Discover and read the best of Twitter Threads about #Opioid
Most recents (24)
2)which underscores the need for close supervision of these patients."
Let's take a look at their rationale for their conclusion.
Of 9940 patients who received 3 or more #opioid prescriptions over an 8 years, 51 experienced an #overdose, 6 of the 51 experienced a fatal event.
Let's take a look at their rationale for their conclusion.
Of 9940 patients who received 3 or more #opioid prescriptions over an 8 years, 51 experienced an #overdose, 6 of the 51 experienced a fatal event.
3)The researchers did not make the yearly data available, nor did they provide data on any known prior history of Substance Use Disorder #SUD within the #Patient population.
It's impossible to determine how they performed their calculations to obtain these results.
It's impossible to determine how they performed their calculations to obtain these results.
4)While they did provide percentage risk based on MME dosages, they also Risk based folks multipliers which obscures actual risk. The highest percentage of risk reported based on MME dosage was less than 2%,
Limitation: Low OD Rate šš¤¦āāļø
acpjournals.org/doi/10.7326/00ā¦
Limitation: Low OD Rate šš¤¦āāļø
acpjournals.org/doi/10.7326/00ā¦
1-#ChronicPain patients knew that the opioid 'guideline' re: prescribing practices was not law.
But as intended, PROP's 'guideline' shaped the Standard of Care re: #opioid prescribing practices so it might as well have been law.
Why?
Tort law.
Let's try and break it down.
But as intended, PROP's 'guideline' shaped the Standard of Care re: #opioid prescribing practices so it might as well have been law.
Why?
Tort law.
Let's try and break it down.
2-Once PROP's āopioid guidelineā was published through CDC, prescribing practices started to formally change nationally and altered how doctors were to treat pain; altering the Standard of Care. This was crafted around an āopioids are dangerous drugs' narrative.
#ChronicPain
#ChronicPain
3-The recommendations to instate a maximum morphine milligram equivalent altered things further in the practice of treating pain. It changed pain treatment recommendations for acute pain, post surgical pain control, and most of all, the way #ChronicPain was treated.
Reviewing some #NorthDakota information surrounding #prescribed #opioids.
#OpioidPrescriptions #declined 34% from 2006 to 2020
Statement in poster ā”ļø āSince 2007 every state has been working to address the #opioid epidemic & best practices are now understoodā
Are they? 1
#OpioidPrescriptions #declined 34% from 2006 to 2020
Statement in poster ā”ļø āSince 2007 every state has been working to address the #opioid epidemic & best practices are now understoodā
Are they? 1
In the #Conclusion
ā”ļø nothing that addresses the #harm of #patients that struggled with #chronicpain. #Nothing re #outcomes of those #abandoned by #physicians & removed from #prescribed #opioids. Nothing about the looming disaster of last #physicians that #prescribe in 2
ā”ļø nothing that addresses the #harm of #patients that struggled with #chronicpain. #Nothing re #outcomes of those #abandoned by #physicians & removed from #prescribed #opioids. Nothing about the looming disaster of last #physicians that #prescribe in 2
#NorthDakota leaving. #Patients having no recourse. #NorthDakota absolutely has growth in area of serving those w #SUD yet in their pursuit to do this, they have #harmed those w #chronicpain & continue to exclude them in discussions or acknowledge these #harms. @hhsndgov 3
As promised, hereās a dive into one state which has few requirements to publicly report how #opioid settlement funds are spentāand issues are already arising: Michigan. #THREAD
2/ Last summer, the Michigan legislature allotted $39M of settlement cash to the state health dept. For the next six months, there was almost no public info on how it would be used. No news releases. No invitation to apply for grants. "It was a black hole," said @opioidpolicy.
3/ Even the stateās Opioid Advisory Commissionācreated to evaluate the use of settlementšµācouldnāt get details. āIt makes it difficult for us to do our job,ā said chair @cara_poland. āWe canāt really identify the impact of those dollars if we donāt know how theyāre being used.ā
Let's break down #TheGreatOpioidLie.
1-"Over-prescribing was the cause of the opioid crisis."
