Category Archives: Prescription medications

The Social Determinants of Addiction

By | February 15, 2018

Opioid use is a serious concern that the executive branch of the United States government recently declared a public health emergency. Based on data from the Department of Health and Human Services, in 2016, 2.1 million people misused prescription opioids for the first time, and 42,249 people died from overdosing on opioids. Also in 2016, 170,000… Read More »

In the fight against the opioid epidemic, states should update their needle and syringe access laws

By | February 8, 2018

During my time as a community pharmacist in Maryland, I often encountered individuals who would approach the pharmacy in search of syringes. Although they would try to disguise their intentions by stating that they needed it for someone else or for an animal, it was apparent why they were there; they were going to use… Read More »

Impact of Medication Adherence on Health Services Utilization in Medicaid

By | February 1, 2018

Medication is an essential aspect of tertiary prevention, as it often addresses symptoms, may restore function, and minimizes adverse consequences associated with chronic conditions. Medication adherence is most often studied in the context of Medicare Part D. In a newly published Medical Care article, Drs. Roebuck, Kaestner, and Dougherty, instead measure the associations between medication… Read More »

Abuse-Deterrent Formulations: A Solution to the Problem

By | January 25, 2018

Despite continuous efforts to address the problem, high rates of prescription opioid use and abuse continue to plague our country.  According to the CDC, deaths involving prescription opioids in the United States have quadrupled since 1999, and so have the sales of these prescription drugs.  In 2015, the American Public Health Association published a policy… Read More »

The Effect of Co-Payments on Incarcerated Women

By | January 11, 2018

Prisoners have a fundamental right to receive health care while incarcerated, a right that is mandated by the US Supreme Court. However, negligent care in prisons persists and is often an issue of limited access due to cost mitigating policies. Since the 1990’s, prison systems have integrated managed care strategies, like co-payments, to mitigate increasing… Read More »

Promoting Primary Prevention of Neonatal Abstinence Syndrome

By | October 19, 2017

“Neonatal abstinence syndrome” (NAS) sounds deceptively innocuous, given that it is literally infant drug withdrawal. It is usually caused by prenatal exposure to opiates but can also result from maternal consumption of other substances, like alcohol and antianxiety medications. Common symptoms include excessive high-pitched crying, fever, sweating, irritability, vomiting, diarrhea, rapid breathing, sleep disturbances, and poor… Read More »

What’s the difference between opioid use, misuse, and addiction?

By | September 30, 2017

Opioid addiction seems to be in the news every day. But what’s the difference between an opioid user and an opioid addict? First, let’s define our terms. Opioids are drugs derived from the opium poppy, including heroin and morphine. The class also includes synthetic opium-derived prescription painkillers including oxycontin and fentanyl, as well as drugs… Read More »

Preventing Health Care that Almost Nobody Needs

By | September 28, 2017

Medicine, alongside achievements in sanitation and public health, remains one of the major achievements of modern society. The reduction (or eradication) of many infectious diseases from the developed world, breakthroughs in anesthesiology and surgery, and advances in the care of chronic diseases (including HIV) are just a few of the multitudes of achievements. But these… Read More »

Mobile Apps to Improve Medication Adherence

What do you use your cell phone for on a daily basis? Many people would say using social media, texting, and placing phone calls– but have you ever considered your smartphone as a tool to improve medication adherence?  Our phones are an integral part of our lives, and consequently, researchers, clinicians, and patients have all… Read More »

Patterns of Opioid Use and Risk of Opioid Overdose

By | July 6, 2017

Opiate overdose is now the leading cause of accidental death in the United States, killing more than 50,000 people in 2015. About 20,000 of those deaths were attributed to the use of prescription opiate medications. As a physician, I want to alleviate my patients’ pain, but I have also taken an oath to do my… Read More »

POLICY UPDATE: Contraception Coverage

The burden of contraception falls primarily on women. In the United States, women need prescriptions for the majority of contraceptive methods, and so are vulnerable to changes in the healthcare system affecting access to care. Recently, President Trump has issued executive orders on religious liberty and related subjects that have paved the way for a rule… Read More »

Problems with Epilepsy Drug Treatment for Older Adults

By | June 3, 2017

Expensive brand-name drugs are prescribed over older, less costly generics whose efficacy and risk profiles aren’t much different. Sometimes the financial issues involved are painfully obvious, such as when a drug company introduces a new, “improved” version of a medication that is merely a longer-acting version of the same chemical entity shortly before the patent expires on the original… Read More »

Patterns of Buprenorphine-Naloxone Treatment for Opioid Use Disorder

By | May 4, 2017

Despite a rapid expansion in the use of buprenorphine-naloxone (bup-nx) as a treatment for opioid use disorder, there is little understanding of the patterns of treatment. In a newly published-ahead-of-print Medical Care article, Brendan Saloner and colleagues from Johns Hopkins used an all-payer claims database to investigate what factors predict the duration of treatment, dosage, and continuity of treatment for… Read More »

Avoiding Anticholinergic Drugs May Reduce Alzheimer’s Risk

By | April 5, 2017

I’ll never forget the time Granddaddy tried to eat my hand. At least that’s how it seemed to me at age six. In reality, he’d simply confused my hand with the straw sticking out of the milkshake we’d brought to him at the nursing home. By that point in his early-onset Alzheimer’s disease, the Granddaddy… Read More »

How did Part D affect mortality among women with breast cancer?

By | March 2, 2017

Ten years ago, Medicare began publicly financing and subsidizing the prescription drug program for seniors known as Part D. Individuals over age 65 with incomes below poverty are dually eligible for both Medicaid and Medicare, and full-benefit dual enrollees are automatically enrolled in a subsidized prescription drug plan with minimal co-payments. Turns out, this policy intervention may have played… Read More »

Chronic pain, opioids, and medical marijuana

By | February 2, 2017

High-quality evidence supports the use of medical marijuana for chronic pain, neuropathic pain, and other conditions. Yet, patients who live in some states can’t legally use it — and are threatened with loss of access to their prescribed pain medications if they do. I know this because a close family member of mine has chronic pain.… Read More »

Economic Burden of the Opioid Epidemic

By | September 29, 2016

According to the U.S. Department of Health & Human Services, in 2014, more than 240 million prescriptions were written for opioids, which is more than sufficient for each American adult to have one full bottle of opioids. Prescription drugs are second only to marijuana as the most abused category of drug in the United States. A recent article… Read More »

The ACA vs. the doughnut hole: Medicare part D utilization and costs

By | September 8, 2016

President Obama’s Affordable Care Act (ACA) included provisions to gradually reduce the Medicare part D “doughnut hole” – a much-maligned gap in coverage that was an economizing feature of President Bush’s legislation. So, how have these changes affected drug use and spending by seniors? A new article in Medical Care provides insights. Under the standard part D benefit… Read More »

Seeking Clarity on Opioid Prescribing

By | July 8, 2016

According to the National Institutes of Health (NIH), more than 18,000 people died from overdoses of prescription opioids in 2014. This is more than the number of overdose deaths attributed to heroin (10,854) and cocaine (5,415) combined. Opioids are pain relievers that are chemically similar to morphine. Existing clinical guidelines recommend against exceeding a threshold… Read More »

Measuring Cost-related Medication Burden

By | February 18, 2016

As readers of Medical Care are no doubt aware, prescription drug expenditures for Medicare beneficiaries are high – nearly $90 billion in 2012.  There is some evidence that Medicare Part D has reduced financial burdens, at least among some beneficiaries, but recent surveys suggest that around 4.4% of individuals ages 65 and older (including those not on… Read More »