Drugs and prescribing

1,242 articles · Since 2007

Articles, page 15

The complications of drug regulation

May 19, 2021May 19, 2021

When the "opioid crisis" is mentioned, most people think of heroin, prescription pills like oxycodone, or — more recently — the powerful synthetic opioid fentanyl. Fewer people would think of novel opioids like tianeptine, although an increasing number of Americans…

When the “opioid crisis” is mentioned, most people think of heroin, prescription pills like oxycodone, or — more recently — the powerful synthetic opioid fentanyl. Fewer people would think of novel opioids like tianeptine, although an increasing number of Americans have taken this substance in the form of over-the-counter supplements like ZaZaRed or Tianna – often without knowing that the substance has opioid properties that can cause dependence and overdose. …

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The complications of drug regulation

Cannabis stigma continues to impede patient care

Jill Becker, MD

May 9, 2021May 9, 20214

"My grandchildren are appalled." So said the elderly patient I saw yesterday. This lovely woman came to our practice for the treatment of extreme pain. At 99-years of age, she has survived multiple cancers and their associated treatments. She is…

“My grandchildren are appalled.”

So said the elderly patient I saw yesterday. This lovely woman came to our practice for the treatment of extreme pain. At 99-years of age, she has survived multiple cancers and their associated treatments. She is now suffering from debilitating, degenerative joint pain. She has tried over-the-counter medications and opioids and is simply desperate for relief. Yet her major concern is what her grandchildren will think. As …

Practicing medicine without a license is illegal. Yet cannabis dispensaries are doing it.

Jill Becker, MD

April 14, 2021Apr 14, 20212

I look forward to clinic days. I thoroughly enjoy meeting with patients, hearing how they’re doing, and helping them to feel better - even if, on occasion, the only thing I can do to help is to listen. Yesterday was…

I look forward to clinic days. I thoroughly enjoy meeting with patients, hearing how they’re doing, and helping them to feel better – even if, on occasion, the only thing I can do to help is to listen.

Yesterday was a clinic day.

In the middle of the morning, I met with a medical cannabis patient treated for anxiety. As we reviewed his current symptoms, medications, and how he is benefitting from …

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The pandemic’s epidemic: opioid use disorder and subpar suboxone access

Claire Simon, MD & Jonathan Staloff, MD

March 26, 2021Mar 26, 2021

The COVID-19 pandemic has devastated America’s health, taking more than 500 thousand American lives, upending the economy, and perpetuating racial health disparities. It also has worsened the country’s ongoing opioid use disorder (OUD) epidemic. In fact, in the twelve-month period ending June 2020, 83 thousand Americans died of a drug overdose, the highest ever recorded in a one-year period and 21 percent higher than the previous year. This dramatic increase in overdose deaths is mostly attributable to the synthetic opioid fentanyl.

The U.S. …

The updated benzodiazepine boxed warning: What you need to know

Christy Huff, MD

March 23, 2021Mar 23, 2021

“I am my story as I would like to raise awareness about the dangers of benzodiazepines and advocate for stronger warning labels.” I paused to wipe away tears before typing the final words of Bobbi’s report into the FDA’s MedWatch…

“I am [sharing] my story as I would like to raise awareness about the dangers of benzodiazepines and advocate for stronger warning labels.”

I paused to wipe away tears before typing the final words of Bobbi’s report into the FDA’s MedWatch online reporting system. Bobbi, a physician assistant, was forced into medical detox by her state medical board after suffering adverse effects from prescription clonazepam. Six years …

The confusing policy surrounding the buprenorphine X-waiver

Julie Craig, MD

March 18, 2021Mar 18, 2021

In the waning days of the Trump administration, a surprising announcement came down from the Department of Health and Human Services (HHS) that the barrier required to write buprenorphine prescriptions for opioid use disorder would be lifted via reform of…

The X-waiver is a rare regulation in American medicine that requires an 8-hour training and documented DEA permission before a medical doctor can prescribe Suboxone to

…

Cannabinoids are medicine, but patients aren’t getting the care they need

Jill Becker, MD

March 9, 2021Mar 9, 20212

It’s Wednesday at 3:27 p.m. I was just in the kitchen cutting potatoes for a belated birthday dinner which, ironically, will be happening very early this evening. I noticed a missed text on my phone and decided to call back,…

It’s Wednesday at 3:27 p.m.

