Drugs and prescribing

1,242 articles · Since 2007

Articles, page 23

The other opioid epidemic that we ignore

January 9, 2018Jan 9, 2018

“I made myself a hypodermic injection of a triple dose of morphia and sank down on the couch in my consulting room ... I told her I was all right, all I wanted was twenty-four hours’ sleep, she was not…

“I made myself a hypodermic injection of a triple dose of morphia and sank down on the couch in my consulting room … I told her I was all right, all I wanted was twenty-four hours’ sleep, she was not to disturb me unless the house was on fire.”
– Axel Munthe, MD, The Story of San Michele (1929)

When people in this country mention the opioid epidemic, most of the time it is …

Take a pill and stop aging. Really?

Stephen C. Schimpff, MD

January 6, 2018Jan 6, 2018

Part of a series. A pill to end aging. Is there or could there be such a pill? Some researchers think so. Many believe that rather than attack the causes and treatment of chronic illnesses one by one, it would…

Part of a series.

A pill to end aging.

Is there or could there be such a pill? Some researchers think so.

Many believe that rather than attack the causes and treatment of chronic illnesses one by one, it would be better to understand the biology of aging and from that learn how to slow the process and hence prevent or delay the onset of various …

Read more…

Take a pill and stop aging. Really?

Is there a PBM mafia?

Kevin R. Campbell, MD

January 4, 2018Jan 4, 2018

The New York Times reported that drug companies, insurers and pharmacies may “team up” to create effective monopolies. Company executives argue that this would be better for patients and would improve care and outcomes — however, nothing could be further…

Many patients and physicians have found frustration when attempting to prescribe a particular medication …

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Is there a PBM mafia?

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It’s time to make oral contraceptives available without a prescription

Jeffrey A. Singer, MD

January 2, 2018Jan 2, 2018

At his recent confirmation hearing, Alex Azar, President Trump’s nominee for secretary of Health and Human Services, was grilled by senators who wanted to know where he stands on requiring employers to provide oral contraception coverage in their employee health…

Relative risk reduction is a troublesome way to convey the benefits of treatments

Peter Ubel, MD

January 1, 2018Jan 1, 20182

How excited would you be about a medication that lowered your risk of cardiovascular death, heart attack or stroke by 1.5%? Excited enough to spend a few thousand dollars a year on the drug? I expect not. What if, instead,…

What if, instead, the drug reduced those same terrible outcomes by 20%? That’s probably enough benefit to interest some in the drug.

Well, those statistics come from the same clinical trial, evaluating the same drug. …

Here’s why direct-to-consumer drug ads need FDA oversight

Zachariah Tman

December 25, 2017Dec 25, 20174

Many physicians in different fields have voiced criticisms against direct-to-consumer (DTC) prescription drug ads. First, a 2013 survey found that 74 percent of physicians believe DTC drug ads overemphasize the benefits of the drugs and misinform patients. Steven Nissen, a Cleveland Clinic cardiologist, interviewed by Rebecca Ruiz on DTC prescription drug ads states, “It’s almost impossible for the public to actually parse the ads and come …

Did diet pills kill my co-worker and friend?

Jennifer Bradley, FNP-C

December 4, 2017Dec 4, 20173

I remember just moving to Atlanta and having breakfast with a new-found friend I had met while working at a hospital as a registered nurse. The food at our chosen eatery was far from great. But I must say, my friend’s enthusiasm for life, specifically living in Atlanta, was fulfilling enough to make me forget the chef’s lackluster culinary skills. She was warm, outgoing, adventurous, somewhat inquisitive — just what …

Here’s how to win the opioid war

Dr. Leonard A. Sowah

November 27, 2017Nov 27, 2017

Trump recently declared a national public health emergency. In this statement he was not talking about HIV or hepatitis C nor was he referring to the increased incidence of gun violence in the country. The president’s statements focused on a very different public health problem; he was talking about America’s high incidence of opioid-related deaths mostly from overdose.

This declaration has been met with various pronouncements including …

Read more…

Here’s how to win the opioid war

Don’t let the opioid crisis affect the treatment course for your patients

T.J. Matsumoto, PA-C

November 21, 2017Nov 21, 2017

Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. …

Who’s responsible for polypharmacy in the elderly?

Michael Kirsch, MD

November 20, 2017Nov 20, 20172

There's a common affliction that's rampant in my practice, but it's not a gastrointestinal condition. It's called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office…

There’s a common affliction that’s rampant in my practice, but it’s not a gastrointestinal condition. It’s called polypharmacy, and it refers to patients who are receiving a pile of prescription and other medications. I see this daily in the office and in the hospital. It’s common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists.

