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A review of Accord's approved drugs in the FDA Orange Book reveals at least one controlled drug, methylphenidate (Ritalin), which cannot be manufactured overseas. A look at the product label shows the drug was manufactured by WES Pharma, a privately-owned company in Maryland. Additional Orange Book review shows WES also manufactures generic Norco, Percocet, and Tylenol with codeine, so they have the capability to handle opioids. Accord's ANDA application for generic OxyContin would of course have to contain the details of which U.S. manufacturing facility would produce the drug, WES or whoever, so this is unlikely to have a major impact on the timing of their OxyContin approval.
Note: the information in this post was generated with A.I. (Actual Intelligence).
No, what we find weird is your absolute obsession with ID's and the motivations of other posters. Too bad you never take even 5 seconds to think about something, because maybe you could have answered your own question. Maybe it would have occurred to you that there are a lot of investors who read this board every day and who rarely if ever post anything. Most of them may not agree with me (yet), but they know who I am and where I come from. They also take note when they see your rude and belligerent responses to long term participants of this board, like what you did to hyder this week. You are a newbie compared to most of us. You were tolerable and maybe even slightly entertaining as N2K's faithful but gullible sidekick, but as Sleuth's lockstep lieutenant your posts are absolutely insufferable. If you've got something to say about the company or the CEO, then say it. But knock off the bullying about the motivations of other investors who express an honest opinion. You might even be able to develop and express your own personality instead of whatever alpha poster you latch on to.
99.99% of the people who read this board understand you can support ELTP without attaching yourself to the current cadre of obnoxious goofballs who are obsessed with the motivations of anyone who tries to participate.
Yes, exactly. In the post you refer to he said the subject interested him, and he had been doing some digging. He provided two links. He never even said he thought any of it was true. Even if he did believe it was going on with NWBO, that's a far cry from where we are today with shorts hiding behind every single post. It really is ridiculous, and you should go toward the light while you still have some credibility left on this board based on your history as a long. You do yourself a disservice when you align yourself with a crew of bullies who have a tenuous grip on reality. You can support ELTP without being a part of this obnoxious cadre of goofballs. Be better.
It's both desperate and despicable to try and put words in a dead man's mouth. You didn't copy and paste any diatribes against shorts because there weren't any. Not one. Not ever. One link was an article he didn't write, and some links weren't even by him. No links mention shorts. There are lots of forms of "manipulation" that do not include shorting. I have said for years the stock is being manipulated, but I don't believe it is being shorted because I understand the objective evidence against it. Seriously, you should copy and paste it here if you can find him espousing anything about shorts, otherwise it is completely dickish to continue to lie about it and say he did.
There's a lot of pent-up anger displayed in this post. I can empathize, but I would prefer to be left out of everyone's cuck fantasies in all future posts. N2K's account is still there. Copy and paste any of his diatribes against shorts right here, with a link. As they say, put up or....
Sleuth if you think trimipramine is worth $1.2M please please please call Hakim today. Elite shareholders would love to discuss this transaction with you. If you think giving someone $10M for drugs you already own or control by contract then you should call me to discuss which of your items you would like to purchase from me. And again, please, try to keep up. Mikah is a parasite. Repeal the Mikah Tax.
Wow Sleuth great question. I am very comfortable that my posts are an accurate recital of the facts, and I always clearly explain my interpretation. You're welcome to disagree with my analysis, but the facts are the facts. If a penny stock newbie sees one of my posts and has a better understanding of the risks involved, then I'm proud of that. What about you? Do you worry about the financial ruin and economic hardship you may have caused to countless number of families by your constant pumping of this ticker for the past 10+ years?
lol kayak you've tried to quit me more times than jammy has quit this message board. Good luck making it stick this time- I'm rooting for you, I really am.
Tomorrow let's add up the times I refer to Mikah as a "tick" or "parasite", and next week let's count up my references to our "oddball CEO." Then maybe we can keep a running total going forward of Mikah Tax, tick/parasite, and oddball CEO. I really appreciate you keeping the discussion going while I'm busy. I remember our old friend N2K used to like to post that repetition is the mother's milk of learning, and he was so right about that. I don't remember him ever posting about shorts or making up fantasies about the motivations of other investors.
