Discover and read the best of Twitter Threads about #opioid

Most recents (22)

Sharing again because there's a huge population I ignored in writing this: Pharmacists. A recent interaction left me in tears- not for the reason you'd think- when yet another pharmacist refused to fill pain meds. We both yelled but it ended with a hug. 1/…
I was out of state when my Rx was due. the VERY pharmacist I quote in my column who invoked her right not to fill for me was working while I visited family in GA. She again told me no, again came with attitude. Knowing I would have to book a last-minute flight home and miss my 2/
twins' b-day party, I confronted her. I said look, I know nothing is changing today and you're not filling this. But this is out of control. I go between these two states often, I work as a reporter in Chicago, I actually just wrote a column about this. And 300 people wrote me 3/
Read 25 tweets
@NitaGhei @DanLairdMD 1/Just to be super clear: there is a strong relationship between prescribed #opioid dose & risk of overdose : the magnitude of that association & degree to which it is causal is not entirely clear. But I agree we should avoid escalating doses unless back is against a wall
@NitaGhei @DanLairdMD 2/However, if a person is stable at a given dose, even if we now say “gosh, wish it were not that high” there is no trial evidence that a reduction dose does improve safety. It is plausible (I offer the idea to my patients!) but no trial evidence .. & there is something key here:
@NitaGhei @DanLairdMD 3/The best advocates for taper are the ones who show great skill and sensitivity and patience in how they carry it out. Including a willingness to stop or reverse the taper (as Canadian Guideline supports) based on how patient does
Read 9 tweets
Data from the Drug Enforcement Agency’s Automation of Reports and Consolidated Orders System (ARCOS) became publicly available from the @washingtonpost. The database tracks every legally sold #opioid pill in the US from manufacture to distribution. #opioidcrisis #painmanagement
The @Washingtonpost analyzed data & looked specifically at hydrocodone (the opioid in Vicodin) and oxycodone (the opioid in Percocet & OxyContin) between 2006-2012.
These opioids alone made up 75% of the total opioids shipped during this period and accounted for 76 BILLION pills. #oxycodone #hydrocodone @JeromeAdamsMD
Read 8 tweets
Colorado AG @pweiser about to give an update on the #opioid lawsuit the state filed against #PurduePharma. Here is a look at opioid deaths in CO since 2000 — up 5x in 20 years
As of June, nearly every state in the US had filed a suit against Purdue Phrama, the pharmaceutical company giant and maker of OxyContin…
The state argues that Purdue and its owners, the Sackler family, downplayed risks of the drug, while heavily marketing its benefits to doctors
Read 7 tweets
🚨🚨🚨ATTENTION #Spoonies #ChronicPain community, people have been asking for the recent clarifications from the @CDCgov and the @US_FDA to take to their #Doctors, so I have created a pinned tweet with everything. #Opioids 🚨🚨🚨
👉👉👉The @CDCgov clarification appears in an article in @NEJM here…
👉👉👉with an accompanying press release:…
👉👉👉A quick way to see most of the article, a separate letter issued by the CDC Director @CDCDirector and the @US_FDA warning is to go here: …
Read 14 tweets
I debated sharing but decided there are important lessons within. Yesterday, I came face-to-face w/ the #overdose epidemic. Shortish story... I was one of the first people on the scene of two 40-ish men slumped over in their work van that was stopped on the hwy.
Alone with kids in the car, I was waved down by a panicked commuter. I stopped & was joined by two other men. Both driver & passenger were unresponsive. Driver had shallow breathing but passenger had no pulse or respiration. We pulled him out of the car & I started 2-person CPR.
It was evident they had overdosed. While I keep a trauma/GSW kit in the car, I do not carry #Naloxone. So all we could do is continue CPR (about 6 cycles) before EMTs arrived, at which point he had a weak radial pulse. Shaken, I shook hands & went on my way. So lessons/thoughts:
Read 9 tweets
Hello & Happy Spring! (Thread) If you haven’t been on here til 1am EST, I’m going to unpack recently announced #opioid bill S-724 (named for John McCain). For reax check out threads by @erinbiba and @AnaMardoll (call @gillibrandNY ASAP to protest bill.) Onto the breakdown:
Sen. Gillibrand introduced this bill with a flip referral to dental work and a misunderstanding of the term “acute pain”. #AcutePain does not mean ‘severe’ in medical terms, it means pain lasting up to/less than 6mos. If you’ve ever had a gunshot wound,
been in/had a serious accident, needed extensive surgery, had #fibromyalgia #arthritis #endometriosis or #pelvicpain #backpain -just to name a few-you may know that sometimes one needs more than 7 days of pain meds.
Read 17 tweets
1/Our letter to @cdcgov,signed by 321 health professionals & 3 Drug Czars, calls upon @cdcgov to address harms to patients with pain due to misapplication of its #opioid Guideline.We thank @MBotticelliBMC @mccaffreyr3 Dr. Jaffe @amersatweets In @nytimes:…
2/We have shared this letter with Congressional Chairs & Ranking Members of key Committees, as @cdcgov has acknowledged something is wrong, but not acted. We commend Dr. Dowell for speaking on this
@HELPCmteDems @GOPHELP @EnergyCommerce @housecommerce…
3/Patients who have severe pain and receive opioids should have been a party to this conversation all along. Their testimony exceeds 120 pages here… Here’s a word cloud of most frequent words utilized -thanks @AllysonVarley
Read 4 tweets
Let's talk about "national emergencies."
There are THOUSANDS of Missing and Murdered Indigenous Women in this country. Sisters, daughters, mothers, human beings that disappear without a trace. Where is the declaration over that crisis? #MMIW #MMIWG #MMIR
In a country determined to place nationalism at the forefront of domestic and foreign policy, we have a shocking number of homeless veterans. In states like Arizona, the number of #veteran suicides is 90.4 per 100,000.…
Read 14 tweets
1/it is neighborhood, not county or state that serves as the most relevant geographic predictor of opportunity- summarizes @nytimes & this bears in many opioid geographic analyses of the last 2 years…
2/The most celebrated paper put forward as refuting the entire Deaths of Despair concept, by Chris Ruhm, relied on COUNTY-level indicators of economic opportunity, & I remember seeing that & thinking that was quite wrong…
3/My child’s public elementary school had both (a) wealthiest neighborhood (fancy houses) (b)highest percent of kids on free/reduced lunches - even in a county level, opportunity and social resources diverge widely - and that means community effects are not just state or county
Read 5 tweets
1/I am sort of gratified to see ⁦@CMSGov⁩ confirm what we have been saying from VA data: that dose based criteria are quite poor at identifying prescription recipients at risk for opioid related harms⁩…
2/CMS tested if #opioid dose > 90 + high # of prescribers/pharmacists could detect people at high risk and it did, sort of weakly, with 2.5% sensitivity, by 2014, given a criterion of later Gerri f a new opioid use disorder diagnosis or an overdose
3/CMS concluded correctly that dose and pharmacy thresholds are not really good at identifying and this not good at helping to mitigate most opioid related harms - and that blunt honesty is what I appreciate about @CMSGov : not much spin!
Read 6 tweets
It’s hard to listen to a man with such a demonstrated inability to tell the truth — or even keep his word with members of either party — try to sell us on the idea that he’s now ready for bipartisanship and unity, that he’s poised to bring us together. #sotu
.@realDonaldTrump’s fantasies about his wall, his deafening silence on climate change & his Nixonian attack on @TheJusticeDept investigators, did not help.
I do applaud @realDonaldTrump’s recognition of our soldiers & law enforcement officers for the terrific work they do, and am eager to help with childhood cancer, infrastructure, and lowered drug prices.

