Hurry back John Oliver!

6/23/2014, Watch John Oliver absolutely destroy Dr. Oz

1/27/2015, Read this before you ever believe another guest on the Dr. Oz Show

1/26/2015, Mandatory Use of Prescription Drug Monitoring Programs

Some studies associate state PDMPs with lower rates of prescription drug abuse and altered prescribing practices, although evidence is mixed and inconclusive…

Other objections are specific to mandating PDMP use. Robust evidence is lacking about how to best target mandates to prescriber types and contexts, which makes defining exemptions a policy challenge. Bluntly framed mandates could require physicians and other prescribers to search PDMPs when not clinically indicated or waste time that could be spent otherwise treating patients. Although mandates are not meant to deter opioid prescribing per se, resistant clinicians may simply decline to prescribe opioids, raise prescribing thresholds, refer patients elsewhere, or substitute to nonmonitored drugs—all of which could compromise appropriate symptom management.

“Compromise appropriate symptom management” is just a nice way of saying that patients will suffer.  Obviously, that’s not a problem, because the PDMPs and the drug war are more important than the patients themselves.

Mandates also can entail substantial punitive consequences for prescribers. Penalties for failure to appropriately use PDMPs range from increased liability risk to loss of licensure or imprisonment—an extraordinary punishment for failing to access a website that may contain information of uncertain value (eTable in the Supplement). Mandates may influence courts to hold physicians negligent—for example, when a patient overdoses and harms herself or a third party—if PDMP data could have raised concerns about abuse and modified prescribing. To allay penalty concerns, about half of states explicitly provide that prescribers are immune from liability for checking or failing to check the PDMP. Whether these immunity grants provide meaningful protection remains to be seen…

Marijuana vs. Prescription Meds

What part of your body hurts the most? Sometimes it’s hard to tell, right? But for me, the answer is usually my head.

Physical activity that increases my heart rate also increases the pounding in my head, so I’ve learned to take it slow. Strong emotions also increase the pounding in my head, so I’ve learned to buffer my emotional responses — in other words, to take it slow. But while I have some control over my physical activity, I don’t always have control over my emotions.  (I blame chronic pain for that.)

Drugs and emotions follow the same pathways in our brains, activating neurons as they travel, like dopamine and serotonin. When I took a Vicodin, I was increasing the same neural activity as when I laugh out loud (or have an orgasm) — just scientifically enhanced and more of it (for less work).

When I took a Valium or a Xanax, these drugs allowed me to slow down my emotional responses, making them easier to control and less apt to cause me more physical pain. Perhaps you could say that they gave me patience. Unfortunately, I think they also brought a little more sadness…

And as I sit here without any medicinal assistance with these issues, I can’t help but reflect on my year in New Mexico’s Medical Cannabis Program. During that time, my anger and sadness were much easier to manage and control (unlike right now, when I simultaneously feel like punching the wall and having a pity party for myself).

I just want pain patients to understand the differences between marijuana and prescription medications. There are benefits (and risks) with both; but in my opinion, while opioids provided more actual pain relief, I think marijuana won for more overall benefits (with less risk). Unfortunately, for a lot of pain patients, opioids are winning the affordability contest.

(I miss you, bud.)

About… life

From Mother Teresa’s Wikipedia page:

In April 1996, Mother Teresa fell and broke her collar bone. In August she suffered from malaria and failure of the left heart ventricle. She had heart surgery but it was clear that her health was declining. The Archbishop of Calcutta… said he ordered a priest to perform an exorcism on Mother Teresa with her permission when she was first hospitalised with cardiac problems because he thought she may be under attack by the devil…

Privately, Mother Teresa experienced doubts and struggles over her religious beliefs which lasted nearly 50 years until the end of her life, during which “she felt no presence of God whatsoever”…,_One_Room

Dr. Gregory House: They’re out there, doctors, lawyers, postal workers, some of them doing great some of them doing lousy. Are you going to base your whole life on who you got stuck in a room with?

Eve: I’m going to base this moment on who I’m stuck in a room with. It’s what life is. It’s a series of rooms and who we get stuck in those rooms with adds up to what our lives are.

Warning Signs of Suicide and Who to Call for Help

National Suicide Prevention Lifeline

1-800-273-TALK (8255) or

I’ve read that some people who have called the suicide hotline did not find it to be of much help. I want to be sure that I’m passing on information that is actually helpful, so if anyone who has used the hotline has an experience they wish to share, please feel free to do so in the comments. Thanks.