Please allow me to summarize with fewer and smaller words. I think you are wrong to say the opioids were sold to reduce risk of litigation against Elite. There was zero risk to Elite because we did nothing wrong. The DEA never accused Elite of leading to the "diversion of opioids." The DEA never treated Elite like a "street dealer." If we're looking to assign litigation risk in this situation, that all belongs to the high-level executive of the second biggest opioid manufacturer during the opioid crisis. That had nothing to do with Elite, but it was Elite shareholders who suffered the effects when the most valuable assets in the history of the company were dumped away after so much hype about our three bucket future. So you're welcome to believe it had to be done in order to decrease risk of litigation, but you have to recognize that Hakim's personal risk from his time at Actavis far outweighed Elite's corporate risk due to our manufacture of hydromorphone and methadone. Where would we be if we had commercialized these drugs on approval? Who benefited the most from depriving the company of the revenue?
Not really. This statement presumes that I believe the opioids were sold off as a reaction to the opioid crisis, which I don't, at least not mainly. But let's just for the sake of argument say the opioids were dumped in order to mitigate legal risk. I would ask: whose risk did we affect? What had Elite done to be worried about? We never sent mountains of oxycodone to Appalachia or Florida. We only had 2 opioids for a few years. We had the least-prescribed dose of hydromorphone, and we had methadone. Methadone is widely used to treat addicts, and it was the only drug available for chronic pain on the VA formulary for a long time. Literally zero legal risk for Elite. So where was the risk we needed to mitigate?
Do you know who did push shit-tons of oxycodone and hydrocodone into the United States? Actavis. They were way ahead of Purdue when it came to slinging oxy in Florida. They sent out so much opioid so fast that in 2012 the DEA called their senior executives in for a pow-wow. Nasrat Hakim was VP Quality at the time. Actavis management left that meeting "taken aback" by the DEA's attitude, which seemed to equate Actavis with "street dealers." It seems like Actavis management was worried about not just liability for their company but also potential liability for themselves personally. I don't know if he was in the meeting at DEA Headquarters, but either way, he would have been well aware of the feelings of the other Actavis executives. He would have been heavily involved in the planning for massive increases in product manufactured. For whatever reason, he left Actavis within months of the DEA meeting.
So for the believers, again I ask: what legal risk was mitigated by dumping our opioids? Whose risk?
More lies from the Hakim Fan Club. If dude is so awesome, why do his supporters have to repeat so many lies in his defense? Mikah never closed its books, despite annual SEC disclosures that said it did. Sleuth knows this, but he asserts the same falsehood over & over. The Adderall Scoop was not a reemergence of Mikah. Elite shareholders were forced to choke down toxic trimipramine from Mikah back in 2017, whether we wanted it or not. A drug so old and laden with anti-cholinergic side effects that literally every other manufacturer except one has trashed their ANDA rights. It really is a terrible, disused drug, on the Beer's List of toxic drugs that should never be prescribed for older patients. Nonetheless, while Elite languished in sub-nickel range, deprived of revenue by dumb decisions and mismanagement, where was our CEO Hakim? He was apparently off duty as Elite CEO and was out shopping for Mikah at the Teva divestiture. He found trimipramine in the bargain bin after all the good drugs had been sold off. He performed some CEO razzle-dazzle and made deals for Mikah with Epic to manufacture and Dr. Reddy to distribute. And then BOOM he sold it off to Elite shareholders for $1.2M plus interest, which seems like a markup of 50-100X over what he paid. What happened to his fiduciary duty to Elite shareholders? We had no one representing us at the table. Hakim sat on both sides and made an incredible deal- for Mikah. It would have been very easy to make this a fair deal for Elite shareholders. He could have hired a neutral mediator to look at the receipt for price paid and potential revenue and determined a fair price for both parties. He could have held a shareholder vote of approval. But, of course, he didn't do any of these things, and he still refuses to show us proof of what he paid for any of the junk ANDA's he dumped on Elite shareholders for 50-100X markup. We were paying him to perform CEO razzle dazzle on OUR behalf but Mikah got the attention while Elite shareholders got the shaft.
Yes, my posts describe the past, but they also describe the future. Mikah is a parasite and always has been and always will be. Mikah was not your friend during the supposed "merge". Mikah was not your friend on the trimipramine deal. Mikah was not your friend on the Adderall Scoop, and Mikah will not be your friend at the time of buyout. Hakim does not purchase an ANDA for Mikah with the intention of flipping it for a nice profit. As his own behavior has proven on multiple occasions, he's not interested in making 25% profit or 50% or even 100%. He demands a 50-100X markup for Mikah, and that is what he expects for the Adderall flip. There's only one way to do it, and that will be through a secret side deal with whatever lower level suitor is willing to get down in the muck and make the deal. There will be a sweet secret deal for Mikah, and once again, Elite shareholders will pay the price.
