He came in for his routine yearly visit with me, stable for the most part in that he was living with his chronic psychotic illness and moving through the world in a fairly normal, logical way most days. He was in his mid-twenties, neat and clean. He was attending to his personal hygiene and wearing rumpled but passable casual clothes. His hair was combed, but it had not been cut ...

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On June 30, 2015, California’s Gov. Jerry Brown signed into law Senate Bill 277 (SB277), which tightened requirements so that parents could no longer opt out of vaccinating their children if they were attending state licensed schools, daycares, and nurseries. Dr. Richard Pan (D-Sacramento), a pediatrician, sponsored the legislation, which quickly became a nationwide litmus test on the debate over personal liberty versus public health in the aftermath of the large, ...

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Winter break back at home with my family may as well have counted as a preceptorship session or two. Ear infections, the common cold, the flu -- if you can name it, there's a good chance someone in my family caught it. We have never collectively consumed as much cough syrup, pain relievers, and antibiotics as we did over these last two weeks. Seriously, the quantity was awe-inspiring. Even though each ...

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Recently, the U.S. Senate passed the 21st Century Cures bill with an overwhelming vote of 95-4 and was approved by President Obama. Yet, the controversy continues. Some people worry that this act is destroying our scientific process and sacrificing patient safety issues. Others proclaim that this is a win for the big pharmaceutical companies, who are already winning by a landslide. And then, there are the voices shouting out with ...

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A couple of weeks ago I started taking medicine to lower my blood pressure and another to reduce my cholesterol. This was a controversial move, given my deep distrust of the practice of medicine, when it is practiced on me, and especially regarding pharmaceuticals. I know that, as a woman of 55 with a very active and healthy lifestyle, no chronic diseases and, most importantly, as a nonsmoker, I am at ...

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Recently, the U.S. House of Representatives passed the 21st Century Cures, known simply as the Cures Act. This is thought to be the largest and most powerful health care-related law since the passage of the Affordable Care Act during Obama’s first term. The Cures Act provides for a large increase in funds for boosting biomedical research and also takes aim at speeding up drug and medical device approvals through the ...

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The blood thinner heparin is not a 21st-century cure. It was discovered 100 years ago by a scientist looking for something else entirely, and is one of the oldest drugs still in regular use. After my daughter was diagnosed with a potentially fatal blood disorder, heparin played a key daily role in her treatment. We’d wash our hands meticulously, lay out gloves and antiseptic wipes, saline flushes for the access lines ...

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Current reports from the International Narcotics Control Board (INCB) suggest that the United States is second on the list of countries with the highest per capita consumption of opiates.  Data from 2014 quotes U.S. use of opiates at 700 mg per capita per year. The only country that has a higher per capita use is Canada at 967 mg per capita both in ME (morphine equivalents). This suggests that in ...

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I spent one year working full-time as a pharmacy technician at a high-volume community pharmacy prior to entering medical school. Besides learning the intricacies of billing and the dispensing process, I was granted personal access into a world nearly all patients, but few providers are aware of.  At the time my job was just that: a job. There were fun perks like counting pills in multiples of five and visualizing ...

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A couple of years ago, I inherited a patient who was on both a patch for the powerful painkiller fentanyl and a high dose of oxycodone four times daily — and she didn't have cancer. I had 15 minutes with that patient to get her medical history, review her medications, assess her current complaints, and decide whether or not to continue her opioid prescriptions. I had no paper records and a ...

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