Author's posts
Codeine cough syrup: a controversial classification
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 essen…
Balancing medical ethics in opioid treatment
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 constant…
Navigating medication prescriptions in a DEA-observed world
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, afte…
Vague criteria can lead to misdiagnosis and prison
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 six…
Balancing opioid medication in chronic pain
She walked in with a cane, bent over like a question mark. She was in her seventies and as sweet as people in that age group tend to be. I think most of the cranky ones don’t make it that far. She was something of an emergency because her doctor …
Doctor convictions: Unmasking the 3 threats you need to know
Why would anyone lie about you? And what makes you prone to conviction? There are three types of people that will absolutely bring your world crashing down on you, and you need to know who they are. But first, we need to understand the formula that pro…
DEA’s criteria for identifying pill mills: a physician’s analysis
Many physicians reading this forum treat pain and addiction and may wonder what criteria the DEA believes to be indicative of a pill mill. The following is from a motion filed in federal court regarding the prosecution of a physician: The government cl…
The persecution of pain management doctors
The call came in during a busy workday. My comprehensive primary care clinic had been built over a decade of hard work and had a general practice clinic staffed by a very capable former surgeon and several nurse practitioners, as well as a pain managem…
