Medications
How Enhanced Recovery After Surgery solves our opioid problems
In retrospect, we were an addicted nation waiting to happen. Not from a self-indulgent culture, not from an unwillingness to suffer hardship, nor any of the generational criticisms of lack of grit. Our opioid crisis derives from an impatient culture that fears loss of health more than health care profit. With pain as most people’s proxy for health, we were …
Topoisomerase inhibitors and chronic pain
Topoisomerase inhibitors emerged in the American medical landscape in 1971, thanks to the discovery by Dr. Jim Wang of the E. coli omega protein. Topoisomerase I, an enzyme identified by Dr. Wang, plays a crucial role in DNA unwrapping from supercoiling. Supercoiling involves tightly wrapping DNA for storage and protection, requiring unwrapping for reading, a process in which topoisomerase is indispensable.
Topoisomerase comprises two main types, aptly named types I and …
Off-label prescriptions, side effects, and lawsuits: Navigating ethical and legal dilemmas
A recent TV advertisement attempted to recruit clients for a class action suit against a pharmaceutical manufacturer (PM) for a medication side effect (SE). The “cause of action” was unstated: was it the side effect’s existence or that the company failed to emphasize its severity?
The SE was acknowledged not only by the company but also the FDA, which nonetheless approved the medication (RX), determining that its benefits outweighed the side …
DEA overreach: a threat to doctors’ freedom in American medicine
Today, doctors’ liberty and property are at risk when they choose to treat a patient. Not because of some new law but because of the misapplication of old ones. The current opioid panic has essentially given the DEA free rein to target any physician whose medical practice they disagree with. This has created a serious problem in American medicine and a unique danger to health care providers in this country. …
Where do they come up with all those goofy names for prescription drugs, anyway?
An excerpt from Pills, Shills, and the Psychiatry Wars: Musings from the Drug Safety & Healthcare News Blog.
I was spreading pine straw around the bushes in my yard in Atlanta, Georgia, when I started thinking about … you guessed it! The goofy names that drug companies come up with for their prescription drugs.
Folks in the blue states are often interested in the customs of us red state folks since …
Gene therapies for chronic pain?
Gene therapy is starting to come into its own, and it will change medicine more profoundly than anything that came before. Just like when antibiotics were discovered almost exactly a century ago, we are on the cusp of another revolution in medicine. One that is orders of magnitude greater than antibiotics.
Recently, in China, five of six children born with an autosomal recessive otoferlin deficiency deafness were cured by the injection …
Ben Franklin’s timeless wisdom: a key to solving America’s opioid crisis
In 1736, Ben Franklin famously advised Philadelphians that preventing fires is better than fighting them. Mr. Franklin’s advice is just as applicable today in addressing America’s opioid crisis. Billions of opioid settlement dollars are being distributed to every state, and a portion of those funds should be allocated to preventing opioid addictions, not just buying fire extinguishers (Narcan) and fighting fires (medication-assisted therapy or substance use disorder treatment). Preventing opioid …
A manifesto for the next revolution in nocebo and placebo studies
An excerpt from The Power of Placebos: How the Science of Placebos and Nocebos Can Improve Health Care by Jeremy Howick. Copyright 2023. Published with permission of Johns Hopkins University Press.
“When he had asked me if I knew the cure for headache, I somehow contrived to …
Cannabis compounds and fracture healing [PODCAST]
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Join L. Joseph Parker, a research physician, as we explore a recent study published in the Journal of Bone and Mineral Research. Discover how two compounds found in cannabis, cannabidiol (CBD) and cannabigerol (CBG), may revolutionize fracture …
Drug prices and fast approvals can harm patients
An excerpt from Big Food, Big Pharma, Big Lies.
Few fail to be shocked at the rising prices of some prescription drugs. “Drug companies have raised prices relentlessly for decades while manipulating the patent system and other laws to delay competition from lower-priced generics,” reported the House Committee on Oversight …
Pain medicine realities: beyond the opioid crisis
In 1990, Ronald Melzack published a paper in Scientific American titled “The Tragedy of Needless Pain.” Many would regard Melzack as the “father” of pain science and the treatment of pain. In that paper, he described the science behind several observations that many clinicians and public health policy decision-makers would find startling in today’s hostile and fraught regulatory environment surrounding the U.S. opioid crisis.
… the fact is …
The erosion of compassion in medicine
With my first thrust on his chest, I shattered his sternum, feeling his bones crumble in my hands. His eyes were wide open but lifeless. Dried secretions crusted his lips. His dusky skin tone indicated my efforts would be futile. Nonetheless, I proceeded with cardiopulmonary resuscitation as I was trained to do.
