Discover and read the best of Twitter Threads about #Addiction

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Here is a preview/summary of my talk today at the @NIH conference on 'Social Determinants of Opioid Use: Establishing a Research Agenda' apps1.seiservices.com/SocialDetermin…
1. Our problem is bigger than #opioids. Its bigger than drugs altogether. An over focus on specific drugs risks that we’ll impose #policies that target specific substances rather than the #underlyingcauses of use.
2. We regularly hear that #addiction is a #braindisease. But its more than that. Addiction is a social disease.
Read 13 tweets
The medical use of #opioids did NOT cause the OD epidemic. But so many people believe it did, that in 2019 even @nytimes agreed with #Kolodny that #racism "protected" black Americans because doctors failed to treat their pain effectively. @afrakt /thread nytimes.com/2019/11/25/ups…
NYT 2019: "African-Americans received fewer #opioid prescriptions, some researchers think, because doctors believed, contrary to fact, that black people were more likely to become addicted to the drugs & would be more likely to sell the drugs."
Black Americans are less likely to receive adequate #pain relief, according to researchers, because there's a lingering (#racist) assumption that black people have a "higher pain threshold" than whites.

#BlackLivesMatter in medicine.
Read 16 tweets
2,887 #vets died of overdose or suicide after their rx #opioid was stopped by the VA in FY 2013. That's just 90 fewer bodies than total US deaths on 9/11. Efforts to stem the crisis of ODs to illegal drugs by restricting rx access have failed b/c medical use isn't the cause. 1/3 Image
2019 study projects 1.21 million will die in US 2015-25 of #opioid ODs AND it explains that rx restrictions aren't just failing to help: they're making the problem worse.

It's obscene.

People w/ #ChronicPain AND w/ #addiction are suffering under a policy that's KILLING us. 2/3
.@headsUPmigraine fights for evidence-based rx #opioid policies that treat people w/ #addiction & #ChronicPain individually, effectively & non-fucking-fatally.

We're looking for partners who advocate for people w/ addiction &/or for #vets (#veterans). threadreaderapp.com/thread/1295072…
Read 3 tweets
Those least likely to develop #addiction are most likely to get an #opioid rx: 1/2 of the 15% of Americans who filled an opioid rx in 2018 were 55+ with 1/4 of all rx's going to people over 65.

2016 study found a 0.3% #addiction rate. The risk of addiction drops .68% per decade. Image
#CDC: Prevalence of substance use disorders involving schedule II #opioids (age 12+ US 2018): 0.6%.

Schedule II drugs can be rx'ed. Most abuse involves illegal drugs. CDC relies on self-reported data for its annual report. cdc.gov/drugoverdose/p…
#CDC 2019: "Rates of #opioid rx's continued to drop, continuing the trend that began in 2012."

But: "The rate of drug overdose deaths increased significantly from 1999 to 2017."

That's because medical use does not fuel the epidemic of overdoses to illegally-obtained drugs.
Read 6 tweets
In 2019, #CDC Guideline authors quoted their 2016 stats:

"nearly 2 million" have #opioid use disorder,
"estimated 3% to 4%" rely on long-term opioid therapy
"approximately 11%" report daily #pain

"Nearly 2 million"=nearly 0.6%. Stick with me.
jamanetwork.com/journals/jama/…
Before governments recommend & legislators, providers, & insurers adopt policies that could harm up to 11% to possibly protect 0.6%, they need damned good evidence that what they're recommending is necessary.

But they didn't know if rx #opioid limits would help or kill.
#CDC set off a tidal wave of limits in 2016, even tho the studies then available on dose limits provided "very-low-quality evidence" that reducing or stopping med would improve pain, function, or quality of life. 76% got the *lowest* rating for evidence.

acpjournals.org/doi/full/10.73…
Read 10 tweets
Yearly since 2012, #opioid prescriptions have hit all-time lows as #overdoses hit all-time highs. Here's why:

1>#Addiction thru medical use is "very rare" (@AmericanCancer Society).

2>Multiple studies show stopping/tapering rx #opioids *increases* the risk of OD or #suicide. Image
#CDC had to get #squirrely w/ data in 2013 to make it seem as tho #opioid scripts were fueling overdoses. Note they compare kilograms per 10,000 to ODs per 100,000 & literally fail to connect the dots when scripts fell in 2012. Image
#Opioid prescribing peaked 8 years ago, & drug overdoses are the #1 cause of death for Americans under 50. Denying or discontinuing medicine *increased* rates of #OD & #suicide.