It does not have to be this way. We don't need Mikah, at all, for anything. All we need is for Hakim to disentangle his personal business from our public company, no different than every other CEO in the developed world. Any ongoing relationship between Elite and Mikah is 100% for the benefit of Mikah and 0% for the benefit of Elite. It's time for Hakim to do the right thing. Hire the mediator, make the deal, have a vote, and let's move on from Mikah forever. Flick the tick. Repeal the Mikah Tax.
Yes, correct. Hakim is obliged to take the profit-split check to the bank every quarter and deposit it in his own personal account. Too bad those numbers aren't being added to Elite's revenue. What would the current share price be if that were the case instead of Hakim getting more and more rich on the side? The repeated self-dealing for personal profit at the expense of Elite shareholders despite a fiduciary duty is just gross. He might like to pretend this situation does not exist, but Elite shareholders are not obligated to keep quiet. We do not need Mikah. Mikah is a parasite and always has been. Flick the tick. Repeal the Mikah Tax.
More fact-free garbage from Sleuth. When someone posts something that is false, they are mistaken. When they have been corrected multiple times and still continue to assert the same falsehood over and over, then they are just lying. As everyone but Sleuth knows, both Adderall IR and ER were fully developed, approved, and on the shelf producing income by the time Mikah scooped us for the ANDA rights. Zero risk, all reward. Any CEO worth anything could have and should have arranged a deal on behalf of shareholders. Hakim was either too lazy or too greedy or both, so he took the sweetheart deal for himself, and now this oddball CEO tries to act pissy whenever shareholders bring it up. He'll keep coming up with reasons to kick the can down the road until he finds some lower tier suitor with an equally shifty CEO who is willing to make a secret side deal for Mikah in exchange for a fat discount on public Elite. We do not need Mikah. Not for anything. It's time for Hakim to disentangle his personal business from the publicly-traded company. No one else is pulling this self-dealing crap on their shareholders, so wake up and stand up for yourselves. Flick the tick, get rid of Mikah for good. Repeal the Mikah Tax.
It really is remarkable how factually-deficient your posts are. FYI, Treppel purchased naltrexone in 2010, and he had a deal in place to contract manufacture isradapine as well. Same with hydromorphone (purchased) and phendimetrazine (contract). Any drug that Mikah owned that was worth a shit had already come to Elite via arm's length deals negotiated by Treppel on one side and Hakim on the other. The rest of Mikah's worthless crap was forced upon shareholders by the Elite board (Hakim's business partners at Epic) in the supposed $10M "merge" in 2013. The $10M deal does not seem to be an arm's length transaction because we subsequently found out Hakim was a member of Epic Investments. It certainly doesn't seem to fulfill the fiduciary duty that the board and CEO had to Elite shareholders.
You are welcome for this history lesson, Sleuth. Try to keep up. Repeal the Mikah Tax.
We all remember Epic Investments, right? These guys were sitting on the Elite board. They fired Treppel and hired their guy, Hakim, and they gave him $10M to "merge" Mikah with Elite. Shareholders did not learn until much later that Hakim was also a member of Epic Investments, not until it had to be revealed in a SEC disclosure. It is notable that Epic Investments controlled Epic Pharma, which signed a deal with Elite to manufacture and distribute the $10M Mikah generics, but then they never did anything with any of them. It is interesting that Hakim's own partners were sitting on our drugs, but he seemed unable or unwilling to do anything about it.
These are YOUR words, Sleuth, not mine. So go ahead and explain what you mean. Until the time was right for whom? Explain to us how the CEO hiding revenue-producing drugs is good for any shareholder not named Hakim. How does this behavior comport with the securities laws of the United States that retail investors rely on in order to make informed decisions? Enough of this oddball CEO and his continuous profiteering through self-dealing. He's gotten rich enough off the backs of Elite shareholders. We need to get rid of Mikah now so true longs will get the payout they deserve instead of donating our buyout proceeds to Nasrat Hakim. Flick the tick, remove the parasite. Repeal the Mikah Tax.