We’ll see how serious he is about those issues in the weeks ahead. #SOTU
Read 4 tweets
1/How your health information is sold and turned into ‘risk scores’ - from @politico ...Let me share a couple insights from using a risk tool paid for by US taxpayers…
2/First, risk scores of high quality use all health information, as VA studies show risk for OD/suicide reflects (a) medical + mental + prior substance use, & (b) # of co-prescribed sedating mess that are crucial. Actual #opioid dose, formulation are relevant, but less so
3/Second, in studies & our biweekly opioid risk mitigation meetings we find most people at risk are at low opioid dose, often not chronic recipients at all, but have significant mental health care needs. We see this again and again.
Read 10 tweets
My name is Lelena.

I am a #ChronicPain patient.

I am required to pee in a cup monthly to show #compliance to my #LowDose #opioid regimen.

I am painted as despicable, helpless, & #unclean by the powers that be.

I am a modern-day #Leper.

#EndStigma #PainLeper
Newsflash, America:

I'm not JUST a #ChronicPain patient.

I am not helpless.

I am not #unclean.

I am not #despicable.

I don't just use #pills to overcome my #SeverePain.

I refuse all #stigma, misconceptions, assumptions, and #labels.

I am an #Overcomer.
I will be criticized for calling myself a #ChronicPain patient.

People will say: she wallows in illness. She enjoys it! She IDENTIFIES with her pain.

Wrong. It is part of my reality. I must face it & battle it daily.

