Speaker 1: 0:01

Welcome to the Healthy Matters podcast with Dr. David Hilden , primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health healthcare and what matters to you. And now here's our host, Dr. David Hilden.

Speaker 2: 0:19

Hey everybody, it's Dr. David Hilden and this is episode four of season three. And today we will be talking about a serious health topic that's been pretty much plaguing our society for quite a while now, the fentanyl crisis. To help us break this down, we are joined today by Hennepin Healthcare Addiction Medicine specialist, Dr. Lauren grabber , an expert on fentanyl and other addictive and sometimes dangerous substances. Lauren, thank you for being here and welcome to the podcast.

Speaker 3: 0:42

So glad to be here.

Speaker 2: 0:44

Okay, Lauren, to start us off, to set the stage for the conversation, can you share some statistics on the rise of fentanyl , uh, and fentanyl related deaths?

Speaker 3: 0:51

Yeah, glad to. And well, and I'll just start by saying, the thing that really shook me is when we learned that in the US our life expectancy was going down for the first time and I thought, gosh, in all the progress that we've made in medicine, all the different things that we try to do and connect with people, why, what is going on here? And really diving deep into what is going on with opioids and particularly fentanyl and how has that contributed. So it's really been an earth shaker for me and really part of what changed my career in terms of like, I need to do better at that. How as I, as a provider, can I be there with people in that way that they need? So I think the short story is that really in around 2018 or 2019, fentanyl became a lot more available. And since that time it's really skyrocketed. In 2022, it claimed over 73,000 deaths, which is more than the total number of American deaths in Vietnam, Iraq, and Afghanistan in those wars. It's more than any year's worth of car accidents and traumatic in so many different ways and touching people throughout our societies. And so I think that that, those statistics have really brought it home for me around, gosh, this is, nope, can't close my eyes on this one anymore.

Speaker 2: 2:02

Why do you think that is? And I'll just, I'll , I'll , the reason I ask that is because I've been practicing now for almost 25 years. I used to write prescriptions for fentanyl and other opioids kind of a long time ago. Maybe not, wasn't wise, but that's what we did back 20 years ago. Why do you think it's rising so much now?

Speaker 3: 2:20

It's so complicated, honestly, as to why fentanyl is so much more available. I think going back, there was a time when I too was advised to, oh, don't worry, just give patients a fentanyl patch. They'll come back in three days. And I think that it , that is because fentanyl is extremely effective for pain, which is why we've used it medically for many, many years, most recently. And I think after a string of events, both starting with prescription opioid over-prescribing and availability, and then moving into more readily available heroin, suddenly fentanyl comes on the scene as a much cheaper and much stronger alternative that it's able, you know, basically by demand that people can access it more readily and it has a much stronger effect.

Speaker 2: 3:04

So you've already alluded to my next question. What is fentanyl exactly?

Speaker 3: 3:08

We call it a high potency synthetic opioid. Okay. What does that mean? Opioids in general are opioid medications that hit that opioid pain receptor and help with pain. And the ones that come naturally are from the poppy plan . Right. So morphine and heroin are both kind of those natural opioids. Fentanyl is synthetic meaning it's made by, made by humans from other different substances that are collected from a number of places around the globe and then come to the US among a various amount of ways. Because it has such a strong medication, a very little bit of it can have a huge impact. And so in some ways that makes it a lot easier to get into the country. 'cause whether it's coming by mail, by land, by water, it can come in small batches and it's harder to detect.

Speaker 2: 3:55

So it doesn't come directly from the poppies, like the natural ones. It does not. It's made in a lab somewhere.

Speaker 3: 4:00

It's made in a lab somewhere. Okay.

Speaker 2: 4:02

So what are its intended medical uses?

Speaker 3: 4:05

Oh, so many. It's really phenomenal for pain in labor and delivery. It's used quite regularly. It's used often in surgery for anesthesia. It's something that helps keep our patients comfortable when they're intubated in the intensive care unit . So it's really broadly used and, and that's partly because it is able to be titrated very, very gently that you can increase it a little bit and have , and like monitor that effect really well. And it's fast acting , so it's also like if it's too much, you can turn it off and, and then be able to support the person in that way. I

Speaker 2: 4:38

Think that's an important point because there's a lot of people listening right now who are about to go get, say their colonoscopy and they might know or they read about it afterwards, oh gee, I got a little bit of fentanyl during that and should they be worried about that? Um , and people actually ask me that because all they hear about fentanyl and frankly the remainder of this podcast, we're gonna talk about some more dangerous uses of fentanyl. But in that medical setting, it has a legitimate use. Correct.

