is a board-certified psychiatrist and attorney serving as Chief Medical Officer of Behavioral Health at Access Telecare, the nation’s largest acute specialty telemedicine platform. He previously served as Chief Medical Officer at Acadia Healthcare, the largest standalone behavioral health provider in the United States. With more than two decades of experience as an addiction specialist, he is a longtime advocate for first responders and attorneys in recovery. He recently joined the boards of the National Eating Disorders Association and Banyan Treatment Centers.

Website: thesavingdose.com

This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions.

If you or someone you know is struggling with substance use disorder, contact SAMHSA’s National Helpline at 1-800-662-4357. Free, confidential, 24/7.

#AddictionMedicine #BehavioralHealth #TheSavingDose #OpioidCrisis #SubstanceUseDisorder #Psychiatry #Telemedicine #AddictionRecovery #Stigma #OpioidUseDIsorder #MOUD #MentalHealth #FirstResponders #HealthcarePodcast #StigmaKills #BrainHealth #PublicHealth #RecoveryPodcast #AccessTelecare #PsychiatryPodcast