"First, do no harm" is one of the most recognized principles in healthcare — but what does it actually mean when applied to substance use treatment?

In this episode, we sit down with Hillary Tamar, a physician specializing in addiction medicine, to explore the complexities of medical ethics, patient-centered care, and the unintended harms that can occur even when providers are trying to help.

The conversation examines the Hippocratic Oath, informed consent, stigma, and the challenges of balancing safety with accessibility in addiction treatment. Hillary shares how her perspective on addiction medicine evolved and why acknowledging potential harm is an essential part of ethical decision-making.

Together, we discuss important questions facing healthcare professionals:

• Can a treatment plan be ethical if it creates barriers that cause patients to leave care?
• How does stigma influence medical decisions?
• Why is asking for consultation a sign of good clinical judgment?
• What happens when healthcare providers become overconfident in complex situations?

This episode invites clinicians, healthcare professionals, and anyone involved in behavioral health to reflect on a simple but challenging question:

Are we always doing what is best for the person sitting in front of us?

This is a conversation about ethics, humility, compassion, and the ongoing work of improving addiction care.

About the Guest

Dr. Hillary Tamar has built her career around a simple idea: people who use drugs deserve gold-standard care that's accessible and dignified. She's double board-certified in Family and Addiction Medicine and serves as a Territory Medical Director for Community Medical Services, leading medical operations for opioid treatment programs across eight states. Off the clock, she's playing soccer, snowboarding, or hunting for the perfect buttercream donut — usually with a crossword close by.

Links:

• Website: https://communitymedicalservices.org/about/leadership-team/
• LinkedIn: www.linkedin.com/in/hillary-tamar-840b88353
• E-mail: hillary.tamar@cmsgiveshope.com

Support the show

Thank you for listening to this episode of Talking Addiction & Recovery Podcast.

To learn more about the podcast visit www.andrewjschreier.com

To inquire being a guest on the podcast or sponsorship opportunities you can e-mail hello@andrewjschreier.com

The podcast is also a platform for FREE continuing education. Licensed and certified professionals are able to listen to select episodes at no cost. Listen to an episode. Take a quiz. Complete an eval. Earn a certificate. Learn more at www.andrewjschreier.com/continuing-education

Talking Addiction & Recovery Podcast is the follow-up to the book "Addiction & Recovery" by author and clinician Andrew J. Schreier. This podcast explores discussions regarding important issues related to addiction and recovery. Information you learn here is not typical of what you will find in academic textbooks and resources; and comes from the experiences of a clinical supervisor, clinical substance abuse counselor, and licensed professional counselor and the work with individuals and others involved in this field. Listen as guests join the show and cover a wide range of topics looking to educate individuals, families, communities, organizations, institutions, mental health professionals, educators, and anyone else impacted by addiction and recovery. Content is not intended to be treatment and is not affiliated with any specific group.

What happens when we stop trying to make reality something other than what it is?

In this episode of the Talking Addiction & Recovery Podcast, we sit down with author, poet, essayist, and U.S. military veteran Kathleen Kilcup to discuss her memoir, Between the Light and Me: A Memoir of Beauty and Violence.

Kathleen brings a deeply personal perspective to addiction, recovery, mental illness, and the complicated relationship we all have with reality. She describes addiction and mental illness as dysfunctional relationships with reality—attempts to make life more or less than what it actually is. Recovery, then, becomes a process of learning to live with "what is" while recognizing the limits of our control.

We explore the idea that changing our surroundings doesn't necessarily change what's happening inside us and the difference between running away from something and running toward a genuine hunger for experience.

Kathleen also challenges the familiar idea that recovery happens through one dramatic turning point. Instead, she describes change as occurring when three things come together: pain, willingness, and opportunity.

Her memoir's title, inspired by an Emily Dickinson poem, provides another powerful metaphor for the conversation—the "fly" representing the addictions and madness that can exist between who we are and the light we're trying to reach.

This is a conversation about addiction and recovery, but it's also about accepting the mixed nature of life: the beauty, the violence, the uncertainty, and the possibility of seeing things differently because of what we've experienced.