First according to the Medical Board of CA, there is no legal definition of 'overprescribing'.
Second, it is a THEORY that the mandate to treat pain led to the overdose crisis
cont...
1-"Over-prescribing was the cause of the opioid crisis."
First according to the Medical Board of CA, there is no legal definition of 'overprescribing'.
Second, it is a THEORY that the mandate to treat pain led to the overdose crisis
cont...
2-The Gov's own stats disprove the access theory. As access to RX meds declines we continued to see a steady increase in drug deaths.
Seems something else might have been a the heart of why we saw a rise in ODs and continue to see record numbers of PEOPLE dying.
#ChornicPain
Seems something else might have been a the heart of why we saw a rise in ODs and continue to see record numbers of PEOPLE dying.
#ChornicPain
3-Could it have been the collective trauma we all experienced after 9/11, then we sent our loved ones off to war, and they were being sent home with broken bodies, then the financial collapse, outsourcing of manufacturing jobs, people losing homes, retirement, investment accts...
Today's Twitter threads (a Twitter thread).
Inside: Google's chatbot panic; and more!
Archived at: pluralistic.net/2023/02/16/tweā¦
#Pluralistic 1/
Inside: Google's chatbot panic; and more!
Archived at: pluralistic.net/2023/02/16/tweā¦
#Pluralistic 1/
This is the last day (Feb 17) of my #Australian tour for my book #ChokepointCapitalism with my co-author, #rgibli. We'll be in #Canberra at the Australian Digital Alliance Copyright Forum:
digital.org.au/2022/11/08/docā¦ 2/
digital.org.au/2022/11/08/docā¦ 2/
Google's chatbot panic: On the infinite insecurities of a self-styled creative genius who really just buys other people's ideas.
3/
3/
Key q for discussion: How will #climatechange address the timing and severity of infectious outbreaks in the years to come?
š¦ influenza, #covid19, & other respiratory dxāed
š¦malaria & other vector-borne illnesses
š½diarrheal & other fecal-oral disease
@Brown_SPH
š¦ influenza, #covid19, & other respiratory dxāed
š¦malaria & other vector-borne illnesses
š½diarrheal & other fecal-oral disease
@Brown_SPH
1. Heat, cold, & water/drought change these pathogensā evolution
2. Heat, cold, & water/drought also change how humans act
3. And health systems are changed, too! (Just look at the effect of Katrina)
2. Heat, cold, & water/drought also change how humans act
3. And health systems are changed, too! (Just look at the effect of Katrina)
We are at a unique moment of ācoupled risksā: urbanization, easy trans-national travel, large agricultural industriesā¦
We get to make decisions every day both to adapt & to prevent. @Craig_A_Spencer
We get to make decisions every day both to adapt & to prevent. @Craig_A_Spencer
With reports suggesting that the administration may soon end the public health emergency (PHE) declaration for #Mpox, I thought Iād do a little review of the #PHE itself š§µ(1/x)
Here's the news report on this: politico.com/news/2022/11/3ā¦)
Here's the news report on this: politico.com/news/2022/11/3ā¦)
Most people probably became familiar with the PHE declaration when first declared for #COVID in January 2020. It has been an important tool in the nationās response to COVID and its end will have significant implications, as we explore here. (2/x) kff.org/coronavirus-coā¦
But the origin of the Section 319 PHE was a 1983 amendment to the PHSA. Believe it or not, the bill was introduced in April of 1983 and passed and signed into law by July of that year! (the good old days?) (3/x) govinfo.gov/content/pkg/USā¦
1/ As if the #opioid crisis and the pending #ONhealth ED collapse werenāt enough, @OntariosDoctors section on Addiction Medicine warning OAT clinics across Ontario could see service disruptions as of Dec 1, 2022 (ironically #internationalaids day)
2/ At issue is the implementation of the new virtual care codes which will slash fees for video consultations with new patientsā patients in rural or remote areas without access to specialists are likely to be most impacted. #onpoli #onhealth
3/The irony is that #mentalhealth in #ontario was pioneering in establishing the virtual care capacity that got us through #covid. Many community-based #buprenorphine programs in rural and remote areas operated virtually prior to the pandemic, increasing #accessibility to OAT.
