The Addicted Mind Podcast

In this episode, host Duane Osterlind sits down with Dr. Muhamad Aly Rifai, a dual-trained internist, psychiatrist, and addiction medicine specialist with over 25 years of clinical experience. Together, they dive deep into a rising public health concern—Kratom and 7-OH products—and unpack the complex neuroscience of how substance abuse alters brain architecture.
Dr. Rifai shares insights from his book, Hijacked Mind: How Addiction Rewires the Soul, exploring the reality of permanent brain changes, the sliver of hope offered by neuroplasticity, and how a holistic Biopsychosocial model can help individuals rebuild their lives.
About the Guest
Muhamad Aly Rifai, MD, is an internist, psychiatrist, and addiction specialist. He serves as the medical director of an addiction treatment center and has spent the last two decades treating individuals facing co-occurring psychiatric disorders and chemical dependencies. He is also known online as "The Virtual Psychiatrist."
Key Takeaways & Discussion Points
1. The Kratom Crisis: Natural Leaf vs. 7-OH
Kratom is a tropical tree native to Southeast Asia. While traditionally used as a tea for pain relief, a massive commercial market has emerged around it in the United States, creating two distinct camps:
The Natural Leaf Camp: Powdered or dried leaves primary containing mitragynine. Many users report it offers relief from chronic pain, fibromyalgia, and fatigue when used responsibly.
The 7-OH Camp: Highly potent, biochemically isolated 7-hydroxymitragynine sold in gas stations and smoke shops as pills, extracts, and drinks.
The Clinical Reality: Because these products are completely unregulated by the FDA, consumers often don't know what they are ingesting. Dr. Rifai notes a dramatic rise in patients requiring medical detoxification from 7-OH products, experiencing severe withdrawal syndromes comparable to high-dose opioid or fentanyl withdrawal.
2. The Neuroscience of a "Hijacked Mind"
For years, addiction wasn't fully understood as an architectural shift in the brain. Dr. Rifai explains the sobering realities of what happens when a substance takes over:
Down-Regulation: Severe drug use causes a decrease in the number and sensitivity of opioid receptors.
Apoptosis: Substances like fentanyl trigger programmed cell death in areas governing executive function, emotional regulation, and perception.
Permanent vs. Adaptable Changes: While some cellular damage is irreversible, neuroplasticity allows the brain to build new neural pathways around damaged areas through targeted treatment.

3. The Biopsychosocial Model for Recovery
Overcoming severe addiction requires a 360-degree approach. Dr. Rifai breaks down the essential framework for a successful recovery program:
Dimension Core Interventions & Strategies Biological Complete abstinence, Medication-Assisted Treatment (MAT) like buprenorphine or methadone, treating underlying psychiatric comorbidities (depression, anxiety), and neurostimulation (like Transcranial Magnetic Stimulation / TMS).Psychological Addressing cognitive distortions "on steroids," processing trauma (which is present in 60% to 70% of addiction cases), and utilizing evidence-based therapies like CBT and DBT .Social Building a supportive network through family involvement, peer support counselors, prescription digital therapeutics (specialized apps), and 24/7 accessible support groups like AA/NA via Zoom.
Words of Hope
"Help is out there. Even if you're hopeless and see no way out, help is available. There is a way out and there is somebody out there to help. So reach out."
Resources & Links Mentioned
Dr. Rifai’s Website: alirifai.com
Dr. Rifai’s YouTube Channel: The Virtual Psychiatrist
Dr. Rifai's Book: Hijacked Mind: How Addiction Rewires the Soul (Available on Amazon)
Suicide & Crisis Lifeline: Call or text 988 (Available 24/7, free, and confidential)

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Supporting Resources:
If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center
NovusMindfulLife.com
We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind
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Ever wonder why two people can experience the exact same event but walk away with completely different emotions?

In this fascinating episode of The Addicted Mind Podcast Plus, hosts Duane and Eric Osterlind dive into the science of optimism and reveal how our attention shapes our reality. They explain that optimism isn't about ignoring negative experiences or forcing positivity – it's about training our brain to process both positive and negative information in a balanced way.

