The most dangerous phrase in senior health might be “I’ve always handled it fine.” We dive into how aging reshapes the risks of alcohol, benzodiazepines, opioids, nicotine, and today’s ultra‑potent cannabis—and why familiar habits can turn hazardous after 65. Drawing on frontline cases and recent research, we unpack the baby boomer lived experience, from “mother’s little helper” to daily cocktail hours in senior communities, then connect it to the biology of aging: slower metabolism, reduced kidney and liver function, impaired balance, and sharper sensitivity to side effects.

You’ll hear why DSM‑5 criteria still apply but require age‑aware interpretation, what “code cannabis” looks like in the ER when edibles or high‑THC products masquerade as stroke, and how subtle red flags—poor sleep, irritability, shakiness, forgetfulness, falls—signal a brewing problem. We get practical about safer detox for older adults, the reality of kindling with alcohol withdrawal, and the medication decisions that matter: when to taper sedatives, how to avoid dangerous interactions, and why nutrition and B‑vitamins can’t be an afterthought. Two real-world cases ground the lessons—titrating decades‑long benzodiazepine and Z‑drug use while reducing fall risk, and using naltrexone strategically for late‑onset alcohol use without tipping a patient into instability.

If you care for an older adult—or you are one—this conversation offers clear steps to lower risk and raise quality of life: rethink sleep meds, reduce alcohol use, check cannabis potency, simplify regimens, and choose therapy and support groups that fit your season of life. Subscribe, share this with a friend or colleague, and leave a review with your biggest takeaway so we can keep building smart, stigma‑free care for older adults.

To contact Dr. Grover: ammadeeasy@fastmail.com

Food isn’t just fuel and obesity isn’t just willpower. We sat down with bariatric surgeon Dr. Mark Vierra to unpack what weight-loss surgery really changes, why genetics and hormones can overpower the best intentions, and how a careful program decides who needs a scalpel and who needs a different plan. From GLP‑1 surges and ghrelin drops to PYY’s “brake,” we walk through how surgery reshapes appetite signals and why even modest weight loss can dramatically improve diabetes and cardiovascular risk.

The conversation goes beyond the operating room. Dr. Vierra explains why five of six referrals don’t get surgery, how he and his partner analyze food diaries, depression, and daily constraints, and when medications like bupropion or GLP‑1s make more sense. We explore binge patterns, the messy reality of predicting who will do well after weight loss surgery, and the tough calls around patients who’ve been told their BMI is destiny when their labs and function say otherwise. The story shifts sharply when we talk alcohol: after gastric bypass, blood alcohol rises faster and stays higher, which raises the risk of alcohol use disorder over time. We share practical ways to screen motives for drinking, plan safeguards with families, and use craving meds thoughtfully.

What ties it all together is respect for biology and the person in front of us. Genetics like MC4R variants and syndromes such as Prader–Willi can drive lifelong hyperphagia; ultra‑processed foods and liquid calories amplify the problem; stigma keeps people from care. We push for a different bias—against soda and engineered foods, not against people—and for care that follows patients long after the incisions heal. If you want a grounded, humane guide to obesity treatment, this conversation delivers clarity without blame.

If this resonated, follow the show, share it with a friend, and leave a review so others can find it. Your support helps us keep building informed, stigma‑free conversations about health.

To contact Dr. Grover: ammadeeasy@fastmail.com

Your brain is ancient, but your world is not. We unpack how a hunter-gatherer reward system runs into modern dopamine superstimuli—engineered foods, infinite feeds, one-click buys, and potent drugs—and why that mismatch can spiral into addiction. Using clear language and vivid examples, we explain cravings, compulsion, and consequences through the lens of dopamine: how normal rewards help us survive, how substances hijack that circuitry, and how constant notifications keep the throttle stuck open.

We go deeper into the factors that raise or lower risk. Genetics account for roughly half of vulnerability and often determine a “drug of choice,” where one person feels sick from alcohol while another feels energized and social. Then we connect the dots between mental health and substance use. Depression, anxiety, ADHD, and PTSD frequently overlap with addiction, and treating one without the other rarely works. The ACEs research shows how chronic childhood stress reshapes the brain and the body, setting the stage for later disease. PTSD flips fight-or-flight on at the wrong time, and many people reach for alcohol or cannabis to blunt nightmares and panic, only to worsen the cycle.

Timing is pivotal. Teen brains run on lower baseline dopamine yet respond fiercely to novelty, making early use more rewarding and more dangerous. We share practical insights about delaying use, protecting brain development, and building real skills for stress, sleep, and conflict. A candid case study ties it together: a young adult mixing alcohol and cocaine, a missed PTSD diagnosis, and a turning point when care shifts to trauma therapy and targeted medications. The takeaway is hopeful and clear—when we treat the pain beneath the substance and rebuild healthy rewards, recovery becomes possible and durable.

If this conversation helped you see addiction more clearly, subscribe, share the episode with someone who needs it, and leave a review with your biggest takeaway. Your support helps more people find science-based care and hope.

To contact Dr. Grover: ammadeeasy@fastmail.com