Cover of ASAM Practice Pearls

ASAM Practice Pearls

ASAM Practice Pearls

By: ASAM Education
Listen for free

Season's Savings | 0.99 €/month for 3 months

5.99 €/month thereafter - terms apply. Cancel monthly.

Season 1 | Season 2

Join ASAM Practice Pearls for in-depth discussions on addiction prevention, treatment, and recovery.

Geared toward healthcare professionals and individuals seeking knowledge, this series explores the latest evidence-based approaches to addiction medicine.

Listen to interviews with leading experts as they delve into critical topics and share practical tools you can use to improve patient care and promote public health.

Copyright 2025 All rights reserved. Hygiene & Healthy Living Physical Illness & Disease
Episodes
  • Gambling and Sports Betting Addiction: Screening and Interventions

    Gambling and Sports Betting Addiction: Screening and Interventions
    7 Sep 2026
    In this season 2 finale of ASAM Practice Pearls, Dr. Stephen Taylor sits down with Dr. Timothy Fong to discuss one of the fastest-growing and most overlooked concerns in addiction medicine: gambling disorder. With sports betting now legal in over 40 states and digital gambling accessible on every smartphone, gambling and sports betting are rapidly expanding. This episode breaks down the prevalence, consequences, and unique aspects of gambling disorder and offers practical, actionable guidance on screening, brief intervention, and treatment. ----more---- Looking for this episode's transcript? Download it HERE Get credit for listening! Claim your 0.5 CEs HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states. Expert Timothy Fong, MD Dr. Timothy Fong is the President of the American Academy of Addiction Psychiatry (AAAP) and a clinical professor of psychiatry at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. He is board certified in adult and addiction psychiatry. He is the co-director of the UCLA Gambling Studies Program, a program that examines the clinical characteristics of gambling disorder in order to develop effective, evidence-based prevention and treatment strategies. Dr. Fong is also a member of the Steering Committee of the UCLA Center for Cannabis and Cannabinoids, whose mission is to address the most pressing questions about the impact of cannabis legalization through rigorous scientific study and interdisciplinary discourse. He is a member of the UCLA Sports Psychiatry Service and the UCLA Sports Medicine Mental Health Team. 📖 Show Segments 00:05 - Introduction 02:38 - Modern Day Gambling: Investing vs Gambling vs Betting04:38 - Prevalence and Public Health Impact08:21 - Consequences of Gambling Disorder14:30 - Screen and Clinical Assessment20:03 - Interventions and Treatment Options23:59 - Practice Pearls27:40 - Conclusion 📋 Key Takeaways Recognize that we are practicing in a gambling-centered environment: The rapid expansion of mobile sports betting, online wagering, and prediction markets has normalized gambling and lowered perceptions of risk. Clinicians should expect to encounter gambling-related harms more frequently across patient populations.Recognize gambling disorder as a serious and potentially life-threatening condition: Gambling disorder is associated with high rates of suicidality, co-occurring substance use disorders, mental health disorders, financial strain, relationship problems, and intimate partner violence. Clinicians should approach it with the same level of concern as substance use disorders.Remember that gambling disorder is often a hidden addiction: Patients may appear highly functional, professionally successful, and psychologically intact while experiencing severe financial losses, emotional distress, and compulsive gambling behaviors. Do not rely on appearance or external functioning to assess risk. Screen routinely and ask the right questions: Gambling should be assessed alongside substance use during intakes, annual assessments, and follow-up visits. Because many patients do not view sports betting, poker, online wagering, or prediction markets as "gambling," ask specifically about betting behaviors. Consider questions such as: Have you ever lied to anybody about spending money on gambling or betting?Have you ever increased your bet, wager, or gambling amount to get the same thrill or rush?How much time, energy, and money do you spend online trying to make more money? Assess financial health as part of both screening and recovery: Ask patients about debt, paycheck-to-paycheck living, loans, and financial stress. Financial difficulties may uncover gambling-related harms that patients are reluctant to disclose, and addressing financial wellness should be part of ongoing recovery planning. Think about gambling when patients are not improving as expected: If depression, anxiety, substance use treatment, or other behavioral health conditions are not improving as expected, consider whether an undiagnosed gambling disorder might be contributing to ongoing distress or risk of return to use.Use brief physician interventions to increase motivation for change: A nonjudgmental conversation that connects gambling behavior to physical health, mental health, finances, and ...
    Show more Show less
    29 min
  • GLP-1s in Addiction Medicine: An Update Since Our Last Conversation

