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I read a brief news item online about the drug manufacturer getting sued, but I didn’t get detailed information until I read last week’s issue of Alcoholism and Drug Abuse Weekly (ADAW).
Here’s the scoop: the Attorneys General for thirty-six states are suing Reckitt-Benckiser (RB, now called Indivior), because the company attempted to block generics from entering the market after RB’s patent for sublingual buprenorphine products expired.
Reckitt-Benckiser manufactured Suboxone and Subutex, which were the initial buprenorphine products that came to market in 2002, after the DATA 2000 law was passed.
As a reminder, before DATA 2000 was passed, it was illegal to treat opioid use disorder in an office setting with an opioid prescription. Doctors have gone to jail for this. Before DATA 2000, opioid treatment programs (OTP) were the only setting where prescribing (methadone was the only approved medication) for opioid addiction was permitted, and these OTPs have always been strictly regulated by multiple governmental agencies.
The FDA has approved only one medication, buprenorphine, to be used under DATA 2000, and only the sublingual form was approved. Then earlier this year, a second form of buprenorphine was approved to treat opioid addiction: the six-month, sustained release implantable rods impregnated with buprenorphine, known as Probuphine.
Buprenorphine taken by other routes of administration aren’t covered by DATA 2000, and therefore can’t be used to treat opioid addiction. These forms include the name brands Butrans patch, Belbucca oral film, and IV/IM buprenorphine used for pain control.
Reckitt-Benckiser’s patent for sublingual buprenorphine tablets was set to expire around 2008. Years before that, RB worked on finding a different delivery system, and the film version of Suboxone came out in mid-2010. This new form had its own patent, so that RB was the only company that could manufacture and sell that form of their medication.
However, since their sublingual tablet had come off patient, other drug companies could make generics, which would bring down the price to consumers of this life-saving medication.
But the Attorneys General allege RB tried to block the release of the generic tablets. RB told their drug salespeople to tell doctors that children were dying from ingesting buprenorphine tablets, and that the risk of prescribing this form of treatment was too great. They said the safest way to treat patients was with the film, which comes individually wrapped in a foil packet. And remember, only RB manufactured this film.
On May 12, 2012, I blogged about Reckitt-Benckiser’s attempt to persuade me to prescribe only the film. In that blog post, I describe how the drug representative told me that sublingual tablets were now suddenly too dangerous to prescribe, due to pediatric overdoses. She also told me it was much better for patients to be prescribed the film, since people addicted to pills could be triggered by tablets.
Her credibility took a big hit that day, because she’d promoted the hell out of her company’s tablet form of Suboxone and Subutex to me for years. I called her out on the inconsistency and disingenuousness of her statements, promulgated by her company, and I blogged about it.
At her next visit, she told me she was “disappointed that I chose such a public forum to describe our conversation.”
It was the first time someone chastised me for something I wrote on my blog, and I was elated. I felt like a real journalist!
She hasn’t visited my office since, and I haven’t missed her. She’s a nice lady, which is the only reason I put up with her in the first place. Right or wrong, I‘ve always found drug reps to be tedious.
I harbor no illusions about what drug reps do. Their job is to sell their product. When I worked in primary care, I was lied to on a regular basis by drug reps. For example, when the drug rep for a company that sold Prempro told me that estrogen replacement therapy reduced the risk of breast cancer. I remember being shocked into silence as I frowned at him, wondering if he thought I was really, really stupid.
Back to the point of this blog. So in 2012, R-B tried to prevent the generic from coming onto the market by saying the pediatric overdose problem was so bad that only the films (still under patent with R-B) should be prescribed
The lawsuit alleges consumers had to pay higher prices due to RB’s efforts to block generic tablets. These states want Indivior, formerly Reckitt-Benckiser, to pay back billions of dollars of profit obtained through unfair practices.
The lawsuit alleges the company manufactured claims of pediatric safety as a way to manipulate doctors into switching their patients over to the film, instead of continuing to prescribe the tablet form of the medication, which would have generic versions coming onto the market soon.
The drug company, as well as the company that developed the film technology, both say they did nothing wrong, and that their product has saved countless lives.
