Painkiller overdose deaths top those from heroin and cocaine

Almost everything I know about chronic pain I learned while working in hospice palliative care, where pain management was one of the most important components in easing the end-of-life suffering of our patients.  But even before then, one April morning in 1983, I listened to my father’s oncologist tell our family:

 We are reluctant to give him morphine for his pain because it’s addictive.”   

My Dad, who had been diagnosed with metastatic lung cancer, died nine hours after that pronouncement. But at least he wasn’t an addict when he died.  Continue reading

Foreign intrigue: when drug companies bribe doctors

Pfizer, the world’s biggest drug company (at least until their blockbuster cholesterol drug Lipitor truly loses its patent protection for real) has reached a legal agreement in principle to resolve a foreign bribery investigation. A final deal could be struck by the end of the month, according to an SEC filing reported on Pharmalot. Three months ago, Pfizer officials said they had “voluntarily” provided information about “potentially improper payments” made by unspecified Pfizer and its Wyeth subsidiaries in connection with sales activities “in countries other than the U.S.”

The other countries were not named.

The move, as described by Pharmalot, comes amid increased scrutiny by the U.S. government into the pharmaceutical industry and its interactions with foreign health care systems.

“In late 2009, the head of the Justice Department’s Criminal Division warned drugmakers that there will be more criminal enforcement against interactions with foreign officials as they seek violations of the Foreign Corrupt Practices Act (FCPA).”

And he apparently meant it.  Continue reading

Universal cholesterol screening for little kids?

November 11, 2011 was a happy day for Big Pharma. That’s the day when The National Heart, Lung and Blood Institute issued new guidelines recommending that every child’s first cholesterol check should occur before the kid hits puberty, between the age of 9-11.  As the Wall Street Journal reported at the time, the guidelines also come amid broad concern about growing numbers of children who are overweight or obese (as about 17% of the little darlings are, triple the level from three decades ago).

These children, say those who wrote these guidelines, are thus potentially on course for diabetes, high blood pressure, heart disease and other serious health problems as adults.

With all due respect to the very smart doctors who came up with what amounts to a resounding high-five victory for marketing-based medicine, I feel compelled to ask:

“What were you thinking?”

Even though the new guidelines contain a mandatory cautionary note (“Drugs? What drugs?”) the corporate pharmaceutical windfall that’s implicit in them is worth celebrating if you happen to own stock in Big Pharma.   Continue reading

When patients demand treatments that won’t work

When my son Ben came down with another killer sore throat this past summer, he went to his doctor for an antibiotics prescription. He’d suffered this condition in the past, and he knew just what would help ease his painful symptoms. Both he and the doctor agreed this sure sounded like strep, so without even having to wait for the throat swab test results for the group A Streptococcus bacteria that cause strep throat, Ben left the doctor’s office with a prescription for antibiotics in hand.

But were antibiotics the appropriate treatment for Ben’s painful problem?  Continue reading