Episode 154 | Oct 30, 2025

A New Model for Addiction Recovery, With Dr. Amy de la Garza and Linnea Offerman

What if recovery didn’t stop at sobriety? This week on Health Coach Talk, Dr. Sandi welcomes Dr. Amy de la Garza and Linnea Offerman from Nosis Health to discuss how functional medicine and health coaching are transforming addiction treatment. Together, they share a groundbreaking model of care that integrates medical treatment, therapy, and coaching to support lasting recovery and whole-person healing.

“Substance use disorder is a brain disease, a chronic disorder that’s relapsing and remitting. In functional medicine, we look at root cause, which means seeing the patient as a whole, using specialized testing, and supporting not just medication and behavioral therapy, but also nutrition, movement, stress management, healthy social connection, and sleep. When we address these modifiable lifestyle factors, people begin healing from the inside out.”

Dr. Amy de la Garza

As double board-certified physician and IFM Certified Practitioner, Dr. Amy de la Garza has spent 15 years treating substance use disorders and realized that the missing link was addressing the root causes such as nutrition, sleep, movement, stress, and connection. By integrating these modifiable lifestyle factors into treatment, she and the Nosis team created a collaborative care model where medical providers, therapists, and health coaches work together to help clients truly heal. FMCA graduate and Director of Health Coaching, Linnea Offerman, brings her own recovery journey and nursing background to the process, helping clients translate lab results and lifestyle recommendations into daily habits that feel empowering and sustainable.

For health coaches, this conversation highlights the growing need for collaboration in addiction recovery and the profound impact of consistent, empathetic coaching. Clients see their coaches weekly and fill the role as the steady, trusted touchpoint that bridges therapy and medical care. Through this model, Nosis is redefining recovery as not just the absence of addiction but the presence of whole-person health and renewed purpose.

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Transcript

Dr. Sandi: Substance abuse is a huge problem in this country and I think it’s getting worse. But we’ve traditionally offered conventional treatments, medication, A.A., recovery groups, which are effective. But what if there was a functional medicine approach? And what if that approach included functional medicine health coaches? Well, the two people I’m speaking about this today on our podcast are really developing a model that I think will be a prototype for substance abuse recovery. So, I’m very excited to bring you these two individuals. Let me tell you about them.

The first is Dr. Amy de la Garza. She’s the co-founder and chief medical officer at Nosis. She’s double board certified in family and addiction medicine and a certified practitioner through the Institute for Functional Medicine, our collaboration partner. Dr. Amy is a pioneer in integrating functional medicine into substance use disorder care with 15 years of clinical experience across the treatment continuum. Dr. Amy is dedicated to guiding individuals and families on their healing journey through evidence-based whole person treatment.

Linnea Offerman, director of health coaching at Nosis is a board certified health coach and person in recovery from food addiction. Linnea has a background in nursing and functional medicine who’s personally transformed her health by losing 90 pounds in nutrition, lifestyle changes, and daily recovery practices. Linnea passionately empowers others towards sustainable wellness with personalized health coaching, nutrition education, meal planning, and practical strategies for lasting health and resilience. And I might add that she is a proud graduate of FMCA, and she got this position at Nosis from a job board notice through our alumni program. So, I know you are going to enjoy this conversation with these two incredible guests today from Nosis.

So, let’s start off by talking about this model. This is a functional medicine framework that you are applying to support people who are in recovery. So, can you explain exactly what that is?

Dr. Amy: Yes, I’ll take that. So, first of all, thank you so much for having us on. We’re really excited to talk about Nosis. So, Nosis is really the synthesis of two founders—myself being one and Duffy Fallon, our CEO, being the other. Duffy is a man in long-term recovery, and I am a physician who’s been treating people with substance use disorders for about 15 years. And about five years ago, I finished my IFM training and really, in my private practice, started to apply the concepts of modifiable lifestyle factors and more functional testing to people with substance use disorder because historically the treatment of people with substance use disorders has been very narrow, right?

