The short-term analysis included 29,442 patients with cannabis dependence matched to 29,442 patients without dependence. Cannabis dependence was significantly associated with an approximately 4-fold higher risk for ED and PDE5i prescription at 3 months to 1 year from diagnosis among all men and those aged 40 years and older and an approximately 3-fold higher risk for men aged 18-39 years, Dr Asanad’s team reported in The Journal of Sexual Medicine. The longer-term analysis included 17,211 men with cannabis dependence matched to 17,211 men without dependence. Cannabis dependence was significantly associated with an approximately 1.2-fold increased risk for ED among all adult men and those aged 40 years and older, the investigators reported. Cannabis Dependence Linked With Erectile Dysfunction, Testosterone Deficiency – https://www.renalandurologynews.com/news/erectile-dysfunction-testosterone-cannabis-dependence
Yikes.
Drugs
The Relationship Between Cannabis and Cardiovascular Disease
Journal article abstract here: https://www.nature.com/articles/s41569-025-01121-6
Video here: https://www.vumedi.com/video/the-relationship-between-cannabis-and-cardiovascular-disease/
Yikes.
DUI/DWI for a New Generation
I am impressed with the ability of some people to injure themselves in creative ways.
Analyzing data from the 2016-2021 National Inpatient Sample, UCLA researchers found that 25% of 7350 patients hospitalized for scooter-related injuries were using substances such as alcohol, opioids, marijuana and cocaine when injured. Published in The American Surgeon, the study also notes that overall scooter-related hospitalizations during the 5-year period jumped more than eight-fold, from 330 to 2705. In addition, the risk of traumatic brain injuries among the substance use group was almost double that of the non-impaired patients. University of California – Los Angeles Health Sciences. “Nearly one-quarter of e-Scooter injuries involved substance impaired riders.” https://www.sciencedaily.com/releases/2025/04/250429195329.htm (accessed May 3, 2025).
AND don’t forget about these things can randomly explode.
“In all of these fires, these lithium-ion fires, it is not a slow burn there’s not a small amount of fire, it literally explodes,” FDNY Commissioner Laura Kavanagh – https://www.statista.com/chart/29472/fires-caused-by-lithium-ion-batteries/
Glenmark Pharmaceuticals Recall (check your prescription bottles)
In February, the FDA found problems with cleaning and testing at the plant in Madhya Pradesh, India, which was the subject of a ProPublica investigation last year. The current recalls, listed in an FDA enforcement report last week, cover a wide range of commonly prescribed medicines, including ones that treat epilepsy, diabetes, multiple sclerosis, heart disease and high blood pressure, among other ailments. A full list of the recalled medications is available here. An Indian Drugmaker, Investigated by ProPublica Last Year, Has Recalled Two Dozen Medications Sold to U.S. Patients https://www.propublica.org/article/glenmark-recalls-two-dozen-drugs
Time to bring the pharma supply chain back onshore.
Controlled Substance Prescribing Patterns – Pennsylvania
Rates of psychostimulant (stimulant)-related overdose deaths in the United States have increased substantially since 2010; in 2022, 32% of all overdose deaths involved stimulants. Citation: Hayden S, Murzynski SM, Bolton A, Goetz CT. Controlled Substance Prescribing Patterns Among Fatal Overdose Decedents with an Opioid, Stimulant, or Both Contributing to Death — Pennsylvania, 2017–2022. MMWR Morb Mortal Wkly Rep 2025;74:205–209. DOI: http://dx.doi.org/10.15585/mmwr.mm7412a2
Prescribed stimulants. Read more here – https://www.dea.gov/factsheets/stimulants
Happy Friday!
Lisdexamfetamine Dimesylate (not just for ADHD anymore)
Llisdexamfetamine dimesylate is currently the only drug to be approved in the USA for the treatment of moderate to severe binge eating disorder (BED) in adult patients. – https://pubmed.ncbi.nlm.nih.gov/29134566/
Just a few side effects BTW.
The prescribing information also includes warnings and precautions regarding serious cardiovascular reactions, blood pressure and heart rate increases, psychiatric adverse reactions, suppression of growth, peripheral vasculopathy (reduced circulation of blood flow to body parts), and serotonin syndrome (a potentially life-threatening overage of serotonin). Please see Vyvanse’s full prescribing information for additional details.
The most common side effects in children, adolescents and/or adults with ADHD taking lisdexamfetamine dimesylate capsules and chewable tablets were anorexia, anxiety, decreased appetite, decreased weight, diarrhea, dizziness, dry mouth, irritability, insomnia, nausea, upper abdominal pain, and vomiting. The most common side effects in adults with BED were dry mouth, insomnia, decreased appetite, increased heart rate, constipation, feeling jittery, and anxiety. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-multiple-generics-adhd-and-bed-treatment
Take Home Lesson for Life Underwriters
Know your drugs and read the prescription DB reports. You’re welcome.