Doctors & policymakers are killing people to "save" them from the "very rare" risk of #addiction.
Read 6 tweets
Thread 🧵 sharing some quotes from an article I reshare often re: racism and the “opioid crisis”

@jnetherland Netherland, J. & Hansen, H. B. (2016). The War on Drugs That Wasn't: Wasted Whiteness, "Dirty Doctors," and Race in Media Coverage of Prescription Opioid Misuse.

1/15
“One of our strongest findings was that drug use in black and Latino urban communities is not considered newsworthy. ...
The absence of stories and what is missing in the stories that exist are in of themselves telling.”

2/15
“Story after story describes drug use in suburban, white communities as a new and dangerous phenomenon, even though decades of the epidemiological evidence shows that blacks and whites have long used illicit drugs in relatively similar proportions (SAMHSA 2014).”

3/15
Read 15 tweets
My college sweetie became an #addiction expert. At his funeral, dozens said he saved their lives. He wrote this about his brother's struggle. I was in the studio. He laid down every track but the drums in 1 take. 5-min dueling guitars start at min 4. soundclick.com/artist/default…
@twtr_is_dumb Listening to Howie's old tracks reminds me of The Other End. I couldn't get them to stop putting up "Jill, Howie, & the Rain" signs. Like showbills for "Yoko Ono & 4 guys from England." #yikes Hope you're staying safe!
ps Ike: That's a really creepy picture of Howie, don't you think?
Read 3 tweets
What have false assumptions about rx #opioids cost people in #pain? Damn near everything.

@Brian_Goldstone's report ought to be required reading for every #PCP & every legislator who wants to play doctor. #MedicalTwitter harpers.org/archive/2018/0…
For 4 yrs, an rx #opioid let Austin Sell escape the cage of pain, care for his kids, study to become a physician asst to help others w/ #ChronicPain. Then lawmakers in DC imposed a limit on what his clinic could prescribe. "And that was it. The app'ment lasted about 10 minutes."
Dr @StefanKertesz told @Harpers: “In a time of incredible tragedy, there’s a desire for something simple to latch onto as a way of explaining it. A story that has a clear-cut villain, with doctors as dupes and patients as innocent victims, is about as easy to sell as any story.”
Read 25 tweets
.@NPR's response to the outcry that they wrongly blamed medical #opioid use as the cause of the OD epidemic? 4 days later they did it again. @BrianMannADK @carriefeibel @vicwj This is LAZY & HARMFUL reporting.

Evidence shows: #ODs & #suicides go UP as # of scripts goes DOWN.
.@NPR @BrianMannADK @carriefeibel @vicwj

🔴 2,887 #vets DIED from #OD or #suicide AFTER their #opioid pain med was stopped in FY 2013.

🔴 1 year of the VA's policy to take #vets off medicine produced just 90 fewer bodies than 9/11. (Link next tweet)
VA study showing people are 4 to 6.8 times MORE LIKELY to die of #overdose or #suicide after discontinuation of a prescription #opioid. THIS IS NOT AN OUTLIER. @NPR, PLEASE contact co-author @StefanKertesz. bmj.com/content/368/bm…
Read 9 tweets
.@AmerMedicalAssn STILL hasn't read a study they published in 2019 showing rx #opioid limits "have failed" to reduce #ODs.

@AmericanCancer Society explains: People "very rarely" become addicted from medical use. Thread: Research shows pushing patients off opioids can kill them.
"#Addiction is very rare" when #opioid pain meds are taken as prescribed (American Cancer Society). Large studies have put the rate of addiction in medical use at under 1%. #cpp

-Brat bmj.com/content/bmj/36…
-Ciesielski
amjmed.com/article/S0002-…
-AmCancer
pdffox.com/get-help-for-c…
Chen et al: Restrictions on rx #opioids "have failed" to reduce ODs. Complex mathematical modeling shows they'll likely have a "modest effect, at best" on expected rises in ODs, which are fueled by illegal drugs. jamanetwork.com/journals/jaman…
Read 10 tweets
For a virus that presents "few to no symptoms" for the majority, "U.S. Orders Up to 600 Million Doses of #Pfizer, BioNTech Covid #Vaccine" (Bloomberg).

bloomberg.com/news/articles/…

So let's take a look at Pfizer.
"Pfizer is a publicly-traded global pharma corp.headquartered in NYC. Its revenues reached $52.5 billion in 2017. #Pfizer makes Advil, Xanax, #DepoProvera, Neosporin, #Lyrica & Dimetapp. Pfizer manufacturers more than 350 different pharmaceuticals & operates in 180 countries.
Pfizer's Lyrica, the new vallium, linked to depression, anxiety & suicide, now top pain medication on PBS. #Pregabalin #Addiction. Addicts of #hydromorphone (#Opioid) (Pfizer) have found a new addiction w/ #Lyrica. Capsules are opened, crushed & snorted.

