Your family is "driving you to drink?"

Erik Gunderson, MD, FASAM

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Marijuana and Music:  Intertwined but not Absolute

Erik Gunderson, MD, FASAM

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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. 

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​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.

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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.

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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.