So, historically, it’s really just been behavioral, so clinical therapeutic interventions, think like CBT, DBT, modalities like that provided by therapeutic clinicians and then 12-step processes, so like A.A., NA. And that really has provided the foundation of substance use disorder treatment for a very long time. And then we add in evidence-based treatments with medications. So, think about… For opioid use disorder, we’re talking about methadone and buprenorphine primarily. And then for alcohol use disorder, going back, opioid use disorder, naltrexone, buprenorphine, and methadone. And then for alcohol use disorder, we have a whole host of medications—naltrexone leading that but disulfiram, acamprosate, and medications like that.

And so really sort of coming into the last 10 to 15 years of more advanced treatment for substance use disorders, we combine those medication modalities—medications for opioid use disorder and alcohol use disorder—and then our clinical therapeutic models and 12-step. And I’ve been doing this for about 15 years and started to realize that we were missing something very critical. Substance use disorder is a brain disease. It’s, in my opinion, possibly a neurodegenerative disorder, but at the very least a chronic disorder that’s relapsing and remitting. And when we think about chronic diseases in functional medicine, we think about root cause, right? So, we have to look at the patient as a whole and we have to do some specialized functional testing, specialized lab testing. And then we have to apply that testing, and we have to apply their story. And we have to take all of that into consideration as we develop a treatment plan. And then most importantly, in my mind, we have to not only apply medication management and clinical behavioral techniques, but we have to help people develop good lifestyle behaviors—nutrition being foundational and primary, movement, stress management, healthy social connections, and sleep. So, the modifiable lifestyle factors of functional medicine. And I’ve been doing in my private practice for quite some time now. I haven’t been collecting data, but anecdotally it seems to really work so much better than just using buprenorphine and sending people to meetings, right? People are actually healing from the inside out.

And so that’s really what Nosis is, is a synthesis of Duffy’s experience with functional and integrative medicine in his recovery and my experience as a clinician, and bringing that together to create this holistic treatment model that we use at Nosis, which is a virtual health platform. And, importantly, I’ve been wanting to use coaches for 10 years but haven’t been able to figure out how to do it in my private practice. And so now I’m so lucky to be able to implement health coaches, and specifically coaches in recovery to this therapeutic model. And it really is the coaching that Duffy, and myself, and our patients, and our staff have really… It’s undeniable that coaching is the key touchpoint and the key to making this whole process really work. So, that’s the introduction.

Dr. Sandi: Well, that is music to my ears. What incredible difference you are making. And I’m curious what happened. How did you initiate the health coaching? What was that like?

Dr. Amy: Well, I’ve known that I’ve needed coaches to do this for a long time. And I’ve just been in private practice and having a very specific type of practice modality based on my family and all of that, and so just haven’t been able to utilize coaches in the way that I had really envisioned being able to include them in my practice. And what Nosis did was open up all of the potential opportunities. It gave us a platform to be able to do it, a platform to hire, a platform to pay, all of that. And so in my mind, coaching has been the missing component of my care of patients with substance use disorder all along. And it’s just that Nosis has now provided us with the ability to engage coaches and bring them into our collaborative care model.

Dr. Sandi: What does that look like? How does that actually work? How are you specifically using coaches to support people?

Linnea: I can hop in with this.

Dr. Sandi: Yeah.

Dr. Amy: Please do.

Linnea: Hi, my name is Linnea. I’m a nurse and health coach. I’m trained through FMCA. And, yeah, so like Amy said, our members that come through Nosis, they get a medical evaluation, and Dr. Amy is working with them, getting these in-depth lab testing, and we’re able to see what their specific needs are but then also… We have a wonderful multidisciplinary approach to taking care of our members. So, besides getting a physician or provider and a health coach, they get a therapist, and all of us work together to take care of these people in recovery.

And so it’s just really, really neat. I get to onboard our members as they come in and do an hour-long intro where we dive into their story, and their history, and why they’re here, and why do they desire to feel better in their body as they’re going through recovery. And then we are their biggest touch point, right? So, Dr. Amy or other providers see them once every three months, maybe a little sooner if needed at first. Our therapists are seeing them once a month, maybe twice a month. But as coaches, we’re seeing our members weekly. And so we are the main touch point. We’re spending the most time, virtually face-to-face with our members, just a very strong touch point, and that has been really phenomenal.

