Sunday, May 15, 2016


Malaria was eliminated form the United States in 1951 but is still deadly around the world. There were 214 million cases and 438,000 deaths in 2015, mostly young children in sub-Saharan Africa. Each year approximately 1,500 travelers become infected abroad and return to the United States.


Anyone can get malaria. Usually people get malaria after being bitten by an infective Anopheles mosquito but malaria is also transmitted by shared needles or syringes. It is not sexually transmitted. Symptoms start ten days to four weeks after infection.

Many effective anti-malaria medications are available. It is best to buy the medications in the United States since there is a risk of counterfeit medications and/or the medications may not be safe. There is no vaccine available yet.

A comprehensive review from the CDC answers almost all questions. 

Monday, May 2, 2016


There are aches and pain of daily life and then there is pain: post-operative, orthopedic or associated with cancer. In the acute situation pain relief will lead to less stress on the body and the mind with the hopes of accelerating recovery. This type of acute pain is an appropriate use of narcotics. In the unfortunate situation the pain becomes chronic. In the past one learned to live with the pain but then the tide turned and the goal was to make everyone ‘pain free.’ The unintended consequence of a ‘pain free’ existence has been an epidemic of drug abuse.

The use of narcotics may be entirely appropriate in acute and self-limited situations but the long-term goal now is to maintain functionality even the face of pain. Complementary medicine, such as acupuncture, plays an important role in the management of pain. Health care practitioners are embracing a new paradigm, some more enthusiastically than others.

The Department of Consumer Protection in Connecticut monitors all dispensing of controlled substances. These include sleeping pills, tranquilizers, codeine cough medicine and most pain medications. From the website: The prescription monitoring program collects prescription data for Schedule II through Schedule V drugs into a central database, the Connecticut Prescription Monitoring and Reporting System (CPMRS), which can then be used by providers and pharmacists in the active treatment of their patients. The purpose of the CPMRS is to present a complete picture of a patient’s controlled substance use, including prescriptions by other providers, so that the provider can properly manage the patient’s treatment, including the referral of a patient to services offering treatment for drug abuse or addiction when appropriate.

Prescriptions for controlled substances cannot be called into a pharmacy but must be written on special paper. The prescriber is mandated to check the database for any prescription for a more than seventy-two hour supply of medication. Prescriptions for chronic pain are typically written for a twenty-eight day supply with the ultimate goal of weaning the patient from narcotics to other modes of pain management.