Medications

DEA’s criteria for identifying pill mills: a physician’s analysis

Physician

August 22, 2023

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 …
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DEA’s criteria for identifying pill mills: a physician’s analysis

Learn to be a Narcan hero: a comic tutorial

Emily Watters, MD

Meds

August 20, 2023

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.)

The importance of physician education regarding psilocybin therapy

Lynn Marie Morski, MD, JD

Meds

July 7, 2023

Psilocybin is a psychedelic compound produced by several species of mushrooms, which has been used for millennia across various cultures. It first gained broader awareness in the Western world during the 1960s and is now the subject of scientific inquiry due to renewed interest in the clinical applications of psychedelic medicines and psychedelic-assisted therapy.

Research into psilocybin and psilocybin-assisted therapy has found it to be effective in addressing a number of …

Ensuring medication safety: a shocking incident that exposed a dangerous flaw

Richard Plotzker, MD

Meds

June 28, 2023

At six-week intervals, I replenish my supply of omeprazole. Initially, I took it for symptomatic relief of GERD, becoming symptomatic again within a week or two during periodic self-directed suspensions. An esophagogastroduodenoscopy, done for another reason, disclosed Barrett’s esophagus, shifting that daily pill of personal comfort to a more essential intervention. It falls within several Gastroenterology Society recommendations as a component of later malignancy prevention. My weekly pill case, set …

How misused terminology and biased studies may be misguiding our understanding of opioid addiction and mortality

Richard A. Lawhern, PhD

Conditions

May 23, 2023

As a health care writer and policy analyst, I frequently encounter the term “risk” in discussions of medical issues. I also frequently see the term grossly misused in both the popular press and medical literature. Nowhere is this more evident than in the 2016 and 2022 CDC Guidelines for the prescription of opioids in the treatment of pain.

In science, the term “incidence” is a measure of the likelihood …

Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

Kevin Pho, MD

KevinMD

May 12, 2023

The medical world is buzzing following the FDA’s green light for Veozah. This is a one-of-a-kind, non-hormonal drug designed to tackle hot flashes in menopausal women. It brings fresh hope to countless women in the U.S. who’ve been grappling with these troublesome symptoms.

Around 80 percent of menopausal women suffer from hot flashes, which bring sudden spells of sweating, flushing, and chills. This unpleasant condition is caused by a glitch …

The real story of Xylazine contamination in street fentanyl and how we can manage it

Julie Craig, MD

Meds

May 9, 2023

Have you heard the news?

“Flesh-eating ‘zombie’ drug ‘kills you from the inside out,'” headlines a CNN article.

“Tacoma market busted for selling ‘zombie’ drug,” barks out a Seattle-area news affiliate.

” Zombie drugs? Florida man stabs couple, eats dead man’s face in ‘random’ attack,” shouts a Syracuse news outlet.

Surely by now, you have heard chilling stories about …

Not treating addiction in criminal justice settings violates the 4 ethical principles in medicine

Casey Grover, MD and Reb Close, MD

Physician

May 4, 2023

As physicians, we are bound by four ethical principles. Beneficence (acting for the benefit of the patient), nonmaleficence (avoiding the harm of the patient), autonomy (respecting patients’ right to make their own decisions), and justice (fair and equitable treatment of patients). When people think of the ethical principles that guide physicians, “First, do no harm” comes to mind.

Unfortunately, our medical system in the United States is violating all four …

The rise and dark side of fungi: Exploring health benefits and pathogenic threats

Sandra Vamos, EdD and Deanna Lernihan, MPH

Meds

April 15, 2023

Fungi have a well-deserved surge in popularity. More mushroom varieties have found their way to grocery store shelves, shopping lists, and food blogs. Mushroom foraging is a trending activity as people endeavor to connect to nature. There is a growing market of mushroom coffee shops touting health-related boosts and “medicinal fungi” being sold as herbal teas and supplements. Innovative products have hit the market, from …

Advocacy and collaboration lead to major patient safety benefits on sterile pharmaceutical compounding: a review of USP’s revisions to Chapter <797>

Elizabeth Rebello, MD

Meds

April 10, 2023

In November 2022, revisions to the United States Pharmacopeia’s (USP) General Chapter <797>, a standard for sterile pharmaceutical compounding – defined as the process of “combining, admixing, diluting, pooling, reconstituting, repackaging, or otherwise altering a drug product or bulk drug substance to create a sterile medication” – were published. USP <797> plays a major role in guiding …