thetimes.co.uk/article/drug-d…
Read 40 tweets
.@BrianMannADK At @headsUPmigraine, Dr @NitaGhei & I are trying to understand why medical research about the "very rare" risk of #addiction in medical #opioid use & the rising rate of causalities from rx opioid limits isn't being reported, even by thoughtful outlets like @NPR.
#Addiction expert Maia Szalavitz explained in 2016, "#Opioid addiction is a huge problem, but pain prescriptions are not the cause." The fact that steep rx limits haven't so much as slowed rising ODs proves her right.

How did @NPR get this wrong? blogs.scientificamerican.com/mind-guest-blo…
.@headsUPmigraine has been on the front line of the twin public health crisis caused by widespread discontinuation & dose reduction of rx #opioids: a rise in unnecessary #disability from #ChronicPain & a spike in #suicide.
Read 9 tweets
@BrianMannADK I was stunned to see your @NPR piece on rx #opioids. I direct @headsUPmigraine & have been writing a paper reviewing research on rx restrictions. Limits haven't just failed to reduce ODs, they've contributed to an INCREASE in ODs, suicide, disability.
AMA Jnl 2019: Efforts to curb ODs "have principally focused on restricting the supply" of rx #opioids. They've "failed to demonstrate a consistent benefit on fatal or nonfatal opioid overdoses." Continuing them "may have a modest effect, at best," on ever-rising illegal-drug ODs.
Since peak in 2012, scripts are down 35% but overdoses are up 250%. That's because #addiction in medical use is "very rare," as @AmericanCancer Society explains. Even #CDC 2016 put unremarkable use at 97%, w/ 3% incl'g non-addictive "long use" & physical dependence.
Read 25 tweets
.@VoteVets You're wrong to make rx #opioids the focus of your anti-Collins ad. #Vets taken off rx #opioids are up to 6.8 times MORE likely to die by OD or #suicide than those who stay on, per 2020 VA study. (thread) bmj.com/content/368/bm…
#Vets whose rx #opioid was stopped after 3 months overdosed or killed themselves at nearly 4 times the rate of those who continued to be treated. Those whose med was stopped after 1+ year ODed or killed themselves at 6.8 times the rate of those still treated (Oliva 2020).
2020 VA study: “Studies have identified a rise in adverse events (death from overdose, suicidal thoughts, self-harm, & hospital admissions or emergency department visits
for substance related events) after stopping treatment with #opioids in patients treated long term” (Oliva).
Read 15 tweets
1/ THREAD: What do you think is the most important article or video in today’s @ProgNewsDaily? There are 80+ to choose from.
progressivenewsdaily.net/#/?utm_source=…

Top stories:
* #Democrats Can’t Quit Their #Addiction to Big-Money #Donors - @newrepublic
2/
* 'Absolute Robbery': #Gilead Announces $3,120 Price Tag for #Covid19 #Drug Developed With $70 Million in Taxpayer Support - @commondreams

* The Republican #Sabotage of the Vote #Recounts in Michigan and Wisconsin - @Greg_Palast

Like, Share & Follow @ProgNewsDaily
3/
* #Trump Deletes "White Power" Tweet After Officials Get Destroyed On Sunday Shows - @RingOfFireMedia @farronbalanced

* 60+ Groups Demand Senate Pass #Sanders Amendment to Slash 'Out of Control' #Pentagon #Budget by $74 Billion - @commondreams

Follow @ProgNewsDaily
Read 6 tweets
1/3 Don’t use drugs alone. Even if you can’t physically be with others, video chat or call someone who can call 9-1-1 (or local emergency line) in case of an #overdose.

Learn how to recognize the signs of an opioid overdose: ow.ly/mro650AaoQX

#CarryNaloxone
2/3 The #stigma around substance use can prevent people from getting the help they need.
3/3 #Addiction is not a choice, it’s a treatable medical condition.

