I don’t want to need it.
That is a thought that has been all too familiar to me when I venture on the patient side of health care, an industry that I study as a scholar as well with the distance of one investigating a foreign land in which they do not intend to become entrenched.
It is a thought that has been all too familiar as I see added to my …
Prescription drug savings: You have to know where to look
Prince died of an opioid overdose. A tragic and avoidable fate but, even more tragically, one that is becoming increasingly common in the United States. Some people who overdose live on the edge of society–homeless and with no access to good medical care. Prince, by contrast, had several mansions and a number of physicians actively involved in his care, physicians aware of his problem with opiates. …
Did Prince die because he had bad doctors?
It’s an unmitigated disaster. One hundred million pain patients. Millions addicted to opioids, hundreds of thousands dead. Pain patients abruptly cut off medication they’ve depended on, sometimes for decades, and offered nothing to replace it. Doctors, fearful of prosecution for overprescribing, dropping pain patients like hot potatoes. Pain patients unable to find any doctor that will treat them. Patients turning to heroin when they can’t get their prescription painkillers. Articles …
The opioid disaster: Stop criminalizing doctors
Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.
I have a proposal to make: over-the-counter antibiotics.
(Insert tongue-in-cheek here.)
Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I …
Why not make antibiotics over the counter?
Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted.
During the same time, I had a case of the blues. I am overstressed at work with several staff on vacation, my college-age children had come home and then left to start their internships, and my …
How Tylenol may relieve both physical and emotional pain
She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to treat her multiple sclerosis? Nope. It was insulin, a drug that has been around for decades.
The price of many drugs has been on the rise of late, not just new …
What’s behind the rising cost of insulin?
The news media is hooked on the opioid prescription drug abuse story. Every day, it seems, I read a new announcement:
What I learned about prescription drug abuse from San Diego
Let’s get this straight. I am a doctor, but I didn’t cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must be to blame.
The truth is that death from opioid abuse is on the rise. The Centers for Disease Control and Prevention (CDC) has …
I am a doctor, but I didn’t cause the opioid epidemic
When I meet strangers, and they ask what I do for a living, the conversation tends to go something like this: I tell them I’m a physician. They ask what type. I say that I am a general internist, but I focus mainly on addiction…addiction to prescription opioids (painkillers) and heroin. Invariably, people will say something like, “This has become such a big problem.” I agree, but then they will …
Drug addiction is a problem that requires treatment, not punishment
I recently had an enormous kidney stone. Well OK, it seemed enormous to me. But in terms of kidney stones, it was reasonably large; 9 mm, in fact. Large enough that I had to have lithotripsy (the use of sound waves to break up the stone) performed by my friend and most excellent urologist, Dr. Robert McAlpine in Seneca, SC.
As uncomfortable as the whole experience was (and it wasn’t my …
Don’t forget the power of over the counter remedies
Of life’s two certainties, death, and cataracts, it seems statins defer one and prompt the other, although not necessarily in the same person. If you blindly love life, you may be blinded by your love for life.
In the HOPE-3 trial, ethnically diverse people without cardiovascular disease were randomized to 10 mg of rosuvastatin daily and placebo. The treatment group had fewer primary events: death from myocardial infarction (MI), …
Opioids, also known as opiates, serve as important prescription medications in medical practice. But within the last decade or so, because of their overuse, misuse and abuse, they’ve also emerged as a leading cause of addiction and death.
Sadly and surprisingly, those most instrumental in creating this epidemic — however unwittingly — are physicians and the pharmaceutical industry.
The question is, how could this crisis have happened? What responsibility should physicians take, …
How the medical profession can solve the opioid crisis
“Does anyone have thoughts about Mr. Jones?” I ask around the table. My primary care team sees veterans who were recently homeless. Many have been severely injured, and half have chronic pain. We have wise nurses, a committed social worker, and something else: time to focus on a vulnerable group.
And here we are today we have Mr. Jones. A bit about his case. He has a history of shoulder pain dating …
If all we talk about are pills for pain, we are having the wrong conversation
ADVERTISEMENT
Over 2 million Americans abuse or are dependent on prescription pain medications. These patients are in the office of every physician in the country, but only 3 percent of primary care providers offer them treatment.
Many patients are being given a sympathetic apology, a hotline to call, or a dead-end referral. Some of them are being sent to methadone clinics, which are often impractical, already-full, or deeply stigmatized. Others make their …
All primary care doctors need a buprenorphine waiver. Here’s why.
Over the past week, while covering the inpatient gastroenterology service, we cared for three patients who were hospitalized with gastrointestinal bleeding who were found to have large, potentially life-threating, stomach ulcers. All three of the patients had abruptly stopped their acid-suppressing proton pump inhibitor (PPI) medication in the preceding 1 to 2 weeks. With PPIs being a primary therapy for gastroesophageal reflux and ulcer treatment, why would these patients have …
Dementia from PPIs: A hypothesis that may have led to gastrointestinal bleeding
On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and …
Are essential oils safe for children?
The microbiome is among the hottest topics in medical and scientific research. The National Institutes of Health and private foundations have invested hundreds of millions of dollars in research to define and characterize the human microbiome. In the next decade, billions more will be devoted to deciphering how microbes influence human health in a positive manner. The White House even issued a national call to action for …
A gastroenterologist shares practical advice on probiotics
Psoriatic arthritis can be a debilitating condition. It can lead to painful complications such as neuropathy. Its treatments can lead to complications such as shingles, which can leave a patient with continuing pain. Ehlers-Danlos Syndrome is for most patients a painful condition that leads to spontaneous dislocations, early arthritis, and frequent migraines. My husband and I have decades of experience between us in living with these conditions.
My husband and I …
It’s time for an honest conversation about pain management
Activism over prescription drug pricing has reached a fever pitch. The recent House subcommittee hearings featuring testimony (or non-testimony in the case of bad-boy Martin Shkreli) from Turing Pharmaceuticals and Valeant executives provided an outlet for public outrage over those companies’ price gouging on life-saving drugs. Meanwhile, presidential candidates Hillary Clinton and Bernie Sanders have both talked up plans to rein in spending on prescription drugs, and even Donald Trump …
Ignore Martin Shkreli. Focus on drug prices instead.
Dear drug reps,
I write you today as a primary care provider who — at the risk of giving you “the keys to the kingdom” — has advice for you.
First, I am not anti-pharma. I recognize the need that my patients and I have for new medications, and I believe that innovation in medicine can grow from free enterprise. But it’s rare that I walk away from an interaction with you …
Insider tips for drug reps to get more face time with clinicians
Get free updates delivered free to your inbox.
