Don’t Ditch The Randomized Controlled Trial
Ditching the RCT means approving treatments without subjecting them to a test that is purposefully designed to reduce the impact of bias when evaluating their efficacy and safety.
Driving While Looking In The Rear View Mirror
About Supervised Injection Facilities
The opioid epidemic is not just an overdose epidemic. It is also an HIV and Hepatitis C epidemic. We need to consider all evidence-based interventions for this, no matter how they challenge our long-held beliefs about morality and addiction.
Behind The Addiction Treatment Gap – Clinician Denial
3 min read…Until a few years ago, I used to spend a few days a year helping psychiatrists prepare for their oral board exams. The exam involved, among other things, interviewing a patient while examiners watched. After the interview the
Peering Behind The Addiction Treatment Gap
The addiction ‘treatment gap’ is real, but treatment capacity and healthcare coverage are not the only factors behind it.
How Not to Screen for Suicidal Thoughts: Lessons from Mountain View Police
4 min read…A couple of days ago, Mountain View, CA police released the video footage of their interaction with Nasim Aghdam about 11 hours before she shot people at You Tube headquarters. It is a remarkably unremarkable video in the
Race & The Opioid Epidemic – Implications For Healthcare Professional Education
4 min read…Generations of medical students learn early and repeatedly in their training to begin the description of a clinical case with demographic information. As in, “AH is a 52 year old divorced, white female who presents with the chief
Initial Reflections on The 2018 National Rx Drug Abuse & Heroin Summit
2 min read…I just returned from my first National Rx Drug Abuse & Heroin Summit in Atlanta. I was registered for the summit last year too but had to cancel my plans at the last minute after my wife needed
Our Ambivalence About Addiction is Killing Us
0 min read…We lost more than 33,000 Americans to opioid overdoses in 2015. Over 50,000 succumbed to all overdoses. That’s more than were murdered, killed themselves or died in car accidents that year. Yet, we can’t make up our mind.
The Story of My Wife’s Brush with The Swinging Opioid Pendulum
A physician traces the evolution of the opioid epidemic while coming face-to-face with the practical reality of America’s swing away from opioid prescribing. Making pain the 5th vital sign directly led to our irrational opioids prescribing. Now, we are prone to the same lack of nuance and clinical judgment in the opposite direction.