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.

Colorful pills don’t paint my world

Fery Pashang, PharmD

Medications

August 8, 2021

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 …

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Colorful pills don’t paint my world

Federal legalization of cannabis: What does it mean for patients?

Jill Becker, MD

Medications

July 26, 2021

I just opened my email inbox to see the following headline: “Senate Majority Leader Chuck Schumer (D-NY), Senate Finance Committee Chairman Ron Wyden (D-OR) and Sen. Cory Booker (D-NJ) will finally release a draft of their long-awaited federal cannabis legalization bill on Wednesday.”

I wholeheartedly support the federal legalization of cannabis. For one thing, it is much safer than almost all drugs and medications available with or without a prescription. And, …

The FDA was wrong about Aduhelm

M. Bennet Broner, PhD

Medications

July 8, 2021

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 …

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The FDA was wrong about Aduhelm

The life cycle of medication consumption

Fery Pashang, PharmD

Medications

July 6, 2021

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 …

These journal ads could not run today

Martha Rosenberg

Medications

July 5, 2021

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 …

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These journal ads could not run today

Does the FDA approval of aducanumab mark the return of science-based medicine?

Robert Trent

Medications

July 4, 2021

The 20th century was an explosion of scientific innovation and discovery. The success of chemistry, physics and biology to produce things such as antibiotics, radiography and genetic analysis could not be ignored.

Medicine is not now, nor has it ever been, a “science.” But over the past century, medicine became science-based. This means that while medicine was not in adherence with the scientific method, it did rely on …

4280: the number of pills Bob took last year

Fery Pashang, PharmD

Medications

June 29, 2021

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) …

Drug advertising has helped created victim politics

Martha Rosenberg

Medications

June 6, 2021

“How dare you suggest I/my son is not sick?” “Stop invalidating the lived experiences of millions of people!” “Able-bodied people like you have no right to report this.” “How dare you suggest my medication has risks?” “You’re not taking my drugs!”

The tweets above are just some of the vehement responses I have received as a health reporter over the years for daring to report that some drugs have a downside …

How a doctor fell in love with a drug addict

Lauren Roth, MD

Physician

June 5, 2021

“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 …

The complications of drug regulation

Julie Craig, MD

Medications

May 19, 2021

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. …

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The complications of drug regulation

Practicing medicine without a license is illegal. Yet cannabis dispensaries are doing it.

Jill Becker, MD

Medications

April 14, 2021

I look forward to clinic days. I thoroughly enjoy meeting with patients, hearing how they’re doing, and helping them to feel better – even if, on occasion, the only thing I can do to help is to listen.

Yesterday was a clinic day.

In the middle of the morning, I met with a medical cannabis patient treated for anxiety. As we reviewed his current symptoms, medications, and how he is benefitting from …

Cannabis card-mills have conflicts of interest

Jill Becker, MD

Physician

April 1, 2021

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 …

My Klonopin withdrawal story

Bethany Silverman

Medications

January 20, 2021

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 …

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My Klonopin withdrawal story

As COVID worsens, don’t forget about the opioid crisis

Vishal Khetpal, MD and Nishant Shah, MD, MPH

Conditions and Diseases

December 13, 2020

For the past seven months, an epidemic in our country has spiraled out of control, claiming thousands of lives that could have been saved. It has been met by an inadequate, meandering national response that has often lacked urgency. It has disrupted families, and at times has overburdened our health care system grappling with limited resources.

This assessment undoubtedly describes the COVID-19 pandemic that is now resurging in many communities across …

How can we improve the quality of medications?

J. Leonard Lichtenfeld, MD

Medications

September 30, 2020

Do you know what it’s like to sit in a meeting and learn that something you hold close as a fundamental principle is probably not as fundamentally true as you thought?

That’s the way I felt earlier this week while attending a meeting on the quality of pharmaceuticals, sponsored by the Food and Drug Administration and Duke University’s Margolis Center for Health Policy.

The meeting—a Read more…

How can we improve the quality of medications?

Why is the government so scared of directly negotiating drug prices?

Robert Laszewski

Medications

August 29, 2020

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 …

Many medical marijuana program websites are silent about possible risks

Erik Messamore, MD, PhD

Medications

August 4, 2020

Click through North Dakota’s Division of Medical Marijuana website, past the addresses of every cannabis dispensary in the state, into the presentations and annual reports, and you’ll eventually come to a 32-slide presentation about the state’s medical marijuana program. You’ll see the 26 diseases that can be treated with marijuana, a colorful flowchart showing the types of available marijuana, and a …

Patients in Sweden received fewer post-op opioids. Why is that?

Richard Young, MD

Medications

July 2, 2020

When I was in Sweden, I heard this phrase several times: “There is no such thing as bad weather, just bad preparation.” They said this when we asked them what they did with their children in dead of winter. The proud parents made it very clear that no matter what the weather, when it is time to go outside for recess at school, or to get out of the house …

It is unethical for the United States to send hydroxychloroquine to Brazil

Charles E. Binkley, MD

Medications

June 7, 2020

Much controversy surrounds whether or not hydroxychloroquine is effective in preventing or treating infection with COVID-19. While much of the data so far suggests that hydroxychloroquine is not effective at treating COVID-19, and perhaps that it might even be harmful, multiple clinical trials focusing both on prevention and treatment are ongoing. The controversy around …

Are there reasons to doubt remdesivir?

Daniel Hopkins, MD

Medications

May 23, 2020

On April 29th Anthony Fauci announced the National Institute of Allergy and Infectious Diseases, an institute he runs, had completed a study of the antiviral remdesivir for COVID-19. The drug reduced time to recovery from 15 to 11 days, he said, a breakthrough proving “a drug can block this virus.” Now people are clamoring for $1,000-a-pill remdesivir.

While the results were preliminary, unpublished, and unconfirmed by …

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Are there reasons to doubt remdesivir?