In the eighth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Ernie Dole, a pharmacist by training, former clinical professor at the University of New Mexico, and someone who spent decades treating opioid use disorder in patients while quietly living with it himself.

Ernie had 30 years of continuous sobriety. Then he relapsed. He is now on buprenorphine, which he credits with saving his life. This episode is one of the most honest conversations The Saving Dose has had about what OUD actually looks like from inside a career built on understanding it, and why expertise and professional arrogance can be their own form of risk factor.

This episode covers the relationship between adverse childhood events and OUD, why healthcare professionals develop opioid use disorder at higher rates than the general population, what it means to lose the art of medicine inside a 15-minute appointment structure, and why compassion is the single most important thing a provider can bring to a patient with OUD.

In this episode:

Why Ernie believes his childhood asthma hospitalizations were an adverse childhood event that shaped his relationship with substances decades before he would have admitted it, and what the connection between ACEs and OUD risk actually looks like in a real life.

Why healthcare professionals, including pharmacists, anesthesiologists, and nurses, develop OUD at rates higher than the general population, and what access and professional arrogance have to do with it.

How 30 years of sobriety ended with a pint of Jack Daniels one afternoon, what Ernie thinks stopped working in his recovery, and why he believes putting a time limit on buprenorphine treatment is a mistake.

What the Pharmacist Clinician Act in New Mexico made possible: how collaborative practice agreements between pharmacists and physicians created a model where every provider practiced at the top of their license and opioid patients got more accountability and better care.

Why fibromyalgia, chronic pain, and OUD are connected through untreated trauma, and what Ernie observed in nearly every female chronic pain patient he treated over the course of his career.

What happens to the clinical relationship when a provider is stuck in a 15-minute appointment structure, and why Ernie regularly ran an hour behind because his patients needed the time.

John's frustration: why physicians have lost the art of medicine, what it means to be accused of practicing Chinese medicine for using multimodal pain therapy in 1999, and how Medicare now penalizes hospitals that do not use that same approach.

Ernie's closing message to every pharmacist, anesthesiologist, and nurse who is struggling: compassion, treatment works, and buprenorphine saved his life.

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. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/

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. Connect with William: https://www.linkedin.com/in/williampedranti/

About the Guest

Ernie Dole is a pharmacist, former clinical professor, and patient advocate based in New Mexico. He developed and led the clinical pharmacy program at the University of New Mexico's outpatient chronic pain center, pioneering a collaborative practice model under New Mexico's Pharmacist Clinician Act that allowed pharmacists to manage complex opioid patients alongside physicians. He speaks from both professional expertise and lived experience with opioid use disorder and recovery.

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.

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