Speaker 3: 5:03

Oh my goodness. It has a very, very legitimate use. And I think for most everyone, even somebody who's been using opioids in the past, when fentanyl is given in a medical setting, it's not only safe, it's very effective. And so I really encourage people that if you're having a painful procedure, if there's an indication that you need this medicine and that's what's being recommended, that it can be a really, really good fit for people.

Speaker 2: 5:26

Okay. So shift gears. How is it used outside the medical settings?

Speaker 3: 5:31

I think it's used in a lot of different ways and for a lot of different reasons. And I say that because our patients come from every background, every neighborhood of the city and really have a lot of reasons about what things started them off in using fentanyl. I think there's a very close association with pain. Um, some , there's often a very close association with going through hard times, whatever that is for a person. And so it's a really personal reason why people start using, it does, it works very well in the beginning phases to block out hard times to help you cope in different ways to help. Finally, it's the only thing that helps take away that pain. And so I think to initiate that some of the, those are some of the multitudes of reasons that people initiate and for parts of the reasons that it really is helpful for that moment in time in somebody's life. And it's, as the body becomes more and more used to the fentanyl use to that opioid exposure, that your own body's response to protect you starts also causing this much more challenging kind of cycle of withdrawal symptoms and more use and a cycle that's really, really hard to escape.

Speaker 2: 6:38

And that would be the disease of addiction.

Speaker 3: 6:40

That's right. It really is. And I appreciate you using the word disease because it really is a disease. It's , there are a lot of brain changes that make it really challenging and really challenging to just stop. It's really not one of the conditions that you can just be like, stop it. Just don't call those people anymore because it has such an unbelievable effect on the body. And fentanyl uniquely does that fairly quickly and so it makes it all the more challenging for folks.

Speaker 2: 7:04

So Lauren , how do people , um, take it? How , how is it used? I

Speaker 3: 7:07

Think like any substance people are pretty creative and you can use it in a lot of different

Speaker 2: 7:11

Ways. I have heard about a lot of them and some of 'em I don't even understand. But yeah,

Speaker 3: 7:14

I mean I think that , you know, people, some people do swallow it the same way people swallow a pill. You can smoke it both in a powder form or a pill form. Certainly you can snort it in the powder form. Um, or I think the most risky way, and we talk about with folks a lot, is IV use. So injecting it into veins. Some people sometimes you can inject it in other ways and get other other effects, but those are the general, those are some of the general ways that people are using. Is

Speaker 2: 7:40

It also true that is found in substances that people are using who aren't aware that that's what they're using? They're they're, they're intending to use a different substance.

Speaker 3: 7:50

You are spot on. It's really true. I think, and actually I find that even more in the last year or two. That is the thing that I'm talking about most with people is that they think they're getting one thing and then actually it's mixed with something else. I think the most common contaminants are with stimulants. So thinking about cocaine, crack, meth, methamphetamines , um, that those are often mixed with mixed with fentanyl, especially the powder forms. And so it's really easy, especially 'cause fentanyl's so powerful, it's really easy to cut it in or mix it in with some of those other substances in a way that could be surprising and devastating.

Speaker 2: 8:27

So why would that be? I mean, i , it it's not the person consuming the substance that's doing that. Why would the, whoever's supplying these substances, why would they mix fentanyl in?

Speaker 3: 8:38

So it's a great question and I guess I wanna believe that it's unintentional in some settings that it's just a matter of being in the same place and almost accidental measuring or mis measuring or not cleaning a surface in a certain way. Um, I think that in other ways it changes a product to be more advantageous and having some different effects, but I think it's hard to say.

Speaker 2: 9:00

So let's shift to the , uh, the larger scope of the problem of fentanyl. Um, if you could, Dr. Grabber , how does it compare to other opioids that people use? Um, uh, like heroin, morphine or oxycodone or any of the other opioids?

Speaker 3: 9:15

Yeah, great question. I think that it's important to know that fentanyl itself is very similar. It works very similar in the body as all of those other types of opioids. It is 50 times stronger than heroin. And so I think just because of that, what, you know, the equivalent of a a person's normal dose of heroin, this would be a much tinier amount of fentanyl. So you can imagine if somebody didn't know what they were getting, both can look the same. They're told that this is one thing or another. It's really easy to take more by accident when you have such a powerful opioid like fentanyl. And there are other high potency synthetic opioids on the market as well. And so I think that fentanyl is the one that is most common right now in the US and that we're talking with patients a lot about. But I think in the world ahead, we can imagine there being even more powerful and more, and which makes more confusing seen in terms of how can I use safely and, and even if I keep using the way I have, is that still gonna keep me safe?

