Opioids are a family of pain medications chemically related to opium and heroin. They include morphine, fentanyl, codeine, hydromorphone and others. Opioids have unique properties that make them both indispensable for pain management and extremely dangerous. Unlike virtually any other family of medications, opioids have no maximum effective dose. If any dose, no matter how high, is ineffective at controlling pain, a higher dose can give more pain relief. Most other ...

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"Hey doc, I saw on an ad on the TV last night about this new asthma inhaler.  Shouldn't I give it a try?" This type of question would occur several times a week.  When I started practicing medicine it was considered unethical to advertise medical treatments.  Now, we're bombarded with enticements for tests and treatments.  The inhaler the patient requested cost $264 a month -- more than double what he was ...

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On February 18, 2014 the Food and Drug Administration indicated their consideration to allow pharmaceutical companies to shorten the list of possible side effects seen by millions everyday and night in pharmaceutical ads and commercials. In recent years, citizens -- patients and consumers -- have been bombarded with numerous and lengthy televised commercials in which pharmaceutical companies push their medicinal wares. It's called "direct-to-consumer" advertising (DTC). Such DTC efforts work for detergents, ...

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From MedPage Today:

  1. 5 Ways Doctors Can Use Data Analytics. Reimbursements are increasingly linked to quality and value metrics, but providers often don't have the best tools to handle that transition.
  2. Killing Pain: Script by Script. Primary care doctors wrote about 53 million benzodiazepine prescriptions in 2013, roughly four times the number written by psychiatrists, a group that penned 13 million benzo scripts.

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I was up helping my son for the majority of the night. He’s got a stomach bug (which he got from his brother) therefore I was up dealing with the enormous mess that comes with vomiting in the middle of the night. I know you know my woe. This is the second round of this bug at our house so I was clearly exhausted when 6am rolled around. First thing I ...

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Despite representing only 4% of the world’s population, the United States accounted for almost 35% ($326 billion) of the global market for pharmaceutical drugs in 2012. Not surprisingly, the pharmaceutical industry’s business practices, considerable marketing budgets, and substantial profits are hotly debated as part of virtually every health policy discussion. But before addressing the possibility of transcendent evil in that industry, we should pose a more mundane yet critical question: ...

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Now that medical marijuana is legal in Massachusetts and licenses have been awarded for the first twenty dispensaries across the state, you'd guess that my practice is busily preparing to meet the demands of patients seeking marijuana prescriptions for several debilitating conditions including chemotherapy-related nausea and AIDS-related weight loss. You'd guess wrong. Since Massachusetts voters approved legalization of marijuana in 2012 I've received no special training (required for physicians to certify patients as ...

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The death penalty has been in the news lately, what with a "botched" execution in Ohio, using a 2 drug method that Louisiana has also recently adopted for it's administration of the death penalty. These changes come on the heels of a new tactic by death penalty opponents: getting European countries to ban their pharmaceutical manufacturers from exporting drugs that may be used to execute people.  These bans were partially responsible for ...

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At least 12 college students have been diagnosed with Meningitis type B (MenB) this year, and cases like this may spread to other campuses unless the Food and Drug Administration intervenes.  While people of any age can contract the infection that affects the brain and spinal cord, children and people over 60 are more likely to contract the infection.  So, too, are college students because of their close contacts in dormitories and ...

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Cardiovascular disease -- including coronary atherosclerosis and cerebrovascular disease -- remains the number one cause of mortality in the United States. One out of three people in this country will die of cardiovascular causes.  Although I can’t say that the other top causes of mortality are particularly attractive -- cancer, chronic lung disease, accidents and dementia -- premature cardiovascular death can certainly be very devastating and it makes sense to do ...

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