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.

#OpioidCrisis #AddictionRecovery #OpioidUseDisorder #MedicationAdherence #MOUD #BehavioralHealth #AddictionMedicine #OpioidTreatment #SubstanceUseDisorder #HealthcarePodcast #TheSavingDose #RecoveryPodcast #MentalHealth #PublicHealth #PatientRetention #MAT #ChronicPain

In the second episode of The Saving Dose, John Hsu MD and William Pedranti go deep into the most dangerous misconceptions driving the opioid epidemic, why physicians are afraid to prescribe, what the difference between dependency and addiction actually means clinically, and why America is in its fourth decade of a crisis that has a known solution most patients never receive.

This episode covers the clinical realities most pain physicians will not say publicly, the myths inside the healthcare system that are directly causing patient harm, and what it would actually take to close the gap between the treatments that exist and the patients who need them.

In this episode:

Why over 90% of pain physicians John knows personally are afraid to prescribe opioids, and what that fear is doing to patients in legitimate pain.

The difference between opioid dependency and opioid use disorder, why the healthcare system keeps confusing the two, and why that confusion is costing lives.

What happened in pain medicine clinics after the 2016 CDC guidelines, the term that emerged in physician circles, and what it tells us about the consequences of policy without infrastructure.

Why a cancer patient on opioids for years is not an addict, and what happens when their medication is stopped without a proper taper.

The multimodal pain therapy approach John was using in 1999 that colleagues thought was acupuncture from China, and why Medicare took 30 years to catch up.

What happens when an OUD patient goes into surgery and their anesthesiologist does not know how to manage their medications, and why this scenario is more common than anyone admits.

88% of opioid overdoses today are from illicit fentanyl, not prescription medications, and what that means for how we are treating the wrong problem.

48 million Americans living with addiction, 5,000 board-certified addiction medicine physicians, and what that ratio says about why we are still in the fourth decade of this epidemic.

Why the medications that reduce overdose risk by more than 50% exist, and why only 25% of the people who need them are receiving them consistently.

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

Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions.

#OpioidCrisis #AddictionRecovery #OpioidUseDisorder #MedicationAdherence #PainManagement #MOUD #BehavioralHealth #AddictionMedicine #SubstanceUseDisorder #HealthcarePodcast #TheSavingDose #RecoveryPodcast #OpioidTreatment #ChronicPain #PublicHealth #DrugPolicy #FentanylCrisis #OpioidEpidemic

In the first episode of The Saving Dose, three addiction medicine and behavioral health executives discuss why opioid use disorder treatment is failing patients, what the medication adherence gap actually looks like from inside the clinic, and what it will take to fix it. Topics include MOUD access, buprenorphine barriers, pain management misconceptions, behavioral health revenue challenges, and the infrastructure gap driving medication non-adherence across America.

This episode covers who they are, what brought them to this space, and why they believe the addiction treatment system is failing not because the science is missing, but because the infrastructure to deliver it consistently has never been built.

In this episode:

Why John Hsu MD walked away from a traditional anesthesiology career to build a medication security company, and the moment in his own clinic that made it impossible not to.

What William Pedranti learned after 20 years building biotech companies about the gap between clinical evidence and real-world patient outcomes, and why addiction treatment has the widest gap he has ever seen.

What Kendra Allen saw working on the frontlines of behavioral health, and why patients in active recovery were losing access to treatment not because they stopped trying, but because the system stopped making it possible.

The parking lot: what John's patients were doing before their appointments, and what it told him about the failure of in-home medication management.

The access problem in a single number: over 50% of patients can be saved by taking their medications consistently. Only 25% of them can access those medications.

Why every person William tells about iPill responds the same way, and what that says about how close this crisis is to every family in America.

What recovery actually requires: medication, consistency, and a system that does not make patients fight for both every single day.

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

Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any treatment decisions.

#OpioidCrisis #AddictionRecovery #OpioidUseDisorder #MedicationAdherence #MOUD #BehavioralHealth #AddictionMedicine #PainManagement #SubstanceUseDisorder #HealthcarePodcast #TheSavingDose #MentalHealth #RecoveryPodcast #OpioidTreatment #PublicHealth