I was just in the kitchen cutting potatoes for a belated birthday dinner which, ironically, will be happening very early this evening. I noticed a missed text on my phone and decided to call back, as was requested. It was from a member of “a network of licensed physicians” as they are looking for Massachusetts physicians credentialed to certify for medical cannabis. I am one of …

6 unconscious biases against vitamins and supplements

Melinda Ring, MD

January 28, 2021Jan 28, 20214

Like many scary health scenarios where patients seek some modicum of influence, the COVID-19 pandemic has led to patient demand for “immune-boosting” dietary supplements. Toilet paper wasn’t the only essential item being limited by stores; bottles of zinc and vitamin C flew off the shelves as consumers stocked up. The role of vitamin D in COVID-19 has been conflated and deflated depending on

…

My Klonopin withdrawal story

Bethany Silverman

January 20, 2021Jan 20, 2021

It was September 11, 2001. My dad had cheated on my mom again, the building that I worked in at that time had received an anonymous tip that we were a potential target for the terrorist attacks, and my mom, who needed a reprieve from my dad’s crap, was vacationing in Florida and was worried for me and my well-being. Plus, my dad was threatening to kill himself, and I …

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My Klonopin withdrawal story

Merging the wisdom of pain medicine and addiction medicine to optimize outcomes

Julie Craig, MD

January 16, 2021Jan 16, 2021

Family lore recalls that my grandfather, succumbing to stomach cancer in the mid-1960s, “died addicted to morphine.” Decades before the AIDS crisis sparked the hospice and palliative care movements, the confluences of pain, dependence, and addiction were confused and regrettably moralized. Since then, the science has excelled, but our clinical understanding of how pain and addiction intertwine remains limited by stigma, assumptions, and the separation of the underlying science

…

How can we improve the quality of medications?

J. Leonard Lichtenfeld, MD

September 30, 2020Sep 30, 2020

Do you know what it’s like to sit in a meeting and learn that something you hold close as a fundamental principle is probably not as fundamentally true as you thought? That’s the way I felt earlier this week while…

Do you know what it’s like to sit in a meeting and learn that something you hold close as a fundamental principle is probably not as fundamentally true as you thought?

That’s the way I felt earlier this week while attending a meeting on the quality of pharmaceuticals, sponsored by the Food and Drug Administration and Duke University’s Margolis Center for Health Policy.

The meeting—a …

The Trump administration is systematically undermining women’s reproductive rights

Alexa Lindley, MD & Emily Godfrey, MD & Monica Agarwal, MD

September 14, 2020Sep 14, 20203

Just this week, the administration asked the U.S. Supreme Court to reverse a lower court ruling allowing women to receive telemedicine abortion services and pills delivered by mail during the COVID-19 pandemic. If Trump wins, millions of women across the…

I met one such woman in my clinic a few months ago. She was a teenager, and she was tearfully anxious. She

…

Clearing the misinformation surrounding medical cannabis

Kevin Hill, MD & Samoon Ahmad, MD

September 6, 2020Sep 6, 20203

An excerpt from Medical Marijuana: A Clinical Handbook. Imagine two patients sitting in the waiting area of a clinic. The first is a man in his sunset years who has recently begun treatment for stage 2 lung cancer. His treatment…

An excerpt from Medical Marijuana: A Clinical Handbook.

Imagine two patients sitting in the waiting area of a clinic. The first is a man in his sunset years who has recently begun treatment for stage 2 lung cancer. His treatment involves the use of chemotherapy, which has significantly reduced his appetite and given him terrible bouts of nausea. The second is a woman in her 30s. She …

Why is the government so scared of directly negotiating drug prices?