Speaker 2: 10:13

This sounds like a really broad question, but could you kind of talk about the, the effects on our society of the, the opioid epidemic in general, but specifically fentanyl, the social effects, the economic effects, the personal effects on people. What , what are your thoughts on that?

Speaker 3: 10:28

Hmm . It is such a deep question and I think the part, you know, working here at, at Hennepin County, I find that we're seeing everybody at every walk of their life that where I feel like I, there , you know, people have their own stereotypes about who are the people who use substances and how has that affected them. I think that what we're really seeing in this moment of the , that fentanyl is just so much more available and it's really crossing every, every , uh, social class and community. You know, we have, we have experiences of people bringing in their young teenagers who are struggling , um, and people who, you know, everybody in the family's college educated has that plans for that kid to go to college and see fentanyl as such a setback in terms of how that's changed that kid's , uh, plans and dreams. And also I think a lot about the new immigrant families that have, that are new to the US navigating this system and trying to figure out how to, how to find their footing and their new and and their new community here. And then for , um, for someone in their family to, to also be exposed to fentanyl and start having, you know, struggling with that space. I think that those things and how that affects different families is incredibly personal, but suddenly these communities and neighborhoods otherwise see themselves as being so different, are truly experiencing the same devastation and loss. And I think you can start to imagine that once , uh, you know, because we often say addiction is a disease of development, you know, what does that mean? People develop struggles with opioids and all other substances largely in their adolescent and early young adult years. And so what happens when we have that swath of our population who's getting affected? That means that it's not only teenagers who are affected and the potential for what that human is going to become, it also means that young parents are affected. How, what does it mean when we don't have our parents to nurture and support those little, those little developing minds and what options and opportunities are they gonna have in the world? It means that when you have more young people struggling with this, how do they care for their elders in the ways that we need to, how do we continue that level of work productivity? I feel like it really, it really takes out a huge portion of our social economy and of our larger community. Can

Speaker 2: 12:38

You touch on the role of , uh, attitudes that people have about addiction? Is there still stigma in, in our communities about the disease of addiction?

Speaker 3: 12:49

Oh, there is so much stigma and it's not just about like, oh, those people who struggle, patients who are struggling also have that stigma within themselves. Just, you know, I saw a lovely human the other day who said, I do not wanna be here in this office with you. And, and I , and I said, well, tell me, you know, tell me more about that. I don't want this to be my truth. I don't want this to be me. I don't want to be this person who's struggling here. And I think that, that that's so real and so felt among folks who struggled. You know, nobody would wish this upon themselves. And so I think, you know, I think about that very intentionally when I walk in a room and when I introduce myself, you know, how am I gonna , how's this gonna land with this person that I'm about to meet? And what kind of, what kind of support do they need in this moment that can help us get through that together?

Speaker 2: 13:39

What a great conversation. Lauren . Let's take a short break here and when we come back, we'll continue the conversation on this important topic. Stay with us. We'll be right back

Speaker 4: 13:51

When Hennepin Healthcare says, we are here for life. They mean here for you, your life and all that it brings. Hennepin Healthcare has a hospital HCMC and a network of clinics both downtown and across the West Metro. They provide all the primary care and specialty care you would expect to find, but did you know they also have services like acupuncture and chiropractic care available at many of their primary care clinics and at their integrative health clinic in downtown Minneapolis? Learn more@hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life.

Speaker 2: 14:30

We're back with a conversation with Dr. Lauren Grabber . She is an addiction medicine specialist here at Hennepin Healthcare in downtown Minneapolis. So learn for many people, they might not know what withdrawal from these substances like, and we've been touching on that a little bit in the first part of the show. So could you tell us what is withdrawal like for people who are using opioids?

Speaker 3: 14:48

I definitely can. I think the best way to think about it is, do you remember, think back, do you remember the worst flu you ever had where it was like your body was hot and cold, you were totally sweaty. Every part of you, every joint you had was aching, you couldn't move 'cause everything was uncomfortable, but you couldn't help but just move. And then layer on that also nausea, vomiting, diarrhea. It feels horrible. It feels like that worst flu times 10, it's deeply physically uncomfortable and, and you get, once you have it, it's the type of horrible that you just are afraid of ever getting again, how can I do anything to never feel that sick again?

