I still recall the ICU physician holding my hand and preparing me for the possibility I might not survive the blood clots in my lungs, pulmonary embolism. It was eighteen years ago when out of the blue, I found myself unexpectedly holding the hand of that gentle, concerned doctor, whose name I do not even know. My son was three years old at the time, and all I could think …
Patients are captive pharmacy benefits manager consumers
It was a warm summer in Maine but felt like a cold winter in the confines of the hospital building. I was seated next to a physician who was quietly working on a big screen monitor. It was a slow workday as I pondered tips and tricks to make the physician workflow efficient while training providers on implementing electronic health records. I stared at the computer screen and the physician …
Do prescription drug monitoring programs hurt more than they help?
As we anticipated the release of new CDC data on overdose deaths, those of us who specialize in substance use disorders braced for grim statistics, but this milestone was still shocking: over 100,000 lives lost to overdoses in one year, the great majority from opioids. Overdose deaths began outpacing traffic fatalities in the United States in 2013, but 2.5 times as many people died from an …
The status quo is failing people with opioid use disorder
A recent headline in my neighborhood newspaper read, “A Dentist Became a Top Opioid Buyer in W. Va. Now a Drug Firm Faces Penalty for Ignoring Red Flags.” The drug firm sent 25,400 hydrocodone pills and 3,600 Xanax to one Huntington, WV area dentist. The DEA raided the dentist’s office and shut it down. The dentist admitted to ordering the pills for personal use.
This summer, also right …
How drug distributors contributed to the opioid crisis
When the FDA approved Gilead’s Truvada (emtricitabine/tenofovir disoproxil) for HIV PrEP in 2012, it was a revolutionary step forward. The drug was safe and up to 99 percent effective in preventing HIV infection in at-risk individuals.
Then in 2019, Gilead received FDA approval for a second drug for PrEP called Descovy (emtricitabine/tenofovir alafenamide), with equivalent efficacy to Truvada. Recent research has shown that by the end of 2020, …
Is Descovy really the better option?
How did we Americans allow health insurers to dictate how physicians practice good medicine? The hypocritic oath says, “Do no harm.” We should not allow insurance company profits to prevent proper care for patients.
Our insurer is now telling our young adult son, a Crohn’s patient (Crohn’s is not yet a curable disease), who has been in remission since he began taking Remicade over 11 years ago to switch to a …
How did we let insurers run health care?
I was asked this question at least three times this week, so I think there must be something going around. It doesn’t help that a Kardashian with 140 million Instagram followers recently signed a deal to become an equity partner and global spokeswoman for a company selling collagen supplements. The global market for collagen-containing products was estimated at $300 million last year, and is projected …
Are collagen supplements good for you? A physician’s deep dive answer.
Creative photography
Year after year, new medications find their way into the market, adding to the abundant and colorful world of pharmaceuticals.
Medications play a dual role in our lives, as they represent wellness and illness concomitantly. I am primarily fascinated by the human love-hate relationship with medicine in the form of dependency and liberation, desire and distaste, and hope and despair. On one …
The abundant and colorful world of pharmaceuticals
Woodworking / Illustration
The problem with the act of taking medications is that it’s so mundane that we don’t see any problem with it.
This machine-cut, flat, unemotional, same-size-fits-all object that we defencelessly welcome in our very private body has a role. Medications occupy our existence by interlocking with our cells and taking control of our body, fighting, provoking, sedating, and changing the music …
The ritual of taking medications: the pill wheel
Pyrography
Medicine bottles are mundane objects tightly woven into our daily lives, with the promise of happier moods, better sleep, and lower blood pressure. Nevertheless, nothing on these objects correlates with hope, faith, or a feeling of healthiness. I aspire to affix a face on these bottles to create conversations among medication manufacturers, prescribers, and dispensers, allowing them to explore what really happens …
Colorful pills don’t paint my world
The Food and Drug Administration (FDA) negated the recommendation of its expert panel and approved Aduhelm to treat Alzheimer’s dementia (AD), contending that the possible benefit trumped the lack of evidence of efficacy. The FDA was inexcusably in error in making this decision. Aside from the likely lack of benefit, the use of this drug can result in many negative consequences that make its use ethically questionable.
The manufacturer submitted two …
The FDA was wrong about Aduhelm
Photography
A person’s lifetime medication consumption has a familiar and predictable pattern. The more a person ages, the greater their number of taken medication. However, the public behavior in initiating medication has been changed compared to thirty years ago.
Nowadays, parents demand to get their hands on OTC meds for their infants and toddlers.
In this piece, I am interested …
The life cycle of medication consumption
Many drug ads in the Journal of the American Medical Association (JAMA) during the 1950s, 1960s, and 1970s would offend today.
In an ad for Valium, we are told that the woman pictured (“Jan”) is “psychoneurotic” because she is unmarried at age 35. “You probably see many such Jans in your practice,” says the ad—“The unmarrieds with low self-esteem. Jan never found a man to measure up to her father.”
Valium was …
These journal ads could not run today
An installation to explore the impact of medications in daily life
Bob is a typical patient at the pharmacy with a chronic illness. Bob, along with 30 other random patients whom I followed in the year 2017, had been picked up to explore the number of medications they consumed in an average year. Bob took 4,280 prescription pills (no data on OTC consumption) …
4280: the number of pills Bob took last year
“Something’s wrong with Eddie.”
In four words, my entire wedding day collapsed around me. I’d just arrived at a beautiful Gothic chapel in a rented 1950 Rolls Royce, mom and dad on either side of me, prepared for a picture-perfect first look with my groom. As his mother’s words echoed in my ear, I immediately thought of all the scenarios that could be easily remedied so we could move forward with …
How a doctor fell in love with a drug addict
When the “opioid crisis” is mentioned, most people think of heroin, prescription pills like oxycodone, or — more recently — the powerful synthetic opioid fentanyl. Fewer people would think of novel opioids like tianeptine, although an increasing number of Americans have taken this substance in the form of over-the-counter supplements like ZaZaRed or Tianna – often without knowing that the substance has opioid properties that can cause dependence and overdose. …
The complications of drug regulation
Two weeks ago, my piece, “Cannabinoids are medicine, but patients aren’t getting the care they need,” was published. Since that time, I’ve heard from quite a few physicians who admitted that they did not know card-mills existed or, if they did, how they were different from Cannabis Specialist Physicians. From their collective perspective, pot was pot. I am grateful to have had the opportunity to …
Cannabis card-mills have conflicts of interest
It was September 11, 2001. My dad had cheated on my mom again, the building that I worked in at that time had received an anonymous tip that we were a potential target for the terrorist attacks, and my mom, who needed a reprieve from my dad’s crap, was vacationing in Florida and was worried for me and my well-being. Plus, my dad was threatening to kill himself, and I …
President Trump recently signed two executive orders directly related to prescription drug prices in the U.S.
One order would allow the “reimportation” of prescription drugs from Canada. This longstanding idea would allow U.S. pharmacies and drug wholesalers the ability to pay generally much lower prices for their prescription drugs by getting them from Canadian suppliers who benefit from government management of the system. Many consumers have been buying direct from Canadian …
Why is the government so scared of directly negotiating drug prices?
An excerpt from Nurses are Nuts.
The pharmacy department plays a vital role in hospitals. They prepare and dispense medications. Sometimes the pharmacist will receive an order from the doctor on a med whose written dosage he is not sure of. In some cases, the pharmacist will …
Nurses do not get paid extra for being pharmacists
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