Robert Laszewski

August 29, 2020Aug 29, 20206

President Trump recently signed two executive orders directly related to prescription drug prices in the U.S. One order would allow the "reimportation" of prescription drugs from Canada. This longstanding idea would allow U.S. pharmacies and drug wholesalers the ability to…

President Trump recently signed two executive orders directly related to prescription drug prices in the U.S.

One order would allow the “reimportation” of prescription drugs from Canada. This longstanding idea would allow U.S. pharmacies and drug wholesalers the ability to pay generally much lower prices for their prescription drugs by getting them from Canadian suppliers who benefit from government management of the system. Many consumers have been buying direct from Canadian …

Many medical marijuana program websites are silent about possible risks

Erik Messamore, MD, PhD

August 4, 2020Aug 4, 2020

Click through North Dakota's Division of Medical Marijuana website, past the addresses of every cannabis dispensary in the state, into the presentations and annual reports, and you'll eventually come to a 32-slide presentation about the state's medical marijuana program. You'll…

Click through North Dakota’s Division of Medical Marijuana website, past the addresses of every cannabis dispensary in the state, into the presentations and annual reports, and you’ll eventually come to a 32-slide presentation about the state’s medical marijuana program. You’ll see the 26 diseases that can be treated with marijuana, a colorful flowchart showing the types of available marijuana, and a

…

Patients in Sweden received fewer post-op opioids. Why is that?

Richard Young, MD

July 2, 2020Jul 2, 20203

When I was in Sweden, I heard this phrase several times: “There is no such thing as bad weather, just bad preparation.” They said this when we asked them what they did with their children in dead of winter. The proud parents made it very clear that no matter what the weather, when it is time to go outside for recess at school, or to get out of the house …

It is unethical for the United States to send hydroxychloroquine to Brazil

Charles E. Binkley, MD

June 7, 2020Jun 7, 2020

Much controversy surrounds whether or not hydroxychloroquine is effective in preventing or treating infection with COVID-19. While much of the data so far suggests that hydroxychloroquine is not effective at treating COVID-19, and perhaps that it might even be harmful,…

Why remdesivir may not be a wonder drug

Daniel Hopkins, MD

May 31, 2020May 31, 2020

Gilead's $1,000-a-pill antiviral remdesivir is no wonder drug. We knew this when it failed for hepatitis, the disease it was created for. And then when it failed for Ebola. And then again, when it failed for COVID-19. But like a…

Gilead’s $1,000-a-pill antiviral remdesivir is no wonder drug. We knew this when it failed for hepatitis, the disease it was created for. And then when it failed for Ebola. And then again, when it failed for COVID-19.

But like a bolt, in late April, a breakthrough: in a second trial for COVID-19 patients, remdesivir sped time to recovery—proof of benefit, …

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Why remdesivir may not be a wonder drug

Are there reasons to doubt remdesivir?

Daniel Hopkins, MD

May 23, 2020May 23, 20202

On April 29th Anthony Fauci announced the National Institute of Allergy and Infectious Diseases, an institute he runs, had completed a study of the antiviral remdesivir for COVID-19. The drug reduced time to recovery from 15 to 11 days, he said, a breakthrough proving “a drug can block this virus.” Now people are clamoring for $1,000-a-pill remdesivir.

While the results were preliminary, unpublished, and unconfirmed by …

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Are there reasons to doubt remdesivir?

4 small changes to help your practice now

Andrew Mellin, MD, MBA

May 17, 2020May 17, 2020

This time of COVID-19 has brought us to a scenario of scale and scope that most had never planned for. Whether you are at a small practice or a large one, you are likely looking for ways to rapidly evolve…

Many physician practices are trying to do more with less in terms of how and where they are spending their …

Drugs and prescribing

Articles, page 15

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