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In episode 46 we discuss using high doses of varenicline and nicotine for smoking cessation. Cinciripini PM, Green CE, Shete S, Minnix JA, Robinson JD, Cui Y, Kim S, Kypriotakis G, Beneventi D, Blalock JA, Versace F, Karam-Hage M. Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial. JAMA. 2024 May 28; 331(20):1722-1731. We also discuss resources for safer substance use, and the recall of dangerous Diamond Shrooms. Yale Program in Addiction Medicine: Resources for Safer Injection and Substance Use San Francisco Aids Foundation: Safer Drug Use CDC: Severe Illness Potentially Associated with Consuming Diamond ShruumzTM Brand Chocolate Bars, Cones, and Gummies --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES. CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music: composed and performed by Benjamin Kennedy Audio Editing by Michael Bonanno Executive Producer: Dr. Patrick Beeman A podcast from Ars Longa Media --- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group. Email: addictionmedicinejournalclub@gmail.com Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club Instagram: @AddictionMedJC Threads: @AddictionMedJC YouTube: addictionmedicinejournalclub Twitter/X: @AddictionMedJC Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.