So…what is the price difference for different forms of buprenorphine? I did some current comparisons for my area on www.goodrx.com, recording the lowest price on the site for people with no insurance. Here are the results:
Generic buprenorphine: dose of 16mg per day, #60 tabs: $133
Generic combination product, buprenorphine/naloxone, dose of 16mg per day, #60 tabs: $243
Name brand Suboxone Film, same dose of 16mg per day, #60 films: $455
Name brand Zubsolv, dose of 5.7mg, two per day, #60 tabs: $455
Name brand Bunavail buccal film, 4.2mg, two per day (highest recommended maintenance dose) #60 films: $455
I’m sure readers find it remarkable, as I do, that all three of the name brand forms are the same price. It’s also interesting that the cheapest form, generic buprenorphine monoproduct, is only 28% of what the name brands all cost.
Here’s something more fascinating – BlueCross/Blue Shield of NC requires prior authorization for every one of their covered patients who are prescribed buprenorphine. For years, this insurance company will ONLY authorize payment for the name brand Suboxone in film form. They refuse to pay for the cheaper generic, either mono or combination forms.
I don’t know why BC/BS decided to only cover the name brand Suboxone films.
I could understand if they wouldn’t pay for the monoproduct, due to concerns that it’s more desirable on the black market, and the insurance company may not want to contribute to this problem. But why do they object to the generic combo product? Perhaps they worked out a special, cheaper deal, or perhaps they were swayed by drug manufacturer patter.
It’s hard for me to see that Reckitt-Benckiser/Indivior did anything different than what other drug companies do routinely. Of course their drug salespeople exaggerated the danger of pediatric exposure to buprenorphine tablets in an effort to influence doctors to prescribe only the films. But their claims were so weak and transparent that it would be a gullible doctor indeed who fell for the company line.
And since when do doctors accept what a drug company salesperson tells them at face value? I’m not saying outright lying by drug company representatives should ever be OK, but…it happens.
The drug companies make big bucks, but they counter by saying they spend so much money in research and development of new drugs, and if it weren’t for their work, we wouldn’t have all these new medications that we have that are extending peoples’ lives.
That’s somewhat of a legitimate point, but at what point do we say the drug companies are making adequate profits or excessive profits? And at what point does an exaggeration about a medication become a lie?


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How to add coconut oil into your bath time regime (without slipping over in the bath).
Coconut Oil is undeniably the scent of the summer. Known as a hero among the body oils, the multitasker runs its own race with health benefits. One of the most obvious benefits is coconut oils’ moisturising properties. Coconut oil is rich in fatty acids such as lauric acid which can improve skin elasticity, bacterial infections and acts as an anti-aging agent, how cool is that?
Coconut Oil is full of antioxidants, most prominently; Vitamin E which fights free radical damage and antimicrobial agents which minimise acne causing bacteria. So, like we said, Coconut Oil is quite the hero.
Dr Teal’s has dipped their toes into the Coconut Oil trend and have created their very own coconut inspired range including an Epsom Salts Soak and Body Wash to make summer last as possible.
Put some time aside and run yourself a bath, adding in the Coconut Oil Epsom Salts which help ease aches and pains whilst moisturising the skin. For some bubbles, (No not that kind, though we’re not totally against the idea) add in Dr Teals Foaming Bath.
If you’re a shower kinda person, lather yourself in the Body Wash which hydrates and conditions the skin to restore softness. The body wash is packed full of ingredients such as Aloe Vera, Shea Butter and Vitamin E to help retain moisture in the skin and leave a subtle glow.
If you’re nuts for coconut, mix together the Dr Teals Mineral Soak with the Dr Teals Coconut Oil to create a luxurious exfoliator scrub which can help minimise the appearance of scarring and stretch marks, leaving you with luminous skin to show off all summer long.
Find Dr Teal’s Coconut Oil range online or in-store at patriating retailers.

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Health and fitness is a phenomenon that is global. Everyone really wants to stay healthier by keeping leading a healthy lifestyle and healthy diet. In a globalwhere 30% of the population is either obese or overweight, there a complete lot of Emphasis on the need to watch weight by eating exercising and right. In 2019, there is absolutely no question that a lot of individuals will be emphasizing staying in sound condition, that will be the perfect answer to maintaining some medical problem from increasing for an extremely very long time. From CBD hemp oil products to making use of plant-based vitamin supplements, listed below are the five major Wellness and health styles you must know.
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- Is it OK to eat 2 protein bars a day?
- Is it bad to eat protein bars everyday?
- What protein is easiest on kidneys?
- Can too many protein bars hurt you?
- What are the side effects of too much protein?
- Can I eat protein bars if I don’t workout?
- When should you eat a protein bar?
- Is it bad to eat protein bars at night?
- Do protein bars make you fat?
- Why Protein bars are bad for you?