Speaker 2: 15:33

Is this what leads to a cycle of using again then?

Speaker 3: 15:36

Oh, I think it definitely contributes. It definitely contributes. Now remember, if you use fentanyl one time for a non-medical indication, usually you're not gonna have these symptoms of withdrawal. And that's because your body hasn't become, hasn't made the adjustments internally to have that tolerance. Okay? And so it's only when you've used for, I would say some nondescript amount of time that then you can develop these terrible withdrawal symptoms and then certainly in those moments, instead of using for any other reason, you're mostly just using, so you are avoiding those symptoms because you what you can ever do to avoid it. It's, it's that horrible.

Speaker 2: 16:15

So it's really horrible. I've heard that from my patients themselves and in fact I've seen it over and over. And for people who are in the hospital, is it dangerous? Is withdrawal itself a dangerous condition?

Speaker 3: 16:28

Great question. I think for most people it's not physically dangerous, although, let me tell you, it feels dangerous given how bad you feel. You really feel like something must be horribly wrong that your body was doing this. But I will say for certain people it could be dangerous. So if you have underlying medical conditions, then it could really, you know, if you, if this is causing increased heart strain, if you're having other things going on that your breathing is more compromised, I mean, I think that this could be more, it can be more dangerous. We certainly think about it as being a concern when someone is pregnant, not that it's dangerous to the pregnant person, but that potentially it could incite preterm labor. So

Speaker 2: 17:06

How long does withdrawal last?

Speaker 3: 17:07

That's a great question. It also really depends on what type of opioid you've been taking. So I think in for heroin, I think most people would develop withdrawal within 24 to 48 hours and then within another 24 to 48 hours they would be through it. I think with fentanyl it's a little bit more tricky. It seems to be hanging out in the system a little bit longer that it makes it a little bit harder and longer for most folks that , some people are saying that it takes even four days for withdrawal symptoms to present and sometimes it takes longer , um, to get through that. So it's really depends on how long acting versus short acting your opioid is.

Speaker 2: 17:43

Dr. John Cole was on this podcast just a few weeks ago. He's an emergency medicine doctor and he talked about one of the, the things he enjoys most about his job is the chance to help people deal with their substance use and particularly their withdrawal symptoms and get them on, on the road to recovery. How is that done? How do we help people get on the road to recovery? Are, are there medications or other safe alternative of drugs that that can help people?

Speaker 3: 18:08

There really, really, really are. So there's a lot of options for people who are seeking both to feel better when they're in withdrawal and also who want to, who want a different path. Um, the medicines that we use most frequently to help with that are methadone and buprenorphine. Buprenorphine is also known as Suboxone. And those medications are fabulous both in helping withdrawal symptoms, but also in helping people maintain their selves, their level of stability so that they're not fighting that withdrawal sickness going forward.

Speaker 2: 18:40

How do you answer the people who say, yeah, but that's just another opioid, you're given somebody an opioid to treat their opioids. I've heard that more times than I can count.

Speaker 3: 18:48

It's really true and I understand why people think about that because your body, if you stop methadone or buprenorphine suboxone, suddenly your body will go through withdrawal. So I think a lot of people are wondering, well then how is it any better? Any different? I mean the difference is that they are longer acting , they are controlled, meaning they come from a place, you know exactly what's in it when you're getting it and it allows you to feel like your normal self without getting sick in a way that you can take control of your life. Again, you know, what is a substance use disorder? What is addiction? It's not just using drugs, it's using drugs in a way that's impacting the rest of your life and making the rest of your life hard. So that's what the suboxone and the and methadone do is they offer you another path where you have control for the rest of your, of for of the rest of the things going on in your world so that you can make decisions in a different way.

Speaker 2: 19:41

If there's anything from a primary care doctor's perspective, which is me that has been positive in the last few years, is wider availability of buprenorphine or suboxone and, and the ongoing , um, use of of methadone treatment centers, they are incredibly effective for, for the people who access

Speaker 3: 20:00

Them. I am really thrilled by some of those changes that's allowed all prescribers, any prescriber who has a DEA license can now give buprenorphine or suboxone to any patient. So that's an amazing thing. That and, and one less hurdle for folks. I will say though, we still live in a world where a lot of prescribers are really scared of prescribing. And so a good part of my job is also walking along with learners with my colleagues to be like, Hey, we can all do this together. Here are some of the ways that I help patients start buprenorphine. So , and you can always call me if you have any questions so that we can really expand the number of people giving this as an option.

