Discover and read the best of Twitter Threads about #cpp

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“Misinterpretation of the “Overdose Crisis” continues to fuel misunderstanding of the role of prescription opioids”

Written with @GhanaboyPharmd @JeffreyFudin @headdock

#TwitteRx #MedTwitter

A brief 🧵to highlight the FACTS:…
This editorial looks to address ongoing #false narratives regarding opioid prescribing and its current role in the #overdosecrisis

In it, we use several excerpts from a recently published news release by PROP, given the distorted reality it represents…

We challenge the view that continued reductions in prescription opioids will be the “key to ending this [overdose] epidemic”…

As if cutting prescriptions in half throughout the US the past decade has resulted in reduced overdose deaths 🧐🧐🧐 Image
Read 6 tweets
The war against opioid Rxs and pain patients is all about $$$. Nothing can compete with opioid rxs to safely or more effectively treat severe pain short or long term for 40 plus years.

A WWII vet had been on #OpioidRxs for his severe pain for 40+ years. Within months of being
Within months of being force tapered off of #OpioidRxs he died.

The #DEA’S efforts to make #OpioidRxs disappear shift all of that money to alternate treatments which are mostly ineffective or to #Cartels who sell their version of pain meds on the street.
The #WarOnOpioidRxs has nothing to do with saving lives. As the supply of safe pharmaceutical pain meds dries up OD’s skyrocket because the #Cartel’s pain meds are laced with illegal fentanyl.

But those not yet killed by the #Cartels will desperately spend their healthcare
Read 4 tweets
How’s #HFPP affecting the care of patients w/#pain? Was there public input when this partnership was formed w/#CMS #payers, #LE? We start with info links & near the end of the thread, an example of one payer’s efforts to fulfill their part.
#cpp #opioids…
Read 14 tweets
Um absolutely adore this thread! I must read for #NEISvoid #CPP #RareDisease. My kids experienced much of what is mentioned in thread. 1st they have a rare disease, 2nd had a rare medical procedure to try to address symptoms, it caused complications. My kids now have T3 1/
the ‘care’ they receive has often been #traumatic as they don’t fit nicely into a box 📦. It’s because of their experiences (& my husbands) that I advocate. As young adults they still have to interact w the #healthcare industry but they are distrustful ( & rightly so). So many 2/
Physicians do not understand #medicaltrauma & their roles in it. I know it’s hard to be a #physician today, I know it’s hard to be in #healthcare but to dismiss, shame & blame a #patient is harmful not only psychologically but physically. 3/
Read 4 tweets
So let's punish Medicaid patients for paying cash for their #PainMedicine prescribed by their DOCTOR because it's against the rules. If Medicaid won't pay for it & the patient isn't allowed to, who PAYS? The person in PAIN by their PAIN going UNTREATED? How does this HELP anyone?
This is literally asking for this person to end up with #CHRONICPAIN as well as the loss of income from being unable to WORK. Does Medicaid pay for PT, massage, yoga, etc...? Hell NO! These stupid rules ensure said patient stays in poverty which also increases OD risk...
How you ask? Because they are in pain from either a painful disease, a surgery, or an injury. Not treating the pain slows down & inhibits healing. Healing occurs the sooner one can get up & moving around. It's essential for blood flow, & oxygenation which are necessary for
Read 8 tweets
#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/
Read 11 tweets
As someone who opposes Islamophobia, why should I vote strategically for a party that drafted a dog-whistle bill around it or that voted for it, over the NDP who didn't?

#Islamophobia #Elxn44 #cdnpoli
As someone who supports labour organizing, why would I vote strategically for a party who doesn't want to strengthen labour laws to support workers during strikes and lockouts, when the NDP does?

#canlab #strike #Elxn44
As someone who wants trade deals that are good for Canada and Canadian workers and don't contain harmful ISDs and respect our sovereignty, why would I vote strategically for any party who undermines that? #trade #cdnecon #Elxn2021
Read 17 tweets
An Anti-Opioid Panic Left New York State Prisoners in Needless, Agonizing Pain. #cpp@life_is_art___⁩ ⁦…
Read 5 tweets
An interesting summary of an interview with Yukihiro Matsumoto, the creator of #Ruby programming language about ‘What’s a Perfect Programming Language ‘

🧵 A Thread for 🧵

#CodeNewbies #100DaysOfCode
(Yukihiro Matsumoto):

Language designers want to design the perfect language. They want to be able to say, "My language is perfect. It can do everything."

But it's just plain impossible to design a perfect language, Why ?
Because, there are two ways to look at a language.

One way is by looking at what can be done with that language.

The other is by looking at how we feel using that language—how we feel while programming.
Read 10 tweets
1)Thanks, but no thanks. @RepJohnCurtis @RepOHalleran @RepMcKinley

Patients have ALWAYS had the option to decline taking Opioids.

This is NOT Empowering Patients.

If you want to Empower Patients focus on a Patients Bill of Rights.
2)Where the focus is based on Individual Patient Needs, not Population Health.