Drug overdose numbers for July have been released by the province.
95 Albertans died by drug poisonings in the month of July.
40 of those were Edmontonians (42%)
92/95 involved opioids (97%)
#yeg #ab #overdose #opioid #edmonton
95 Albertans died by drug poisonings in the month of July.
40 of those were Edmontonians (42%)
92/95 involved opioids (97%)
#yeg #ab #overdose #opioid #edmonton
It's International #OverdoseAwarenessDay.
Opioids are commonly used for the treatment of pain.
Ā
Their non-medical use, prolonged use, misuse and use without medical supervision can lead to #opioidĀ dependence and other health problems.
Ā
šbit.ly/3jsTqPI
Opioids are commonly used for the treatment of pain.
Ā
Their non-medical use, prolonged use, misuse and use without medical supervision can lead to #opioidĀ dependence and other health problems.
Ā
šbit.ly/3jsTqPI
Opioids include compounds extracted from the poppy seed as well as semisynthetic & synthetic compounds that can interact with #opioidĀ receptors in the š§ .
Ā
šbit.ly/3jsTqPI
Ā
šbit.ly/3jsTqPI
#OpioidĀ overdose risk factors incl.:
Ā
ā¦ļø using opioids without medical supervision
ā¦ļø high dosages
ā¦ļø resuming opioid use after an extended period of abstinence
ā¦ļø use by injection
ā¦ļø concurrent medical conditions
ā¦ļø combining with other substances/medicines
Ā
ā¦ļø using opioids without medical supervision
ā¦ļø high dosages
ā¦ļø resuming opioid use after an extended period of abstinence
ā¦ļø use by injection
ā¦ļø concurrent medical conditions
ā¦ļø combining with other substances/medicines
How do you spell Government Waste?
NEPO!
@kennethpolite of @TheJusticeDept side stepped questions from journalist inquiring as to the costs involved in the new Strike Force.
The @DEAHQ has documented that diversion of RX is rare. Only 1%
justice.gov/opa/pr/justiceā¦
NEPO!
@kennethpolite of @TheJusticeDept side stepped questions from journalist inquiring as to the costs involved in the new Strike Force.
The @DEAHQ has documented that diversion of RX is rare. Only 1%
justice.gov/opa/pr/justiceā¦
are diverted.
Yes... that's where the Millions of taxpayer's dollars are going!
š§How coincidental that this strike force targeting physicians & pharmacists was announced the day following the Supreme Court voted 9-0 that the Government must prove beyond a reasonable doubt
Yes... that's where the Millions of taxpayer's dollars are going!
š§How coincidental that this strike force targeting physicians & pharmacists was announced the day following the Supreme Court voted 9-0 that the Government must prove beyond a reasonable doubt
that the defendant knowingly or intentionally acted in an unauthorized manner.
The ruling is explained here by @RonChapmanAtty
Would it surprise anyone to learn that @kennethpolite was involved in the #Ruan case?
federaldefenseblog.com/blog/ruan-v-unā¦
The ruling is explained here by @RonChapmanAtty
Would it surprise anyone to learn that @kennethpolite was involved in the #Ruan case?
federaldefenseblog.com/blog/ruan-v-unā¦
š§ and *what* do Federal Law Enforcement & AG's consider *Dangerous prescribing*?
Let's take a look!š
The DEA perceived this CA Pain Management to be a "High Prescriber"šÆ
In 3 years he issued 9,000 RX. Oh My, How Shocking!!!
federalregister.gov/documents/2022ā¦
Let's take a look!š
The DEA perceived this CA Pain Management to be a "High Prescriber"šÆ
In 3 years he issued 9,000 RX. Oh My, How Shocking!!!
federalregister.gov/documents/2022ā¦
Now, this wasn't 9k #Opioid RX. It was 3 different controlled substances either alone or in combination.
Their is NO law that defines "Over prescribing" or prohibits co-prescribing of any medication combinations. The FDA warning requires a Risk/Benefit analysis to be performed
Their is NO law that defines "Over prescribing" or prohibits co-prescribing of any medication combinations. The FDA warning requires a Risk/Benefit analysis to be performed
to determine if the benefits for each "Individual Patient". Just like with ANY other medical condition. An Informed Consent discussion which includes both potential risks & benefits of any treatment options should be performed.
