Topics in Palliative Medicine

023 - GLP-1 Agonists and Addiction: Surprise!

Questions? Comments? Send us a message! [https://www.buzzsprout.com/twilio/text_messages/2436798/open_sms] Recent research indicates that GLP-1 receptor agonists, originally developed for diabetes and obesity, show significant potential in treating substance use disorders (SUDs) and serious mental illnesses. Clinical trials and preclinical studies suggest these medications, such as semaglutide and exenatide, can effectively reduce alcohol cravings and consumption by modulating the brain's reward circuitry. Beyond addiction, these drugs may mitigate the metabolic side effects and weight gain associated with antipsychotic treatments for mental health conditions. While evidence is particularly strong for alcohol use disorder, preliminary data also suggest benefits for nicotine and opioid misuse. Despite this promise, widespread clinical adoption faces hurdles regarding insurance reimbursement and the need for larger, long-term studies. Broadening the use of these medications could bridge the gap between metabolic health and neuropsychiatric recovery. Check out simplyherbals.net [https://simplyherbals.net] and tell them Topics in Palliative Medicine sent you! Support the show [https://www.buzzsprout.com/2436798/support] Thank you for your interest in Ethics in Palliative Medicine!  Follow us at https://epionepalliative.com and on X: @PallCareEthics

022 - A 10 Minute Treatment for Depression : DMT in a Phase 2a Study

Questions? Comments? Send us a message! [https://www.buzzsprout.com/twilio/text_messages/2436798/open_sms] We discuss a Phase 2a clinical trial investigating the use of intravenous DMT (SPL026) as a fast-acting treatment for major depressive disorder. The research demonstrates that a single dose, paired with psychotherapeutic support, leads to a rapid and significant reduction in symptoms that can last up to three months. Unlike traditional antidepressants that take weeks to work, this short-acting psychedelic provides an immediate effect and was found to be generally safe and well-tolerated by participants. Dr. Steve’s commentary emphasizes that this modern research addresses a forty-year gap in psychedelic studies caused by previous political and regulatory restrictions. Overall, the findings suggest that DMT could offer a highly efficient alternative for patients who do not respond well to conventional therapies. Check out simplyherbals.net [https://simplyherbals.net] and tell them Topics in Palliative Medicine sent you! Support the show [https://www.buzzsprout.com/2436798/support] Thank you for your interest in Ethics in Palliative Medicine!  Follow us at https://epionepalliative.com and on X: @PallCareEthics

021 - Ethics Roundtable: Prescribing Controlled Substances in a Terminally Ill Patient With Suspected Substance Abuse Disorder and Opioid Agreement Violations

Questions? Comments? Send us a message! [https://www.buzzsprout.com/twilio/text_messages/2436798/open_sms] This is an interdisciplinary ethics roundtable centered on a terminal lung cancer patient suspected of diverting methadone and violating his controlled substance agreement. Various experts, including physicians, a lawyer, a chaplain, and a psychologist, evaluate the conflict between the duty to relieve suffering and the necessity of maintaining legal and professional boundaries. The contributors suggest strategies ranging from stricter monitoring and liquid formulations to involving social services to investigate potential exploitation. While some argue for immediate dismissal due to safety risks and illegal activity, others emphasize harm reduction and the moral imperative to avoid patient abandonment. Ultimately, the text highlights the complex challenge of managing refractory pain in patients with possible substance use disorders during end-of-life care. Support the show [https://www.buzzsprout.com/2436798/support] Thank you for your interest in Ethics in Palliative Medicine!  Follow us at https://epionepalliative.com and on X: @PallCareEthics

ACHPN Board Exam Review Part 6: Leadership

Questions? Comments? Send us a message! [https://www.buzzsprout.com/twilio/text_messages/2436798/open_sms] The ACHPN Prep (Advanced Certified Hospice and Palliative Nurse) series on the Topics in Palliative Medicine podcast consists of several parts designed to help clinicians prepare for board certification. Description: The final installment of the prep series focuses on professional issues and leadership. It discusses the "Advocate" role of the ACHPN, quality improvement processes, and staying current with clinical practice guidelines to ensure high-quality patient outcomes. Support the show [https://www.buzzsprout.com/2436798/support] Thank you for your interest in Ethics in Palliative Medicine!  Follow us at https://epionepalliative.com and on X: @PallCareEthics

020 - The Surrogate vs the Advance Care Plan

Questions? Comments? Send us a message! [https://www.buzzsprout.com/twilio/text_messages/2436798/open_sms] This episode presents an "Ethics Roundtable" discussion, focusing on the complex case of a 68-year-old female veteran, LK, whose advanced directive conflicts with her family's wishes regarding life-sustaining treatment. The source explores this ethical dilemma from multiple professional viewpoints, including a trauma surgeon, ethicist, spiritual care provider, physician, lawyer, and social worker. Each perspective offers insights into the challenges of honoring patient autonomy when a designated surrogate is deemed unsuitable and family members disagree with the patient's explicit end-of-life instructions. The central theme revolves around the legal and moral obligations to uphold a patient's advanced directive, especially when a surrogate's cognitive impairment or emotional distress prevents them from making decisions aligned with the patient's stated wishes. keywords: autonomy, advance directive, surrogate decision making, substituted judgement Support the show [https://www.buzzsprout.com/2436798/support] Thank you for your interest in Ethics in Palliative Medicine!  Follow us at https://epionepalliative.com and on X: @PallCareEthics