Ryan Lissack

CEO of QuickMD. Prior CEO and CTO of @MedMen. Sold my first 3 companies to @salesforce and @Disney and @ticketmaster

[Ryan Lissack @ryanlissack]

Last week, nitazenes. This week, cychlorphine.

Next week: why the system that is supposed to stop this keeps failing, and what a different approach would look like.

QuickMD offers evidence-based treatment for opioid use disorder. Same-day visits from home, on your schedule.

[Ryan Lissack @ryanlissack]

Cychlorphine was first detected in drug checking programs in 2024.

It has since spread to at least 12 states and been linked to dozens of deaths.

Most people have never heard of it.

That is exactly where we were with fentanyl in 2013:

[Ryan Lissack @ryanlissack]

Prescription opioids. Heroin. Fentanyl. Nitazenes. Cychlorphine.

Each transition was driven by the same mechanism.

Regulatory pressure on one substance creates incentives to develop something structurally different.

The illicit market adapts faster than the regulatory system.

[Ryan Lissack @ryanlissack]

The study is observational and cannot establish causation.

But a 47% reduction in worsening substance use disorder during semaglutide treatment is not a number you ignore.

Keep up to date with QuickMD for the latest in evidence-based care.

[Ryan Lissack @ryanlissack]

A Lancet Psychiatry study published this month tracked nearly 100,000 people with depression or anxiety over more than a decade.

Depression risk down 44%. Anxiety down 38%. Substance use disorder down 47%.

Here is what is actually going on:

[Ryan Lissack @ryanlissack]

Not all GLP-1 medications showed the same effects.

Liraglutide showed partial benefits.

Exenatide and dulaglutide showed none.

This is not a class effect. It is specific to certain medications within the class.

[Ryan Lissack @ryanlissack]

A new synthetic opioid emerges. Standard detection misses it. Clinicians are not trained to recognize it.

We have been here before.

The response needs to be faster this time.

Next week, Part 2: the newest synthetic opioid detected this month across multiple US states.

[Ryan Lissack @ryanlissack]

Nitazenes were synthesized in the 1950s and never approved for medical use.

They were too dangerous.

They are now showing up in counterfeit prescription pills across the US.

And most clinicians have never heard of them:

[Ryan Lissack @ryanlissack]

Naloxone can reverse a nitazene overdose.

But because of their potency, a single dose is often not enough.

Most people administering naloxone have no idea they need to give more.

That gap is costing lives.

[Ryan Lissack @ryanlissack]

Buprenorphine stabilizes the opioid receptor system while the rest of the brain recovers.

It is not a replacement for recovery.

It is the clinical foundation that makes recovery neurobiologically possible.

QuickMD offers evidence-based treatment for opioid use disorder. Same-day visits from home, on your schedule.

[Ryan Lissack @ryanlissack]

One of the most common questions patients in opioid use disorder treatment ask is some version of this.

Will I ever feel normal again?

It is a reasonable question.

And the honest answer is more hopeful than most people expect:

[Ryan Lissack @ryanlissack]

With sustained abstinence supported by medication, the dopaminergic system begins to recalibrate.

Prefrontal cortex function recovers.

The stress response normalizes.

For most people meaningful cognitive and emotional recovery is measurable within months.

[Ryan Lissack @ryanlissack]

GAD is highly treatable.

Most people with it have never had that conversation.

Not because the treatment does not exist.

Because nobody told them they needed it.

Keep up to date at QuickMD.

[Ryan Lissack @ryanlissack]

Most people who have generalized anxiety disorder have never been told that is what they have.

They have been told they are a worrier.

That they need to relax.

That everyone feels like this sometimes:

[Ryan Lissack @ryanlissack]

Many people spend years managing the physical symptoms without anyone connecting them to anxiety.

They see doctors for the fatigue and the headaches.

They try sleep interventions for the insomnia.

Nobody asks the right questions.