This is a very serious charge you're leveling against the CEO. Do you have any evidence to support your accusation that the CEO intentionally manipulated the share price downward while he was receiving tens of millions of shares in salary? It does make one wonder. The share price remained terribly suppressed for so long it certainly seemed like it was being intentionally manipulated by someone, and as you say here, the CEO's fingerprints are all over it. He also parked the $10 million worth of Mikah generics with his business partners at Epic, so they were essentially buried deep and produced very little revenue. It seems you may have a point here about Hakim being the culprit behind the prolonged three penny share price. It also seems he's gotten plenty rich off Elite shareholders, despite his fiduciary duty to us. Never forget the past is prologue, and his intentions for Mikah should be obvious to all clear-minded longs. It's time to kick Mikah to the curb and get rid of the parasite forever. Flick the tick. Repeal the Mikah Tax.
Sometimes replying to your posts feels like picking on the slow kid on the playground. It brings me no joy. Nonetheless, I am obviously minding my own business when I stand up to protect my investment. There's nothing unusual about doing that, despite the acute hissy fits it seems to elicit from certain members of this message board. What is aberrant and unusual is the behavior of the oddball CEO. He's the public CEO who owns a private competitor, and he's the one who mixed his business with my business. Let's be clear-- I do not have any fiduciary duty to Hakim, but he has a fiduciary duty to me. I say enough of him taking advantage of me and every Elite shareholder. It's time to get rid of Mikah once and for all. Flick the tick. Repeal the Mikah Tax.
I sleep very well, thank you. Maybe it's because I know what the word parabolic actually means, who knows? I do know that Elite shareholders provide Hakim with an extremely generous salary, bonus, and living expenses, including a car. Even when revenue was way way down from his refusal to commercialize our approved products, he still took his full bonus every year. As I recall, Hakim liked his salary in shares and his bonus in cash. He accumulated massive shares for himself during this time period when the share price was so depressed for so long. It went on so long it almost seemed like the share price was being intentionally suppressed. But who would benefit from doing such a thing? Who would have the power to do something like that?
Like you said the CEO has done an amazing job, unfortunately it was as the CEO of Mikah. As the CEO of Elite, meh 😑. He has done an incredible job of accumulating fabulous personal wealth, I will give him that, but I refuse to give him any portion of my payout. Hakim has already gotten rich enough off the backs of Elite shareholders. It's time to get rid of Mikah for good and repeal the Mikah Tax forever. Flick the tick.
It seems you finally got the balls to reply to me directly. Maybe spending the whole day reading all of my old posts has helped you to mature and grow a set. You are correct that I purchased my first and the vast majority of my shares before I ever heard of Nasrat Hakim. I did buy some shares after Hakim was appointed CEO, but it was before his billion dollar lie about SequestOx bioequivalence was revealed by the FDA in the 2016 CRL. It was also before it became obvious to me the original generics for which we paid Hakim $10M were not worth a fraction of that and were being buried by his business partners at Epic so it wouldn't be so obvious to Elite shareholders. We've all been through a lot since then with this oddball CEO and his aberrant corporate behavior, and we all deserve a fair payout in the end. We most definitely should not have to pay the Mikah Tax to Hakim at the end of all this. True longs like myself are only interested total proceeds at the end of the road, and I'm not interested in donating any of mine to Nasrat Hakim. Flick the tick. Get rid of Mikah now and forever.
First, fear mongering is especially effective when there is in fact something to fear, such as the Mikah Tax we will all pay at buyout. I agree with you that the board will not accept any plan that Hakim does not endorse, and the Mikah Tax will only be repealed if Hakim believes he needs to do it. I disagree with your portrayal of the board as independent from Hakim, and as I understand it, lack of an independent board will definitely be a part of plaintiff's arguments. Also, I never said it was a requirement for Elite to buy the other half of Adderall in order for the company to be sold. What I said is that if Hakim still owns the Adderall ANDAs at the time of the buyout, then it will have a significant detrimental effect on the payout received by Elite shareholders -- the Mikah Tax. We need a neutral mediator to establish a fair price to get rid of Mikah once and for all. Whatever the cost now, it will be a small price to pay to repeal the Mikah Tax forever.
You should stick with your delusional fantasy world.
