Physicians writing on KevinMD about prescribing: the prior authorization that stands between a prescription and a pharmacy, opioids and the tapers that followed the CDC guideline, GLP-1 drugs and what happens when patients stop them, compounded and direct-to-consumer drugs, shortages, and what a prescription costs the patient. Three maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

The conflict of interest that discloses as nothing

Medications
September 23, 2026

With 66 percent of U.S. adults, some 131 million people, now taking prescription drugs, and with Medicare drug spending running into the hundreds of billions, it is worth asking how the pharmaceutical industry came to occupy so central a place in American health care. Several recent developments show how the relationship works.

The FDA announced this month that it is hiring more than 2,000 employees, rebuilding after reductions …

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The conflict of interest that discloses as nothing

How fentanyl misinformation turns suspicion into fact

Medications
September 16, 2026

Numbers do not have to be fabricated to mislead. They can be technically accurate and still create a false story when “detected” becomes “caused,” “involved” becomes “alone,” and a preliminary suspicion becomes a headline.

This dynamic played out following a May 2026 emergency in Mountainair, New Mexico. Three people died in a home where investigators found fentanyl, para-fluorofentanyl, and methamphetamine, while eighteen first responders later reported symptoms such as nausea, …

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How fentanyl misinformation turns suspicion into fact

Is personalized antithrombotic therapy ready for practice?

Medications
September 6, 2026

Peripheral artery disease (PAD) affects millions of Americans and remains a leading cause of disability, repeat hospitalizations, and limb loss. Advances in endovascular devices, surgical techniques, and medical therapies have dramatically improved our ability to restore blood flow to the legs. Yet despite this progress, one challenge continues to limit long-term success: what happens after the procedure.

Following lower extremity revascularization, most patients are prescribed blood thinners to help prevent clot …

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Is personalized antithrombotic therapy ready for practice?

The 2026 7-OH ban will hit dependent users the hardest

Medications
September 3, 2026

“If you violate our rule, we are going to make you pay for it. You could be looking at up to 30-year prison sentences, and believe me, we will be looking to make some examples of bad actors.”

With these words, Florida’s attorney general announced the state’s June 2026 scheduling of 7-hydroxymitragynine (a short-acting psychoactive agent that shares common properties with both opioids and stimulants) and other concentrated derivatives of …

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The 2026 7-OH ban will hit dependent users the hardest

Are peptides safe? What the evidence actually shows

Medications
August 31, 2026

Peptides are rapidly becoming one of the most talked-about developments in modern medicine. They are being positioned as solutions for weight loss, muscle recovery, anti-aging, skin health, and overall performance. Patients are increasingly arriving at appointments with detailed questions about specific compounds, often influenced by social media, wellness clinics, and direct-to-consumer marketing.

At a foundational level, peptides are not experimental substances. They are short chains of amino acids, essentially small proteins, …

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Are peptides safe? What the evidence actually shows

How supplement fraud slips past a certificate of analysis

Medications
August 27, 2026

In our first article, we discussed the international regulatory clash between U.S. supplement mandates (21 CFR 111) and foreign food/supplement laws. This gap can lead to inadequate dietary ingredient identity verification.

“We review a Certificate of Analysis (CoA) for 100 percent of our globally sourced ingredients.” This is a frequently offered defense by supplements’ brand owners when challenged on international supply chain vulnerabilities. To a physician, this defense sounds like an …

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How supplement fraud slips past a certificate of analysis

The Seroquel controversy most doctors have forgotten

Medications
August 27, 2026

Few drugs boast the rap sheet of Seroquel (quetiapine). After the pharmaceutical industry marketed atypical antipsychotics like Seroquel as amazingly superior to older antipsychotics like Thorazine and Haldol (pay no attention to their same tardive dyskinesia side effects), Seroquel became its manufacturer’s second-best-selling drug globally, behind only Nexium and netting $5.3 billion in 2011. Many have forgotten Seroquel’s contested past, including how an early proponent went to prison in a …

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The Seroquel controversy most doctors have forgotten

Why a supplement supply chain hides behind its label

Medications
August 19, 2026

“I bought this premium multivitamin online,” Patient A tells you during a routine history-taking at the annual checkup. “It’s a prominent Japanese brand. Since people over there have such long life expectancies, this has to be safer and purer than a domestic brand, right?”

As a health care provider, you would find it easy to agree. Countries universally recognized for longevity and high-quality standards enjoy an organic, built-in reputation for wellness …

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Why a supplement supply chain hides behind its label

BPC-157 safety remains uncertain without human evidence

Medications
August 14, 2026

This patient had done everything right. Six months earlier, he had come into my office barely able to lift his arm above shoulder height, the result of a rotator cuff injury that had quietly worsened over a year of ignoring it. We treated it with the art of clinical approach: an image-guided intra-articular injection to calm the inflammation, followed by a disciplined course of physical therapy. He showed up for …

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BPC-157 safety remains uncertain without human evidence

Why medical cannabis for seniors is surging

Medications
August 14, 2026

Seniors are increasingly turning to cannabis to find relief from the suffering and medical indignities of aging. I see this every day in my primary care clinic. Whether it is the grinding discomfort of chronic pain, the anxiety associated with losing friends and abilities, or the soul-crushing misery of insomnia, older adults are discovering that medical marijuana can often do what many of our standard prescriptions cannot. They are finding …

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Why medical cannabis for seniors is surging

Prescription drug suicide risk is still being hidden

Medications
August 12, 2026

What if you were an MD/researcher at a top 10 medical school who came face-to-face with a lethal side effect to a popular drug? But, when you tried to reveal it, you were engulfed by a legal and professional character assassination campaign that included threats against your academic position and journal publishing history, physical surveillance by private investigators, and even a home break-in?