So, Dr. Amy gives them some guidance on, “This is what I’m seeing with your labs, and I really think we should go this way,” or, “We need to work on insulin resistance,” or, “We need to work on cholesterol,” whatever it is. And then we come together and set those SMART goals. And what can we do, and what seems feasible, and what is attainable, taking really small steps. But it’s just really impactful. Hearing Duffy’s story when we first started working together, he was in recovery for quite a number of years feeling miserable in his body. He’s like, “I’m sober but I feel like garbage.” And then he found functional medicine, made lifestyle changes, changed his nutrition, changed his activity level, worked on stress management, got better sleep. And he will tell you now that it feels good to be in recovery, and this is what living really feels like.

So, just being sober is not enough. And I think a lot of us, even if we’re not in the addiction recovery world, can understand that, right? Just having a medication take away our symptoms doesn’t make us feel better, and lively, and vibrant. And so we need these modifiable lifestyle behaviors. And so that’s really a cool thing as a coach is walking alongside someone, and watching them, and supporting them as they make these decisions to make these changes. And change is hard, so you need that person to come alongside you. So, it’s been a really amazing joy to support our patients and our members.

Dr. Sandi: Well, I hear the joy in your voice, your excitement. You clearly are in a profession as a health coach and this role that is bringing you joy.

Linnea: Absolutely.

Dr. Sandi: And then we hear that so much amongst our graduates. And you are an FMCA graduate. This is a career that brings transformation to you as a coach with every encounter. And I’m curious of the role of families of support networks. Do you have… Because there’s Al-Anon and families have traditionally been involved in the recovery process, but how does that work with your program with Nosis?

Dr. Amy: That’s a really good question. You’re right. Families are impacted by all chronic disease in some way or another. If they have a family member that has heart disease or a lifestyle-related cancer or diabetes, families are definitely impacted. But with mental health and substance use disorder, families are just impacted in such incredibly powerful, and tragic, and at times beautiful ways. And so we don’t have specific family engagement within our program, but all of our patients have to have… Well, we encourage all of our patients to have a family member that’s on their treatment team in the sense that we have a release to talk to those families. And so we really try to engage family members, specifically if patients are having a particular challenge. But we have members who actually bring family members to visits, specifically around nutrition. That’s a big one. So, Linnea actually has a couple of members that bring their spouses to meetings so that they can really work together to start implementing some of these behavioral changes. I don’t know if you want to speak a little bit more to that, Linnea, but it’s really powerful.

Linnea: Absolutely. That’s the main thing that I see is that we welcome multifamily members in our coaching sessions, right? There’s a time and a place. There’s really important time to have that one-on-one space where the member can feel at ease to share whatever. But then at the same time, I’ve also… I just recently had a member that came on and brought his wife because she does a lot of the cooking in the house. And so we had a great collaborative meeting, and she had a ton of questions about what’s best for him. It was a really fun dynamic to see them together, “No, I don’t do that.” “Yes, I do.” But just talking through it and just having some space for the other people in the house that are touched by these lifestyle things, right? We often are influenced by the people we’re around, and so if family members are willing to take on these lifestyle changes as well, it can be incredibly impactful and supportive for the person going through it themselves. So, yeah. So, we definitely welcome it. Like Dr. Amy said, there’s nothing very specific, but we definitely welcome joint meetings. Absolutely.

Dr. Sandi: Yeah, there’s something just as that family member wouldn’t set up a bar.

Dr. Amy: Exactly.

Dr. Sandi: And the same thing if they’re eating out or we know that people tend, in families or people, eat the way their friends eat or there’s a lot of social pressures in families, or there’s a family member who doesn’t understand, “Why do we have to eat fresh whole foods?” That person could be very addicted to ultra-processed foods or sits on the couch and watches television and doesn’t want to go out and take a walk. But if the whole family is committed to getting healthier together, then that would be going the one way towards ensuring the success of what you’re doing. But speaking of what you’re doing, Linnea, do you have any issues in terms of building trust and rapport with people who may be distrustful and they may have experienced trauma or may in other ways have some challenging issues? So, how do you find working with these individuals?

