Reflections on Psychiatry & Psychology

After 30+ years serving San Diego, Point Loma Shelter Island Drug and Point Loma Cabrillo Drug closed. Crime and PBM “clawbacks” strained the small, personal pharmacies. Owner Michael Saad sold to a chain after years of 12-hour days. Loyal patrons will miss the care.

Pharma has saved millions but is driven by profit. New drugs are priced high to recoup R&D costs; when patents expire, generics get cheaper. Companies often use tactics to extend profits beyond patent life.

A JAMA Psychiatry study found U.S. psychiatrists increasingly go cash-only (19% to 27%). Self-pay visits are longer and more frequent, suggesting higher value than brief insurance “med checks.”

In 2019, Elijah McClain died after EMTs injected him with 500 mg ketamine during a police arrest. The text argues ketamine is not a sedative but a dissociative anesthetic that inhibits GABA indirectly and can raise heart rate and blood pressure. In a stressful arrest, this may worsen agitation and cardiac strain. It concludes ketamine should not be used to “sedate” detainees.