When you try to recite real world facts, you reveal how little you know. You've repeated this nonsense multiple times. What the hell are you yammering about? Adderall IR was approved in Dec '18 and ER in Dec '19. The Lannett distribution deal was in place in 2019, and both drugs were already launched by the time Mikah scooped the ANDA from SunGen May 2020. Got that? No more development money was needed, and both drugs were producing income. The idea that there was no way to arrange financing on behalf of Elite shareholders is nonsense and requires a delusional mindset to believe. The simple fact of the matter is that Hakim was either too lazy or too greedy to do anything except take the sweet deal for himself. And now he intends to parlay his personal ownership of Adderall into huge fortune that will cost Elite shareholders dearly at buyout. It's time to repeal the Mikah Tax. Flick the tick. Get rid of Mikah now and forever.
No worries, friend, you will receive the maximal benefits when the Mikah Tax is repealed. You can thank me after Elite shareholders get the fair buyout price they deserve.
Insider ownership is usually a positive, but it is a strong negative when the insider is the owner of a competitor, like Mikah. Savvy investors avoid high tax investments, and the Mikah Tax is the biggest tax of them all. Capital gains taxes will be dwarfed by the Mikah Tax we all pay at buyout. We do not need Mikah for any reason at this point. Not one. The longer Mikah remains intermingled with Elite, then the more obvious it becomes what Hakim's intentions are. He will flip Adderall for a massive profit, just like he did with his worthless cadre of ancient generic ANDA's and toxic trimipramine. Buy low and unload it for 50-100X markup to a buyer who cannot say NO. He will demand a secret payoff for Adderall that will substantially affect the buyout price for Elite and the payout to Elite's shareholders. The lickspittle shareholders who act like this transaction would be too complicated or too expensive are just making excuses for their dear leader, probably due to some version of battered spouse syndrome. "He has always treated me like this- this is all I deserve." Wake up! You do not have to tolerate this oddball CEO's aberrant behavior. This is not usual- what he is doing and how he is behaving- and that is why Mikah is a profound drag on Elite stock. It's time to repeal the Mikah Tax now and forever. Flick the tick. Get rid of Mikah.
imanjen13, it takes a special level of weakness to be too afraid to reply directly to the post to which you are referring, and I doubt any spineless investors like this would ever stand up for themselves and against a self-dealing CEO. Luckily there are many other investors with better reading comprehension skills.
I said we are back to 2016 price levels. I did not mention my cost average.
This obviously such complete bullshit that anyone with basic math skills knows it to be a lie.
What "major investment" did he put in?? He got paid $10M and $1.2M for ANDA's not worth a fraction of that. He has made small, high-interest loans. What did he invest??? I thought my point was clear. Here it is again, maybe try reading more slowly.
Right, just like I've been watching it grow for the past 8 years. My investment has finally grown back to it's 2016 level. Hakim's show has been marked by monumental failures of his own making and only moderate successes that required a lot of help. Throughout his entire tenure he has ignored his fiduciary duty to Elite shareholders and repeatedly favored himself in a series of unfair self-deals with Mikah. He charged us $10,000,000 for a rag tag collection of ANDA's that weren't worth half a million dollars on their best day. To hide the malfeasance, he then parked those ANDA's with his BUSINESS PARTNERS at Epic and proceeded to blame THEM for doing nothing. He lied to shareholders and the whole world in a press release that claimed SequestOx was bio-equivalent with comparator, when he very well knew it was very far from bio-equivalent under fed conditions. It was a billion dollar lie, and shareholders had to be told about it by the FDA in a CRL. He hyped the 3 buckets incessantly, and then he sold off the generic opioids nearly as soon as they were approved. He starved the company of revenue, and then claimed to be the savior by overcharging us 100X for toxic trimipramine, which Mikah acquired long after Hakim told shareholders and the SEC that Mikah had wound down operations. When Elite had the opportunity to acquire full ownership of the their flagship Adderall ANDAs, Hakim couldn't be bothered to arrange a deal on behalf of shareholders. Instead, he made the deal for himself, and it has been a very lucrative deal for Mikah and Hakim personally. But the Adderall profit splits are only a drop in the bucket compared to what he intends to get for these ANDA's. When it finally comes time for a buyout, he will make a secret side deal for these properties that will make him fabulously wealthy. Whatever slimy second tier company is willing to deal with him, they will gladly make an overly generous secret deal for Mikah in exchange for a massive discount for public Elite. Hakim gets the gold saying "None of your business" while shareholders sit and wonder what happened to our payout.