Through practical examples and evidence-based strategies, they show listeners how to break free from negative thought spirals and develop genuine optimistic thinking. Whether you're dealing with anxiety, depression, or just want to build more resilience, this episode offers simple yet powerful tools to help you unlock your inner optimist and transform how you experience life's challenges.

Download: Unlocking Your Inner Optimist Worksheet

Key Topics
The difference between toxic positivity and genuine optimism
How attention bias affects our experience of events
The science behind optimistic versus pessimistic thinking
Three evidence-based strategies for developing optimism
The role of physical movement in changing perspective
How optimism builds resilience and creativity
Practical daily exercises for training your brain

Timestamps
[00:01:27] The power of perspective: Same event, different experiences
[00:03:42] The science behind attention and optimism
[00:05:19] Why this isn't toxic positivity
[00:09:30] Introduction to practical strategies
[00:09:54] The two-chair technique explained
[00:11:28] The daily spotlight exercise
[00:13:02] The reframe challenge technique

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In this episode of The Addicted Mind, host Duane Osterlind sits down with author, veteran, and off-grid farmer Robert "Bob" Stark. Bob shares his powerful journey of overcoming an 18-year battle with substance abuse, transitioning back to civilian life after parachuting into Iraq during the initial invasion, and deconstructing the rigid constraints of hyper-masculinity.
Bob opens up about how he used writing to process unaddressed childhood and combat traumas, moving from anger and blame to deep internal healing. Today, Bob celebrates 11 years of clean and sober living on a 40-acre off-grid farm in the Kenai Peninsula of Alaska, where he is learning to balance strength with the gentleness his family deserves. Tune in to hear an inspiring conversation about resilience, the power of putting pen to paper, and the continuous journey of transformation.

Key Takeaways & Highlights
The Reality of Post-Combat Transition: Bob shares the stark contrast of sleeping with a rifle by his side in Iraq to sleeping in his car just two weeks later, highlighting the hyper-vigilance and isolation many veterans face.
Breaking Out of the "Man Box": A deep dive into the societal expectations of male stoicism. Bob discusses the challenge of moving away from the "power through it alone" mentality to embrace emotional vulnerability and gentleness as a father.
Writing as a Catalyst for Healing: Bob reveals why he is his most honest self when putting pen to paper. He shares how writing his two books allowed him to reframe his life experiences and process deep traumas without finger-pointing or resentment.
Manifesting Dreams Off-Grid: From living with candles, oil lanterns, and no refrigeration to building a thriving 40-acre solar-powered farm with his family, Bob talks about the power of vision boards and relentless action.
Action Beats Stagnation: Why thriving in recovery requires a willingness to keep trying new therapies, habits, and paths until something finally sticks.
Bob’s One Piece of Advice: If you are feeling lost or stuck, start with the smallest foundational pieces: look at your lifestyle, your routine, your diet, and your sleep habits.

Robert Stark (Bob) is an Army veteran who served four and a half years in the military, including a deployment as a paratrooper during the invasion of Iraq. He is the author of two deeply personal books, War Flower and Just Like a Soldier, which chronicle his experiences with trauma, military life, and long-term recovery. Bob has been clean and sober for 11 years and lives off-grid in Alaska with his wife, Savannah, and their four children, where they run their family farm, Secret Garden Alaska.

Resources & Links Mentioned
Robert's Website & Farm: Secret Garden Alaska (Find his books, blog, and products here)
Books by Robert Stark: * War Flower
Just Like a Soldier
YouTube Channel: Secret Garden Alaska


