Drugs and prescribing

1,225 articles · Since 2007

Physicians writing on KevinMD about the drugs they prescribe and the ones they cannot get: prior authorization and step therapy, opioid prescribing and the tapers that followed the CDC guideline, the GLP-1 drugs from Ozempic to oral Wegovy and what happens when patients stop them, shortages, compounded versions, and what a prescription costs the patient. Three maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words, Prior authorization: what physicians say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

Latest articles

Are 12-step programs maligned because they sell nothing?

Martha Rosenberg

October 13, 2026Oct 13, 2026

Twelve Step programs like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous are free, self-supporting, and do not advertise. That's why many do not know about them and their success rate. Instituted in the 1930s, such programs promote no drugs and…

Twelve Step programs like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous are free, self-supporting, and do not advertise. That’s why many do not know about them and their success rate. Instituted in the 1930s, such programs promote no drugs and use no psychiatric or psychology experts, relying instead on peer-to-peer healing and often meeting in church basements.

In the last decade, drugmakers and insurance companies, distressed by all that non-prescription health …

Does nicotine cause cancer? What clinicians should say

Giorgi Mzhavanadze

October 13, 2026Oct 13, 2026

A patient considering a nicotine patch asks, "Doesn't nicotine cause lung cancer?" A reassuring answer should not minimize nicotine's risks. It should explain why a nicotine patch and a cigarette are not medically equivalent. Our survey in Ukraine suggests that…

A patient considering a nicotine patch asks, “Doesn’t nicotine cause lung cancer?” A reassuring answer should not minimize nicotine’s risks. It should explain why a nicotine patch and a cigarette are not medically equivalent.

Our survey in Ukraine suggests that this distinction warrants attention. Healthy Initiatives collected 1,538 responses to a questionnaire targeting health care professionals between October 2025 and September 2026. Asked to identify the most harmful components of smoking, …

Hunger after stopping tirzepatide can feel like burning

Patience C. Ennis

October 5, 2026Oct 5, 2026

When my hunger returned, it felt as though my stomach was burning from the inside out. It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with…

When my hunger returned, it felt as though my stomach was burning from the inside out.

It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with hunger that intense. My attention narrowed to what I could eat to make it stop.

I am a registered nurse with more than thirty years of clinical experience. I have had bariatric …

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Does CVS controlled substance policy put patients at risk?

Arthur Lazarus, MD, MBA

October 2, 2026Oct 2, 20262

Recently, a close friend called me in a panic. He was running dangerously low on lorazepam and asked if I could prescribe a small, bridging quantity over the weekend until his regular refill was due in a few days. As a physician, I wanted to help, but I first advised him to do what any reasonable patient would: call his pharmacy, CVS, explain the situation, and ask for a sliver …

What did the tirzepatide study actually test?

Jeffrey Laman, MD

September 28, 2026Sep 28, 2026

If you take Ozempic, Wegovy, Mounjaro, or Zepbound, or you are simply trying to make sense of GLP-1s (glucagon-like peptide-1) and GIPs (glucose-dependent insulinotropic polypeptide), you may have seen a recent Medscape article asking whether GIP really adds any benefit in type 2 diabetes. It is a fair scientific question. The problem is that the headline makes the answer sound much clearer than it is.

The study behind the article, …

The conflict of interest that discloses as nothing

Martha Rosenberg

September 23, 2026Sep 23, 2026

With 66 percent of U.S. adults, some 131 million people, now taking prescription drugs, and with Medicare drug spending running into the hundreds of billions, it is worth asking how the pharmaceutical industry came to occupy so central a place…

The FDA announced this month that it is hiring more than 2,000 employees, rebuilding after reductions …

Why cannabis use disorder and withdrawal go unnoticed

Ginger Constantine, MD

September 20, 2026Sep 20, 2026

Cannabis use disorder (CUD) and cannabis withdrawal syndrome (CWS) have been recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for more than a decade. Researchers have documented symptoms of anxiety, irritability, insomnia, depression, decreased appetite, intense cravings, physical symptoms, and more. Despite years of published evidence, cannabis use disorder remains one of the most underrecognized and under-resourced substance use disorders in health care. The latest findings from …

How fentanyl misinformation turns suspicion into fact

Lynn R. Webster, MD

September 16, 2026Sep 16, 2026

Numbers do not have to be fabricated to mislead. They can be technically accurate and still create a false story when "detected" becomes "caused," "involved" becomes "alone," and a preliminary suspicion becomes a headline. This dynamic played out following a…

Numbers do not have to be fabricated to mislead. They can be technically accurate and still create a false story when “detected” becomes “caused,” “involved” becomes “alone,” and a preliminary suspicion becomes a headline.

This dynamic played out following a May 2026 emergency in Mountainair, New Mexico. Three people died in a home where investigators found fentanyl, para-fluorofentanyl, and methamphetamine, while eighteen first responders later reported symptoms such as nausea, …

The nociplastic pain question new pain therapies avoid

Amir Friedman, MD

September 15, 2026Sep 15, 2026

Systematic review data puts the prevalence of central sensitization features among knee osteoarthritis patients at approximately 36 percent by validated instrument. More than one in three patients carrying an orthopedic diagnosis you trust, presenting with pain that structural intervention may…

In my last piece, I argued that glucagon-like peptide-1 (GLP-1) pharmacology and neurotechnology …

mRNA hype moves faster than the evidence behind it

Harry Oken, MD

September 12, 2026Sep 12, 2026

mRNA technology may be both a remarkable scientific tool and a very effective marketing machine. Those are not mutually exclusive. The challenge is distinguishing a promising platform, a useful treatment, and a product promoted beyond what the evidence can support.…

In early 2020, COVID-19 was frightening. We did not know how readily the original strain would spread or how much illness and death it would cause. We soon learned that risk …

Side effects of osteoporosis drugs the trials never proved

Michael Duben, MD

September 10, 2026Sep 10, 2026

I have spent nearly twenty-five years treating osteoporosis. The drugs have gone from oral and intravenous bisphosphonates to several classes with better efficacy and, mostly, better tolerability. Their reputation has gotten worse. Some of that is a jaundiced view of the pharmaceutical industry, some the internet doing what the internet does. But a meaningful share comes from the government. The Food and Drug Administration (FDA) prints warnings its own trial …

Is personalized antithrombotic therapy ready for practice?

