Your family is "driving you to drink?"
Erik Gunderson, MD, FASAM
Marijuana and Music: Intertwined but not Absolute
Erik Gunderson, MD, FASAM
During the last week I haven’t been able to get out of my mind several
patients for whom marijuana use and music are intimately connected.
In particular, a couple individuals are struggling with early marijuana
abstinence and a perceived need to avoid music to break the association
and stop smoking. Others would like to decrease their marijuana use
and smoke intermittently, but the integral aspect of music triggers the
marijuana habit, whether through attending live shows, hanging at home
in the evenings, or during jam sessions with friends. For all these
individuals, life without music would not be living, and avoiding music
to achieve marijuana abstinence or reduction would be unsustainable.
The current post examines the marijuana-music connection from a cognitive, behavioral, and neurobiological perspective, concluding with some music recommendations that are perhaps out of the mainstream. To the extent that specific songs, artists, or music genres might trigger marijuana cravings and use, hopefully exploration of new music types and artists could lead to marijuana-free associations and facilitate reaching one’s goals for abstinence or intermittent use while keeping the music playing.

Your family is "driving you to drink?"
Erik Gunderson, MD, FASAM
Although it may seem at times that your family is “driving you to drink,” the long-term
research of Dr. Marc Schuckit clearly demonstrates that your family history –
specifically whether or not you have a biologic parent with alcoholism – can influence
your reaction to alcohol’s effects, and, as a consequence, the amount of alcohol you
may be consuming. Combined, your family history and reaction to alcohol influence
your risk for developing an alcohol use disorder.
Dr. Schuckit’s research revolutionized our understanding of genetic and
environmental risks for developing alcohol dependence, or alcoholism. Most
importantly, his findings provide clues as to whether you or your family members
have increased susceptibility to alcoholism. If you already have an alcohol problem,
his research may help explain why.

Dr. Schuckit receives the 2012 John P. McGovern Award from Dr. Gunderson, AMERSA Executive Committee member
Must buprenorphine (Suboxone/Subutex) treatment be started in the office?
Erik Gunderson, MD, FASAM
Starting buprenorphine (Suboxone/Subutex) treatment – buprenorphine induction – is
challenging for patients and clinicians. Patients are required to be in mild opioid withdrawal prior to starting the medication. Initial treatment guidelines published a decade ago recommend that withdrawal be assessed and medication initiated with direct observation and monitoring for 2+ hours. As such, office induction poses a treatment barrier for both physicians and patients.
Alternate practice models of induction may facilitate induction. Published studies by Dr. Gunderson and colleagues provide practice-based evidence to help guide the induction process.
