S3 E14 Jakob comes home, at least for one episode!S3 E14 Jakob comes home, at least for one episode!
Pondoff's Anonymous
Jakob Miller joins Chris, Zoë and Jeff for a raw, funny and detailed conversation about harm reduction, detox meds and why outpatient care matters so much. The group talk through ibogaine, ketamine, Suboxone, methadone, Vivitrol and naltrexone while challenging quick fixes and stressing long-term recovery over lifelong maintenance.
1:35:38•27 Apr 2026
Jakob Miller on Harm Reduction, Hard Detoxes and What Truly Helps You Get Clean
Episode Overview
- Medications like Suboxone, methadone, ibogaine, ketamine, Vivitrol and naltrexone can help, but none replace therapy, support and ongoing recovery work.
- High-dose Suboxone and long-term methadone can create severe withdrawal and extra risk if doses are missed, so conservative dosing and tapering are crucial.
- Harm reduction is seen as vital in the community to keep people alive, but Jakob argues that inside treatment the focus should shift to full recovery rather than indefinite maintenance.
- Outpatient care after inpatient treatment is framed as where the "real work" starts, helping people apply coping skills in everyday life with accountability and support.
- Comfort medications can make detox far more bearable, and many withdrawal symptoms have a strong mental component, especially when people are still in chaotic environments.
“I've never met an addict so sick they can't get clean.”
How do people cope with the challenges of staying sober? This candid chat on Pondoff's Anonymous brings Jakob Miller back into the studio for what starts as light banter and quickly becomes a straight-talking masterclass on treatment, harm reduction, and what “getting clean” actually looks like. Chris, Zoë and Jeff catch up with Jakob on married life and the ever-busy Illinois Recovery Center, then shift into the messy realities of modern addiction care.
Jakob is open about not being a fan of using drugs long term to treat addiction, yet he’s clear that medicines have their place. He talks through ibogaine, ketamine, Suboxone, methadone, Vivitrol and naltrexone, stressing that nothing is a magic fix and that any medication has to be paired with therapy and real recovery work.
His biggest worries sit with over-prescribing and big doses: people on 24–28mg of Suboxone instead of the 2–4mg he thinks is plenty, brutal withdrawal if a dose is missed, and methadone detox that “felt like a month” of feeling ill. He’s blunt about conferences that once claimed Suboxone had “no withdrawal symptoms” and “no street value”, calmly calling that out as nonsense based on his own experience.
You’ll also hear why he loves short-term use of meds for detox and blockers like Vivitrol and naltrexone, but pushes hard for tapering and long-term freedom. Jakob explains why outpatient care is where “the real work begins”, how comfort meds ease detox, and why he’s pro harm reduction **before** treatment but wants the focus to shift to full recovery once someone walks through the centre doors.
There’s plenty of dark humour, a few savage jokes, and a serious message under it all: “I’ve never met an addict so sick they can’t get clean.” If you’re weighing up meds, detox, or what kind of support to look for, could this conversation help you ask sharper questions about your own recovery path?
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