Is personalized medicine worth the cost? [PODCAST]

The Podcast by KevinMD

Podcast

April 8, 2023

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

In this episode, we discuss personalized medicine with guest Ketan Desai, a physician-executive. We explore how Henry Ford’s mass production method influenced the pharmaceutical industry, and how personalized medicine presents new challenges. CAR T-cell therapy is an …

Counterfeit drugs: a hidden danger lurking in your medicine cabinet

Emily Kahoud

Meds

April 1, 2023

The timing of the United States Drug Enforcement Administration’s One Pill Can Kill campaign is crucial, considering the recent Carrollton teen tragedy in which Fentanyl-laced pills posing as oxycodone were distributed through a “juvenile dealer” to high school students who then sold the deadly drugs to high school and middle school students. Commenting on the dramatic increase in drugs laced with Fentanyl in North Texas, Nexus Recovery Center’s …

Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

Julie Craig, MD

Meds

March 27, 2023

In March 2020, I was directing a federally qualified health center in rural New Mexico when the first flashover of COVID ripped through the state. In two days, the clinics transitioned from an entirely in-person model to a near-total remote model. The transformation was raw and unplanned, trialing mediocre communications platforms in real-time and stumbling through the vagaries of electronic prescribing. As we got our feet under us, unexpected upsides …

An inside look at the orphan drug revolution [PODCAST]

The Podcast by KevinMD

Podcast

March 11, 2023

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

Join us as we explore the history and evolution of the orphan drug revolution with James Geraghty, a health care executive. Discover how the pharmaceutical industry of the 1970s, driven by a pursuit of predictable profitability, led …

Why North American medical cannabis can’t compete globally

Michael Sassano

Meds

February 5, 2023

The United States and Canada started a movement that began as medical cannabis and quickly exploded into adult-use cannabis markets. However, the North American operators failed to properly regulate the processes from growing to manufacturing to compete in a global pharmaceutical-level market. Europe has taken the lead as the heavy-weight producer of truly medical-grade pharmaceutical cannabis flowers and products. Notably, many operators in the U.S. and Canada claim to produce …

Pain management beyond prescription pills [PODCAST]

The Podcast by KevinMD

Podcast

January 31, 2023

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

In this episode, we welcome Cindy Perlin, a licensed clinical social worker and chronic pain survivor, to discuss the ongoing issue of prescription painkiller abuse and the dangers of relying on medication to treat pain. Research shows …

The dark side of cannabis: increased risk of psychosis

Ken Finn, MD

Conditions

January 31, 2023

Psychosis is a broad term that describes a change in the perception of reality. It can be caused by various conditions, including metabolic, psychiatric, neurologic, genetic, and other medical conditions, as well as licit and illicit substances, particularly cannabis. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) states that abnormalities define these disorders in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), …

Timely treatment decisions: the promise of surrogate markers

Layla Parast, PhD

Meds

January 4, 2023

Driving around, searching for children’s Tylenol and a pharmacy that had the antibiotics my son needed, was not how I wanted to spend the holidays. I am not alone – shelves are bare, and antibiotics are in short supply as we head into the new year in the midst of a triple threat of COVID-19, flu, and RSV.

While this drug shortage is incredibly frustrating, at least there is …

The promise of patient-centered biotechnology

James Geraghty, JD

Meds

December 22, 2022

An excerpt from Inside The Orphan Drug Revolution: The Promise of Patient-Centered Biotechnology.

Pre-revolutionary stirrings

Every revolution rises up against an order in need of reform. For the orphan drug revolution, that order was the pharmaceutical industry of the 1970s. Most pharma companies had been founded by entrepreneurial chemists or pharmacists decades …

A rush to judgment on acetaminophen?

M. Bennet Broner, PhD

Meds

December 6, 2022

Less than a year ago, a position paper/meta-analysis was published whose authors concluded that the pain reliever acetaminophen, and products containing this compound, were contraindicated in pregnancy as they could result in premature or stillborn births or developmental defects. Earlier studies appeared more positive and resulted in recommendations for its use by professional and governmental organizations. The present authors acknowledged this disjunction and made both the routine recommendations for further …

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A rush to judgment on acetaminophen?

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