It is a good idea to check on the current price of medications once in a while. When I do this, I am invariably surprised by price changes since the last time I looked. On the one hand, once a medication goes generic, the price will fall to a small fraction of what it used to cost. This process can occur quickly, say over 6 months, or may take a couple of years until it hits bottom. On the other hand, sometimes drugs that had been cheap, quickly and inexplicably become expensive. The current prices for antipschotics show both trends. Continue reading
The question was raised recently about how to handle inmates who prior to jail, were enrolled in a methadone or Suboxone program to treat narcotic addiction. Should they continue the methadone or Suboxone in jail? Or should they instead be enrolled in the jail opioid detoxification program (we use clonodine at my jails) and withdrawn? Continue reading
Well, JailMedicine is now over six months old and has been more fun to write and much better received than I had imagined it would be. JailMedicine has had over 30,000 hits! Thank you especially to those of you who have written comments. I have my opinions on certain topics (as you have read) but I realize that smart and accomplished people sometimes disagree with me–and sometimes they are right and I am wrong! We all learn and become more effective clinicians when alternative views are expressed and debated–so please comment!
What can I do to make JailMedicine better? Continue reading
Reader Question of the Week:
How do I go about convincing the management team to allow me to treat inmates for STI’s. It is common practice to obtain a UA for c/o burning etc per protocol. But, I am not allowed to move forward with determining if they have an STD if the UA is negative and s/s persist. I am told there was previous funding for this, but was lost with budget cuts. I am tempted to treat these inmates per WA State Department of Health Guidelines for STD management anyway. Would this be wrong? How would I know what to give them? I would be guessing. I am thinking azithromycin 1 gm and flagyl 500 mg po bid x 7 days? Comments? Continue reading