prescription drugs


She was 29 years old and so obese that she had to walk through the door to my office sideways.  She had put on most of the weight, she said, after she had
been date-raped.

She did not remember much about what happened.  She knew the guy who had been with her, and avoided him as best she could, although she still had thoughts of him, that intruded into either her nighttime dreams or her daytime thoughts.  And she had the characteristic “hyper-arousal.”  I have learned, the hard way, never to think of slamming the door or clapping my hands to test this one.  I only did that once or twice and always regretted it.  I just asked her if a sudden noise made her jump in the air, ever, and she nodded.  “How did you know?”  she asked. Read more on Roofies, Ruffies, or Mexican Valium: It Doesn’t Say “I Love You.”…


I was a staff psychiatrist at the Las Vegas VA, when the endocrinologist who was assigned from that august institution to take care of me told me that Meridia for weight loss would be a good idea.

Surprisingly, the first thing that came up on my search today was something from the Forbes magazine health editor. Duh, this is a business story.

When I declined Meridia, because of what he thought were “only a few”
reports of sudden death, I was packing on the weight steadily– due exclusively because of his treatment for me — which included taking a lot of insulin which obviously I did not need.  After all, I had a bit much blood sugar and he never noticed it was chasing my triglycerides, and/or never saw this, although it had been starting even then to become evident to me. Read more on Harmful Drugs Are Reported As Business News — Not Health Or Medical…


“I really don’t need medicine.  I am fine and I applied to the fire department and I will be a firefighter.”

This is a typical response from a man.  In our culture, we raise junior John Wayne types — tough and independent.

He was in the room with his mother, who was fighting back tears.  “I have tried everything to make him take medicine.  I can beg him, but he does not take it very often.” Read more on The Mother Who Learned To Trust…

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I’ve heard people say this about something that is a waste of money, “You might as well just flush your money down a toilet.”

That isn’t always the best way to dispose of something – even excess money.

Recently there was a major national “event” where people take back and dispose of drugs free of charge. It was supposed to have something to do with publicity. Since I am constantly trying to be the most up-to-date of anyone who prescribes psychotropic drugs, I have to conclude that the publicity is unlikely to have been extremely effective.  My patients sometimes exchanges prescriptions with friends or family — or steal them — and when I tell people they are only intended for the person whose name is written on the label, they get angry at me. Read more on Disposing Of Old Prescriptions Is Tricky…

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Rarely do I see a poll or study that lines up so perfectly with what patients tell me as this study showing that plenty of women have no interest in sex. Whatever creator you believe in, with a seemingly infinite sense of humor, has given males a sexual response that sometimes looks or sounds like little more than a simple spinal cord reflex.

Although I will admit that I am sometimes a bit surprised at what the cues are, there seems to often be something unlikely that provokes the pleasure response pretty directly. Two of the strangest – and yet most common – things men tell me that are “turn-ons” are seeing a woman’s fingers with deep red fingernail polish resting on her blue-jeans leg warmers; and watching a woman bend over to fix the sink (yes – fully clothed). Read more on Lack Of Female Desire? Throw A Pill At It!…

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I guess the death of Anna Nicole Smith has become old news.  All I found in the daily newspaper was a short item saying that the trial was going on in Los Angeles.

After more than one internet search, the only mention I found of what is going on online is this one, in what seems to be a Seattle tabloid.

I strongly suspect that this is a road that has been travelled more than I know.  After all, I am not exactly a celebrity watcher. Nevertheless, from what we already know about folks like Michael Jackson, and from what Dr. Nathalie Maullin seems to have said under oath, I think we have a pretty good idea of what it is like to be a drug-seeking celebrity.

First, I think it worth noting that Dr. Maullin was on staff at Cedars-Sinai at the time. Now putting aside the PR of the latter (it is allegedly the best in L.A.; they have ads and some top notch publicity firm–) Cedars Sinai is a hospital.  I can testify that to be on staff at any clinic or hospital, they do a background check. Read more on Anna Nicole’s Doctors Couldn’t Have Made Worse Decisions If They Tried…


She was a 33 year old raven-haired exhausted woman who had probably been a beauty before she bore children, now aged 9, 6, and 4.  She wanted a renewal on her sleeping pills.  She did not want the antidepressant or anything else, just sleeping pills. She said that since the children all slept through the night, now she could, too.  She had not only a tubal ligation at her final pregnancy, but an ex-boyfriend who was no more than a distant memory.