About the Guest

Kathleen Kilcup spent five years serving in the US Army as a Russian linguist. She holds an MFA in poetry from UC Riverside and an MA in religion and arts from Yale. Her poetry and essays have appeared in Tin House, Image, Salon, Western Humanities Review, and elsewhere. She writes The Mess on Substack and lives with her family in Oklahoma City. She is the author of Between the Light and Me: A Memoir of Beauty and Violence.

Links:

• Substack: https://substack.com/@kathleenkilcup?r=11vp8n&utm_medium=ios&utm_source=stories&shareImageVariant=image
• Amazon: Between the Light and Me: A Memoir of Beauty and Violence: Kilcup, Kathleen: 9780802885272: Amazon.com: Books
• Barnes & Noble: Between the Light and Me: A Memoir of Beauty and Violence | Barnes & Noble®

Support the show

Thank you for listening to this episode of Talking Addiction & Recovery Podcast.

To learn more about the podcast visit www.andrewjschreier.com

To inquire being a guest on the podcast or sponsorship opportunities you can e-mail hello@andrewjschreier.com

The podcast is also a platform for FREE continuing education. Licensed and certified professionals are able to listen to select episodes at no cost. Listen to an episode. Take a quiz. Complete an eval. Earn a certificate. Learn more at www.andrewjschreier.com/continuing-education

Talking Addiction & Recovery Podcast is the follow-up to the book "Addiction & Recovery" by author and clinician Andrew J. Schreier. This podcast explores discussions regarding important issues related to addiction and recovery. Information you learn here is not typical of what you will find in academic textbooks and resources; and comes from the experiences of a clinical supervisor, clinical substance abuse counselor, and licensed professional counselor and the work with individuals and others involved in this field. Listen as guests join the show and cover a wide range of topics looking to educate individuals, families, communities, organizations, institutions, mental health professionals, educators, and anyone else impacted by addiction and recovery. Content is not intended to be treatment and is not affiliated with any specific group.

Brian Ward, a gambling recovery advocate, certified gambling recovery mentor, musician, and national leader, joins me in a heartfelt conversation about recovery, identity, and the many roles we carry throughout our lives.

Brian shares his personal journey from experiencing gambling-related harm to becoming a respected voice in the recovery community through peer support, advocacy, leadership, and education. Along the way, he reflects on the importance of support systems, balancing multiple passions, and finding ways to integrate rather than separate the different parts of ourselves.

Together, we explore questions that reach beyond gambling recovery:

• How do we balance ambition and opportunity in early recovery?
• Is there a "right" timeline for pursuing goals?
• What role do mentors, sponsors, peers, and loved ones play in our success?
• How much of our recovery story should define us?
• Can we truly know someone beyond what they choose to disclose?

Drawing comparisons between musical ensembles and recovery communities, Brian highlights how no meaningful achievement happens alone and encourages listeners to build their own "band" of support.

This conversation challenges simplistic narratives about addiction and recovery while reminding us that every person is far more than the worst thing they have experienced.

About the Guest:

Brian Ward is a Certified Gambling Recovery Mentor in Oregon. He is a person who has experienced gambling harm and works and volunteers to support people on similar journeys of growth and discovery. He is also a father, husband, musician, and martial artist.

Links:

• Website: VPGR.Net (Voices of Problem Gambling Recovery)
• Email for contacting: Brian.w.cgrm@gmail.com

Support the show

Thank you for listening to this episode of Talking Addiction & Recovery Podcast.

To learn more about the podcast visit www.andrewjschreier.com

To inquire being a guest on the podcast or sponsorship opportunities you can e-mail hello@andrewjschreier.com

The podcast is also a platform for FREE continuing education. Licensed and certified professionals are able to listen to select episodes at no cost. Listen to an episode. Take a quiz. Complete an eval. Earn a certificate. Learn more at www.andrewjschreier.com/continuing-education

Talking Addiction & Recovery Podcast is the follow-up to the book "Addiction & Recovery" by author and clinician Andrew J. Schreier. This podcast explores discussions regarding important issues related to addiction and recovery. Information you learn here is not typical of what you will find in academic textbooks and resources; and comes from the experiences of a clinical supervisor, clinical substance abuse counselor, and licensed professional counselor and the work with individuals and others involved in this field. Listen as guests join the show and cover a wide range of topics looking to educate individuals, families, communities, organizations, institutions, mental health professionals, educators, and anyone else impacted by addiction and recovery. Content is not intended to be treatment and is not affiliated with any specific group.