Meds

The preference for insurance coverage of opioids over non-pharmaceutical options explained

Meds
August 16, 2023

Pain is the primary reason people seek medical care. Pain is also the problem that ignited the opioid crisis and continues to supply fuel. Eighty percent of opioid misuse begins with a pill prescribed for pain. Purdue invested heavily in marketing Oxycontin to physicians, training them that home opioids are the standard of care for recovery from surgery. While addiction debunked the myth of universal safety, two fallacies embedded in …

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The importance of physician education regarding psilocybin therapy

Meds
July 7, 2023

Psilocybin is a psychedelic compound produced by several species of mushrooms, which has been used for millennia across various cultures. It first gained broader awareness in the Western world during the 1960s and is now the subject of scientific inquiry due to renewed interest in the clinical applications of psychedelic medicines and psychedelic-assisted therapy.

Research into psilocybin and psilocybin-assisted therapy has found it to be effective in addressing a number of …

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It is time for the FDA to re-evaluate metrics for weight loss drugs

Meds
July 4, 2023

Between 2013 and 2016, 49.1 percent of U.S. adults surveyed had attempted to lose weight within the last 12 months. Weight loss medications have reached the public eye in popular culture and practice. To be considered effective in a clinical trial by the FDA, the drug candidate must demonstrate a statistically significant difference in mean weight loss between the active product and placebo-treated group of at least five …

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Ensuring medication safety: a shocking incident that exposed a dangerous flaw

Meds
June 28, 2023

At six-week intervals, I replenish my supply of omeprazole. Initially, I took it for symptomatic relief of GERD, becoming symptomatic again within a week or two during periodic self-directed suspensions. An esophagogastroduodenoscopy, done for another reason, disclosed Barrett’s esophagus, shifting that daily pill of personal comfort to a more essential intervention. It falls within several Gastroenterology Society recommendations as a component of later malignancy prevention. My weekly pill case, set …

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The surprising risks of long-term proton pump inhibitor use

Meds
June 18, 2023

A lot of my patients take proton pump inhibitors (PPIs). They generally work pretty well for their intended use. By limiting the secretion of gastric acid from the stomach, they can effectively blunt uncomfortable symptoms of erosive gastritis, gastroesophageal reflux disease, H. pylori infection, and peptic ulcers. However, without further evaluation, these medications are not designed to be prescribed indefinitely, or for more than a two-month period. When patients experience …

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Unveiling the game-changing diabetic drugs: Revolutionizing weight loss and diabetes management

Meds
June 13, 2023

The drug representative had a smug look; she knew she had a winner. She didn’t need to sell anything—the American public had already bought the story. There are very few drugs in history where patients are excited about the conversation and want to take a new medication. I am talking about the new class of diabetic drugs called GLP-1 (glucagon-like peptide) agonists. The particular drugs are Ozempic (semaglutide) and Mounjaro …

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From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

Meds
June 6, 2023

The Moscow mule, a mix of ginger beer, an ounce of vodka, and a squeeze of lemon, has become one of the favorites among cocktail aficionados across the United States. It delivers on all that it promises, namely, an easy-to-make tasty drink, except it has nothing to do with the Russian capital whose name it bears. The birthplace was New York’s Chatham Hotel in Lower Manhattan, and the year was …

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The deadly consequences of a shortage: The Pluvicto crisis leaves metastatic prostate cancer patients in limbo

Meds
May 12, 2023

You’ve recently been diagnosed with metastatic cancer. You started the recommended first-line therapy, but it isn’t cutting it. There is another available treatment, but your hopes are crushed upon learning that you will have to wait at least three months before the life-extending medication can be produced for you and reach your location. All the while, your cancer will continue to grow and spread, slowly eating your body from the …

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The real story of Xylazine contamination in street fentanyl and how we can manage it

Meds
May 9, 2023

Have you heard the news?

“Flesh-eating ‘zombie’ drug ‘kills you from the inside out,'” headlines a CNN article.

“Tacoma market busted for selling ‘zombie’ drug,” barks out a Seattle-area news affiliate.

” Zombie drugs? Florida man stabs couple, eats dead man’s face in ‘random’ attack,” shouts a Syracuse news outlet.

Surely by now, you have heard chilling stories about …

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The cannabis education gap: Why patients are left in the dark

Meds
May 1, 2023

Imagine that you are suffering from chronic pain.

