Medications and Prescribing

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.

Navigating the prescription drug abuse epidemic

Chiduzie Madubata, MD

Medications

July 2, 2014

Over the past few months, more attention has been paid to the prescription drug epidemic, with increasing rates of accidental deaths noted across the country. Legislatures in different states are currently considering laws to provide first responders access to reversal agents, such as naloxone, to treat people found on the scene who have likely overdosed on these medications. With increasing media coverage, the public is becoming more aware about the …

The case of Makena: Speaking out against unfair drug pricing

Rekha Murthy

Medications

June 29, 2014

I’m 34 weeks pregnant and working hard to keep this baby inside me for as long as possible. As with my last pregnancy, there’s a real risk that the baby could come too early. But we’re both holding on so far, thanks to a combination of luck, modified bed rest and medical science.

The science is my biggest concern right now. I will spare you much of it because, man or …

E-cigarettes are an emerging threat to children

Afshine Ash Emrani, MD

Medications

June 29, 2014

There is a new emerging health threat to our children: nicotine poisoning.

The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year.

Here’s the fact every parent should know: 1 tablespoon of nicotine oil can be lethal to a 60-pound child!

When doctors were campaigning against tobacco companies through public health legislation, we did not foresee a resultant new market for …

It is wrong to subsidize rich, European nations

Peter Ubel, MD

Health Policy

June 12, 2014

People have criticized the Affordable Care Act for amounting to a large transfer of wealth, from wealthy Americans to those not as well-off. But the real transfer of wealth has been from United States to other developed nations, whose health care costs we have subsidized for many years by paying so generously for many of our health care services. No better example of this comes to mind than the price …

Dr. Bob Sears deserves blame for declining vaccination rates

Jennifer Gunter, MD

Medications

June 9, 2014

Baby-vaccination

Measles is on its way to an all time high.

In 2000, measles was eliminated (meaning some travelers from areas with low vaccine penetration might arrive in the U.S. with the disease, but no case came from U.S.), but has been slowly creeping back. Since 2008, this has been more than a trickle.

Let’s put the important goal of measles elimination in perspective. Before …

Applying the anti-vaccine mentality to car seats

Lucy Hornstein, MD

Medications

June 9, 2014

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What if a big TV station came out with a blockbuster story claiming that infant car seats were implicated in cerebral palsy (CP)? After all, something like 99.7% of babies diagnosed with cerebral palsy had been brought home from the hospital in a car seat. In fact, every single time they went anywhere in a car, they were strapped into them. That’s …

The problem with an anti-medication bias

Albert Fuchs, MD

Medications

June 6, 2014

“I don’t like taking medicines.”

All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans.

When I was new to practice such an utterance would shock and confuse me.

“I don’t want to take any medicines,” a patient would declare.

“That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going …

Find yourself a physician who is stingy with prescriptions

Roy Benaroch, MD

Medications

June 5, 2014

Antibiotic use is the direct cause of the rise of untreatable superbugs that are killing people.

Antibiotic use is also the cause of most cases of C. diff colitis in kids, a potentially life-threatening, difficult-to-treat gut disorder. Antibiotics have also been linked with recurrent wheezing in infants and inflammatory bowel disease. They can also trigger allergic reactions that can be …

Medical cannabis: Be informed and challenge the myths

Arielle Gerard, MD, MPH

Medications

June 1, 2014

Medical cannabis is a treatment option with a low risk of dependence, minimal side effects, and few detrimental health effects, that has the potential to help hundreds of thousands of people suffering from various debilitating symptoms. Medical cannabis has gotten a bad rap over the past several decades in the United States due to laws put into place in the early-mid …

The unintended consequences of marijuana legalization

Brian C. Joondeph, MD

Medications

May 31, 2014

Colorado and Washington are the first states to legalize recreational marijuana. In my state of Colorado, Amendment 64 was passed by 55 percent of voters by ballot referendum last year and took effect on January 1 of this year. State government officials are giddy with the prospects of increased revenue from marijuana sales. Marijuana tourism is booming in Colorado, giving new meaning to “Rocky Mountain High.” Now, four months into this new experiment, it may be worth looking …

Curing hepatitis C, but at what cost?