I will never understand why shareholders show such incredible deference to a self-interested mediocre CEO like Hakim, but I for one think he's gotten rich enough off the backs of Elite shareholders. It's time for him to do the right thing and extract Mikah entirely from Elite. We need a neutral mediator to simulate an arm's length transaction, and we need to buy out Mikah immediately. Whatever the cost, today is the cheapest it will ever be. Tomorrow it gets more expensive and every day thereafter it gets harder and costs more to do. If we continue to kick the can down the road until the buyout, then Hakim will get his secret side deal for Mikah, and Elite shareholders will get screwed yet again. Fiduciary duty be damned. This is the Mikah Tax we will all pay at buyout if we don't force Mikah out now. All one has to do is look at Hakim's history with Mikah and Elite shareholders, and it becomes obvious what his intentions are for Mikah and Adderall.
Stop making excuses for a man who has screwed you over multiple times. Flick the tick, repeal the Mikah Tax now.
Mikah may not stop an eventual buyout, but it will definitely slow it down and diminish the payout. Top tier companies will not want anything to do with negotiating with Hakim for both Elite and Mikah, and those that do will expect a deep discount for public Elite in exchange for their private generosity for Mikah. When the buyout finally occurs, every Elite shareholder will pay the Mikah Tax. A true long investor shouldn't care about the day to day share price. A true long should only worry about their total proceeds at buyout, including tax liabilities. A true long should be working diligently to unwind the intermingling of Mikah and Elite -- it is nothing more than common sense tax avoidance strategy.
Mikah Tax -- the cost we will all pay at buyout due to the ongoing intermingling of Mikah and Elite.
1. Cost of Second Tier Suitors -- top companies will stay away 2. Cost of Secret Side Deal with Hakim -- shareholders will never know how much money he demands for himself on the side 3. Cost of Mikah litigation -- multiple class action suits are guaranteed
Repeal the Mikah Tax!! Let's get rid of Mikah now and forever.
This is easy, but Hakim will have to be willing to do some things he's never done before- be honest and forthright with shareholders and give us a seat at the table. Every agreement between Mikah and Elite has Nasrat sitting on both sides of the table making deals which are not arm's length and which clearly favor Mikah, despite his fiduciary duty to Elite shareholders. Every deal Mikah has with an outside party is secret, including when Mikah scooped Elite on the Adderall purchase. In order to repeal the Mikah Tax, we need a neutral third party arbiter who can simulate an arm's length deal and establish a fair price for shareholders to buy out Mikah and be done with them for good. This does not get easier to unwind as Elite grows- it gets more difficult and more expensive. We need to repeal the Mikah Tax now.
I think when Hakim said to stop sending in stupid questions, this is the kind of crap he is talking about. He knows Mikah is a very serious issue, and I suspect it weighs on him heavily. Hakim knows every Elite common shareholder will pay a hefty Mikah Tax at the time of buyout, including himself. For now, paying the Mikah Tax will pay off for him because of his Mikah proceeds, which only he enjoys. The rest of us will pay the Mikah Tax without receiving any benefit at all. What is the Mikah Tax? This is the cost we will all pay at buyout due to the ongoing intermingling of Mikah and Elite.
Mikah Tax 1. Cost of Second Tier Suitors -- top companies will stay away 2. Cost of Secret Side Deal with Hakim -- shareholders will never know how much money he demands for himself on the side 3. Cost of Mikah litigation -- multiple class action suits are guaranteed
A true long shouldn't care about the day to day share price. A true long is only worried about their total proceeds at buyout, including tax liabilities. A true long should be working diligently to unwind the intermingling of Mikah and Elite -- it is nothing more than common sense tax avoidance strategy.
Repeal the Mikah Tax!! Let's get rid of Mikah now and forever.
I couldn't have said it better myself, guilty as charged. If you want evidence-based clinical care with drugs and procedures that are proven safe and effective, then come see me. If you want to pay cash out of pocket for the latest and greatest tik tok treatment or whatever overpriced drugs that kayak's friends say works good for them, then you'll have to log in with your favorite medical profit bot. "Do your own research," as they say, and never mind those cardiovascular risk factors, some new pill will be along any day to melt that the atherosclerosis away. Don't be a jackass and wait for it to be proven effective, and don't be a pussy and wait for it to be proven safe. If it's expensive, then it must work. And if they sell it on the internet, then it has to be safe. Sheesh Kayak, good luck with the horse dewormer in the next global pandemic.