Each Patient should be entitled to an Individualized Treatment plan with all effective treatment options available based on their health history.
3)The treatment plan should be a Joint Decision Making Process between the Patient & their Doctor.

No one else's health issues should a factor in the decision making process.

Policymakers & All of the alphabet soup agencies need to remove themselves from the Dr/Pt Relationship!
Read 7 tweets
C++ Standard Library Algorithms
Quick Visual Reference
Part 1/32 - Sorted Range Operations
#cpp #cplusplus #algorithms #programming #cheatsheet
C++ Standard Library Algorithms
Quick Visual Reference
Part 2/32 - C++20 Sorted Range Operations
#cpp #cplusplus #algorithms #programming #cheatsheet
C++ Standard Library Algorithms
Quick Visual Reference
Part 3/32 - Binary Search
#cpp #cplusplus #algorithms #programming #cheatsheet
Read 32 tweets
Hey #CPP fam! Have any of you ever felt blackmailed or coerced into talking medication just to get your pain meds? Details will follow in the enclosed thread. 1/?
I’m currently #inpatient for a #SickleCellCrisis and the morning attending talked with me in front of the nurse that instead of getting pain meds every two hours, It would be every three hours, but I would get some breakthrough doses so my pain doesn’t spiral out of control.
However, every time I asked for a dose, the orders weren’t in the system. So I’ve been fighting for these extra doses ALL DAY LONG! I could tell that the nurse felt bad about it too. At shift change the orders STILL AREN’T IN THE COMPUTER! 😡🤬😤
Read 6 tweets
Hey #CPP fam! Can someone please point me to the right direction? I’m currently inpatient due to a #SickleCellCrisis and I usually get IV Benadryl because I’m severely allergic to CHG and adhesive tapes. However the docs are only giving me oral meds which just isn’t working.
The allergic reaction I get is that my skin blisters with extremely intense itching to the point that it causes pain. The blisters are delicate and pop open with the slightest touch, even when rubbing against clothing and eventually everything scabs up.
I have photo documentation of the allergy, and the doctor is still refusing to give me IV Benadryl, citing protocol and hospital policy. My arms are scarred up from the last time this happened when I was admitted here. I called patient services and left a message.
Read 6 tweets
Been saying for many yrs even decades that pain does kill. I felt very close 2 death just 5yrs ago when I couldn't lift my head, take noise, light etc. Went 2 dr + said if he can't help me I'd hv 2 call ambulance f/his office. He increased patch 12mcg 'n changed 4 better! 2/8
Fast forward to last mos. Hv had 1 crisis aftelr another 4 many yrs now. Most disturbing was my body runs away on me + am 99% crippled + bedbound. Nobody would listen + I didn't have co-pays 4 many needed tests! Cldn't get help f/anyone 4 many diff conditions + needed tests! 3/8
Read 10 tweets
Today I wish to honor @kathleenaie.
She was a Wife
A Mother
A Dear Friend, &
A Fierce Advocate for #PainPatients.

Kathleen passed away suddenly. She was & will always remain a force for good. She fought tirelessly for others.

We will miss her SO much. Thank you, Kathleen!🌸💚
She was ever-present & vocal about the issues #PainPatients face in medicine today.

Her mission in life was to help others in any way she could.

I believe her poor little body couldn't keep up with her heart & her passionate pursuit of restoring rights & medication for #CPP.
I admired her tremendously. I'm disappointed in myself, because I always meant to tell her how much I looked up to her.

I'm grateful I had the opportunity to know her, if only though our advocacy & shared passion for others.