    GLP-1s in Addiction Medicine: An Update Since Our Last Conversation
    24 Aug 2026
    In this episode of ASAM Practice Pearls, Dr. Stephen Taylor welcomes back Dr. Stephanie Weiss and is joined by Dr. Anna Lembke to explore an update on GLP-1 receptor agonists for alcohol use disorder (AUD), discussing current research, how things have evolved since the last discussion, and the challenges and implications of integrating these innovative treatments into addiction care. ----more---- Looking for this episode's transcript? Download it HERE Get credit for listening! Claim your 0.5 CEs HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states. Expert Stephanie Weiss, MD, PhD Dr. Stephanie Weiss is a Research Physician with the Translational Addiction Medicine Branch (TAMB) of the NIDA Intramural Research Program. She holds a PhD in pharmaceutical chemistry and a medical degree from the Cleveland Clinic Lerner College of Medicine. Board-certified in emergency medicine, addiction medicine, and medical toxicology, Dr. Weiss focuses on caring for patients with poisonings, overdoses, and medication misuse. Her research interests include novel psychoactive substances, medication misuse, and improving urine drug testing interpretation. Expert Anna Lembke, MD, FASAM Dr. Anna Lembke received her undergraduate degree in Humanities from Yale University and her medical degree from Stanford University. She is currently Professor and Medical Director of Addiction Medicine, Stanford University School of Medicine. She is also Program Director of the Stanford Addiction Medicine Fellowship, Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and a diplomate of the American Board of Psychiatry and Neurology and the American Board of Addiction Medicine. 📖 Show Segments 00:05 - Introduction 04:15 - Latest Developments in Research05:34 - Prescribing GLP-1's Off Label06:28 - Challenges With Prescribing07:36 - Who Benefits From GLP-1's and Who Doesn't09:52 - Potential for Other SUD Treatment Beyond AUD11:18 - Side Effects, Tolerability Concerns, and Adherence Challenges15:11 - Where GLP-1's Fit into the Treatment Toolbox16:19 - Unanswered Questions about GLP-1 Treatment19:14 - GLP-1's Possible Impact on Mood25:11 - Dosing Strategy and Titration Approach26:36 - Life After GLP-1s: Rebound Risk and "Chipping"28:52 - Biggest Surprise from the Research So Far31:05 - Practice Pearls32:34 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Emerging evidence continues to build for GLP-1s in AUD: Multiple recent clinical trials of semaglutide for AUD have reported positive findings, with additional studies expected to be published in the coming year. While the evidence base is growing, GLP-1s are not yet FDA-approved for the treatment of substance use disorders.Continue to prioritize FDA-approved medications for AUD first: Clinicians should start with established treatments such as naltrexone, acamprosate, and disulfiram before considering off-label GLP-1 therapy.Consider GLP-1s for patients with AUD and relevant co-occurring conditions: Patients with refractory AUD who have not responded well to evidence-based treatments and also have obesity, diabetes, binge eating disorder, food addiction, or treatment-resistant depression may be good candidates for a GLP-1 trial.Start low and titrate based on efficacy and tolerability: There is currently no established optimal GLP-1 dose for AUD. Clinicians prescribing GLP-1s off-label should begin with low doses and gradually titrate while monitoring symptom improvement and adverse effects. Note: A 7.2 mg injectable semaglutide dose was approved in March 2026 for chronic weight management. Although this dose has not been studied in clinical trials for AUD, its availability may be relevant for patients who experience only a partial response at lower semaglutide doses.Prepare patients for common gastrointestinal side effects: Nausea, constipation, diarrhea, abdominal discomfort, belching, reflux, and worsening GERD symptoms are among the most commonly reported adverse effects. Many patients adapt over time, and symptoms may improve despite subsequent dose increases.Monitor for changes in mood, motivation, and reward-seeking behaviors: In addition to reduced cravings for alcohol, some patients report diminished interest in food, pleasurable activities, or other rewarding experiences. At the same time,...
    Show more Show less
    34 min
  • Addiction Care in Custody: Trust, Treatment, and Advocacy