- What are the symptoms of too much protein?
- How long do protein bars last?
- How many protein bars can I eat a day?
- Do protein bars make you lose weight?
- What protein bars are the healthiest?
Is it OK to eat 2 protein bars a day?
Try not to consume more than 2 sugar free protein bars at a go.
If you are consuming above 2 sugar free protein bars in a day try to consume them as far apart in 24 hours interval..
Is it bad to eat protein bars everyday?
“I prefer real food as a main source of protein,” says Goodman. “Since bars are considered processed food, I would not recommend them as an everyday solution.” “If you’re talking about a bar made out of whole foods with minimal added sugar, then yes, you can have one every day,” adds Gorin.
What protein is easiest on kidneys?
15 Kidney-Friendly Protein Foods for Keeping Albumin UpBurgers. Made from turkey or lean beef, both of these protein sources give you iron to help prevent anemia. … Chicken. Protein from chicken can range from 14 to 28 grams. … Cottage cheese. … Deviled eggs. … Egg omelet. … Egg whites. … Fish. … Greek yogurt.More items…
Can too many protein bars hurt you?
Can too much protein be harmful? The short answer is yes. As with most things in life, there can be too much of a good thing and if you eat too much protein, there may be a price to pay. For example, people that eat very high protein diets have a higher risk of kidney stones.
What are the side effects of too much protein?
Risks of eating too much proteinWeight gain. High-protein diets may tout weight loss, but this type of weight loss may only be short-term. … Bad breath. … Constipation. … Diarrhea. … Dehydration. … Kidney damage. … Increased cancer risk.Heart disease.More items…
Can I eat protein bars if I don’t workout?
Why? Because extremely low-calorie snacks don’t do anything for you in terms of providing energy to sustain you until your next meal. So workout or not, you’re fine.
When should you eat a protein bar?
As you’d probably guessed, the best time to enjoy a protein bar is pre or post workout. Beforehand a protein bar can help to boost your performance and after it will contribute to muscle repair and growth.
Is it bad to eat protein bars at night?
“It can be very beneficial to have protein and healthy fat in the evening,” he says. “The protein will be used to repair muscle tissue and fat will help slow the digestion process so you can sleep through the night.
Do protein bars make you fat?
Weight gain If this is your goal, protein bars may be a helpful addition to your diet. Many protein bars are calorie dense, meaning they provide a significant number of calories in just one serving, making it easy to add calories without having to eat a lot of extra food.
Why Protein bars are bad for you?
Commercial high-protein products, in particular high-protein bars, are not as healthy as perceived by consumers. These products are considerable sources of total fat, saturated fat and also provide salt and sugar. As such they should be considered a “top-shelf” food.
What are the symptoms of too much protein?
Symptoms associated with too much protein include:intestinal discomfort and indigestion.dehydration.unexplained exhaustion.nausea.irritability.headache.diarrhea.
How long do protein bars last?
1 yearA: Pure Protein bars have a 1 year shelf life. Expiration dates and lot numbers are the stamped numbers on the bottle. The format is the lot number followed by the expiration date. We recommend contacting the Amazon seller directly to see if they can provide the lot numbers or expiration dates on their inventory.
How many protein bars can I eat a day?
Are there any limits on how many protein bars I should eat in a day? A. Technically there isn’t, though it’s recommended not to have more than one or two per day. Ideally, try to eat healthy and obtain protein and nutrients through well-rounded meals with quality foods.
Do protein bars make you lose weight?
Not only are protein bars good for weight loss, but they are also great for maintaining a healthy lifestyle. Protein filled recipes are a healthy choice for the long term, even after you’ve reached your weight loss goals, protein can help maintain your strength, muscle and body composition.
What protein bars are the healthiest?
The 15 Best Protein Bars For Men 2021 Almond Honey. RiseBar amazon.com. … Cookie Dough. Probar amazon.com. … Blueberry Muffin Protein Bar. Quest Nutrition amazon.com. … Mint Chocolate Chunk. … Carb Killa Protein Bar, Chocolate Cream. … Salted Caramel Cookie Dough. … White Chocolate Raspberry. … Grandma’s Lemon Square.More items…•


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Why did you choose this product?
I have been on diets before but I have never been able to eat the foods I normally eat and feeling full is the best part besides actually loosing weight. I recommend this to everyone....