Linnea: Absolutely. So, one of the very cool things about Nosis is that all of us coaches so far are in recovery ourselves. And that is hugely impactful. So, I have a food addiction. And even though it’s not a substance use in the traditional term, it is substance for me for ultra-processed food and sugar. I have to stay completely abstinent.

Dr. Amy: For a lot of people. For a lot of people, especially people with substance use disorder.

Linnea: Absolutely, right? Cross addiction can be very, very strong. Think about going to an A.A. meeting and it’s caffeine and cookies, right? You trade one substance for the other.

Dr. Amy: And cigarettes.

Linnea: But many of our coaches are in long-term recovery from a substance, alcohol or drugs, that they have overcome. They’re in active continued recovery. And there is something really powerful about building that relationship, saying, “I understand. I’m in recovery. I’m watching the walk. I’m talking the talk.” And that goes a long way with building rapport. There still are definitely challenges, but that has been the one thing that we are really proud of and we hope to be able to continue. And as we grow and need more health coaches, finding health coaches that have that personal recovery story or even in their family, right, impacted by a family member. And so they have this really strong understanding. And so that is an immediate rapport builder right away.

But spending that time to share our story with them before they share theirs with us so that they know that this is a safe place that they can trust us. And then being consistent. Consistency is really, really important. And that I’ve found is one of the biggest struggles with someone that has some trauma concerns or is having a hard time actively staying in recovery and sober from their substance. There is that fall off, not coming to sessions and not messaging back and so staying consistent and consistent and sharing that with them so that they then can feel ready to be consistent as well.

Dr. Sandi: Makes sense. Such a good model. So, Dr. Amy, we often hear I heard it was at an event this past weekend at a conference and the implication was conventional treatment is really the only way and particularly A.A. that you cannot recover unless you are going to A.A. meetings and talking about it as if that is the only option. So, do you get pushback or can functional medicine be a replacement or is it enhancement? And I know you touched on this earlier, but can you comment on that?

Dr. Amy: That’s a really good and important question that I’m glad you asked because I want to be very clear that, first of all, everybody has their own path to recovery from whatever it is—food, behaviors, substances. There are a million ways to skin a cat here. But functional, integrative, lifestyle medicine, no matter what you want to call it, this is complementary to evidence-based treatment for substance use disorder, and I want to make that incredibly clear. We are not saying that by getting your labs done, by taking supplements, by changing your nutrition, that you’ll somehow be able to become sober and be in long-term recovery. Maybe somebody could do that.

But in our program, medication management—especially for people that are high risk for overdose fatalities, like with opioid use disorder—the use of buprenorphine or getting people into opioid treatment programs to use methadone or using Vivitrol is absolutely first line. We have to do that first. We have to treat people’s behavioral health diagnoses—depression or anxiety—specifically with evidence-based medications if they need it. And we need to bring people into clinical therapeutic models, whether it’s with our therapist or using an outside therapist. We often have people that are running parallel intensive outpatient programs with us, and we need to use all of those evidence-based treatment modalities.

And then bringing in lifestyle still as foundational. I consider it the third leg of the stool, 100%. Dealing with the physiologic catastrophes that happen with substance use disorders through lifestyle medicine and through functional testing is absolutely the third leg, but it’s complementary to all of our evidence-based treatments. And just another word about 12-step or abstinence-based models, Duffy is a 12-step guy. A lot of our members are 12-step guys and gals. So, A.A./NA is critical for some of our members, but it doesn’t always translate for everyone. And so I think we just really use all the tools in our toolkit because this is a really challenging disease process, and we need as many tools as we can possibly get. And functional integrative lifestyle medicine is one of the most important tools we have.

Dr. Sandi: That’s so true. Can you describe your model in terms of collaboration? We talk about a collaborative care team at FMCA. We train our students to work at a collaborative care team and this is the collaborative care model. So, what does that actually look like between the health coaches and the other members of the team, the therapists, the physicians?

