To understand the Vicodin story we first have to understand how habit-forming medicines are currently prescribed in the U.S. The Drug Enforcement Agency divides potentially addictive substances into different schedules. Schedule II controlled substances are prescription medicines that have a high potential for abuse and severe dependence. They include all the opiate (narcotic) pain medicines, like morphine, oxycodone, and fentanyl. These medications must be prescribed on a paper ...

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When I was in middle school, I went to Lake Tahoe with my best friend on a ski trip. I had only been skiing a few times before, and even though my friend was only twelve, she was already a talented and experienced skier. She was patient with me, but I became increasingly frustrated as I had trouble going down even the most basic runs without falling. At one point, after falling ...

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To almost every claim that the American healthcare system is overpriced, defenders of the United States can point to the comparison problem -- it is not fair to compare American surgeons, or hospitals, to our peers in Europe when American surgeons and hospitals are not the same as in those other countries.  Our surgeons are better trained, the defenders retort, and our hospitals offer higher quality care.  When quality measures ...

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The state of diabetes drugs has gotten to the point where it is good news that a drug does not produce worse outcomes than a placebo. I am not kidding. The New England Journal of Medicine published two trials, each testing whether a diabetes drug increased the risk of heart attacks and death from heart disease. The trials are a result of FDA guidance for companies to assess the cardiovascular safety of new ...

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Flu season has begun, which means that it’s flu shot time. I see lots of different responses when I talk to families at our clinic about the flu shot. Some are happy to get it. Others are unsure, worried about side effects. Others plain old refuse. Plain old refusal isn’t an option for me -- as a doctor and an employee of Boston Children’s. I need to get it -- and I ...

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I recently testified before the Medical Licensing Board of Indiana regarding the pending emergency rules for physicians prescribing opioids for chronic pain. The session went on for four intense hours -- ten minutes of which had been promised to me. At my turn, I stated my name, told the Board I hailed from from Indiana’s prescription ground zero, gave a brief summary of my credentials, thanked the Board, the American Academy ...

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Mail order pharmacies like Express Scripts and Medco have become increasingly prominent players in health care. But these companies are a lot more than simply mail order pharmacies, they are in fact a new generation of pharmacy benefit managers (PBMs). PBMs are essentially middle-men between insurance and pharmacy, with companies like Express Scripts merging the dual functions of a PBM and pharmacist into one. PBMs manage and administer medication benefits ...

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Did your team win this weekend? I hope so. It is so exciting when your team gets to throw up a “W” after their first contest. It gives all the fans hope for a successful and exciting season. Fall also is a time to cheer for our annual opportunity to protect our families against a predictably unpredictable opponent: influenza. That’s right. It’s time to defend against the flu by getting an annual flu vaccine. This ...

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Everywhere I look today, I see ads claiming huge savings from drug discount cards. These cards promise huge savings to consumers, yet they are unable to deliver on these outrageous statements. Now, when I see these ads, I’m skeptical -- and you should be too because not all the claims are real. The old saying, “If it seems too good to be true then it probably is” also applies to drug ...

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You’re at the doctor’s office, and you see strolling up to the window a good-looking, well-dressed professional. They’re usually pulling a little discreet cart, and after a few words with the receptionist they’re rushed right back. Sometimes they’ll bring a tray of cookies, or they’ll be followed by a caterer with a cartful of food. You think they had an appointment? No, but you can be they’re here to see the ...

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