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Supporting Resources:
If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center
NovusMindfulLife.com
We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind
Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode, Duane Osterlind talks with Nawal Roy, the visionary behind Holmusk, the world’s largest clinical data platform for mental health. After a successful career in finance, Nawal pivoted to healthcare, driven by the realization that mental health is one of the most complex, yet least quantified, areas of medicine.
They dive deep into how Holmusk has spent 11 years building a "scientific-grade" database of over 42 million patients, shifting mental health care away from "hunches and poetry" toward precision and evidence-based science.
Key Discussion Points
The Data Gap in Mental Health: Historically, mental health treatment has relied on clinician intuition rather than hard data. Nawal explains how Holmusk "normalizes" messy, unstructured electronic health records to create a searchable, scientific database.
The 10-Year Wait: Data reveals a heartbreaking reality: the average journey from the onset of symptoms to receiving meaningful care is 8 to 10 years.
Ending the Trial-and-Error Cycle: A typical acute patient might cycle through 10 to 12 different medications over 18 months before finding what works. Nawal discusses how large-scale data can help clinicians find the right treatment faster.
The Power of Comorbidity: Mental health doesn't exist in a vacuum. Treating depression can significantly improve outcomes for physical conditions like diabetes, yet these are often treated as separate issues.
Measurement-Based Care: Nawal argues that "engagement is not outcome." He highlights the desperate need to move toward a system that measures functional improvement (like GAF or CGI scores) rather than just "showing up for therapy."
AI and the Future of Psychiatry: How Holmusk is using Natural Language Processing (NLP) to "read" thousands of unstructured doctor's notes and train AI models to provide clinically accurate—not just "nice sounding"—guidance.

"Mental health is currently closer to poetry than science... we need to bring the level of rigor found in pediatric oncology to the mental health community." — Nawal Roy
"You can't improve what you don't measure. If we have data, we can actually make real, significant change to people's lives." — Duane Osterlind
Big Takeaways
Demand Data: Patients and stakeholders should demand that mental health be treated with the same clinical rigor as physical health.
Outcome over Engagement: Simply attending sessions isn't enough; we must measure whether the patient is actually getting better.
The Role of AI: AI has the potential to democratize access to care, but it must be trained on massive, clinically valid datasets to avoid "hallucinations" and provide safe, effective support.
Resources Mentioned
Holmusk: holmusk.com
NeuroBlue: Holmusk’s flagship data analytics platform.
ACE Study: Referenced by Duane regarding Adverse Childhood Experiences and their long-term health impacts.

LinkedIn: Nawal Roy

Follow and Review: We’d love it even more if you could drop a review or 5-star rating over on Apple Podcasts. Simply select “Ratings and Reviews” and “Write a Review” then a quick line with your favorite part of the episode. It only takes a second and it helps spread the word about the podcast.
Supporting Resources:
If you live in California and are looking for counseling or therapy please check out Novus Mindful Life Counseling and Recovery Center
NovusMindfulLife.com
We want to hear from you. Leave us a message or ask us a question: https://www.speakpipe.com/addictedmind
Disclaimer

See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Download: Shame Sabotaging Your Recovery Worksheet
Have you ever noticed that after a slip in recovery, your thoughts immediately jump to "I'm worthless" or "I'm never going to get better"? These aren't just random negative thoughts – they're part of a powerful emotion that might be secretly sabotaging your recovery journey. In this eye-opening episode of The Addicted Mind Plus, hosts Duane and Eric Osterlind dive deep into the crucial difference between guilt and shame in addiction recovery. Through evidence-based research and practical experience, they reveal why many people mistakenly identify their shame as guilt, and how this misunderstanding can keep them trapped in the addiction cycle. The hosts share three powerful, scientifically-backed tools that listeners can start using immediately to build shame resilience and strengthen their recovery journey. Whether you're in recovery yourself or supporting someone who is, this episode offers essential insights into breaking free from the destructive grip of shame while building a healthier relationship with yourself and others.
KEY TOPICS
The critical difference between guilt ("I made a mistake") and shame ("I am a mistake")
How toxic shame fuels the addiction cycle
Research findings on shame's direct link to substance use problems
The importance of shame resilience in recovery
Three easy tools for breaking the shame spiral
The role of connection and community in overcoming shame
Practical language shifts for transforming shame into growth
TIMESTAMPS
[00:01:20] Introduction to shame's impact on recovery
[00:02:31] Research findings on shame vs. guilt in addiction
[00:04:00] How toxic shame creates a negative cycle
[00:08:14] First tool: The Language Shift technique
[00:09:40] Second tool: The Shame Interrupt method
[00:11:00] Third tool: The Connection Practice
[00:13:40] Community resources and next steps

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