Drugs and prescribing

1,242 articles · Since 2007

Articles, page 29

What I learned about prescription drug abuse from San Diego

June 10, 2016Jun 10, 2016

The news media is hooked on the opioid prescription drug abuse story. Every day, it seems, I read a new announcement: The CDC has issued guidelines for prescribing opioids for chronic pain. The FDA has announced immediate-release pain medications will…

The news media is hooked on the opioid prescription drug abuse story. Every day, it seems, I read a new announcement:

The CDC has issued guidelines for prescribing opioids for chronic pain.
The FDA has announced immediate-release pain medications will need to have “black box” warning labels about the risk of addiction, abuse, overdosing and even death.
The White House has requested $1.1 billion in its 2017 budget to combat

…

I am a doctor, but I didn’t cause the opioid epidemic

Tanya Feke, MD

May 26, 2016May 26, 201629

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…

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 …

Drug addiction is a problem that requires treatment, not punishment

Chinazo O. Cunningham, MD

May 21, 2016May 21, 20166

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 …

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Don’t forget the power of over the counter remedies

Edwin Leap, MD

May 3, 2016May 3, 20164

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 …

God is in the statins

Dr. Saurabh Jha

April 18, 2016Apr 18, 201610

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…

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), …

Read more…

God is in the statins

How the medical profession can solve the opioid crisis

Robert Pearl, MD

April 14, 2016Apr 14, 201623

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…

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, …

If all we talk about are pills for pain, we are having the wrong conversation

Stefan Kertesz, MD

April 8, 2016Apr 8, 20164

“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 here we are today we have Mr. Jones. A bit about his case. He has a history of shoulder pain dating …

All primary care doctors need a buprenorphine waiver. Here’s why.

Alicia Agnoli, MD, MPH

April 8, 2016Apr 8, 20167

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…

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 …

Dementia from PPIs: A hypothesis that may have led to gastrointestinal bleeding

Corey A. Siegel, MD & Jeffrey Adler, MD & Jenna Koliani-Pace, MD & Shawn Shah, MD

March 24, 2016Mar 24, 20162

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 …

Are essential oils safe for children?

Justin Morgan, MD

March 13, 2016Mar 13, 20163

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 …

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Are essential oils safe for children?

A gastroenterologist shares practical advice on probiotics

Matthew Ciorba, MD

March 10, 2016Mar 10, 20162

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 …

It’s time for an honest conversation about pain management

Holly Clowers, MD

March 7, 2016Mar 7, 201623

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 …

Ignore Martin Shkreli. Focus on drug prices instead.

Naomi Freundlich

February 28, 2016Feb 28, 201614

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 …

Insider tips for drug reps to get more face time with clinicians

Paul B. Kubin, PA-C

February 22, 2016Feb 22, 2016

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…

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 …

Vaginal marijuana for menstrual cramps. Does it really work?

Jennifer Gunter, MD

February 11, 2016Feb 11, 20165

Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD. Foria claims they can treat the…

Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?

THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to …

The nightmare of medicine is the absurd price we have to pay

Manoj Jain, MD, MPH

January 27, 2016Jan 27, 2016100

A grandmother develops a boil that turns out to be a difficult-to-treat staph infection (MRSA). She needs high-powered antibiotics. A middle-aged man who received a blood transfusion decades ago now has hepatitis C and needs anti-viral medicine. A young woman…

The marvel of medicine today is that we can treat all three infections, and save the lives …

This doctor won’t prescribe Addyi, the “female Viagra.” Here’s why.

Jennifer Gunter, MD

January 9, 2016Jan 9, 20169

Addyi (flibanserin), the drug to increase female libido had a timid entry into the market with very few prescriptions considering the “hype.” Bloomberg Business reported 227 prescriptions in the first month. That’s a pittance considering Valeant paid $1 billion for…

I am unlikely to help Valeant recoup their investment, because the more I read about this drug, the worse it looks. Here’s why:

It barely works

One of the study endpoints (meaning …

Martin Shkreli speaks an inconvenient truth

Dr. Saurabh Jha

January 6, 2016Jan 6, 20167

I don’t subscribe to conspiracy theories. I never believed a second shot was fired. Nor do I believe that Bill Clinton was stalked on the grassy knoll. So I won’t speculate that Martin Shkreli’s arrest for alleged securities fraud that…

Just because something isn’t suspicious doesn’t mean that it isn’t odd.

Shkreli is a perfect poster child for rapacious …

How physicians can curb the prescription opioid epidemic

American Society of Anesthesiologists & Anita Gupta, DO, PharmD

December 31, 2015Dec 31, 201511

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. With the holiday season upon us, there is no better time to reflect on how we as physicians can better serve our patients -- not only in the…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

With the holiday season upon us, there is no better time to reflect on how we as physicians can better serve our patients — not only in the treatments we provide — but in how we tackle growing health issues such as the overuse and abuse of prescription opioid painkillers.

The problem

The United States is facing …

Pharmaceutical free speech is anything but free

Kenneth Lin, MD

December 30, 2015Dec 30, 201514

The American Medical Association (AMA) recently called for a ban on direct-to-consumer (DTC) advertising of prescription drugs and medical devices, arguing that this type of advertising drives the nation’s escalating drug bill by creating demand for new, expensive medications that are often no more effective than older ones. Since the first televised prescription drug ad aired in the U.S. in 1983, pharmaceutical companies have spent billions of dollars …