Speaker 2: 20:35

I've done just that. I've called Dr. Grabber and her colleagues in our addiction medicine division to help me to do just that. So I've heard of this other one, Cray , Tom Kra , I don't even know how you say it. Is that a safe substitute and you know, or are there other herbal things that seem to help?

Speaker 3: 20:53

Wonderful question. A lot of people say that one differently. I say Kratom , a lot of other people say Kratom . I think the part to know about it is that is a, it's very interesting. It's, it is nerve , it's from Southeast Asia and it is both an opioid and also a stimulant. So it works sometimes like fentanyl and it works at other times a little bit like cocaine or meth. So it's a little bit more complicated of a , of a , of a substance now. It's very accessible. It's very available at gas stations, at a lot of head shops and different tobacco stores

Speaker 2: 21:26

At gas stations.

Speaker 3: 21:27

Indeed, indeed,

Speaker 2: 21:28

I learned something today.

Speaker 3: 21:29

So, and I think a lot of people, there are a lot of folks online in different places who've shared their experiences trying to come off of fentanyl using substances like Kratom that they can do their own sort of self taper. I have to say it's not perfect. And I think that, I think that while there may be a handful of folks that that has worked to help them decrease the amount of fentanyl they're using, I think it also can cause other stress and strain in the body that wasn't anticipated. And again, because it's not a controlled substance, it's not a medicine that's been like approved by the FDA or that's regulated at all , uh, I think that it's really hard to consistently know what you're getting.

Speaker 2: 22:06

So for these treatments like buprenorphine and methadone, how long are people on them? Is the goal to taper off after a certain period of time or are you on them indefinitely? It's a

Speaker 3: 22:15

Great, and again, a really personal question for the person in that, in that scenario, because I think previously we were like, oh, let's just stabilize a person, have them take the medicine and then they'll come off of it and live a normal life. And I think that that is true for about a , a third of people that they can, after about three to six months of either being on buprenorphine, suboxone, or methadone, that they're able to wean down and, and because of how things else have changed in their world, don't need that anymore. About a third of people really do continue to feel like those cravings, those thoughts continue to be so persistent in their life that having that extra support from the medications allows them to do their life. And I really, really support those people. I am, I'm not as aggressive as I used to be around coming down off of doses because I see how effective and this medicine is in stabilizing people. And so I think that that's really true now . So I said that a third of people don't need it after a three to six months, a third of people really do, and then a third of people relapse and kind of enter in that cycle again. And we catch them wherever they are in that moment and how we can, and how we can help them not only, not only to necessarily find that moment of abstinence, but how to be safer even if, even if that next step is ongoing use. I will say though, that, and I want, I hope listeners hear this too, is that when a person comes into our system and has symptoms of withdrawal, it's not just methadone and suboxone, buprenorphine that we use to support people, we want people to be able to have a comfortable and respected hospital stay. We have a lot of medications that we can give people to help them be comfortable so that this, nobody wants to be in the hospital but let it be more tolerable. And so I really say that out there because it is my goal, the goal of my team, and really every person here that this can be not as miserable as what everybody anticipates withdrawal being.

Speaker 2: 24:09

I'll second that. What a great philosophy of care. Let's shift a little bit to something you alluded to a few minutes ago about harm reduction. What other harm reduction strategies are available? And I'm thinking of things like needle exchanges or, or wide distribution of naloxone. Yeah . What's the latest?

Speaker 3: 24:28

Well, let me tell first I'll say what harm reduction is. So I think harm reduction is a really natural philosophy that we can think about when we talk about changing any behavior. You know, for me, I'm gonna get on that exercise bike every day in the morning before I go to work. Oh, I do that. Well , I'm , I , I think most humans do, right? Right. Um , but I have to tell myself I'm not just gonna snap my fingers and jump on that bandwagon. I have to say, Lauren, let's get on the bike one time per week. And like, what is the way, what are the small steps in between me being a non exercising person and being an exercising person, right? It's not just one and then the next. And so I think, I think a lot about substance use in that same way, right? Like I, how, how reasonable is it for me to expect somebody who's been using, whose body is wired in a different way now to use substances to have, you know, be be smoking fentanyl much more regularly. Like what's the real , like, is it real for me to be like, stop that. I mean oftentimes not entirely. So is there a way that I can help support people to do that in a safer way so that they first use less or use safer and then we can keep working towards that goal of stopping. And I think just as you alluded to, syringe exchange is , is a huge thing, huge part of that for people who are using IV drugs. So for people who are inject , injecting fentanyl, having your own syringe clean every single time you inject is huge. We know that even reusing a needle twice dulls the blade that puts you at higher risk for getting infections. So it's, so I think I talk about that a lot with patients who use IV drugs that they know it's not just about having your own needles, it's also about using your own needles once every time you are trying to, trying to inject. So that's one example

Speaker 2: 26:14

Before you move on, I'm hesitant to even say it, but doctor, you're giving needles to people who are using drugs, you're, you're making the problem worse. We've all heard that. I know that's not a true statement, but how do you even respond to that?