    Addiction Care in Custody: Trust, Treatment, and Advocacy
    10 Aug 2026
    In this episode of ASAM Practice Pearls, Dr. Stephen Taylor hosts Dr. Justin Berk to discuss addiction care for individuals involved in the criminal justice system, including patients in custody and those transitioning back to the community. The conversation explores practical strategies for building therapeutic alliances with incarcerated patients, advocating for evidence-based treatment in correctional settings, and navigating common barriers to care. The episode covers opportunities for clinicians to provide compassionate, patient-centered care that improves outcomes for this high-risk population. ----more---- Looking for this episode's transcript? Download it HERE Get credit for listening! Claim your 0.5 CEs HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states. Expert Justin Berk, MD, MPH, MBA, FASAM Dr. Justin Berk is an addiction medicine physician-researcher and the former Medical Director of the Rhode Island Department of Corrections. He is an Associate Professor in the Departments of Medicine and Pediatrics at the Alpert Medical School at Brown University and the Director for the Center of Health and Justice Transformation at Brown University Health. He completed residency at the Urban Health Combined Internal Medicine – Pediatrics Residency Program at Johns Hopkins Hospital and is Board Certified in Internal Medicine, Pediatrics, and Addiction Medicine. His research and advocacy focus on the intersection of addiction medicine, correctional health, and health equity. 📖 Show Segments 00:05 - Introduction 03:09 - Building Rapport with Patients in Custody08:23 - Evidence for MOUD in Jails and Prisons11:05 - Overcoming Implementation Barriers for Evidence-based Treatment13:11 - Advocating for Patients in Custody17:25 - Reentry and Continuity of Care19:44 - Addressing Diversion Concerns23:22 - Privacy, Autonomy, and Care Coordination24:50 - Lightning Round Q&A28:05 - Practice Pearls29:58 - Conclusion and Additional Learning Opportunity  📋 Key Takeaways Recognize the justice system as a critical treatment touchpoint: Approximately 58% of individuals in state prisons and 63% of individuals in jails meet criteria for substance use disorder, making correctional settings an important, and often underutilized, opportunity to initiate evidence-based addiction care.Tailor clinical management to the correctional setting: Jails and prisons present distinct clinical challenges, with jails more commonly managing acute intoxication, withdrawal, and trauma, while prisons often focus on chronic disease management and long-term care.Use humanistic, patient-centered care to improve engagement and outcomes: Small actions, such as requesting the removal of handcuffs during clinical encounters, advocating for privacy, facilitating necessary evaluations, and coordinating directly with correctional facilities during transitions of care, can build trust and strengthen therapeutic relationships.Use hospitalization to close care gaps for patients in custody: When feasible, initiate evidence-based treatments during hospitalization rather than deferring care. Consider starting HCV treatment, optimizing medication for opioid use disorder (MOUD), addressing rehabilitation needs, completing necessary diagnostic workups, and documenting ongoing care requirements.Support access to MOUD in correctional settings: Evidence demonstrates that methadone and buprenorphine save lives, reduce overdose risk, improve treatment retention, and improve outcomes, yet many of these treatments remain unavailable in many correctional facilities.Recommend and document evidence-based treatment regardless of anticipated barriers: When MOUD is clinically indicated, formally prescribe or recommend treatment, even if continuation is uncertain, to create a clear record of the standard of care and support future treatment access.Balance diversion concerns against the benefits of treatment: While diversion of medications such as buprenorphine can occur, concerns are often overstated and should not prevent patients from receiving evidence-based treatment for opioid use disorder.Prioritize overdose prevention during the reentry period: Individuals face an exceptionally high risk of fatal overdose immediately after release, making reentry planning, continuity of care, and ongoing ...
    Show more Show less
    31 min
adbl_web_anon_alc_button_suppression_t1
No reviews yet