And I do. Despite all the negativity I face from others.
Read 5 tweets
As @POTUS signs HR 6, the SUPPORT for Patients and Communities Act, to provide tools in the fight against the #OpioidCrisis, we thought we’d share some insights from our 2017 hearing featuring Nobel laureate Sir Angus Deaton, among others.
@POTUS Sir Deaton argued that deaths from legal and illegal drugs are contributing to an almost unprecedented increase in overall mortality among middle-aged white non-Hispanics. A century of mortality decline came to a halt at the end of the 20th century in America.
@POTUS The increase, argued Deaton and Anne Case, is due to a rise in drug, alcohol and suicide related deaths; they stated that the liberal prescription of opioids for pain relief fueled the epidemic.
Read 17 tweets
Selected list of #indictments and #sentencings
Aug 15-22, 2018
1. Ricky Johnston from Las Vegas admitted to receiving over 600 images of toddlers & children engaged in sexually explicit conduct. He was sentenced to 144 months in federal prison.

#childpornography #childsexabuse #RickyJohnston #projectsafechildhood…
2. Operation Darkness Falls results in arrest one of the most prolific dark net drug dealers in the world.
Matthew & Holly Roberts used the darknet marketplace to distribute #fentanyl #oxycodone #heroin #meth & other drugs.

#darknet #silkroad #alphabay…
Read 31 tweets
Sometimes one interesting story leads to another. Last year I wrote about how some U.S. govt probes into global drug trafficking by Hezbollah’s terrorist wing were derailed by the Obama admin's zeal for the Iran nuclear deal.
After we published that story, a message popped up in my encrypted email inbox. A former DEA and Justice Dept official told me the same thing happened to his team, but worse... and in Afghanistan.
This one involved standing down a long-running DEA investigation in Afghanistan into the kingpins atop the global narcotics trade, who supply more than 90% of the world’s heroin and help fuel the #opioid crisis in the U.S.
Read 16 tweets
The American #HepatitisA epidemic is out of control. Cases reported in nearly every State, mostly in #Homeless and/or #opioid using populations. Examples [multiple tweets]:
West Virginia (since Mar2018)
404 cases
280 hospitalized
1 dead…
Utah (since Jan 2017)
271 cases
138 hospitalizations
Risk factors
Homelessness + drug use = 37%
Drug use = 27%
Homelessness = 8.5%
Epi-Linked =14%
Travel = 1.5%
Unknown =12.4%
Incarcerated =14.7%
Michigan (since Aug2016)
cases = 850
hospitalizations = 686
14.8% of total males = MSM
3% of total = healthcare workers
4.7% = food handlers
Read 9 tweets
[1] #AboutTheOpioidEpidemic : There was a 300% rise in annual #opioid overdose fatalities in the past 10 years, mostly correlated with the #Obama presidency (Here are numbers for #Mass) :
[2] #AboutTheOpioidEpidemic : What most have not noticed, the OD RATES are highest in battleground electoral states. Not blue, not red - Battleground. Very high correlation .
[3] #AboutTheOpioidEpidemic : Nearly 200,000 American lives have been lost in the #opioidEpidemic . Possibly even 300,000 . While the media howls about #Charlottesville which was tragic, the #opioidepidemic is still rarely mentioned.
Read 9 tweets
Doctors are no longer a driving part of the #OpioidHysteria. They never really were. Why why why are we still getting these stories instead of what’s really going on? Alt facts much? How very Trumpian. News media needs to take a good look in the mirror & start facing the truth.
Define “overprescribing” please. 91 ppl per day die from overdoses: from what exactly? Which meds? Multiple meds or just Opioids? God I’m fucking tired of this whole bs narrative still going on.
How about the painful stories of vulnerable ppl -disabled-Veterans-elderly- being cut off from #opioids & committing suicide b/c their pain is so bad?? #SuicideDue2Pain #PainKills
Read 18 tweets
While UT fought #opioid epidemic, @SenOrrinHatch enabled it from DC. Here’s why it's personal for me. 1/11 #utpol…
This isn't the first time @SenOrrinHatch has played politics with Americans' health, especially in Utah. 2/11
In 2016, @SenOrrinHatch, who received almost $180K in drug industry donations, led the way in hobbling the DEA's 3/11
Read 11 tweets
If you’re a politician (or anyone) that supports stricter laws on #Opioid prescribing but not on #GunControl don’t tell me you care abt ppl.
If you’re a politician (or anyone) that supports #AbortionBans but not #GunControl don’t tell me you care about people.
If you’re a politician (or anyone) that supports #RefugeeBans but not #GunControl don’t tell me you care about people.
Read 7 tweets

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