It’s more important than ever to show compassion and help #EndStigma.

ow.ly/axFi50Aapj6
Read 3 tweets
FDA HHS CDC all say patient consent should be obtained before tapering rx #opioids except in rare emergency cases. Many drs & hospitals aren't following this guidance. Here's a letter that protected my rx. Please feel to use it or the research it contains: docs.google.com/document/d/e/2…
Federal Health & Human Services tells doctors: "Avoid insisting on #opioid tapering or discontinuation when opioid use may be warranted": "CDC Guideline...does not recommend opioid discontinuation when benefits of opioids outweigh risks."
HHS & CDC both tell doctors to "consider individual patient situations" & to "avoid misinterpreting cautionary dosage thresholds as mandates for dose reduction" when prescribing #opioids.
Read 13 tweets
Here @jasonluan88 responds to arguments for #safesupply brought forward by advocates on social & mainstream media, but it appears that he needs help with understanding and interpretation of the arguments and data in support of safe supply.
Thread: 1/
#Abpoli #Ableg
In the headline @jasonluan88 continues to use stigmatizing language with the word “addict”. People who use drugs are people first!
Stigma causes people to to use and die alone.

Here are helpful resources on stigma for the minsiter.

#ableg #abpoli
2/
canada.ca/en/health-cana…
A person with lived and living experience is free to chose how they self-identify, but unless @jasonluan88 has lived experience he should stick to #PersonFirstLanuage
#Abpoli #Ableg
3/
Read 17 tweets
Solutions to societal problems cost money and motivation.

Aggressive and inhumane behaviour that is driven by an intense need that will sacrifice everything else for its fulfillment.

yorkshireeveningpost.co.uk/news/crime/mar…
Judge Christopher Batty was spot on when he said "It is very sad that two lives have been ravaged by addiction."

"Both of you have positive qualities that have been dissipated because of your addiction to drugs and alcohol."
The judge said that two lives have been destroyed but in truth, it is four that have (notwithstanding the impact on extended families).

We urgently need to restore our drug and alcohol rehabilitation support services which were devastated by a decade of austerity and cuts.
Read 10 tweets
(1/x) Day 7: Pinch hitting for @BonuraErin on this tweetatorial for the #COVID intercession she masterfully designed! On 5/6, we had me discussing the international pandemic responses (2-9) & Dr. Kelsey Priest (@kelseycpriest) talking #syndemics Re addiction dz & COVID19 (10-18).
(2/x) Session 7.1 (Strnad): COVID - Comparing the World’s Responses: We attempted to discuss this topic w/ language highlighting the ways that understandable and changeable actions that countries, businesses, & people perform have influenced different national stories of COVID.
(3/x) Comparing data like national deaths, or even national deaths/per capita can be misleading during a pandemic that is influencing different countries at different times. When did #COVID really hit the countries? Where are you in the epidemiological curve? Eg)
Read 20 tweets
Good Day 🌎! Are you ready for one of Gods🌿to be Federally Legalized? I have stood strong on this since #DJT announced he would run in 2015. Follow along for my thoughts and leave a comment below. Please retweet and lets help those who need it most. #WWG1WGA
2) Starting off we know the issues with his brother and #Alcohol which for most would lead them to believe he was completely against any and all substances. However I am lead to believe the exact opposite.
3) #Drugs and #Alcohol both are known to have horrible side effects that contribute to many of the horrible #sickness and #disease we know today. We have all long known the power of this 🌿. This leads me to a Poll, Lets keep you engaged!
Read 18 tweets
Tweet 1: " Many people ask me why someone on opioid against #treatment (OAT) to manage their #addiction would still use heroin at the same time. It comes down to what fuels on individuals addiction (a thread)"
Tweet 2: "2/ First, you have to understand why someone might start using #opioids or other drugs in the first place. For me, I started using heroin to deal with deep-rooted trauma that was causing me incredible emotional pain"
Tweet:3 "3/ Soon I had to keep using heroin regularly to stave off the debilitating withdrawal from not using. So I was using heroin for two reasons: to manage trauma and to manage withdrawal"
Read 6 tweets
Back when Donelle was still working out of home, in the Before COVID days, she came home in a crabby mood. Sat down to supper and for 15 minutes unloaded on boy and I about how hard her day was. Crabby customers, multiple change orders, long drive up lines...(1/)
...late deposit drop offs, etc. Derek, between bites of hot dish looks at her and asks "Did anybody die?". Donelle still in Bank ID Badge with plate of hot dish now in front of her wasn't sure she heard so asked him to repeat. "Did anybody die?" with fork pointing at her (2/)
My wife, his mother, looks at him quizzically replying "No, why?" The boy now turns his fork to me "When dad has a bad day at work it's because one of his clients died." He points fork at mom "When you had a bad day you had to work hard." He then went back to his hot dish. (3/)
Read 15 tweets

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