That is the basic plot of the newly …

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Prescription drug suicide risk is still being hidden

Fentanyl interdiction will not end the overdose crisis

Health Policy
August 12, 2026

Overdose deaths are falling in the United States, a sign of genuine progress. But President Trump’s claim that his administration has nearly stopped drugs from entering the country by sea confuses an interdiction statistic with an overdose-prevention strategy.

Trump has repeatedly asserted that his administration reduced maritime drug arrivals by 97 percent or more. That figure, however, merely compares drug seizures across two selected months. Because seizures measure what …

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Fentanyl interdiction will not end the overdose crisis

3 realms every drug development leader must bridge

Medications
August 11, 2026

Pharmaceutical research and development (R&D) has never lacked scientific ambition. The more challenging issue is transforming good science into programs that operate efficiently, address the right questions, and ultimately enhance patient care. This necessitates a different type of R&D leader.

Traditional research leadership often emphasizes depth in a scientific discipline. While that expertise is crucial, modern drug development is no longer a series of isolated scientific tasks; it is a comprehensive …

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3 realms every drug development leader must bridge

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BPC-157 is promising but unproven, a surgeon warns

Medications
August 11, 2026

Decades in the operating room have taught me that the brain is akin to a spiderweb: fragile, interconnected pathways. When trauma or disease hits neural tissue, our toughest battle is protecting blood flow, controlling swelling, and keeping cells alive under extreme stress. That’s probably why researchers are captivated by BPC-157, or Body Protection Compound 157.

This synthetic 15-amino-acid peptide mimics a tough protective protein found naturally in human gastric juice. Unlike …

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BPC-157 is promising but unproven, a surgeon warns

Direct-to-consumer drug ads turn doctors into speed bumps

Medications
August 4, 2026

While recuperating from my shoulder replacement (and after signing the usual stack of preoperative forms absolving the surgeon, the hospital, the anesthesiologist, and possibly the parking attendant of every imaginable complication, including dying on the table), I had a lot of time to watch television. Daytime television. The kind with a steady rotation of direct-to-consumer pharmaceutical ads.

If you ever want to understand the state of American medicine, don’t read policy …

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Direct-to-consumer drug ads turn doctors into speed bumps

Why drug advertising is not the public service it claims

Medications
August 3, 2026

I have authored previous articles on pharmaceutical advertisements. I noted that they used glitz to sell their products, which was not helpful to patients, especially as many new products had potentially more severe side effects than older ones and were not necessarily more effective. The only significant difference may be that newer products are more expensive.

Safety is a greater concern at present, as the Food and Drug Administration (FDA) has …

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Why drug advertising is not the public service it claims

Semaglutide and cravings: what the 2026 trial changed

Medications
July 31, 2026

Patients start glucagon-like peptide-1 (GLP-1) drugs expecting to think less about food. They did not expect to think less about alcohol. The nightly drink became easier to skip. Cigarettes felt less urgent. Cannabis, gambling, or compulsive shopping sometimes lost their pull. As “food noise” quieted, another possibility emerged: Perhaps these drugs were turning down craving itself.

At first, these reports might have seemed like coincidences. Instead, they sparked new research. Scientists …

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Semaglutide and cravings: what the 2026 trial changed

Big Pharma’s drug marketing got stealthy, and you are the target [PODCAST]

Podcast
July 29, 2026
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

The pharma rep with the free lunch is gone. What replaced it is harder to see, and aimed at you and your doctor. Martha Rosenberg is an investigative reporter who has worked at …

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Big Pharma’s drug marketing got stealthy, and you are the target [PODCAST]

Why the fear of drugs in pregnancy can do its own harm

Medications
July 18, 2026

Marc Stone, MD served as deputy director for safety in the FDA Center for Drug Evaluation and Research’s Division of Psychiatry until 2024.

Martha Rosenberg: Recent news items about Tylenol and SSRIs in pregnancy can bring up memories of thalidomide and DES scares. Can you offer perspective?

Marc Stone: The thalidomide crisis was horrifying and so graphic, but the drug was never approved in the U.S., and there were only a few …

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Why the fear of drugs in pregnancy can do its own harm

What is the Medicare GLP-1 Bridge program?

Medications
July 2, 2026

As our understanding of obesity as a chronic disease has evolved, one paradox has been the ongoing barriers to accessing effective therapeutics for this condition, an approach vastly different from the way we treat other chronic diseases like heart disease, hypertension, or cerebrovascular disease.

Thankfully, that era has ended, and in July of this year, Medicare will begin covering access to GLP-1s for the treatment of obesity.

Why is this important for …

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What is the Medicare GLP-1 Bridge program?

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