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.

#OpioidUseDisorder #AddictionRecovery #BehavioralHealth #TheSavingDose #HealthcarePodcast #Buprenorphine #MOUD #AddictionMedicine #PharmacistLife #ChronicPain #SubstanceUseDisorder #MentalHealth #RecoveryPodcast #OpioidCrisis #ACEs #TraumaInformedCare #PublicHealth #HealthcareProfessionals

In the seventh episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Ed Mahon, an investigative journalist at Spotlight PA who has spent years covering how opioid settlement funds are being allocated across Pennsylvania and who actually has a say in those decisions.

The opioid epidemic has generated one of the largest legal settlements in American history. Billions of dollars have been distributed to states and counties with the stated purpose of funding addiction treatment, recovery services, and prevention programs. What is actually happening with that money, and whether the communities most affected by the crisis have a seat at the table when spending decisions are made, is a question most media coverage has not answered.

That is what Ed covers. This episode goes inside the accountability gap at the center of the settlement distribution process, why the voices of people directly affected by addiction are still being left out of policy decisions, and what investigative journalism is doing to close that gap in Pennsylvania.

In this episode:

What the opioid settlement funds are, where they came from, and why the distribution of billions of dollars to states and counties has not automatically translated into better treatment access for the people who need it most.

Who is making the decisions about how settlement money gets spent, why those decision-making bodies often do not include people with lived experience of addiction or recovery, and what that absence costs in terms of policy effectiveness.

What Spotlight PA's Voices of the Epidemic series uncovered about the gap between how officials describe the settlement spending and what is actually happening on the ground in affected communities.

Why Pennsylvania is a useful lens for the national picture: what the state's experience with the opioid crisis, from rural counties to Philadelphia, reveals about the structural challenges that no amount of settlement money fixes on its own.

The intersection of chronic pain and addiction: why 25% of Americans living with chronic pain and nearly 50 million Americans with some form of substance use disorder are not entirely separate populations, and what treating both in the same patient requires.

John's multimodal pain treatment approach: ultrasound-guided pain blocks, anti-seizure medications, acupuncture, TENS units, and physical therapy — a framework he has been using since 1999 when a colleague accused him of practicing Chinese medicine on American patients.

Why 75% of patients do not take their medications correctly, why complete medication transparency is essential to individualizing care, and what happens to treatment outcomes when that transparency is missing.

What people who want to make a difference on the opioid crisis can do, and where to follow Ed's ongoing investigative coverage.

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

Ed Mahon is an investigative journalist at Spotlight PA covering opioid settlement accountability and addiction policy in Pennsylvania. His work focuses on how settlement funds are allocated, who has a voice in those spending decisions, and elevating the perspectives of people directly affected by the opioid crisis. Follow his work at spotlightpa.org.

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.

#OpioidSettlement #OpioidCrisis #AddictionRecovery #BehavioralHealth #PublicHealth #TheSavingDose #HealthcarePodcast #OpioidUseDisorder #InvestigativeJournalism #DrugPolicy #AddictionMedicine #ChronicPain #PainManagement #SubstanceUseDisorder #Pennsylvania #OpioidFunding #RecoveryPodcast #MOUD

In the sixth episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Kevin James, a chronic pain patient, advocate, and member of Chronic Pain Australia, speaking from Brisbane, Queensland.

Kevin has lived with chronic pain for years. He has navigated the Australian healthcare system, fought for access to treatment, and watched the fear campaign around opioid prescribing export itself from the United States to the rest of the world. He is not speaking as a physician or a policy expert. He is speaking as someone who has sat on the other side of the desk and has been told his pain was not real, or was manageable without medication, or was something psychological exercises could fix.

This episode covers what chronic pain actually looks like from the inside, why global overcorrection on opioid prescribing is leaving legitimate pain patients without treatment, what holistic pain management actually means when it is done correctly, and why Kevin's message to every prescriber, policymaker, and clinic operator comes down to one sentence: holistic care is the biscuit.

In this episode:

What it is like to be a chronic pain patient navigating a healthcare system that has been reshaped by fear rather than evidence, and why access to adequate pain treatment has become harder even for patients with documented, diagnosed conditions.

Why the opioid fear campaign that originated in the United States has spread globally, what it is doing to pain management practices in Australia, and why Kevin believes America's prescribing overcorrection is being imported by countries that did not need it.

The difference between opioid dependency and opioid use disorder from a patient's perspective, and why conflating the two has caused legitimate pain patients to be treated as addicts when they are not.

What holistic pain management actually requires: not just psychological exercises and pain reprocessing therapy, but medication, individual treatment, and a care plan built around the whole person rather than a protocol designed to reduce prescribing liability.

Why imaging technology misses the majority of pain causes at the microscopic level, and what happens when clinicians assume that what the scan cannot find must be psychological.

John's take on post-surgical pain management in America: what it means when hospitals advocate for Tylenol-only pain protocols after total knee replacement, and why that trend concerns him as a practicing anesthesiologist.

The patient advocacy landscape in Australia: what Chronic Pain Australia is doing on the ground with peer support groups and at the federal government level in Canberra to have chronic pain recognized and funded as a chronic disease in its own right.

What Kevin would say to every prescriber, policymaker, and clinic operator if he had one sentence: treat the individual, treat the whole person, and do not assume that because you cannot find a physical cause the pain is not real.

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

Kevin James is a chronic pain patient and patient advocate based in Brisbane, Queensland, Australia. He is a member of Chronic Pain Australia, the only organization in Australia providing face-to-face peer support groups for people living with chronic pain, and is involved in advocacy efforts at the federal government level to have chronic pain recognized and funded as a standalone chronic disease. He speaks in a personal capacity.

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.

#ChronicPain #OpioidUseDisorder #PainManagement #AddictionMedicine #BehavioralHealth #TheSavingDose #HealthcarePodcast #ChronicPainAwareness #OpioidCrisis #PatientAdvocacy #PainPatient #MOUD #AddictionRecovery #SubstanceUseDisorder #PublicHealth #HolisticHealth #ChronicPainAustralia #GlobalHealth