Her last doctor, apparently a rarity, had actually started by prescribing the sleeping pills every third night. That had not lasted more than four weeks or so.  She wanted, and felt she “deserved,” sleep every night. She was convinced that was what the insurance doctors gave the rich people, so she was not going to let anybody skimp on her. Sleeping pills every night.  She would not have to think about anything other than keeping a bottle by her bed and getting it into her mouth.  Sleep would be automatic and life would be sweet.

The last doctor had been, to his credit, assertive enough to tell her that if this was what she wanted, she would be coming in every three months for the rest of her natural life on planet earth, to get sleeping pills. She thought that was just fine; that it was what everyone did and should do, since we had something as wonderful as sleeping pills in the world. Read more on Pharmaceutical Companies Are Stealing Our Dreams…


She was nearly thirty, dark haired and round-faced and ambitious, and wanted to be a drug and alcohol counselor, maybe.  Maybe not.  She had only three months of sobriety from alcohol; probably wanted to be one of those people in power.  So many programs dry people out and let them “stay on” a bit.  So many people use their own exaggerated stories to “help” other people stay sober.  A closet industry of subjective touchy feely, trampling, as many do on my long years of difficult, mind boggling training with cheap feel-good.

Her drug and alcohol counselor had told her that she would feel rotten for a while, so she had accepted that. But she felt obligated to tell me that she had felt rotten, so I let her talk and tried to listen.

People coming off alcohol may take as much as a year to get their sleep cycle back (alcohol represses Rapid Eye Movement sleep) and to stop feeling a little bit nervous.  But this was not that. Read more on Serotonin Syndrome: Less Is More…


A nurse told me, “she called the clinic and she was ranting.  She must have been drunk.” I did not think she was.  She was a born-again Christian who did a lot of Bible-thumping, not that Bible-thumping by itself actually prevents anyone from drinking. She was in her fifties, trying to go back to school to get a college diploma she had missed earlier in life, with marriage and children. Something spiritual and faith based.  I didn’t care what she wanted to learn about, for I truly respect people who are trying to accomplish things. I just didn’t think she would want to be seen buying a bottle of anything, for she was so sensitive about a public image that did not mean very much to anybody else.  I think she was sensitive about it because she lived alone and her church was her surrogate family and they lived near her.  All her life was in walking distance.  Somehow I just did not see her as a drinker.

“I think she did something she usually does not do when she calls us. I think she just took everything her pain doctor prescribed for her.”

I had seen this woman in the office a few days before.  She told me she had not yet taken any of her pain medications that day.  She was awake and alert and pleasant, really pleasant.  She told me she did not sleep and so she needed some sleeping pills. She had been in the hospital for something unrelated, some kind of a minor surgical procedure.  Somehow, a nurse I work with had done the research and talked to someone who had taken care of her in the hospital. She slept.  Lots.  Late.  Missing breakfast and eating it when it was cold.  She had been on a relatively low dose of pain medications for her chronic pain problem.  As far as I could figure, and I had taken care of her for a while, her pain was what you call “benign” pain.  I mean, and she had told me the truth on this one, she had osteo-arthritic pain..  So how did she end up on so much pain medicine, and asking me for sleep medicine which she had not received, since in the hospital she had been taking the same thing I had prescribed. Read more on It Was All Prescribed…

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People who have panic disorder go to doctors to take care of it.  I have had maybe hundreds of patients, more than I can count over my years of practice, who have come to me with this.  Most of them do well. Usually the panic disorder runs its course.

That is not to say that panic disorder is not terrifying.  Often people believe that their first panic attack is a heart attack.  Often they have come to me already addicted to benzodiazepines by emergency room physicians who (understandably) worry a lot more about the immediate comfort of the patient than about the long term situation. Here is the official government take on panic disorder. Yes, find a psychiatrist you can trust. Yes, they recommend family and support groups.  Good stuff, but free and easy to recommend. Yes, there is some exciting new research but as long as insurance companies and HMOs determine how people get treated, it is unlikely that research will be quickly translated into treatment.

Most people who go with the mainstream treatment do pretty well. Here is another description of mainstream treatment, a little more complete. Read more on A Real Doctor — Like House MD…