Over 2 million Americans abuse or are dependent on prescription pain medications. These patients are in the office of every physician in the country, but only 3 percent of primary care providers offer them treatment. Many patients are being given a sympathetic apology, a hotline to call, or a dead-end referral.  Some of them are being sent to methadone clinics, which are often impractical, already-full, or deeply stigmatized.  Others make their ...

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Over the past week, while covering the inpatient gastroenterology service, we cared for three patients who were hospitalized with gastrointestinal bleeding who were found to have large, potentially life-threating, stomach ulcers. All three of the patients had abruptly stopped their acid-suppressing proton pump inhibitor (PPI) medication in the preceding 1 to 2 weeks.  With PPIs being a primary therapy for gastroesophageal reflux and ulcer treatment, why would these patients have ...

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On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and ...

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The microbiome is among the hottest topics in medical and scientific research. The National Institutes of Health and private foundations have invested hundreds of millions of dollars in research to define and characterize the human microbiome. In the next decade, billions more will be devoted to deciphering how microbes influence human health in a positive manner. The White House Office even issued a national call to action for ...

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Psoriatic arthritis can be a debilitating condition. It can lead to painful complications such as neuropathy. Its treatments can lead to complications such as shingles, which can leave a patient with continuing pain. Ehlers-Danlos Syndrome is for most patients a painful condition that leads to spontaneous dislocations, early arthritis, and frequent migraines. My husband and I have decades of experience between us in living with these conditions. My husband and I ...

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Activism over prescription drug pricing has reached a fever pitch. The recent House subcommittee hearings featuring testimony (or non-testimony in the case of bad-boy Martin Shkreli) from Turing Pharmaceuticals and Valeant executives provided an outlet for public outrage over those companies’ price gouging on life-saving drugs. Meanwhile, presidential candidates Hillary Clinton and Bernie Sanders have both talked up plans to rein in spending on prescription drugs, and even Donald Trump ...

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Dear drug reps, I write you today as a primary care provider who -- at the risk of giving you “the keys to the kingdom” -- has advice for you. First, I am not anti-pharma.  I recognize the need that my patients and I have for new medications, and I believe that innovation in medicine can grow from free enterprise.  But it’s rare that I walk away from an interaction with you ...

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Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD. Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible? THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to the ...

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A grandmother develops a boil that turns out to be a difficult-to-treat staph infection (MRSA). She needs high-powered antibiotics. A middle-aged man who received a blood transfusion decades ago now has hepatitis C and needs anti-viral medicine. A young woman with HIV develops golf-ball-size lesions in her brain, has toxoplasmosis and needs anti-parasite medicine. The marvel of medicine today is that we can treat all three infections, and save the lives ...

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Addyi (flibanserin), the drug to increase female libido had a timid entry into the market with very few prescriptions considering the “hype.” Bloomberg Business reported 227 prescriptions in the first month. That’s a pittance considering Valeant paid $1 billion for the drug. I am unlikely to help Valeant recoup their investment, because the more I read about this drug, the worse it looks. Here’s why: It barely works One of the study ...

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