How many patients were being treated with CS?
How many patients were being treated with CS?
Important š§µ about the #CDC, #COVID, the #opioid crisis, & #pain:
This article does a great job of showing how the CDC is easily influenced by whatever political party is in charge and whoever is paying for the current narrative.
1/?
reason.com/video/2022/06/ā¦
This article does a great job of showing how the CDC is easily influenced by whatever political party is in charge and whoever is paying for the current narrative.
1/?
reason.com/video/2022/06/ā¦
At this point, it should be clear to nearly all Americans that claims/guidelines/etc of the CDC are rarely crafted solely for public health.
The bullš© claims about the opioid crisis is as politically/financially driven as any. Itās time for Congress to force the CDC to:
2/?
The bullš© claims about the opioid crisis is as politically/financially driven as any. Itās time for Congress to force the CDC to:
2/?
1) end current & expose previous private funding
2) have meaningful oversight
3) most importantly - WHEN (not if) scientific (or any other type of) fraud is discovered, any guidelines or actions based on the fraudulent or skewed data must be rapidly and publicly reversed.
3/?
2) have meaningful oversight
3) most importantly - WHEN (not if) scientific (or any other type of) fraud is discovered, any guidelines or actions based on the fraudulent or skewed data must be rapidly and publicly reversed.
3/?
The intrusion into the practice of medicine is based on race, gender, sex and disability discrimination.
1st target #Pain management
2nd target Gender Affirming Care
3rd target #Abortion
What will they target next?
#StopCriminalizingPatientCenteredCare
1st target #Pain management
2nd target Gender Affirming Care
3rd target #Abortion
What will they target next?
#StopCriminalizingPatientCenteredCare
Misinformation & propaganda is being disseminated by the government and still floods the media. The #Gaslighting of America has been extremely effective.
dovepress.com/misinterpretatā¦
dovepress.com/misinterpretatā¦
Individuals with incurable chronic illnesses, #RareDiseases #Disabilities that involve severe pain as a component are being deprived of appropriate medical treatment.
Thread š§µ: Reflections of a Parent/Caregiver After Six Years Implementation of CDC Guidelines (warning long but I am very interested in feedback)
Since babies, my kids, have intimately known #pain. At one time their #pain was intermittent & #acute. Sadly, they now struggle 1/
Since babies, my kids, have intimately known #pain. At one time their #pain was intermittent & #acute. Sadly, they now struggle 1/
#chronicpain & are young adults. Our kids 1st 13/16 years of life, our family had a #safetynet, their #pediatrician. He was highly intelligent, compassionate, he challenged the system & in the most authentic sense #partnered with families. #Pain was not a major concern when 2/
We've lost too many in this insane '#opioid' war.
The sick & injured are spending the last years of their lives fighting, suffering, begging MDs & GOV for the medicines they need to mediate their pain.
They say taking our medicines away is to 'save' people.
No one is being saved.
The sick & injured are spending the last years of their lives fighting, suffering, begging MDs & GOV for the medicines they need to mediate their pain.
They say taking our medicines away is to 'save' people.
No one is being saved.
Death due to #Untreatedpain or #Undertreatedpain is death by a thousand cuts.
