Discover and read the best of Twitter Threads about #addiction

Most recents (24)

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
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…
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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
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…
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.@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
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
(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
Dearest colleagues, friends, public (anyone who wants to know), I’m going to tell you about an urban family doctor’s job before & during #COVID19 Here’s my story as told in 16 tweets (1/17): #medtwitter #onpoli @ontarionurses @OntariosDoctors @OntarioCollege
I take care of 1400 patients in @ottawacity in a #patientcentredcare clinic with a rainbow flag and the words “Common Ground.” I have many #LGBTQ patients, and also #Indigenous patients and #mentalhealth and many who live with physical/cognitive disabilities. (2/17) @CBCOttawa
Before the pandemic, I’d start at 9am with #Pediatrics, immunizations, answering questions, addressing parental #depression and #anxiety. Then I’d see other patients with infections, injuries, #diabetes, chronic illnesses. My clinics ended at 6pm, then paperwork. 5 days/wk (3/17)
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The @CuyahogaCounty Board of Health & the #Ohio #Health Dept are investigating a cluster of #COVID19 cases at Salvation Army’s Harbor Light complex in #Cleveland. The complex includes a #homeless shelter. cleveland.com/news/2020/04/c… @CityofCleveland @CleDPH @CCBH_Net @OHdeptofhealth
According to Thomas Applin of Salvation Army of Greater Cleveland Area Services, 5 staff members & 6 residents tested positive for COVID-19. Clients & staff are being screened & tested. Residents who have tested positive have been quarantined in a separate part of the building.
Salvation Army’s Harbor Light residential complex has a #homeless shelter, #addiction services & a community #corrections program for people recently released from #jail or serving out the remainder of their sentence. It houses about 450 residents & has about 150 staff members.
Read 4 tweets
Ok #Patriots let’s think about this..numbers for #Covid_19 are low in our #Hospitals . What would we #Quarantine and clear out hospitals for ? Especially in a #shutdown ? If all “legit” business operations will get #stimulus then what happens to the “non-legit”?...
...well they are in suspense! Running low on drugs and money. #mercy and #comfort are what would be needed to help #withdrawal victims. Right ? Why else send them to the largest #drug areas in the #USA ? Where else would the most unfortunate section of humanity...
...go? What if all drugs (illegal) run out ? Because the plan is to hold out on them. Then not stimulate anything that can’t be verified through the #Fed ? #TrustThePlan #Q has told us #WWG1WGA . #Addicts are part of us all and we know they have been sunk into darkness...
Read 5 tweets
There follows a long thread.
A thread about #alcoholism #addiction #mentalhealth...and #love.
There. I've got the hashtags over. Now we can begin...
I’m going to share something with you, which I never expected to talk about publicly; but these strange, stressful times have brought the subject to the fore in many of us, and I hope that my story might help others going through similar…1/50 (...)
(This is all written with the kind permission of the other person involved, and that takes not only real guts, but also trust in me to write about it fairly and kindly.) So… 2/
Read 52 tweets
We're still supporting our clients, and we're working hard on getting our new website launched so we can widen the digital MH info & support for everyone. In the meantime, we're all in this together. Here's a thread of support & resources for #coronavirus & #mentalhealth 👉
1. We're a founding member of @mentalhealthuk and they've created this great resource on looking after your mental health during #Covid19, which also contains advice for carers > mentalhealth-uk.org/help-and-infor…
2. Our friends at @AwareNI are offering support online and on the phone >
Read 12 tweets
"Most patients do not 'get high' from taking #opioids, & #addiction is unlikely if your risk for addiction is low: those at greatest risk have a history of addiction w/ alcohol or other drugs." — Canadian Guideline for Safe & Effective Use of #Opioids #pain #cpp | thread
Current Canadian Guidelines for Safe and Effective Use of #Opioids for #ChronicPain | Info for Patients:

1) "#Opioids are used to improve your ability to be active and reduce pain." nationalpaincentre.mcmaster.ca/opioid/cgop_b_…
2) "There are side effects from #opioids, but they can be mostly controlled with increasing your dose slowly."

Most common side effects: nausea, constipation, drowsiness, dizziness, itching. (Canadian Rx Opioid Guidelines).
Read 16 tweets

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