You should call your buddy tonight and tell them how proud you are of the naltrexone. I wouldn't worry about congratulating them for making healthy choices or actively taking steps to become more fit. No need to mention the spouse who was there to encourage and support the tough decisions every step of the way. Depending on how good of a friend you are, you might want to mention the Oar Health website they use says "plans start at $39/month", so they paid at least $468 for their one year supply of naltrexone, which is easily available through GoodRx for $170 per 365 tablets. So Oar Health appears to be getting $300/year markup for a generic drug that any patient could acquire from any local pharmacy, with a prescription from their doctor. If they had a PCP, they could get their naltrexone and have plenty of cash left over for a variety of excellent generic drugs to manage blood pressure, cholesterol, metabolic syndrome, and just about any other problem they want to talk about. Not to mention they might actually get to have a real discussion about the risks and benefits of drug therapy, including potential side effects and interactions, as well as an opportunity to have a rational discussion of available options. Or instead they can continue clacking away with an unknown human chatbot provider with a financial incentive to prescribe a marked-up drug.
If you ever develop an intellectual curiosity, Kayak, or if you ever just want to stop looking like a gullible dullard staring wide-eyed at the next snake oil sensation, then start by looking up the difference between an anecdotal report and a randomized, prospective study. Learn the difference between peer reviewed journals and pay per click "news" sites. Try to understand the placebo effect and how it might be boosted by the actual healthy lifestyle modifications that are taking place at the same time as drug therapy. My sincere best wishes for you are that you never develop any health problems that cannot be solved by an anonymous internet chatbot with a private label pharmacy mailing out overpriced generic drugs.
You confuse problem drinking and alcoholism. You confuse the complexity of real life patients with the sophistry of what you can know from reading one click-bait "news" article. I tried to help you sound less simple, but you either didn't read what I wrote or you couldn't grasp the main concept. Of course there are always exceptions to general rules, and I haven't seen everything yet. However, in my experience, neither problem drinkers or alcoholics ever think they need naltrexone or any other formalized support, including AA and similar orgs. They might go to therapy or attend some AA meetings, usually to make someone else happy. They might accept a prescription, maybe just to please me, because they can tell I want them to take it. They have every intention of following through, but like you, they don't understand what they're up against. I've managed this disease in the ER. I've managed this disease in the ICU. I've managed this disease at hospital discharge. I've managed this disease from the clinic over multiple years. You are welcome to accept the knowledge that I'm offering you based on my own extensive first hand experience, or you can reject it and continue to make simpleton statements that do a disservice to anyone who has suffered in proximity to an alcoholic who can't see the chaos they cause.
Kayak if you being wrong is wonderful for my patients, then they should be paying me more, because you being wrong has never been in shortage. I would say that your understanding of alcoholism as a simple problem that can be fixed with one pill per day is naive and very typically American. It ignores the underlying issues that frequently lead to problem drinking, especially untreated anxiety and PTSD, and it disrespects the millions of families that have been ripped apart by generational alcoholism. I do have some experience prescribing naltrexone to alcoholics, and I've never had anyone come back and describe a miraculous change in their desire to drink alcohol. That may happen for a few individuals, like the lady quoted in the article, but that is not the usual response. In my experience as an ER doc, hospitalist, and PCP, most alcoholics do not change until they have hit rock bottom. A functional alcoholic will go through every stage of semi-functional and mostly-dysfunctional until there is nothing left- no job, no one home, and all their enablers completely burned out. It is particularly sad, especially for family, to see an alcoholic who seems to be at rock bottom but who in fact had further to fall. I've never had any alcoholic continue with naltrexone on the way down. Ever. But I have had better luck on the rebound. I have been able to convince some recovering alcoholics to stay on naltrexone, and a few have said they think it is helpful to cut down on their cravings. Even if they do, there will be setbacks. It is a part of the process and not a sign of weakness. This where the former enablers need to step in to become supporters. Make the setback a quick stumble and not a free-fall back to the bottom. Naltrexone does nothing to address anxiety, depression, PTSD, bipolar, schizophrenia, etc, etc, etc, and if you ignore any of those issues, then recovery is unlikely.
Naltrexone may be helpful for some alcoholics, but it is far from a miracle cure. I cannot speak for what other doctors know or don't know about naltrexone, since most of them do not have my excellent training or my decades of real world experience at every level of patient care. But I suspect most of them know that fixing the devastation caused by alcoholism is a lot more complicated than simply prescribing one naltrexone tablet per day. Wishful thinking does not replace a comprehensive treatment plan. No combination of pharmaceuticals is enough to do the job without aggressive cognitive therapy at the same time.