Linnea: So, we meet as a team every other week and go over case studies, concerns. We have active, within our EHR, our secure health record, we have care team message boards. And we’re very active in reading each other’s notes. We’ve worked very hard to make our notes simplified and collaborative so that everybody understands each other’s notes. We all read each other’s notes. We’re in contact with each other. We have specific parts in our note at the very end that says like “red flags for the care team.” We are consciously and consistently thinking about who’s going to see this person next, what do they need to know, and working together. I had a member with some… I had some concerns for what he shared with me that day. I immediately sent a message to Dr. Amy, and she rolled with it, and then I circled back. So, we are a small, unified team that works really well together. We stay on top of everything very well and beautifully. I don’t know if you have anything to add for that, Amy.

Dr. Amy: Yes, this is a big missing piece in all areas of medicine, I think, but specifically in the treatment of people with addiction. Their care is often very fragmented. They have a physical health doctor over here, a psychiatrist over here, maybe a therapist over here, maybe someone else managing their nutrition. So, it can be very fragmented. And for someone, especially in early recovery, that is just… It almost never works. People always fall through the cracks. No one’s communicating with each other.

And so our vision from the very first moment that we conceived this idea—Duffy and myself—was to have everybody on one EMR, everybody using one specific kind of note framework so that we can really be collaborative with integrity. And there’s very few things that sort of slip by. Patients have sort of this… They don’t have “sort of.” They have a safety net built into place because what we really want to do is to catch problems early so that people don’t have to go to a higher level of care. They don’t end up back in the ER, end up back in the hospital, or end up back in an expensive residential treatment episode. So, that’s really part of our mission is to create a safety net so that people don’t have to be constantly going back into higher levels of care because it’s expensive, it’s disruptive, it’s traumatizing. And so that’s really part of our vision, and I think we’re doing it pretty well. We have to figure out how to scale it, but that’s sort of the next piece of our story.

Dr. Sandi: Yeah, well, you read my mind, because that’s what I wanted to discuss with you, because this is such an impactful, such a beautiful model that deserves to be scaled. And also one of the questions I always get every time I give a talk, you get a lot of talks about how to onboard a health coach, why you need a health coach in your medical practice. But the question that comes up, how do I pay a coach? So, would you care to comment on how is that reimbursed? How are the services of a health coach reimbursed? And again, is your model… Is it insurance-based, private practice? Is it private pay? Is it a grant? Can you describe that?

Dr. Amy: Yeah, so right now we’re cash-based. We are gathering enough patients to have a small sort of pilot group. And we have those patients now, and we’re collecting a lot of data, so a lot of data around abstinence, self-efficacy, quality of life, also using medical symptoms questionnaires to follow physical health symptoms, and then using outcomes around laboratory analysis. So, we’re gathering all of this data in hopes that, as we become funded, so we’re just going into our first fundraising rounds now, we can actually bring on more coaches, more therapists, more providers, and we’re working to scale this model. And our hope is that by collecting this data and getting some really good outcomes, we’ll probably start with employers first and create an employer-based model where we get a certain amount of reimbursement for each member and hope to provide some return-on-investment data for employers so that then we can hopefully move on to hospital systems and then onto insurance-based systems, value-based care, things like that. So, our coaches are reimbursed within our larger model. Does that answer your question?

Dr. Sandi: Absolutely, yes. And plans to grow. Hire more coaches. How many coaches do you currently have, Linnea? And you are head coach.

Linnea: Yes. Yep. I’m the director of health coaching, and there are four others besides me.

Dr. Sandi: All right.

Linnea: Yeah. And so it must be…

Dr. Sandi: Yeah, so… I’ll ask each of you what do you see in the future of addiction recovery? What would your ideal… If you had a magic wand, what would you see in the future for Nosis as well as the whole field of addiction recovery?