I can only hope to be more like Kathleen. 🙏🌸💚
Read 4 tweets
This is the Dec, 2015 IPRCC meeting that talks about HHS’ plan and the CDC guidelines. Starting at 4hrs, 18 min, we have Wanda Jones, principal deputy to asst. sec of HHS speak about how HHS planned the guidelines. This is really interesting info.
At 4 hrs 41 min, the CDC rep presents the overview of the guidelines. At 4:52 sec., the Q and A’s. This really shows how there were a lot of concerns from the research panel (NPS) about the consequences and methods/bias involved in the formation of the CDC GLs.
#ipp #cpp #PROP
At 5 hrs 24 min we have the evidence that shows the IPRCC (NPS) was not happy about the CDC guidelines and had a discussion about how to handle that. Listen carefully.
Read 8 tweets
#cpp The National Pain Strategy is a complete disaster. It’s so transparent, when you spend your life on the sidelines you observe a lot-like gaslighting by policy in service to the War on Drugs. The U.S. NIH has known since the 1970s that opiate pain medicines are safe,
miraculously helpful for most people in pain, and addiction is rare with use. This same society that doesn’t want to have to see bodies with painful illness created the conditions of poverty and despair that led people prone to addiction to start using drugs irresponsibly.
NPS was a plan to make us fit into a tidy box that looks just how the morally, physically, financially superior want everything around them to look. Chronically ill, disabled people frequently in need of medicine to mitigate pain just..."don't look hygenic” if you live in a
Read 11 tweets
I find it wildly inappropriate that #AndrewKolodny is promoting opioid free breast surgery by elevating a #pacira pharma-paid MD! Talk about a sexist hypocrite. See for yourselves! #ipp #cpp #PROP #PainProfiteers…
Just an FYI- Pacira - maker of #Exparel, a patented post op buvicane injectable that’s being advertised as the answer to the opioid crisis. The corruption, smh.
Read 6 tweets
Here is the #PedsICU #BestOf2020 collection.
Jointly chosen by @Dr_Hari_Krishna @sgdambrauskas @miguelrrMD
Pubmed collection 40 articles:…
Infographic (clickable PDF) in English:
#PedsCICU #NeuroPICU
The #Bestof2020 #PedsICU pubmed collection will also be available in the FREE #PICCHub app (sponsored by @PICSociety) as the latest monthly #PICUJournalwatch collection:
Download links: Android:…
.@sgdambrauskas and @MiguelrrMD will be simultaneously sharing their thoughts about the #PedsICU #Bestof2020 collection in a tweetorial.
Read 40 tweets
@ravensspirit68 @funchefchick @NitaGhei @StefanKertesz @AllysonVarley @PainPtFightBack @LelenaPeacock @tal7291 @urbanfatbiker I'm working on a big annotated bibliography of #cpp/rx #opioid research that I'll put online for activists to use. Here are studies I've got on #CPP-associated #suicide. Send me titles & authors for papers I'm missing & I'll add them. I'll link them below.
Tang et al 2006 review: Risk of death by #suicide at least doubled in #ChronicPain patients. Ideation is 3 times more common; lifetime prevalence of about 20%. 8 risks for suicidality in chronic pain were identified, half are physical.…
Tang et al: 8 risks for #suicide in #ChronicPain patients: 4 are physical, including type, intensity & duration of pain & sleep-onset insomnia co-occuring with #pain; 4 are psychological. CP is a neurological suicide risk AND a psychological risk.
Read 15 tweets
For each #Province and #Territory in #Canada, here is the help that was offered to those living with #disabilities. This will include the #Federal help offered as well as any hoops #PWDs may have needed to jump through to get it and whether CERB was clawed back or not.
This is based on my own research, and if anyone sees anything I missed or may have gotten wrong please let me know.
Let's start with #Yukon
According to several articles, eligible families on #disability supports we're to get up to $400 to help with costs until August. Unknown what eligibility was.
#CERB was exempt from clawbacks.
Read 19 tweets
Risk of OD to prescribed #opioids is 0.13% (Kaiser, Jnl of Pain 2019), while risk of death by OD increases more than 300% with dose variability of ≥30% (JAMA 2019).

VHA study: discontinuation increases the risk of death by #OD or #suicide up to 6.8 times (BMJ 2020). / thread
0.13% = risk of OD to prescribed #opioids (Kaiser 2019). Dose reduction is "inconsistent" in lowering OD risk. Research found "no support for RSM [risk stratification & monitoring] as a means of decreasing overdose.”

Jnl of Pain 2019;20(1)…
0.1% to 0.23% = risk of OD to prescribed #opioids, per Canada's 2017 Guideline.

0.1% for <20 MED, 0.14% for 20–49, 0.18% for 50–99 MED, 0.23% for ≥100 MED.

Discontinuation carries a significantly higher risk of death.
#PCP #MedicalTwitter…
Read 10 tweets
There is a very simple way to prove that #CPP & #IPP are NOT addicted to our #OpioidRxs. All that needs to be done is to cure our pain. When our pain is cured no one will need to taper us. We would do our own record breaking taper because we are not addicted to our Rx’s.
When our pain is gone we much prefer a drug free life, and we are absolutely not addicted to our pain. Will you accept this challenge Dr Kolodny? Cure our pain if you are that skillful as a doctor then just watch us run from drugs. Try saving us instead of killing us. Until then
Until then, until you can cure our pain the humane and ethical way to treat pain patients is to restore as much of our #QOL as possible which will allow us to have a near normal life while we wait for doctors to find a cure for our pain. #IPP
Read 3 tweets
0.1% = rate of fatal #OD in the medical use of #opioids acc'g to 2019 research from Kaiser Permanente (link below).

Bwn 2006-2014, 41 of 31,142 died of OD, a rate of 5 per year. Risk stratification did not lower OD rates. Dose reductions were "inconsistent" (VonKorff). /thread
2,887 #vets died by #overdose or #suicide after their #opioid medicine was stopped by the VHA in FY2013 (90 fewer than on 9/11) (Oliva et al 2020).

Patients whose rx opioid was stopped were 3 times MORE likely to die by OD than those whose medicine continued (James 2019).
4.9% of discontinued patients died of OD.
1.7% of continued patients died of OD.

Discontinuation of rx #opioids was associated with 1.35 times the risk of death & 2.94 times the risk of fatal OD compared to patients whose rx continued (James et al 2019).
Read 12 tweets

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