Albert Fuchs, MD

Conditions and Diseases

May 27, 2014

In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis: liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis …

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Curing hepatitis C, but at what cost?

It’s time for doctors to say no to drugs

James C. Salwitz, MD

Medications

May 22, 2014

The United States of America is addicted to narcotics. I do not mean the millions of individuals who are hooked. I mean the whole nation is jonesing for the stuff. I also do not mean the junk that slips into our nation in coffee cans or across midnight borders. I mean the billions of pills pouring off assembly lines. I could blame pharma or the FDA, but the truth is …

A holistic view on integrative medicine

David L. Katz, MD

Medications

May 21, 2014

I was recently on the Katie Couric Show to discuss integrative medicine. Somewhat ironically, I returned from Manhattan that same day to a waiting email from a colleague, forwarding me a rather excoriating critique of integrative medicine and asking me for my opinion.

The juxtaposition, it turns out, was something other than happenstance. The Cleveland Clinic has recently introduced the use of herbal medicines as an option for its patients, generating considerable media attention. Some of …

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A holistic view on integrative medicine

Lethal injection perverts the ethics of practicing medicine

Karen S. Sibert, MD

Medications

May 20, 2014

I give what could be lethal injections for a living.

That’s right. Nearly every day I give someone an injection of midazolam, vecuronium, and an IV solution containing potassium chloride–the three drugs in the “cocktail” that was supposed to kill convicted murderer Clayton Lockett quickly and humanely in Oklahoma.

Here’s the difference between an executioner and me. I use those medications as they are intended to be used, giving anesthesia to my …

A few thought-provoking questions about essential oils

Justin Smith, MD

Medications

April 29, 2014

I get asked a lot about essential oils. I answer very little. Why?

The answer is simply that we don’t know much about how or if they work. Except from stories about how they have helped certain people in certain situations, no one has done a large studies to truly evaluate their effectiveness or safety.

The main explanation for why they are used is that people (parents) are simply looking for something that’s an alternative to …

E-cigarettes lack scientifically based guidance

Ruth Macklin, PhD

Medications

April 17, 2014

The debate over e-cigarettes has been heating up. Are the smokeless, battery-powered, nicotine-dispensing devices a gateway to smoking for young people or a helpful way for smokers to quit? Public health experts can be found on both sides of the debate.

An article in the New York Times cited two leading figures, Dr. Michael Siegler from Boston University and Dr. Stanton A. Glantz from the University of California, San …

Did ProPublica unfairly target Dr. Yoav Golan?

Ford Vox, MD

Physician

April 14, 2014

A recent ProPublica expose co-published with the Boston Globe typifies a growing gotcha genre of health journalism that portrays doctors as the enemy in a struggle for honesty and openness in medicine. These reports make unfounded leaps in their efforts to subject doctors to levels of skepticism once reserved for politicians and lawyers. They’re going to end up doing patients a disservice. For this particular hunting expedition ProPublica set its sights on …

Why so many Americans believe in health care conspiracy theories

Deceased, MD

Physician

April 12, 2014

There is a JAMA article out that is very telling: Medical Conspiracy Theories and Health Behaviors in the United States. It is a must-read article for anyone who wonders why the public does not seem to advocate for themselves when it comes to their medical care in the US.

The first theory studied in the article states that the FDA is purposely preventing the public from getting natural cures …

For all those executed, the cause of death is homicide

Joel Zivot, MD

Physician

April 6, 2014

On March 10, I found myself at the front gate of the Florida State Prison, stethoscope and blood pressure cuff in hand, to examine Robert Henry at the request of his public defender.

Henry is scheduled to be executed Thursday evening by lethal injection. His crime was the murder of two people during a robbery more than 30 years ago.

He’s a 55-year-old African-American man with hypertension, elevated cholesterol, and a history …

The shocking ingredient in natural medicine

Pamela Wible, MD

Medications

April 3, 2014

So you think your medicine is natural. Ever wonder what’s inside? A product can be labeled “natural” if the main ingredient is from an animal, plant, or mineral. Arsenic, horse urine, and cow brain are natural. But are they natural for you? Here are four drugs whose origins may surprise you.

Insulin was discovered in 1922. Until the 1980s, all insulin was …