Meds

The testosterone surge: Are men chasing solutions or creating new risks?

Meds
December 13, 2024

Among men, even before COVID-19, the popularity of testosterone therapy since 2000 likely outpaced the clinical need. There have been a number of proposed reasons for this, such as increased direct-to-consumer marketing for low testosterone treatments and the rise of clinics based around testosterone prescribing hidden under the guise of “men’s health.” Much of this growth was seen from 2000-2013 in older men before a decline around the time the …

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Navigating patient transitions following the withdrawal of Oxbryta

Meds
November 21, 2024

The withdrawal of Oxbryta (voxelotor) from global markets, announced by Pfizer after a recent data review revealed a rise in deaths and complications, has left sickle cell disease (SCD) patients in a precarious situation. The sudden nature of the announcement caught the patient and physician community off guard, as there was no prewarning. For an already narrow world of options available to people with sickle cell disease, this came as …

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Are you taking FDA-unapproved drugs without knowing it?

Meds
November 6, 2024

If you think the labyrinth of U.S. government agencies and congressional subcommittees is complicated, be grateful you are not a pharmacy owner! Just to get your drugs reimbursed, you must navigate a river of upstream, midstream, and downstream suppliers, health plans and insurers, employers and other payers (including federal and state governments), rebate aggregators, “white and brown baggers,” and an alphabet soup of entities/concepts called things like PSAOs, GPOs, NADACs, …

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The hidden medication putting Parkinson’s patients at risk

Meds
October 14, 2024

At the doctor’s office, in the ER, in the hospital, how many times are you asked about your drug allergies? A lot! And, as a common practice when in the hospital, you’ll even get a red bracelet or something to indicate such. There are strict rules around allergies; from techs to transport to MDs, hospital staff are well-trained to look for these bracelets and to make sure that you don’t …

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How drug and soap commercials are manipulating you

Meds
October 5, 2024

Having worked as a copywriter and creative director at some of the world’s top ad agencies, including McCann Erickson (now McCann Worldgroup), I am vehemently critical of new advertising. Why? I know the tricks and how they manipulate well — think the old TV series Mad Men.

Leading the list of ads that I hate are direct-to-consumer (DTC) drug ads which began in the late 1990s. I am especially critical of …

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GMP vs. non-GMP: the hidden truth about your supplements

Meds
September 24, 2024

Suppose you are looking for multivitamin supplements. You pick up two containers of multivitamins and wonder which one you should get. At first glance, they have similar labels, but then you notice that one has a comment indicating that the supplement was manufactured in a registered GMP-compliant facility, and the other does not.

Then you ask yourself the following questions: How much of what ingredients are included in proprietary blends? Where …

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Doctors beware: the hidden legal risks of following CME guidelines

Meds
September 14, 2024

I have a problem with some of the continuing medical education courses offered by large health care institutions, even those like Harvard and Mayo, which have outstanding reputations for evidence-based medicine. That’s because what they teach, although scientifically sound and in line with the Department of Health and Human Services and CDC recommendations, can get you prosecuted and convicted by the DEA. If you get targeted for practicing the way …

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Doctors under fire: Is the DEA turning them into drug dealers?

Meds
September 7, 2024

In the state of New York (you already know it’s going to be bad), a doctor and a pharmacist were arrested in a sting operation conducted by a joint task force of the DEA, FBI, IRS, and probably CIA and CBS, though I have no proof of the latter two. The doctor, Mordechai Bar, and the pharmacist, Feroze Nazirbage, have been accused of “violating their oaths,” something you almost never …

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Why isn’t medical advertising regulated like other advertising?

Meds
September 7, 2024

As long as you live, you will never hear an article from news media contending that “America Runs On Duncan.” Why? Because the line is a marketing allegation created by the advertising company and designed to sell product.

Yet news media repeat medical claims from drug makers found in journals like they are news––which gives Pharma companies free advertising and can mislead consumers and patients.

