Pharmaceuticals

A look at substance use disorder

Substance_use_disorder

This HND piece gives an introduction to this major problem, beginning with a breakdown of the ten biggest addictions, and the number of people so encumbered. We then move into the treatment modalities of behavioral therapy and medication-assisted treatment (MAT).

Unfortunately, the reputation of MAT--which can be quite effective--has been spolied a bit by unscrupulous practitioners, but those operations are gradually being pushed out by the ethical clinics. There really is hope for those in the grips of substance abuse disorder.

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A look at ketamine

KetamineThis HND piece examines the anesthetic ketamine, delving into its history, current uses, and prospective applications as a therapy for depression, anxiety, PTSD, and in cocaine addiction treatment. Ketamine was first introduced as a replacement for PCP, used in the 1950s and early 1960s as a general anesthetic. But PCP had nasty hallucinogenic side effects, as was taken off the legal market.

While ketamine in proper doses can have mild hallucinogenic side effects of its own, it is mostly well tolerated and is quite safe. We describe the non-anesthetic uses as ketamine infusion grows in popularity.

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The state of medical cannabis

Medical_cannabisThis HND piece examines the odd disparities and paradoxes in our country's approach to regulating cannabis. Not only are there state-to-state differences, but there is a bizarre situation at the federal level. Even though a particular preparation of cannabidiol is now FDA approved, cannabis is still considered a Schedule I controlled substance. That is, of course, unless the cannabis is that exact preparation of CBD—Epidiolex—which is merely Schedule V.

We contrast this mess with the situation in Australia, where medical cannabis is legal at the federal level throughout the country. It's all about Prohibition, isn't it? To prove this, we reference the work of Fredric Wertham.

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Keeping track of your drugs and their proper dosing

Keeping_track_of_drugs

This HND piece examines how we handle the massive numbers of prescription drugs in our midst. With the majority of Americans on at least one drug, and over 20 percent on five or more, this is a big deal. In fact, with more than 4 billion prescriptions being filled every year, it is a huge deal, and can also engender plenty of potential danger.

We provide some helpful hints, and link to good apps to maintain control of your drugs and dosing, and introduce a cool new security product that should help stop prescription drug abuse.

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Hot topics for mid-January

This HND piece focuses on two items: A new diagnostic for colorectal cancer that seems every bit as effective as a colonoscopy, and requires only a simple blood draw; and some controversies that are sure to arise as CBD becomes a mainstream drug.

While colonoscopy is the gold standard, many people for whom this test is indicated do not comply. It is certainly invasive, and requires a prep that is not as nasty as some years ago, but is still a bit unpleasant. The new blood test from CellMax Life looks impressive in trials.

As to CBD, Epidiolex—a purified CBD extract boasting an FDA approval (for certain seizure disorders)—is looking for great things. Only, it will cost more than $30,000 per year. This is ironic, since CBD has long been known to have wonderful anti-seizure properties, and has been used for this purpose for a number of years. Look for the insurance industry to push back. Fun, fun, fun.

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Controlled substances: Who's watching the controllers?

This HND piece focuses on serious vagaries in how a particular controlled substance, CBD, is regulated. The case discussed involves Epidiolex, a CBD isolate recently FDA-approved for certain seizure disorders.

CBD is considered a Schedule I substance, which means that it has no approved medical usage. But, I guess it now does, so what is to be done? Let's just say that what the Feds did pleased the makers of Epidiolex...and no one else. Regulatory politics at its absolute worst.

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More on CBD

This HND piece is a follow-up to previous postings on this exciting Cannabis extract. Cannabidiol is rapidly growing in popularity because it provides virtually all the medical benefits of Cannabis, without the psychotropic effects. As such, it should be of no interest to the DEA, but may eventually come under the FDA.

Thus, CBD suppliers are encouraged to act as if they already were regulated. Note how the FDA is starting to go hog-wild on e-cigarettes if any further convincing is needed. The piece provides many useful links—especially to research studies on how CBD can benefit sufferers of 46 medical conditions.

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The benzo predicament

This HND piece examines the country's most UN-heralded drug problem.  I'm talking about benzodiazepines--aka "benzos."  This class of drugs is not only very addictive, but it is extremely difficult to wean yourself off them.  Some patients go on tapers of decreasing the dose 1-2% per MONTH.

We give you plenty of depressing facts and figures, and quote well-regarded sources, including Drs. Kelly Brogan and Peter Breggin.   Don't miss this one.

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The opioid epidemic: One man's progress is another man's pain

This HND piece dissects the American Medical Association's recent touting of its progress in fighting the opioid epidemic. Their big argument is that opioid prescriptions have been decreasing every year since 2013. But, is this unmitigated good news?

Not if it negatively affects those sufferers of chronic pain, who really need these meds. In fact, misuse of pills was never a big factor in the opioid problem. It's heroin/fentanyl that's actually killing people. Besides, regardless of the scripts being down, the number of overdose deaths increases every year.

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Sublocade: A new injectable for addiction treatment

This HND piece spotlights a new drug that could prove quite effective in the treatment of opioid addiction. Sublocade is an injectable form of the established drug buprenorphine, and offers certain advantages over the conventional sublingual administration. Medication is steadily released into the bloodstream, which helps patients to be compliant with the regimen, and diversion is a non-issue. Various security protocols would be in effect, and the drug does carry a boxed warning.

Some within the addiction treatment community see Sublocade taking attention away from the heavily promoted Vivitrol—and they consider that a good thing.

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