L. Joseph Parker is a research physician.
A recent article in the Macomb Daily reported that a “Shelby Township doctor was convicted last Thursday of all counts for conspiring to distribute more than 300,000 opioid prescription pills valued at over $6 million, following a trial in U.S. District Court in Ann Arbor, according to federal authorities.”
This sounds very serious on its face. But without context, the public, and even we, have no idea what this means. …
In 1999, Sally Clark was convicted of murder. Her son, Christopher, had been born in September of 1996 and by all accounts, had been a healthy baby. Just three months later, an ambulance was called to the home, and the baby was dead.
The mother, Sally, said that she had just put him to bed and found him unresponsive not long after. The police were suspicious; she seemed a little cold …
When I started medical school thirty years ago, and learned about the discovery of streptomycin, I wondered what it must have been like for the doctors who first used it to cure the “white death.” How satisfying it must have been to tell a previously hopeless patient, “We can cure you.”
What brought this to mind was my rotation at an old part of the hospital where I was training. I …
First, it’s essential to understand that your prosecution doesn’t define you as a person. Most likely, the DEA never bothered to speak with you before deciding to arrest and prosecute you. Even if they did, the decision to prosecute you had been made long before any conversation took place. Your prosecution is the result of a long and strategic process, one in which the very notions of truth and justice …
The sciences and even medicine have long been used to justify atrocities. In the early 1800s, the United States of America was a slave nation. Citizens were allowed to purchase and imprison other races and hold them in bondage as property. This is different from indentured servitude, where someone is held in bondage until they pay off a debt. The indentured servant still has some rights and autonomy; the slave …
New Zealand just rescinded its ban on tobacco smoking at the same time that Donald Trump just suggested the death penalty could cure the drug problem. What did New Zealand learn? And how has drug prohibition worked out in the past?
In 1511, the governor of Mecca, Khair Beg, had a serious problem. A powerful stimulant was coming into common use and was spreading throughout the city. This stimulant was clearly …
Every time an American fills a prescription, a searchable electronic database record is made. This record is kept, like the paper records of a few decades ago, to allow for verification of medications dispensed in the U.S. But in the past, to access these records, enforcement agencies had to get a search warrant signed by a judge. This meant that the authorities had to have and show to the court …
In a recently published study, it was found that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) was shown to predict the diagnosis of heroin addiction with an accuracy rate of around 85 percent. This is an amazing development and could open the door to knowing who is at high risk of opiate addiction before the prescription is written. If similar markers can be found for …
Have you ever wondered why some people always seem to be in pain? Or why someone can receive a prescription for a minor procedure and immediately feel drawn to drug use?
Scientists may have recently figured out one of the reasons for these behaviors, and they may start early in life. The developing neuron is remarkably similar to a tree. The branches are the dendrites that receive electrochemical signals from the …
The practice of medicine has always been difficult. In the best of times, physicians must make fast decisions under very stressful conditions. Every time a doctor navigates a crisis, they reflect on what decisions they made and how they might improve. At least the good ones do. This soul-searching often involves discussions with colleagues and staff on the events and decisions made.
Mortality and morbidity discussions, M&M as we say, are …
According to a report from the U.S. Department of Justice, 37 percent of the people in prison have a history of mental health problems. This was not always the case. The United States at one time had state mental health facilities, where those with mental illness could be treated. From 1870 to 1955, these numbers increased until it peaked at almost 600,000. This was 0.36 percent of the then population …
We have a problem with current recommendations for depression treatment. Thirty-five percent of patients will not go into remission or get any relief at all from SSRIs and SNRIs. And even when it does work, it takes about six weeks to start having an effect.
The prevailing theory was that serotonin, abbreviated 5-HT, was the “satisfaction” neurotransmitter. Just as dopamine has been considered the pleasure neurotransmitter. Using selective serotonin reuptake inhibitors …
In a recent study published in the Journal of Bone and Mineral Research, it was found that two compounds found in cannabis, cannabidiol, and cannabigerol, may not just ease the pain of fractures but also speed up fracture healing. The study, titled “Cannabidiol (CBD) and Cannabigerol (CBG), Nonpsychotropic Cannabinoids, as Analgesics that Effectively Manage Bone Fracture Pain and Promote Healing in Mice,” is …
What do you do if you get an administrative or court subpoena to produce “all” medical records on one or more patients? Are you sure that your electronic medical records can even create a true “legal” chart? With everything recorded chronologically? How would you know if something was left out?
And if you get an administrative or court subpoena for “all” medical records, what does that mean? What about access logs …
In 1985, Mr. Charles McCrory was on trial. Charles had found his wife dead, and her family was convinced that he was responsible, despite the fact that Charles denied any involvement and just wanted to grieve in peace. There was no real evidence against him, but the state had an ace up its sleeve in the form of Dr. Richard Souviron.
Dr. Souviron was a forensic odontologist, which is a dentist …
Recently, a group of researchers at the University of California, San Francisco, reported that they may have found the holy grail of pain management. They accomplished this by performing “the first-in-human, long-term direct brain measurement of chronic pain-related neural activity.”
Physicians have long sought a reliable way to detect and track the presence of chronic pain and its response to treatment but have failed completely so far. Old tropes like …
Did you know that promethazine with codeine cough syrup had a high risk of diversion and high risk of addiction? I didn’t.
From my experience, this is the only effective prescription cough medicine available. Sure, you can prescribe what is essentially over-the-counter dextromethorphan. But be ready when the patient throws a fit because that’s what they’ve been using for the last several days or weeks, and it wasn’t effective. Tessalon Perles …
What is a legitimate medical reason to prescribe an opioid medication today? For pain or addiction? Who decides which patients are worthy of treatment? This question is not just of academic interest. Any prescribing medical provider today must constantly live in fear that a law enforcement agent somewhere will disagree with the prescriber’s answer to these questions. On its face, it seems simple. If a patient has severe pain, a …
I sit in my clinic office, looking at today’s schedule. It’s a nice office with lots of white and pastels, modern furniture, an up-to-date computer, and a desk. I always wanted my clinic to look like something from the future, and now, after twelve years, it finally does. Besides the screen on my desk, there is a large screen on the wall to my left, the patient’s right. From my …
The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn’t include specific diagnostic criteria for this condition. Over the next sixty years, the DSM went through six revisions, with a slow evolution of the terms “substance abuse” and “dependence.” The first was limited to substance use causing social and occupational problems, while the last …
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