Of course, every doctor feels that he …

Battling the opiate crisis on the front lines

Tom Fowler, MD

November 16, 2017Nov 16, 2017

Jim Johnson is the director of the West Virginia Office of Drug Control Policy, and an advocate on the front lines of the opioid epidemic. During his previous job as the police chief from Huntington, WV he spearheaded a comprehensive initiative of education, syringe exchanges, and Naloxone distribution that has shown promising results in a community where up to 10 percent of the population is plagued with opioid dependence. His …

Drug price hikes sometimes have catastrophic effects on patients

Suhas Gondi & Zoe Tseng, MD

November 9, 2017Nov 9, 2017

When I found out my patient was in the hospital again for the third time in six months, I wondered why her asthma had flared. Was the cold weather bothering her? Was her treatment regimen inadequate? When I spoke with her, I discovered the heartbreaking truth: she had been limiting her albuterol inhaler use because she simply could not afford to take it as much as she needed.

For many of …

Why this anesthesiologist says “no” to fentanyl

Karen S. Sibert, MD

October 26, 2017Oct 26, 20178

No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice. I’ve been teaching clinical anesthesiology, supervising residents and medical…

I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in …

Beware of online retailers selling designer benzodiazepines

Abraham M. Nussbaum, MD

October 24, 2017Oct 24, 2017

One of Max’s friends taught him an easy way to buy shady drugs. What he learned almost killed him, and it opened my eyes to a hiding-in-plain-sight source of dangerous drugs that is amplifying the opioid epidemic. When Max (not…

When Max (not his real name) developed pancreatitis a decade ago, his physicians prescribed opioids to ease his extreme …

Don’t take opioids off the market. Make it harder to abuse them.

Zaina Qureshi, PhD

October 8, 2017Oct 8, 2017

How can we combat the opioid epidemic? One of the government’s most recent suggestions is to take Opana ER, an opioid indicated for very severe pain, off the market. The request, filed by the U.S. Food and Drug Administration in…

How can we combat the opioid epidemic?

One of the government’s most recent suggestions is to take Opana ER, an opioid indicated for very severe pain, off the market. The request, filed by the U.S. Food and Drug Administration in June, was linked to concerns of abuse-related HIV and hepatitis C outbreaks.

But removing access to opioids altogether isn’t the solution. There are individuals …

Why do we keep prescribing heroin for our patients?

Myles Gart, MD

September 27, 2017Sep 27, 20176

In order to fully understand the issues surrounding opioid prescribing practices, it is important to review a brief history of how these drugs came to market. Opium was the first opioid, derived from the sap of opium poppies whose growth…

In order to fully understand the issues surrounding opioid prescribing practices, it is important to review a brief history of how these drugs came to market.

Opium was the first opioid, derived from the sap of opium poppies whose growth and cultivation dates back to 3,400 BC. In the 18th century, physicians in the U.S. used opium for multiple ailments. Towards the end of the 18th century, the addictive qualities of …

The cost of drugs confounds this gastroenterologist

Michael Kirsch, MD

September 25, 2017Sep 25, 2017

Most of us do not know the basics of economics, although we should. It impacts every one of us every day that we are alive. Yet, for most of us, once we get beyond the law of supply and demand,…

Most of us do not know the basics of economics, although we should. It impacts every one of us every day that we are alive. Yet, for most of us, once we get beyond the law of supply and demand, our knowledge of the subject starts to vaporize. I can’t explain fiscal or monetary policy. While I regard economics as a science, it seems that experts routinely interpret data differently, …

Improving drug adherence will take more than money and technology

Skeptical Scalpel, MD

September 16, 2017Sep 16, 20173

I recently asked, “Who’s to blame?” for patients not taking their medications and cited a couple of papers describing the poor state of medication adherence. I concluded nonadherence was a huge problem, and doctors failing to educate their patients was…

To support my contention that physicians are not the reason why patients do not take their medications as ordered I submit the following new information.

A …

Dying at home: The problem hospices have with stolen opioids

Melissa Bailey

August 31, 2017Aug 31, 20173

Nothing seemed to help the patient — and hospice staff didn’t know why. They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain. The answer came…

Nothing seemed to help the patient — and hospice staff didn’t know why.

They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain.

The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high …

Want to stop the opioid epidemic? Stop prescribing opioids.

Jenny Hartsock, MD

August 24, 2017Aug 24, 201711

What is it like living in pain? Those of us who have ever experienced unremitting pain for months or years know that it is enveloping and all consuming. I struggled with intractable pain for several difficult years, and I am…

That is a horrible reality millions of people are living in right now. The chronic pain population …

Drugs and prescribing

Articles, page 23

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