In this episode of Pain Matters, Shravani Durbhakula, MD, MPH, MBA, speaks with Maia Szalavitz, award-winning New York Times opinion writer and AAPM 2025 Featured Speaker. Recorded April 4, 2025, at the AAPM PainConnect 2025 meeting, their conversation explores themes from Szalavitz’s recent writing on addiction, harm reduction, and drug policy. Maia shares her personal journey through addiction and recovery, and offers insights into the critical distinction between dependence and addiction. They also discuss the effectiveness of harm reduction strategies when it comes to opioids, the potential of emerging treatments like Ozempic, and the role of media in shaping public understanding of addiction. Throughout, Szalavitz challenges traditional narratives and advocates for evidence-based, compassionate approaches to drug policy and treatment. She also offers tips for how medical professionals can make their voices heard.

*Views expressed by our guests are their own and do not necessarily reflect those of the hosts, their institutions, or the American Academy of Pain Medicine.

About the Guest:

Maia Szalavitz
Maia Szalavitz is an acclaimed journalist and author known for her expertise in addiction, harm reduction, and drug policy. Having personally experienced addiction, Szalavitz's work draws deeply from her own journey to recovery. Her celebrated books include "Unbroken Brain: A Revolutionary New Way of Understanding Addiction" and "Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction." Szalavitz frequently contributes to major publications with opinion pieces that challenge traditional views on addiction and advocate for science-based approaches to drug policy.

Episode Summary:

🔑 Key Takeaways

• Addiction vs. Dependence: Szalavitz emphasizes the critical distinction between physical dependence and true addiction — a nuance often misunderstood in both policy and clinical settings.
• Harm Reduction Works: Szalavitz says that strategies like syringe exchange and safe use education are not just compassionate — they’re backed by evidence and save lives.
• Ozempic and New Treatments: The conversation touches on the potential of drugs like Ozempic in treating addiction, and what the early research suggests.
• Media’s Role: Fair and science-based journalism is essential — Szalavitz critiques the harm caused by sensationalized or "artificially balanced" reporting on drug use.
• Policy Reform: Current drug policies often criminalize rather than help — Szalavitz calls for systemic change rooted in public health, not punishment.

Resources:

• Maia Szalavitz: Personal Website
• Books by Maia Szalavitz: Undoing Drugs, Unbroken Brain