Shred: The Revolutionary Diet: Six Weeks, Four Inches, Two Sizes (Hardcover)
|Genre||HEALTH & FITNESS / Diets|
|Publisher Date||2012-12-24 00:00:00.0|
|Publisher||St Martins Pr|
|Unit weight||1.05 lb|
|Subtitle||The Revolutionary Diet: Six Weeks, Four Inches, Two Sizes|
|Authors||Smith, Ian K., M.D.|
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I have been on diets before but I have never been able to eat the foods I normally eat and feeling full is the best part besides actually loosing weight. I recommend this to everyone.Read More
Good shake recipes and helpful snack lists for 100 calories and 150 calories. Manageable weight loss plan.Read More
Shown on Steve Harvey show where he lost 10 pounds in 6 weeks. One woman lost 10 and another lost 13 on his show too. Good diet plans and recipes.Read More
This book is helpful in getting you to understand by you are overweight and understand the not eating isn't the answer but good well balanced meals all day.Read More
This book has been talked about on the Dr. Oz Show as well as the Steve Harvey Show. I could have gotten the paperbook, but for only a couple of dollars more, I decided on the hardbook. I have browed thru it and look forward to attempting this diet. Thanks again overstock. Good job, and it was delivered within the time frame as promised, actually a day earlier.Read More
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Regardless of the general public’s perception of Pit Bulls, Pit Bull owners swear by the breed. We are one of those owners!
Our Staffy is the best family dog we’ve ever had, and we want him to be happy and healthy. Whether you have a Staffordshire Bull Terrier, an American Staffordshire Terrier, an American Pit Bull Terrier, or a beloved Pit Bull mix, good health starts with proper nutrition. That is why we’re talking about the best dog food for Pit Bulls.
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Different Types of Dog Food
1. Kibble or Dry Food
This is the most common and cheap type of dog food. It lasts a long time, is the most convenient, and companies can customize it with different supplements to meet different needs. Let’s face it, people. It doesn’t get any easier than scoop and serve. The crunchiness of the kibble promotes dental hygiene and prevents tartar build-up, which is one of the reasons our vet has always recommended dry food. Try to avoid artificial colors, flavors, and preservatives, and unhealthy fillers with no nutritional value.
2. Canned or Wet Food
Canned food does have a long shelf-life, but can start to get expensive. Canned food is mostly water (when reading the label, “Moisture” % = water %), and the higher the water content, the less room for nutrient content. The less nutrient content, the more your dog will have to eat to meet their nutritional needs which can lead to obesity. It is also cooked at very high temperatures to sterilize the food, which further degrades the nutrient value canned food does have. This is often the go-to choice for those with senior dogs having dental issues.
Everyone agrees that this type of food is better offered as a treat than a diet for your pet. These foods are often lacking in nutritional value and generally contain many artificial colors and ingredients.
4. Home Cooked
This diet gives you total control over what goes into your dog’s mouth, and if you go this route you have done a little bit of research on canine nutrition. My sister-in-law relishes creating a home-cooked chicken and rice meal for her pup every day, but I don’t have the time or the energy. Kudos to those of you who can make it happen!
5. Raw (Frozen or Freeze Dried)
This diet is one of the healthiest options. It consists of raw meat with some bones and organs mixed in and comes in frozen or freeze-dried form. But it is very expensive (expect to spend at least twice as much as dry kibble, possibly 3-4 times more), and it doesn’t last very long in the fridge once it’s been thawed. As with any raw meat, there are sanitary considerations that can lengthen prep-time and clean-up. Make sure to store this food exactly as recommended by the manufacturer.
How Much Should I Feed My Pit Bull?
The answer to this question comes down to size and energy expenditure which varies in this breed. A pocket pit can weigh in at 35 pounds, while its larger counterpart can come in a beefy 70 pounds. On average, a healthy pit bull requires 1100 calories per day. An incredibly active one may need 1700 calories. Older dogs who are much less active may only need 875 calories per day.
Our Staffy is extremely high energy and usually starts his day with a run on his Tuff Mutt Hands-Free Leash or a biking expedition on his Bike Tow Leash, so we feed him more than a dog who is not getting this much activity. During the winter, when he has less opportunity for activity and we see his weigh start to climb, we feed him less.
Three Things To Watch Out For When It Comes To Feeding Your Pit Bull
1. Overeating: Feed Two Times Per Day
The Pit Bull breed is known for its insatiable appetite. If you leave your pit to free-feed (keeping food in the bowl and leaving it out all the time), chances are your pooch will revel in this endless buffet. Not only can this lead to obesity, taking you down a path toward many future troubles, but it can cause bloating leading to a condition known as gastric torsion. When a dog woofs down all its food without chewing, it can result in a quick build-up of gas. The stomach can twist, preventing the gas from being released, and the dog will continue to bloat. This problem requires immediate veterinary attention.