Compounding Compounds the Problem
Compound pharmacies that bulk produce weight-loss drugs without FDA approval are doing so without that oversight. And because compounding pharmacies aren’t required to report instances of patient harm involving their medications, problems may go undetected.“It’s kind of like ‘Whack-A-Mole,’” said Al Carter, a pharmacist and executive director at the National Association of Boards of Pharmacy. He said state boards will only investigate when they receive a complaint.“There are bad actors out there, purporting to be compounding pharmacies that are licensed in specific states or have the credentials to be able to compound when in actuality they don’t,” said Carter. “My understanding is most licensed, legitimate pharmacies aren’t compounding” weight-loss medications. ‘Compounded’ weight-loss drugs are a growing problem for state regulators – https://stateline.org/2024/07/08/compounded-weight-loss-drugs-are-a-growing-problem-for-state-regulators/
A website sold patients obesity drugs at affordable rates. Now they’re paying the price.– https://www.npr.org/2025/02/08/nx-s1-5246124/a-website-sold-patients-obesity-drugs-at-affordable-rates-now-theyre-paying-the-price
“The two main goals of the medication are weight loss and diabetes management, so patients should stay on the lowest dosage possible until they feel like they’ve plateaued,” said Charu Sawhney, DO, MPH, an internal medicine physician with Harbor Health in Round Rock, Texas. When patients move up on the dosage too fast, they’re going to have more trouble, said Sawhney. “This is when we see the most severe side effects like the malnutrition and dehydration that can sometimes land patients in the hospital,” she said. Considerations for Prescribing GLP-1s Get More Complicated – Medscape – February 07, 2025 – https://www.medscape.com/viewarticle/considerations-prescribing-glp-1s-get-more-complicated
I admit as a Former Fat Man that the world of obesity and now a miracle drug to fight the disease fascinates the hell out of me. Caveat emptor!
Ugh… Kids These Days!
While cocaine was once the drug of choice, bankers are now reportedly turning to the ADHD medication for work days that can last as long as 22 hours, along with nicotine patches and energy drinks. 90-hour-a-week Wall Street bankers snorting lines of Adderall at their desks – https://www.telegraph.co.uk/world-news/2024/12/15/90-hour-a-week-wall-street-bankers-snorting-adderall-desks/
It never ceases to amaze this Old Underwriter how people manage to find creative ways to kill themselves.
GLP-1 – Compounded or Brand-Name?
Caroline Apovian, MD, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, Boston.
“Doctors who are obesity medicine specialists like myself in academic centers do not prescribe compounded semaglutide or tirzepatide,” she said.
Many of the compounded prescriptions, she said, come from telehealth virtual–only companies interested in profits.
GLP-1 Prescribing Decisions: Compounded or Brand-Name? – Medscape – November 14, 2024 – https://www.medscape.com/viewarticle/glp-1-prescribing-decisions-compounded-or-brand-name-2024a1000krd?
To be clear, all of my GLP-1 posts are not anti-pharma. If you can afford these medications and they work for you on your weight loss journey that’s great. Just be aware of the possible side effects and the fact these medications are for life. You will regain all that you’ve lost if you stop taking the drug.
Here’s the link to Complications? What Complications? (just another GLP-1 receptor agonist post)
Mind the Gaps – Update 11.10.24
More good news since I posted Mind The Gaps.
On November 5, the US Food and Drug Administration (FDA) updated the labels for all glucagon-like peptide 1 receptor agonists (GLP-1 RA) with a warning about pulmonary aspiration during general anesthesia or deep sedation. The affected drugs are semaglutide (Ozempic, Rybelsus, Wegovy); liraglutide (Saxenda, Victoza); and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 tirzepatide (Mounjaro, Zepbound). FDA Updates GLP-1 Label With Pulmonary Aspiration Warning – Medscape – November 06, 2024. https://www.medscape.com/viewarticle/fda-updates-glp-1-label-pulmonary-aspiration-warning-2024a1000k84?src=rss
Interesting potential side effect. This is from the FDA on regulated GLP-1 RA drugs. But since I know a lot of you out there are using the compounded version…
Death is also a potential side effect of the FDA regulated version.
Susan McGowan, 58, took two low-dose injections of tirzepatide, known under the brand name Mounjaro, over the course of about two weeks before her death on 4 September.Her death certificate, seen by the BBC, lists multiple organ failure, septic shock and pancreatitis as the immediate cause of death – but “the use of prescribed tirzepatide” is also recorded as a contributing factor…There have been 23 suspected deaths linked to semaglutide in the UK via the yellow card scheme since 2019. Nurse’s death linked to approved weight-loss drug – https://www.bbc.com/news/articles/cz6jg6nw2zeo?
Yikes.
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