In the third episode of The Saving Dose, William Pedranti sits down with Kendra Allen to map the full continuum of addiction treatment in America and go inside the operational reality of the clinics trying to deliver it. This is not a conversation about clinical failure. It is a conversation about what happens in the seven days between appointments, why most practices have no visibility into that window, and why that invisibility is where most recoveries end.

This episode covers the levels of care most families do not know exist until they are desperate, what medication-assisted treatment actually is and why the stigma around it is costing lives, how opioid treatment programs are bleeding patients they cannot afford to lose, and what Kendra calls the black box: the gap between the clinic visit and the outcome where providers are flying blind and patients are on their own.

In this episode:

What you can do when a loved one needs addiction treatment, why calling your insurance company may not be the right first step, and how to potentially navigate a system that was not designed to be navigated by someone in crisis.

The full continuum of care from detox through residential to partial hospitalization, intensive outpatient, and MAT: what each level means, what it may cost, and what could drive the decision between them.

Why medication-assisted treatment may not be giving patients a synthetic high, where the stigma around MAT can come from, and what that stigma may do to the patients who need it most.

The shame cycle: some reasons why patients who relapse between visits do not tell their providers the truth, what that dishonesty can cost the clinical relationship, and why it may be a predictable system failure rather than a character flaw.

What it looks like inside a clinic when a patient walks in with a dirty drug test and a story about poppy seed muffins, and what a provider is supposed to do with that.

Why the seven to fourteen days of medication a patient takes home can be one of the highest-risk windows in recovery, and what can happen when that medication exists in a household where someone else is also struggling.

Outcomes happen between visits. What Kendra means by that, what her definition of the black box actually is, and why closing it can be the central operational and clinical challenge facing opioid treatment programs in America.

Why patient churn is not a marketing problem or a clinical problem but an infrastructure problem.

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/

Kendra Allen is the CRO of iPill with 20 years in behavioral health revenue strategy, payer contracting, and regulatory navigation. She founded and exited a national healthcare consulting firm.

Connect with Kendra: https://www.linkedin.com/in/kendra-allen-cro/

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.

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