Anahita Dua, MD, MBA

September 6, 2026Sep 6, 2026

Peripheral artery disease (PAD) affects millions of Americans and remains a leading cause of disability, repeat hospitalizations, and limb loss. Advances in endovascular devices, surgical techniques, and medical therapies have dramatically improved our ability to restore blood flow to the…

Following lower extremity revascularization, most patients are prescribed blood thinners to help prevent clot …

The 2026 7-OH ban will hit dependent users the hardest

Julie Craig, MD

September 3, 2026Sep 3, 2026

"If you violate our rule, we are going to make you pay for it. You could be looking at up to 30-year prison sentences, and believe me, we will be looking to make some examples of bad actors." With these…

“If you violate our rule, we are going to make you pay for it. You could be looking at up to 30-year prison sentences, and believe me, we will be looking to make some examples of bad actors.”

With these words, Florida’s attorney general announced the state’s June 2026 scheduling of 7-hydroxymitragynine (a short-acting psychoactive agent that shares common properties with both opioids and stimulants) and other concentrated derivatives of …

Are opioid prescribing rates really driving overdoses?

Hunter Dlugas

September 3, 2026Sep 3, 2026

There very well may have been times throughout our country's history where opioids have been overprescribed, such as the Civil War era and 2000 to 2010. Of course, determining whether opioid prescribing is actually excessive requires one to quantify an…

There very well may have been times throughout our country’s history where opioids have been overprescribed, such as the Civil War era and 2000 to 2010. Of course, determining whether opioid prescribing is actually excessive requires one to quantify an association of opioid prescription rates with some relevant population characteristic (e.g., opioid overdoses per capita). Failing to consider the relationship between opioid prescription rates and any other population characteristic …

GLP-1 weight regain: We are funding the wrong half

Hana Kahleova, MD, PhD, MBA

September 1, 2026Sep 1, 2026

I have some version of the same conversation every week now. A patient is starting semaglutide or tirzepatide, and partway through the visit they ask the question I suspect most of us are hearing constantly: What happens if I ever…

For a while I gave the honest-but-incomplete answer, that we’d cross that bridge when we got there. I don’t anymore, because I think the real answer has less to do …

Are peptides safe? What the evidence actually shows

John K. Smith, MD

August 31, 2026Aug 31, 2026

Peptides are rapidly becoming one of the most talked-about developments in modern medicine. They are being positioned as solutions for weight loss, muscle recovery, anti-aging, skin health, and overall performance. Patients are increasingly arriving at appointments with detailed questions about…

At a foundational level, peptides are not experimental substances. They are short chains of amino acids, essentially small proteins, …

Sliding scale insulin is a 1934 idea in a 2026 hospital

Michael Duben, MD

August 28, 2026Aug 28, 2026

Somewhere in a hospital right now, a physician is ordering a sliding scale of short-acting insulin to be given before a meal, at a dose set by the premeal blood glucose. Not a correction dose for hyperglycemia on top of a meal dose. The meal dose. Blood glucose before a meal describes what has already happened. It says nothing about whether the tray holds 20 g of carbohydrate or 90. …

How supplement fraud slips past a certificate of analysis

Alisa Sano, MPH

August 27, 2026Aug 27, 2026

In our first article, we discussed the international regulatory clash between U.S. supplement mandates (21 CFR 111) and foreign food/supplement laws. This gap can lead to inadequate dietary ingredient identity verification. "We review a Certificate of Analysis (CoA) for 100…

“We review a Certificate of Analysis (CoA) for 100 percent of our globally sourced ingredients.” This is a frequently offered defense by supplements’ brand owners when challenged on international supply chain vulnerabilities. To a physician, this defense sounds like an …

The Seroquel controversy most doctors have forgotten

Martha Rosenberg

August 27, 2026Aug 27, 2026

Few drugs boast the rap sheet of Seroquel (quetiapine). After the pharmaceutical industry marketed atypical antipsychotics like Seroquel as amazingly superior to older antipsychotics like Thorazine and Haldol (pay no attention to their same tardive dyskinesia side effects), Seroquel became its manufacturer’s second-best-selling drug globally, behind only Nexium and netting $5.3 billion in 2011. Many have forgotten Seroquel’s contested past, including how an early proponent went to prison in …

Is your patient’s new symptom a prescribing cascade?

Narinder Singh Parhar, MD

August 26, 2026Aug 26, 2026

Modern scientific medicine has given humanity extraordinary tools. Antibiotics transformed once-lethal infections into treatable illnesses. Cardiovascular medications prevent strokes and myocardial infarctions. Insulin, anticoagulants, immunotherapies, psychiatric medications, and countless other treatments have extended and improved millions of lives. The problem…

The problem is not medication. The problem begins when our capacity to prescribe becomes greater than our discipline to ask whether every intervention remains necessary. That distinction is increasingly important in an aging …

Drugs and prescribing

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