Category Archive: Medications

Opioid cheating is a billion-dollar industry

If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a […]

Pain care must be patient-centered, integrated, and individualized

Purdue Pharma recently ran a full-page advertisement in the Wall Street Journal and the Washington Post asserting that the company, which manufactures prescription opioids, wants to limit the use of prescription opioids. While this ad may have left some readers confused, one point rang true: “we believe the country needs a new approach to prescribing […]

The erosion of informed consent in medical research

The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years (“Informed Consent for Babies: When Experts Disagree,” “Informed Consent in Infant Research: Ethical Problems Remain,” “Informed Consent in Comparative Effectiveness Research,” and “The […]

Kratom: harmless herbal supplement or dangerous drug?

What is it? Kratom is a powdered herbal supplement derived from the leaves of a tropical evergreen tree that is native to Southeast Asia and is usually taken orally but can also be brewed into teas. It is commonly used by consumers as an alternative medicine to self-treat opioid addiction and chronic pain.  The leaves […]

Changing the treatment plan when covering for another doctor

I was a little taken aback when Dr. C. changed my patient from warfarin to one of the novel anticoagulants. And one I seldom use, at that. I have only worked with her for about three years, and we seem to come from the same mold: seasoned family docs with a penchant for teaching and […]

Changing the treatment plan when covering for another doctor

I was a little taken aback when Dr. C. changed my patient from warfarin to one of the novel anticoagulants. And one I seldom use, at that. I have only worked with her for about three years, and we seem to come from the same mold: seasoned family docs with a penchant for teaching and […]

We should all care when patients get too many Z-paks

Many people seem to believe that the Z-pak possesses magical qualities. Patients come in requesting it for the common cold, because it worked for them in the past. Not only do many believe it cures the common cold, but they think it can treat any infection. Have a urinary tract infection? Just ask your doctor […]

The misguided expectation of eliminating pain

I am against all forms of bodily pain, both foreign and domestic. I wish the world were pain-free. When I am suffering from even a routine headache, I want immediate relief just like everyone else. The medical approach to pain control has changed dramatically even during my own career. When I started practicing a few […]

Are abuse-deterrent opioids the solution to the opioid crisis?

As a primary care doctor who cares for many patients with opioid-use disorder, I am invested in timely and effective strategies to curb our nation’s opioid epidemic. Because so many instances of opioid addiction and overdoses begin with or involve commonly prescribed opioids, we need multiple strategies that address the significant harms associated with prescription […]

Why do so few doctors treat people with opioid addictions?

Dear Doctor, Please help me understand why so few of you have chosen to treat people with opioid addictions. I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals with opioid […]

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