Neudexta (Avanir): newly approved drug contains DXM

For over 20 years, I have subscribed to The Medical Letter on Drugs and Therapeutics. This nonprofit publication does not accept advertising. Its subscriber base is primarily medical doctors. Occasionally, I'll cite a Medical Letter article (www.medicalletter.org) on new drugs.

The June 13, 2011 issue has an overview of newly FDA- approved Nuedexta / Avanir. This new drug contains dextromethorphan and quinidine sulfate, and is indicated for the oral treatment of pseudobulbar affect in patients with ALS (Lou Gehrig's disease) and multiple sclerosis. "Pseudobulbar affect, also known as pathological laughter and crying or emotional lability, is common in ALS and MS." Some of the side effects noted in The Medical Letter of this drug combination are nausea, headache, diarrhea, fatigue and dizziness.

Remember to interview your suspect/arrestee about medical conditions, and the treatment they are receiving for the condition (s). Better to learn during the investigation phase, rather than be surprised in court!

More on the importance of Report Writing

The June, 2011 issue of The Thin Blue Line, the publication of the Los Angeles Police Protective League, contains a nice article by Detective Tyler Inzen. Detective Inzen emphasizes that "You can only control what you can control." How true. One can't fix all the wrongs of society, or stop all the crime in one's community. But as a police officer, you can control what you put down in writing. And as Gary Ingemunson has pointed out in The Thin Blue Line, short of testifying in court, writing a report may be the most important thing an officer does. As I have emphasized in prior posts, be scrupulously accurate and honest in all of your reports. Thoroughness must preempt brevity.

Cell phones and "behavioral toxicity"

Neil Rubin, a Detroit News columnist, wrote an article on cell-phone dangers that was published in the June 16, 2011, edition of the paper. Mr. Rubin pointed out that there really is no proof of danger from cell phone radiation. As I read the article, I thought of a term in the drug abuse field that is relevant to cell-phone dangers: "Behavioral Toxicity." I e-mailed the following letter (in part) to Mr. Rubin.

There are few, if any, documented cases in which an individual has died due to an overdose of marijuana (spelled "marihuana" in Michigan's legal code) or LSD. However, if an LSD user thinks he can fly like Superman and jumps off the Penobscot Building, that person will assuredly die. And if a driver who has used marijuana doesn't "think" to stop at a railroad crossing and strikes a passing train, that person will also die. Similarly, the cell phone radiation may not cause brain tumors. If a driver, however, talks on a cell phone (and/or texts) while driving, that person has a much higher liklihood of being involved in a crash, possibly a fatal one. This is an example of what can be called "behavioral toxicity."