We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradi…
Category: Meds
Esketamine is not a breakthrough new drug: Why the nasal spray for depression is old news
The FDA has given official approval to market eskatamine as a treatment for depression. As expected, there has been great fanfare (press releases, morning TV talk show guests, NPR segments and so on). The news leaves me salty. The esketamine story reve…
Inappropriate antibiotics are the new drugs of abuse
In my clinical practice, I have encountered patient aggression typically with narcotic medications, in particular with the refusal of a refill due to evidence of concerning behavior, like a positive drug screen for drugs not prescribed. Aggressive beha…
The tip of the iatrogenic benzodiazepine iceberg
Life experience gives one an intimate appreciation for the meaning behind the saying “just the tip of the iceberg.” Everyone’s encountered something that turned out to be much larger and more complex than was initially understood. In my experience, med…
A Xanax prescription that should have been rejected
In hindsight, I should have never accepted a Xanax prescription from my doctor. What followed was catastrophic — rapidly developing tolerance and physical dependence on the drug and a prolonged illness. Three-and-a-half years later, I am still slowly t…
How opioids can destroy the most beloved of personalities
“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…
How opioids can destroy the most beloved of personalities
“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-…
A shortage of Kayexalate leads to an ER visit
Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody had Kayexalate, the time-tested antidote, i…
The problem with high-potency marijuana
Advocates for the legalization of medical and retail marijuana are quick to point out all the possible benefits that a community might see from such a venture. These include increased jobs, increased tax revenue, possible medical benefits and they adve…
Generics aren’t going to help the cost of chemotherapy drugs
Chemotherapy drugs have become ridiculously expensive. Many new drugs come to market costing more than $100,000 per patient for a full course of treatment. Often, patients have to pay a significant portion of these costs. For example, a 20% co-insuranc…