It’s best to feed your dog two times a day and leave the bowl out for 30 minutes each time. If your dog is like ours, the food will be gone in about a minute and a half. To help with digestion, avoid rigorous activity for 30 minutes after eating.
Our vet told us that bull terriers are a highly allergic breed, and we have had two major episodes of full body hive outbreaks, the source of which we’ve never been able to determine. If you start your dog on a new food and suspect an allergic reaction, it’s best to take your dog for a consultation with your veterinarian. Watch for excessive licking, scratching, rashes and hives. Stomach sensitivity can also present with loose stools and nausea. Just as we can develop allergies or food sensitivities later in life to a food we have always enjoyed, so can they, so just file that away in the back of your mind for future reference. Check your dog food’s top 5 ingredients for bone meal, meat by-products, soy, wheat, or eggs as these are common irritants for many dogs.
3. Food Composition
The Association of American Feed Control Officiants (AAFCO) recommends at least of 18% protein for maintenance in adult dogs and at least 5% fat. But because bullies are such a muscular and often high-activity breed, you may want to look for one with a protein content upwards of 25%.
The most important thing is to look for high-quality protein. You’re looking for real meat as the first ingredients, not meal or by-products. We all need protein to build and repair muscle and other body tissues, form new skin cells, and grow hair. Protein assists in creating hormones and enzymes that are required for normal function. It provides energy and keeps the immune system strong.
Again, grains are not a great source of carbohydrates for bullies as they trend toward allergies. This is why we are now living in an era of many grain-free foods.
The Best Dog Foods for Pit Bulls
The #1 ingredient in all Merrick’s Grain-Free foods is high-quality deboned meat. They supplement with industry-leading levels of Omega 3 & 6 to promote healthy skin and coat, and also add glucosamine and chondroitin for healthy hips and joints. Their foods are cooked in the USA one batch at a time and contain no by-products, artificial preservatives, corn, wheat, soy or gluten ingredients.
We first started on Merrick Grain Free Texas Beef and Sweet Potato when we were going through a second round of training with our furry friend at about 2 years old. Our trainer, formerly an expert dog trainer for the U.S. Army, highly recommended this food because of the quality to value ratio. He just felt like for the money you’re spending, it doesn’t get better than this. I can’t remember what we were feeding Buddy before, but once we started him on this food he became obsessed with meal time. After more than a year, he is just as crazy about this food as the day I first poured it into his bowl. I also like that the kibble size is relatively small for dogs that tend to swallow food whole. If you have a dog with major allergies, check out their Limited Ingredient options. This food is our top choice.
This food also has high-quality protein as its first ingredient. It is free from corn, wheat, and filler, and contains no artificial colors, flavors, or preservatives. They supplement with vitamins and minerals and Omega 3 & 6. Taste of the Wild also adds doggie probiotics, their own Proprietary K9 Strain, developed specifically for dogs and added after the cooking process to make sure that they survive and thrive in the GI tract. They also add dried chicory root as a source of prebiotic fiber. This food is also made in the USA.
These grain-free recipes start with high-quality deboned meat. They also add essential vitamins and minerals, Omega 3 & 6, and probiotics to help with digestion. Made in the USA, Wellness foods contain no wheat, corn, soy, meat by-products, or artificial colors, flavors, or preservatives.
If your dog is highly allergic, a limited ingredient food may be the way to go. Unique to this brand is Blue Buffalo’s exclusive LifeSource Bits, containing a precise blend of antioxidants, vitamins, and minerals, which are cold-formed. This means that they cut the amount of heat exposure to these bits to prevent the important nutrients from being destroyed in the manufacturing process. This food is comprised of high-quality protein, easily digested carbohydrates, a healthy blend of vitamins and minerals, and Omega 3 & 6. They use no poultry by-product meals, no corn, wheat, soy, dairy, or eggs, and no artificial flavors or preservatives.
These limited ingredient formulas are made with 7-10 recognizable key ingredients, plus all the vitamins and minerals your dog needs. Even if your dog doesn’t have sensitivities or allergies, owners report that their dogs still love the great taste. High-quality protein is always the first ingredient, and these foods never contain any corn, wheat, or soy.
We know you want to keep your bully healthy from the inside out. Any of these choices will give your pup a healthy base for a happy life.