Speaker 3: 26:27

Well , I really understand why people would have that concern, right? Because they're like, aren't you just making it worse? But the truth is people are brilliant and creative and if I don't give them needles, they're gonna get needles from someplace else that inevitably isn't going to be as safe. And so I think it's kind of like being in that moment trying to be humble with our patients and recognizing like, what's gonna happen here and what are the small steps that I can show? Like, I see you, I wanna make sure you're safe. This is one thing I can do to partner with you because I do talk about it with people. This is the long game. We're I'm playing the long game. I wanna hang in with you right now in helping you be safer so that when you are in a different place already three months, six months from now that we're in it together and that we've built that relationship.

Speaker 2: 27:10

So what other risk reduction techniques are out there?

Speaker 3: 27:13

I'll share two more that I think are unbelievably impactful. So one is naloxone. Naloxone, otherwise known as Narcan, can be given either in the nose or in the muscle. And that alone is the opioid overdose reverser . So it's an opioid blocker. So when given it, if somebody is overdosing, it saves people's lives. And I tell you between 2021 and 2022 here in Minnesota, the wide distribution of that naloxone is no doubt part of why we did not see further opioid death increases. So that's a huge part. And I carry Narcan , I joke I carry it with me to the movie theater because I don't know who's gonna be in the bathroom stall next to me. And it's only, it only has to happen to you once for you to be unprepared that you want that with you all the time. The second thing, and especially in the era of fentanyl that I think is so important is using with a friend. Okay, why is that important? Because you cannot guarantee the dose of fentanyl that you are getting, nor exactly what else, what other substances are mixed with it. The risk of opioid overdose is high. If you use with another person in the room with you, you are so much safer in ca in the event that you do overdose, that that person will be able to call and get help administer Narcan when you need. And that's something I talk about with my folks all the time because making sure you have that other person looking out for you is so important at this time.

Speaker 2: 28:32

What impactful bits of advice , um, this has been an incredibly great conversation with Dr. Lauren grabber about fentanyl and the opioid epidemic in general, but before we let you go, if you could leave our listeners with any aspect of , uh, substance use is the opioid epidemic, what would that be?

Speaker 3: 28:49

I think I would always, you know, people always ask me like, how do you do your job? Isn't that so sad, so hard to see people struggling? And I have to say, I love my job. I love my job because I have the honor of getting to connect with people when they feel terrible. And together we make a plan of how, how this can be better. And so every time I walk out of a room, I walk out with that hope that this can be better, that we can do this together. And I think that the medications that we use to treat opioid use disorder, suboxone, buprenorphine, methadone, are really effective in helping people reclaim that bit of themselves for whatever time period that is. And so I have such joy in this work and I really appreciate the opportunity to come and share a little bit about my experiences.

Speaker 2: 29:35

How lovely to hear that. And thank you for the work you're doing, and thank you for being on this podcast with us. We've been talking with Dr. Lauren Grabber , an addiction medicine specialist here at Hennepin Healthcare in downtown Minneapolis. Thanks for being on the show and thank you listeners for being with us today. I know this is a difficult topic and many people out there are either dealing with addiction or are close to someone who is. So if you or someone you love is experiencing substance use problems, please reach out for help from a trusted loved one or your medical professional. And I hope you'll join us on the next episode of the Healthy Matters podcast when we'll be talking about your hearing with audiologist Dr. Janet Hanson of Hennepin Healthcare. In the meantime, be healthy and be well.

Speaker 1: 30:16

Thanks for listening to the Healthy Matters podcast with Dr. David Hilden . To find out more about the Healthy Matters podcast or browse the archive, visit healthy matters.org. You got a question or a comment for the show? Email us at Healthy matters@hcme.org or call 6 1 2 8 7 3 talk. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas At Highball Executive Producers are Jonathan, CTO and Christine Hill . Please remember, we can only give general medical advice during this program, and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.