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How do clinicians balance the urgent need to relieve suffering with the risks associated with opioids and other substances? In this episode, psychologist Travis Heath speaks with pharmacist and educator Dr. Mark Garofoli—widely known as “Pain Guy”—about pain management, addiction, fentanyl, trauma, nicotine, psychedelics, and the evolving drug landscape. Together, they explore the human realities behind public health messaging, the importance of compassionate clinical relationships, and why substance use conversations require nuance rather than fear-based thinking. This is a thoughtful discussion for therapists, healthcare providers, educators, and anyone working at the intersection of pain, mental health, and substance use.