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.
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.
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 🙄🤦‍♂️

acpjournals.org/doi/10.7326/00…
Read 7 tweets
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. Image
2-Once PROP's ‘opioid guideline’ 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 ‘opioids are dangerous drugs' narrative.
#ChronicPain Image
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. Image
Read 10 tweets
Reviewing some #NorthDakota information surrounding #prescribed #opioids.
#OpioidPrescriptions #declined 34% from 2006 to 2020

Statement in poster ➡️ ‘Since 2007 every state has been working to address the #opioid epidemic & best practices are now understood’

Are they? 1
In the #Conclusion
➡️ 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 Image
#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
Read 5 tweets
As promised, here’s a dive into one state which has few requirements to publicly report how #opioid settlement funds are spent—and 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 state’s Opioid Advisory Commission—created to evaluate the use of settlement💵—couldn’t get details. “It makes it difficult for us to do our job,” said chair @cara_poland. “We can’t really identify the impact of those dollars if we don’t know how they’re being used.”
Read 11 tweets
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... Image
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
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... Image
Read 11 tweets
Today's Twitter threads (a Twitter thread).

Inside: Google's chatbot panic; and more!

Archived at: pluralistic.net/2023/02/16/twe…

#Pluralistic 1/ Tweedledee and Tweedledum, standing at the bottom of Humpty
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/doc… 2/
Google's chatbot panic: On the infinite insecurities of a self-styled creative genius who really just buys other people's ideas.

3/  Image: Cryteria (modified) https://commons.wikimedia.org/wi
Read 25 tweets
Key q for discussion: How will #climatechange address the timing and severity of infectious outbreaks in the years to come?

🦠 influenza, #covid19, & other respiratory dx’ed
🦟malaria & other vector-borne illnesses
🚽diarrheal & other fecal-oral disease

@Brown_SPH
1. Heat, cold, & water/drought change these pathogens’ 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)
We are at a unique moment of “coupled risks”: urbanization, easy trans-national travel, large agricultural industries…

We get to make decisions every day both to adapt & to prevent. @Craig_A_Spencer
Read 7 tweets
With reports suggesting that the administration may soon end the public health emergency (PHE) declaration for #Mpox, I thought I’d do a little review of the #PHE itself 🧵(1/x)
Here's the news report on this: politico.com/news/2022/11/3…)
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 nation’s response to COVID and its end will have significant implications, as we explore here. (2/x) kff.org/coronavirus-co…
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/US…
Read 10 tweets
1/ As if the #opioid crisis and the pending #ONhealth ED collapse weren’t 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 patients— 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.
Read 9 tweets
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
In the first 7 months of this year there have been 923 overdoses in Alberta, compared to 966 last year in the same time period which is a decrease of 4.5%.

#ab #overdose #opioid
During the first 7 months of this year in Edmonton there have been 347 overdoses compared to 342 in the same time frame last year which is a 1.5% increase.

#yeg #overdose #opioid #edmonton
Read 6 tweets
It's International #OverdoseAwarenessDay.

Opioids are commonly used for the treatment of pain.
 
Their non-medical use, prolonged use, misuse and use without medical supervision can lead to #opioid dependence and other health problems.
 
👉bit.ly/3jsTqPI
Opioids include compounds extracted from the poppy seed as well as semisynthetic & synthetic compounds that can interact with #opioid receptors in the 🧠.
 
👉bit.ly/3jsTqPI
#Opioid overdose risk factors incl.:
 
♦️ using opioids without medical supervision
♦️ high dosages
♦️ resuming opioid use after an extended period of abstinence
♦️ use by injection
♦️ concurrent medical conditions
♦️ combining with other substances/medicines
Read 6 tweets
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/justice…
are diverted.

Yes... that's where the Millions of taxpayer's dollars are going!

🧐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-un…
Read 15 tweets
🧐 and *what* do Federal Law Enforcement & AG's consider *Dangerous prescribing*?

Let's take a look!👀

The DEA perceived this CA Pain Management to be a "High Prescriber"😯

In 3 years he issued 9,000 RX. Oh My, How Shocking!!!
federalregister.gov/documents/2022…
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
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?
Read 10 tweets
Important 🧵 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/…
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 bull💩 claims about the opioid crisis is as politically/financially driven as any. It’s 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/?
Read 4 tweets
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 The intrusion into the practice of medicine is based on race
Misinformation & propaganda is being disseminated by the government and still floods the media. The #Gaslighting of America has been extremely effective.
dovepress.com/misinterpretat…
Individuals with incurable chronic illnesses, #RareDiseases #Disabilities that involve severe pain as a component are being deprived of appropriate medical treatment.
Read 22 tweets
Thread 🧵: 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/
#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/
the kids were under his care. The nature of their disease often brought us to the ER & hospitalizations. The hospitalizations resulted due to inability to manage #pain, dehydration, & other issues caused by a flare in their #disease. My husband & I attempted to minimize the 3/
Read 45 tweets
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.
Death due to #Untreatedpain or #Undertreatedpain is death by a thousand cuts.

#RxOpioidsSaveLives
#PainKills
Read 10 tweets
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
Read 6 tweets
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 ‘national standard’ of care established by @CDCInjury @CDCDirector. The guidelines are NOT 3/
Read 9 tweets
Yes, we are still in the middle of a global pandemic, #COVID19, but let’s 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 Image
In 2017 (more than 4 years ago), @HHSGov declared the #opioidepidemic as a public health emergency. An “emergency” situation that we have not been able to control yet... #publichealthemergency #ph260720
hhs.gov/opioids/about-…
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 Image
Read 12 tweets
1/Prescription opioid counts have fallen to levels last seen in 1992,reports ⁦@US_FDA⁩ 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 “initial prescription” have declined, reports @US_FDA Corinne Woods, PharmD to today’s session for Duke-Margolis and FDA (2 images here)
Read 7 tweets
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.
I speak here on behalf of the NGO #ENCOD, the European coalition for just and effective drug policies.
And now I'd like to speak a few words about #kratom (Mitragyna speciosa).
First of all I'd like to remind the committee that banning #hemp, #poppy & #coca was not very successful and even led to more potent derivatives and synthetic imitations. Also these bans fueled violent crime and human rights violations worldwide.
Read 15 tweets
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/s…, 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
Don’t assume that standard withdrawal advice is safe, it often isn’t. 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, it’s withdrawal not relapse.
Read 5 tweets
#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/
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

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