#RxOpioidsSaveLives
#PainKills
#RxOpioidsSaveLives
#PainKills
Big last day of #APSAD40 today for #opioid research. I'll be presenting in a symposium of #naloxone today, and then super excited to chair two sessions on #overdose and prescription #opioid treatment ... a couple of highlights include ... 1/
2/ New research on the implementation of prescription monitoring in Victoria with @LouisaPicco @PPrathivadi and @Sarah_Haines_ (all superstar PhD researchers in the @MonashAddiction crew)
3/ @DrTinaLam_AU (also from @MonashAddiction) presenting on prescription opioid overdose using emergency department data and @JMoullin from @CurtinUni talking about pharmacists and naloxone supply in Western Australia
Dear @OptumRx & @SanfordHealth you are NOT his #physician. You know nothing of his #health hx. Two years ago #Sanford #Bismarck #pain clinic pulled all #patients off #opioid #pain medications. This was not #patientcentered care, but care deemed appropriate BY administrators 1
Now @OptumRx & @SanfordHealth #insurance sending out letters re #opioid #pain #medications. My son had to move from a #Sanford clinic to another clinic due to #abandonment. Yep, abandonment. Plain & simple what you did was harmful & not based on #patients needs. You need 2
to look at research, that shows the harms of what u r doing. @SanfordHealth administration in Bismarck informed me 2 years ago when all #patients pulled off #opioids that it was the ānational standardā of care established by @CDCInjury @CDCDirector. The guidelines are NOT 3/
Yes, we are still in the middle of a global pandemic, #COVID19, but letās not forget about the #opioid epidemic, a public health issue we have been dealing with a while... What can we do about it?? #ph260720 #opioidepidemic
In 2017 (more than 4 years ago), @HHSGov declared the #opioidepidemic as a public health emergency. An āemergencyā situation that we have not been able to control yet... #publichealthemergency #ph260720
hhs.gov/opioids/about-ā¦
hhs.gov/opioids/about-ā¦
According to @CDCgov and @NIDAnews, more than 70,000 Americans die every year due to opioid overdose. That is 70,000 lives (read in bold!) lost every year, the majority of which is preventable. #opioidepidemic #opioidskill #opioidoverdose #ph260720
1/Prescription opioid counts have fallen to levels last seen in 1992,reports ā¦@US_FDAā© Corinne Woods, PharmD for workshop at Duke Margolis today
2/Prescription #opioid milligrams are at levels of early 2000s. That number is higher (relative to prescription count) according to @US_FDA Corinne Woods, PharmD at Duke-Margolis today - I think this difference reflects the patients with long term receipt.
3/Total milligrams and total count of oral tablets in an āinitial prescriptionā have declined, reports @US_FDA Corinne Woods, PharmD to todayās session for Duke-Margolis and FDA (2 images here)
Here's my 5 min talk I just held at the 44th #ECDD:
<< Dear Expert Committee on Drug Dependence,
my name is Fabian Steinmetz. I'm from Germany and I'm an Eurotox-certified toxicologist and professional risk assessor at an international consultancy.
<< Dear Expert Committee on Drug Dependence,
my name is Fabian Steinmetz. I'm from Germany and I'm an Eurotox-certified toxicologist and professional risk assessor at an international consultancy.
An important review which finds that we are overprescribing potentially harmful drugs and that people are far too often left on drugs with no proper review.
theguardian.com/society/2021/sā¦, via @guardian
theguardian.com/society/2021/sā¦, via @guardian
If you are called in for a review of your #antidepressants, #antipsychotics, #benzodiazepines or #opioid pain meds, it is very important that your prescriber works with you to reduce slowly and safely. Mishandled withdrawal can have lifelong consequences. @sajidjavid
Donāt assume that standard withdrawal advice is safe, it often isnāt. Learn from others experiences, use liquid forms or tapering strips to allow your body chance to acclimate to the change, especially at low doses. If you feel unwell after reducing, itās withdrawal not relapse.
#PathologizingPain
#ChronicPain is the most prevalent health issue for Americans, yet, there is a lack of acknowledgment of the impact of pain on individuals QoL as well as access to quality options available. The last several years we have seen a proliferation of 1/
#ChronicPain is the most prevalent health issue for Americans, yet, there is a lack of acknowledgment of the impact of pain on individuals QoL as well as access to quality options available. The last several years we have seen a proliferation of 1/
psychological strategies be touted as solutions for both #chronicpain & #acutepain. This has been fostered by the #CDC guidelines as well as various independent groups. As an individual who works in the area of mental health I am alarmed at the amount of #gaslighting that 2/
to those with #chronicpain & the belief by many physicians & professionals that psychological strategies will alleviate #chronicpain as a stand-alone strategy. I DO believe that psychological strategies CAN be of benefit addressing pain, but, how #pain is being #pathologized 3/
