Jul 09, 2017 Chris Foley

The new opiate…but it’s not a controlled substance…

The substance above is commonly used to treat “nerve pain” but is also prescribed and used for just about every kind of pain — muscle, joint, headaches, you name it — is the new “companion” drug for opiate users to gain a better “high”.  Gabapentin, aka, Neurontin, is the de rigueur new designer drug to go into your opiate sandwich.  In fact adding some gabapentin — or it’s much advertised cousin, Lyrica — to the treatment mix is frequently the quickest way to end a visit with a chronic pain sufferer whose diagnosis continues to be frustratingly ambiguous.  Hmm.

 

Last December, Ohio’s Board of Pharmacy began reporting sales of gabapentin prescriptions in its regular monitoring of controlled substances. The drug, which is neither an opioid nor designated a controlled substance by federal authorities, is used to treat nerve pain. But the board found that it was the most prescribed medication on its list that month, surpassing oxycodone by more than 9 million doses. In February, the Ohio Substance Abuse Monitoring Network issued an alert regarding increasing misuse across the state.  (Internal Medicine News 7.6.17)

 

Just like the laws of thermodynamics, for every action there is an equal an opposite re-action.  Here, my detective nose is once again going down that road that begins with asking the question, “What is REALLY happening here?”  So often I see patients who have been bounced around from clinic to clinic, specialist to specialist, Mayo to Mayo.  Dust to dust, ashes to ashes.  We live in a medical world increasingly dominated and frustrated by ill-defined, chronic, painful, and dysfunctional conditions for which we have seemingly continued to add one Band-Aid drug after another. Very little gets resolved. Did I mention Lyme disease? Now, we have created a new Pharnkenstein, and there will be more. Until the medical system begins to honestly address underlying causes and reasons for these chronic conditions, the drug industry will continue to spawn new black market epidemics.

So, what could be the harm in this seemingly innocuous add-on medication?   There is strong evidence that gabapentin and its cousin, pregabalin (Lyrica), actually inhibit dendritic plasticity and may also adversely affect reproductive functions. In other words long-term use of these two drugs will create infertility and inhibit one’s ability to learn. One might even say that it would accelerate brain aging and limit cognitive function.  The apparent benefit of these drugs in their use for chronic pain seems to largely come from limiting new “pain synapses”. That is certainly not a bad thing. However, unless the underlying reason for the pain is more aggressively sought, the patient is left to a future of simply covering it all up. Eventually, the brain is affected adversely. But also, eventually, novel and abusive uses of these drugs are discovered. This seems to be just the beginning.

 

 

 

Jul 04, 2016 Chris Foley

Zika may be just another Y2K…

…because it is appearing to be a virus in search of a disease…and perhaps a vaccine.  Nothing serves up a better medical version of “never letting a crisis go to waste” than some new, mysterious illness that seems to evoke billionAedes egyptis of dollars of federal aid overnight to the vaccine makers and their academic partners.  Although this virus certainly causes human illness, it does not appear to be either new nor as dangerous as the newsies would like it to be. »

Jul 03, 2016 Chris Foley

The CPT corner: diet and cancer…”Eat anything you want…”

Today wBroccolie will start a new weekly feature that focuses on the world of the “code”.   Most patients are oblivious of the fact that physicians have given up their professional status for the most part to that of representing an insurance interest.  In fact many academic MDs who are comfortably positioned in a tenured university position argue that clinical decision making should above be centered around that which is best for the overall “public health”.  Would “resource allocation” best serve the broader community if grandpa did or did not get that new hip or heart valve, for example.  The ever-evolving Current Procedural Terminology codes — aka, CPT codes — continue to influence and mold clinical decision making.  There is a direct relationship between this CPT culture and the reason why oncologists are tone deaf about diet… »

Jun 23, 2016 manager

Alzheimer’s at Harvard: We might have gotten this all wrong…

Bugs in your brain
Bugs in your brain

…and those crazy Lyme doctors might have been right.  Yes, there does appear to be some concern now that the abnormal protein accumulating in the membranes of individuals with documented dementia — AKA “Alzheimer’s disease” — may actually simply be the immune system’s reaction to infection.  Physicians familiar with the management of chronic Lyme disease, who have been told that there is no such thing, can perhaps now be exonerated for being absolutely correct about this organism.   In an important position piece published in Science Translational Medicine, “Alzheimer’s would be triggered by a normal immune response gone astray or into over-drive in response to bacteria or other pathogens.” as reported in USA Today.   »

May 23, 2016 admin

Did you know that your tax dollars are sending illegals to US medical schools?

Free medical education for illegals
Free medical education for illegals

As astonishing as that sounds, it is true based on a recent news story that has popped up as a result of several states challenging President Obama’s “DACA” executive order.  The Deferred Action for Childhood Arrivals or “DACA” is one of our creative president’s executive orders that protects the children of illegals who came here “through no fault of their own”.  Now the legal focus is on the use of taxpayer dollars to fund the medical education of these grown children:
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May 23, 2016 admin

The next time you consider a colonoscopy, remember that you have a 30% chance of incompetence

So-tell-me-everything-you-told-the-nurse-5-minutes-ago-Funny-medical-picturesShoving a large fiberoptic device where the sun don’t shine has become one of those hated rituals that we are all told to do in the interest of “prevention”. Well, first it is most definitely NOT prevention but rather earlier “detection” of cancers that have likely been brewing for years based on our understanding of the nature of colorectal cancer growth.

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May 23, 2016 admin

A major rearrangement of power in the health care system

… is underway and is being accomplished completely under the nose of the patient public, physicians, and even the legal profession.  Over the past year, there has been an effort to create a national consortium or commission that would effectively centralize the credentialing of medical licenses among the states.  »