The most recent example is the “news” …

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The long strange trip of psychedelic drugs

Meds
September 5, 2024

In the mid-1960s, the Grateful Dead were the house band for Ken Kesey’s Acid Tests, parties in which people were “tripping out” on LSD, parties that helped bring psychedelics into the counterculture. Psychedelic drugs have been the focus of extensive clinical research since then, and their potential therapeutic benefits have seen renewed interest in recent years. It’s been a long, strange trip for certain because, despite extensive research, there are …

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Clinicians should not overlook the benefits of botanicals and dietary supplements

Meds
August 24, 2024

A patient recently came to my office seeking antibiotics for her viral URI symptoms. After a shared decision-making discussion on using Echinacea (an immunostimulant with antiviral, anti-inflammatory, and antimicrobial effects) instead, we were able to forgo the unnecessary antibiotic. Approximately 25 percent of U.S. adults report concurrently taking a dietary supplement with a prescription medicine. As a resident physician in primary care, I regularly receive questions from patients regarding …

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A game-changer in methamphetamine treatment

Meds
August 22, 2024

The standard treatment for methamphetamine poisoning is “sedate and wait.” There is no antidote to methamphetamine; instead, we typically aim to cover up the unwanted symptoms. We prescribe our favorite sedative, Ketamine or a B52 cocktail (Haldol 5, Ativan 2, Benadryl 50), and often multiple dosages are required to control the agitation and ensure the safety of both the patient and …

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A true win for the DEA and society at large

Meds
August 19, 2024

In most physician prosecutions for treating pain or addiction, there is never any actual evidence of criminal intent. Just the nebulous argument that a doctor “ignored the risk of overdose,” “ignored the risk of addiction,” or performed “an insufficient medical exam.” I have a big problem with these because the doctor didn’t ignore anything in about 80 percent of the cases I evaluated. Indeed, the DEA had to lie to …

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From conviction to appeal: a doctor’s opioid case sparks debate

Meds
August 14, 2024

A doctor in Virginia named Joel Smithers was serving a 40-year sentence in an Atlanta prison when he won his appeal to the 4th Circuit. No, he didn’t shoot someone. That’s probably 25 years. He treated patients in pain. Now, he will get a new trial where he will be bludgeoned again with false metrics and innuendo. To ensure that the benefit of the doubt prevails, a Reuters article starts …

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The truth behind opioid use disorder

Meds
August 12, 2024

Anyone reading health care news today must be aware that American medicine – particularly pain medicine – is in crisis. Doctors are experiencing high levels of burnout due to administrative burdens, prior authorization demands, and a health care system that often prioritizes efficiency over patient care. This burnout is leading to mental health issues and, in some cases, physician suicides.

Medicare payments to physicians have decreased by 26 …

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Are rapid weight loss drugs hiding the real obesity problem?

Meds
August 10, 2024

According to some academics, in 2019, a ban on junk food advertising across London’s entire public transport network—foods and drinks high in fat and salt and ads for foods–resulted in the prevention of 100,000 obesity cases. Yet the U.S. love affair with the new semaglutide-based weight loss drugs like Ozempic gives junk food advertising and availability a huge pass.

Drug makers and Wall Street are pleased that instead of changing …

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Are you storing your medications wrong?

Meds
August 3, 2024

Today, I want to talk about how creative humans are. As physicians, we encounter patients with ideas that amaze us every day and make our lives interesting, to say the least. The best ones are often the elderly, who have years of experience and unique ways of getting things done that differ greatly from the current generation.

I came across an elderly patient in the office who had previously been diagnosed …

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Are Ozempic patients on a slow-moving runaway train?

Meds
July 30, 2024

Have you ever heard of a drug called Ozempic? Just kidding. As we all know, this medicine and numerous related drugs are the rage. It is classified as a GLP-1 drug. The percentage of my patients who are taking these drugs is steadily rising. Of course, initially, Ozempic’s purpose was in diabetic management. Once it was discovered that weight loss was a “side-effect,” a new therapeutic mission was discovered. Indeed, …

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How weight loss drugs are creating a medical dilemma

Meds
July 22, 2024

On my outpatient clinical rotations last year, I saw ample management of heart disease and smoking cessation counseling. I also saw the annual physicals and checkups. But what surprised me was how many patients were on medications that were just now becoming more mainstream. I’m sure you’ve heard of one in particular—Ozempic. But it wasn’t just Ozempic. There was also Wegovy and Mounjaro. These medications, in the family of semaglutides, …

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To anesthetize, or not to anesthetize: a pervasive dilemma of the GLP-1 era

Meds
July 9, 2024

Since the United States Food and Drug Administration approved exenatide in 2005, it took decades for the American Society of Anesthesiologists (ASA) to identify and address perioperative safety concerns, if any, among patients using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as exenatide. This delay could be due to several factors: GLP-1 RAs were initially used only for managing diabetes and later for obesity, and now potentially for a wide …

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CME Spotlights