The pain keeps you awake at night so you don’t get much sleep. Lack of sleep most nights and the ensuing chronic fatigue causes you some anxiety during the day. Your primary care physician suggests that she is concerned with the increasing amount of aspirin and ibuprofen you are consuming to manage the pain. She can prescribe opioids to help with the pain, …

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Are doctors ready to discuss psychedelic therapies with patients?

Meds
April 28, 2023

As I’m pre-charting for my primary care clinic, I see Ms. C on the schedule, whom I know well through our nearly monthly follow-up visits over the past two and a half years of residency. We talk in Spanish as it’s her preferred language. She shares her escalating distress over being an immigrant, a full-time caregiver for her dad with advancing dementia and three kids, and current marital issues while …

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The rise and dark side of fungi: Exploring health benefits and pathogenic threats

Meds
April 15, 2023

Fungi have a well-deserved surge in popularity. More mushroom varieties have found their way to grocery store shelves, shopping lists, and food blogs. Mushroom foraging is a trending activity as people endeavor to connect to nature. There is a growing market of mushroom coffee shops touting health-related boosts and “medicinal fungi” being sold as herbal teas and supplements. Innovative products have hit the market, from …

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Advocacy and collaboration lead to major patient safety benefits on sterile pharmaceutical compounding: a review of USP’s revisions to Chapter <797>

Meds
April 10, 2023

In November 2022, revisions to the United States Pharmacopeia’s (USP) General Chapter <797>, a standard for sterile pharmaceutical compounding – defined as the process of “combining, admixing, diluting, pooling, reconstituting, repackaging, or otherwise altering a drug product or bulk drug substance to create a sterile medication” – were published. USP <797> plays a major role in guiding …

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Counterfeit drugs: a hidden danger lurking in your medicine cabinet

Meds
April 1, 2023

The timing of the United States Drug Enforcement Administration’s One Pill Can Kill campaign is crucial, considering the recent Carrollton teen tragedy in which Fentanyl-laced pills posing as oxycodone were distributed through a “juvenile dealer” to high school students who then sold the deadly drugs to high school and middle school students. Commenting on the dramatic increase in drugs laced with Fentanyl in North Texas, Nexus Recovery Center’s …

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Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

Meds
March 27, 2023

In March 2020, I was directing a federally qualified health center in rural New Mexico when the first flashover of COVID ripped through the state. In two days, the clinics transitioned from an entirely in-person model to a near-total remote model. The transformation was raw and unplanned, trialing mediocre communications platforms in real-time and stumbling through the vagaries of electronic prescribing. As we got our feet under us, unexpected upsides …

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The real cause of America’s opioid crisis: Doctors are not to blame

Meds
March 22, 2023

We’ve all heard about America’s so-called “opioid epidemic.” Nearly 100,000 people died in 2021 of causes that included overdose by one or more narcotic drugs and often alcohol. We also hear assertions from anti-opioid advocates that this epidemic was caused by doctors “over-prescribing” opioid pain relievers to their patients. These assertions are fundamentally wrong on fact. U.S. national health care policy and law redirections are needed to correct such distortions.

Doctors …

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Can personalized medicine live up to its hype in health care?

Meds
February 18, 2023

The genius of Henry Ford was in his perfection of mass production. Ford’s assembly lines produced oodles of Model T, with economies of scale so that the cost of each car fell to the point that even those working in those lines could afford them. His method was copied by other car manufacturers and ultimately by other industries as well.

The pharmaceutical industry was one of them. The industry mass produces …

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The effects of the nationwide stimulant shortage on a private psychiatry practice

Meds
February 8, 2023

I have a solo outpatient private practice focusing on psychiatric medication management and brief therapy for adults. Early on, I decided to accept insurance to help address the shortage of psychiatrists in this country. Because of the advances in telemedicine since the pandemic, I can see patients throughout the state where I am licensed. This should be the happiest time in my career. After several years of working as an …

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Why North American medical cannabis can’t compete globally

Meds
February 5, 2023

The United States and Canada started a movement that began as medical cannabis and quickly exploded into adult-use cannabis markets. However, the North American operators failed to properly regulate the processes from growing to manufacturing to compete in a global pharmaceutical-level market. Europe has taken the lead as the heavy-weight producer of truly medical-grade pharmaceutical cannabis flowers and products. Notably, many operators in the U.S. and Canada claim to produce …

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CME Spotlights