Dr. Amy: I don’t know if this sounds narcissistic or… I don’t know. I mean, I want us… We will be the model. This is the way that people with all chronic disease should be treated, with this holistic, collaborative, safety net type of care. But for people with substance use disorder who are arguably the most sensitive, vulnerable humans that we take care of, we have to start building in innovative, thought-provoking, data-driven, outcomes-driven treatment. And that’s really what Nosis is. I mean, Duffy and I want to plant a flag in the space, and we want this model to be the flagship, to be the essence of treatment for people with addiction. And that’s my vision. That’s Duffy’s vision. And Linnea, you need to tell us what your vision is, what your thoughts are.

Linnea: Well, I second everything Amy said. I mean, I just feel so honored to have come in on the ground level with Nosis, and I’ve been there from day one. And seeing their very first member is that it’s just been a joy and a privilege, and I’m loving every minute of it. So, I assume my hope and dream for addiction recovery is that, especially going through this Nosis model with lifestyle changes and really looking at real health, is that people in recovery own it and are proud like, “Yeah, I’m a person on recovery because I have more resilience and health in my body than other people that have not gone through recovery, right?” There is something so powerful about having gone through something so life-altering, challenging, impactful, gut-wrenching…

Dr. Amy: Devastating.

Linnea: Yes, that when you get to the other side, you are this rock of a person. And to have the Nosis side where it’s not just that mental stability and vibrancy but that health vibrancy and to say like, “I have taken my body and my mind through the trenches, and I’ve come out the other end. And I am proud of where I am.”

Dr. Sandi: Yes. Yes. Well…

Dr. Amy: Well said.

Dr. Sandi: Oh, absolutely. I am so excited about your mission, to see you grow, and I’m right there with you. And I would like to see extending because we tend to think of addiction recovery as alcohol addiction, drug addiction, but we have a growing food addiction with all the…

Dr. Amy: Which is huge.

Dr. Sandi: We haven’t touched on… which is a huge problem but social media addiction, porn addiction, young people, men…

Dr. Amy: Gambling.

Dr. Sandi: Yes, gambling addiction.

Dr. Amy: Internet gambling.

Dr. Sandi: Yes. Yes, people who are in their rooms, they don’t go out, they don’t socialize. They are just on their screens. This is a serious issue. And it’s all tied into our growing mental health crisis where they’re not eating the right foods, they’re not moving their bodies, they’re not getting fresh air or getting adequate sleep, good relationships, community. We’ve lost this and so I think that your mission can be broader to look at applying this functional medicine model. Functional medicine is the future of medicine. And when we have a functional medicine doctor with a functional medicine health coach, that can be the future.

Dr. Amy: Yay.

Dr. Sandi: Make it happen. So, well, it has been an absolute pleasure to talk to you. Where can people find you if they want to know more about Nosis, about your work?

Linnea: nosis.health is our website. Absolutely, go to nosis.health and you will learn about us and our program. As things change and grow, we’ll update the website. I know individually you can find me on a lot of the social media platforms @healthy_looks_good_on_you and I know Dr. Amy has a LinkedIn that will provide the link as well.

Dr. Sandi: Fabulous. Well, I know there will be a lot of interest from our health coaches who are listening to say, “I want to be part of that,” as well as people who may be wanting recovery for themselves or for a loved one. And I’m assuming you serve people around the country, around the world?

Dr. Amy: Not yet. Not yet. We are in process of a big fundraising sort of exercise, and we hope to have a national offering within the next probably 60 to 90 days that will be coaching based. And then we will be expanding out our medical platform to a few different states.

Dr. Sandi: Okay, and I should have asked that at the beginning, where are you?

Dr. Amy: Utah. Right now we are currently providing care in Utah because that’s where I’m based and our therapist is based here. Yeah, but like I said, we will be expanding on a national level sooner than later and then in specific states as we start to grow. Yeah, and if anyone wants to get in touch with me specifically, I’m amy@nosis.health and I’m happy to answer questions for providers, for coaches, for patients, for families, for anyone.

Dr. Sandi: Wonderful. Well, this has been absolutely an honor to talk to you, to see your excitement about this mission and I’m in to help you grow this wonderful model. So, thank you so much for being on “Health Coach Talk.”

Dr. Amy: Thank you for having us.

Linnea: It was a pleasure. Absolutely. Thank you.