Soon the room was bustling with medical residents and nurses. A controlled chaos ensued. We inserted a breathing tube …
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A doctor’s thoughts on The Retrievals podcast
I recently listened to the podcast mini-series The Retrievals. It was fascinating and absolutely worth a listen. It’s the story of a Yale infertility clinic where a nurse was stealing fentanyl and replacing it with normal saline. As a result, women ended up getting egg retrievals with only midazolam, no pain control. There were interviews with women who described the horrific pain of the procedures but didn’t feel that they …
Exploring psychedelic therapies [PODCAST]
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Join Thaís Salles Araujo, an internal medicine resident. Discover the potential benefits, challenges, and the need for greater awareness and education in integrating these therapies into modern medicine. Gain insights into the evolving landscape of patient care, with a …
Codeine cough syrup: a controversial classification
Did you know that promethazine with codeine cough syrup had a high risk of diversion and high risk of addiction? I didn’t.
From my experience, this is the only effective prescription cough medicine available. Sure, you can prescribe what is essentially over-the-counter dextromethorphan. But be ready when the patient throws a fit because that’s what they’ve been using for the last several days or weeks, and it wasn’t effective. Tessalon Perles …
Navigating medication prescriptions in a DEA-observed world
I sit in my clinic office, looking at today’s schedule. It’s a nice office with lots of white and pastels, modern furniture, an up-to-date computer, and a desk. I always wanted my clinic to look like something from the future, and now, after twelve years, it finally does. Besides the screen on my desk, there is a large screen on the wall to my left, the patient’s right. From my …
Psilocybin therapy explained [PODCAST]
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Join Lynn Marie Morski, a physician, attorney, and president of the Psychedelic Medicine Association. We’ll explore the historical roots of psilocybin, its emerging clinical applications, safety considerations, and the role of health care professionals in educating patients.
DEA’s criteria for identifying pill mills: a physician’s analysis
Many physicians reading this forum treat pain and addiction and may wonder what criteria the DEA believes to be indicative of a pill mill. The following is from a motion filed in federal court regarding the prosecution of a physician:
The government claimed in the motion that pill mills, “have been found to have common characteristics, including some or all of the following”:
- Clinics are cash only and do not accept …
Learn to be a Narcan hero: a comic tutorial
Discover the ins and outs of nasal Narcan alongside psychiatrist Emily Watters. In this comic tutorial, she’ll walk you through the steps in her signature straightforward style, helping you grasp the essentials and empowering you to be a Narcan hero. (Click to enlarge.)
Past Week
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Forced voicemail and diagnosis codes are endangering patient access to medications
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The One Big Beautiful Bill and the fragile heart of rural health care
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America’s ER crisis: Why the system is collapsing from within
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Why timing, not surgery, determines patient survival
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How early meetings and after-hours events penalize physician-mothers
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FDA delays could end vital treatment for rare disease patients
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Past 6 Months
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Forced voicemail and diagnosis codes are endangering patient access to medications
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How President Biden’s cognitive health shapes political and legal trust
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Why are medical students turning away from primary care? [PODCAST]
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The One Big Beautiful Bill and the fragile heart of rural health care
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Why “do no harm” might be harming modern medicine
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Here’s what providers really need in a modern EHR
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Recent Posts
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Addressing menstrual health inequities in adolescents
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How to advance workforce development through research mentorship and evidence-based management
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The truth about perfection and identity in health care
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Healing beyond the surface: Why proper chronic wound care matters
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Why specialist pain clinics and addiction treatment services require strong primary care
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Past Week
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
The One Big Beautiful Bill and the fragile heart of rural health care
-
America’s ER crisis: Why the system is collapsing from within
-
Why timing, not surgery, determines patient survival
-
How early meetings and after-hours events penalize physician-mothers
-
FDA delays could end vital treatment for rare disease patients
-
Past 6 Months
-
Forced voicemail and diagnosis codes are endangering patient access to medications
-
How President Biden’s cognitive health shapes political and legal trust
-
Why are medical students turning away from primary care? [PODCAST]
-
The One Big Beautiful Bill and the fragile heart of rural health care
-
Why “do no harm” might be harming modern medicine
-
Here’s what providers really need in a modern EHR
-
Recent Posts
-
Addressing menstrual health inequities in adolescents
-
How to advance workforce development through research mentorship and evidence-based management
-
The truth about perfection and identity in health care
-
Civil discourse as a leadership competency: the case for curiosity in medicine
-
Healing beyond the surface: Why proper chronic wound care matters
-
Why specialist pain clinics and addiction treatment services require strong primary care
-
