Discover and read the best of Twitter Threads about #opioids

Most recents (24)

Our latest work published in @PAINthejournal: Attention to Breath Sensations Reduces Pain Independent of Endogenous Opioids.

We dissected components of mindfulness meditation by randomizing folks to a #mindfulness #meditation, sham-mindfulness, + slow-paced breathing group 1/n
This was a double-blinded, randomized crossover designed study where subjects received IV naloxone or placebo-saline during noxious heat (49°C) to determine which aspect of mindfulness (if any) engages endogenous opioids to reduce pain. 2/n
We discovered that mindfulness and slow-paced breathing significantly reduced pain independent of endogenous opioids.

However: Sham-mindfulness meditation reduced pain during saline infusion but analgesia was reversed when we blocked endogenous #opioids 3/n
Read 10 tweets
1/important clarification from AL Med board- initiation of a controlled substance can be done without in-person exam for duration of this declared public health emergency. This partially alleviates pressure on long-term opioid recipients. I’ll clarify why “partially” next
2/The public health issue is 10 mn pain patients on long term #opioids who must repeatedly see their docs in-person to CONTINUE the Rx’s. It is a major risk to them and the health system. Did DEA require that, ever? Not exactly, but in a way EVERY agency influencing opioids does!
3/Docs caring for patients on long term opioids have to guess how to continue the Rx without being subject to suspicion, investigation & rebuke from a variety of actors, including but not limited to law enforcement (quality metrics, insurers). ALL treat continuation as suspicious
Read 9 tweets
Dr. Kertesz addresses the doctors who believe no one should be started on #opioids in this tweet. I'd like to chime in as well.

I believe it should be a carefully thought out decision between doctor & patient. I'm a patient that benefits from #LongTermOpioidTherapy. A few notes:
I finally got a diagnosis that isn't half-assed. I have #EhlersDanlosSyndrome, among other things. It's extremely painful. It started to set in during college. I should have know that wearing a backpack shouldn't have been excruciating. It was. I didn't go on an #opioid regimen
for years, however.

I finally tried #opioids long-term around the age of 28. I was working as a freelance photographer. Hauling equipment around became so painful, I hit a WALL around the age of 30. I had to slow down, whether I liked it or not. I got married, & after that, my
Read 10 tweets
🔴 RT to help us hold @PennStHershey Med Director accountable for false claims about #ChronicPain & rx #opioids on KATU-TV 2/12. She smeared her own patients, spread misinformation, & stigmatized all people in pain. We've asked her to apologize & correct the record. /thread
.@PennStHershey: Why do you have confidence in Dr Delone? A kid in your onco waiting room who reads this
@AmericanCancer brochure has more accurate info than she does.
cancer.org/content/dam/ca…
.@AmericanCancer: “When pain meds are taken the right way, addiction is very rare" ('19).

@PennStHershey Med Director: “We know that these do not make you more functional. They make you addicted and dependent.”
Read 10 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
.@MedPageToday Your 3/1 illustration about #opioid tapering is so offensive I won't retweet it. #ChronicPain, not the medicine that relieves it, is the ball & chain millions drag behind us. I direct @headsUPmigraine. I know people who died after being forced off safe med. /thread
Shame on you for perpetuating the stigma & misinformation that's ruining & even ending people's lives. "When #pain meds are taken the right way, #addiction is very rare." #opioids #cpp #spoonie cancer.org/content/dam/ca…
#CDC's Guidelines put the rate of non-problematic use of rx #opioids at average 96.97% w/ 3.03% including non-addictive "dependence." Brat 2018 reviewed 1+ million post-op patients & found rate of 99.4% unremarkable use; 0.6% included patients who refilled, @MedPageToday.
Read 9 tweets
.@BridgeMichigan You gave positive press to BC/BS Michigan's decision to pay doctors 35% more if they don't prescribe #opioids post-op. This thread is a #factcheck.

1) You never mentioned that restricting rx access has failed to curb ODs, which are fueled by illegal drug use.
Jnl of AMA study: Efforts to curb ODs focused on "restricting the supply of prescription #opioids...have failed to demonstrate consistent benefit." Continuing these policies "may have a modest effect, at best."

This is widely known. Your writer didn't know it.
2) A 2017 study looked specifically at rx post-op & found 99.4+% safe use. The 0.6% included people who refilled their rx. You just gave great press to @BCBSM who's paying doctors to leave patients in pain to avoid meds w/ +99.4% safe use. (Citations in report below.)
Read 12 tweets
1) One of my occupational hats includes critical review of the medical literature for drugs or treatments, sometimes to testify as expert witness. What you are doing by trending #Prednisone to demonize a drug when you have NO medical training is murderous.
2) Life threatening diseases frequently involve using drugs with unwanted side effects. You are the same people that, with no biochemical, pharmacological or medical training are demonizing #opioids and physicians, when the (very) American problem is related to ...
3) ... synthetic opioids available in the black market and supplied by the Transnational Criminal Organization Triad in partnership with the Mexican Cartels. American politicians take their 10%, as always.
Read 6 tweets
1/
Hey folks: I wanted to share something @apmresearch just released that I’m very proud of:

Our VOTER PROFILE TOOLS, as part of our broader #RepresentingUS project. (Read: A wealth of data to understand the US electorate in interactive @tableau tools.)
apmresearchlab.org/representingus…
@APMResearch @tableau 2/
We at @apmresearch released these tools on #IowaCaucus day, but expect that they will be valuable up until the #2020election & beyond—to understand how eligible voters differ—often dramatically—from state to state & in each congressional district.

apmresearchlab.org/representingus…
@APMResearch @tableau 3/
Already I’ve read numerous #media stories about the #IowaCaucuses & #NewHampshirePrimary saying those states don’t reflect the nation’s #demographics, but the #journalists didn’t include any data as to HOW they differed and to what degree.
Read 22 tweets
1. The @CDCgov has just released a report showing that life expectancy rose in 2018, for the first time since 2014, inching up to 78.7 years. This followed three straight years of decline marking the tail-end of @BarackObama's presidency. cdc.gov/nchs/data/data…
2.The 3 leading causes of death, heart disease, cancer & 'unintentional injuries' all showed decreases, although the latter, which includes drug overdoses, showed the most proportional decrease. This was the first decline in 20 years of drug-related deaths healio.com/primary-care/a…
3. In fact drug overdoses had increased from 17,400 in 2000 to an astonishing 70,200 by 2017, disproportionately affecting poor communities as well as Americans living in rural areas. 47,600 were from #opioids & 78% of these, classified as White kff.org/other/state-in…
Read 14 tweets
I have a grievance regarding my mom's care during her bout w/#sepsis. #dementia

At the end of October 2019, my husband & I awoke to find mom's breathing labored, & her mumbling to let her sleep. We let her rest. A fever spiked within the hour, & suddenly she became deathly ill.
She was twitching, sweating profusely, in full rigors, & unable to sit up/speak well. She looked TERRIFIED. I thought she had a stroke. Turns out, it was a high fever from an infected gallbladder. She landed in the #ICU. ALL her vitals were jumping around. It was horrible.
She landed in the ER & eventually the ICU. Turns out she had #sepsis from the infected gall bladder. The ICU's 1st step? Changing her meds around INSTANTLY. Specifically they rescinded ALL #opioids abruptly. After over a decade on them, she was thrown into acute withdrawal in ICU
Read 16 tweets
Time for "What's My #ChronicPain Personality Disorder?"

Does continual #pain make you suspect others aren't on your side? Does severe pain make you detach from relationships or restrict your emotions? You have a CLUSTER A Disorder! / thread
When you're in #pain, do you feel excessively emotional & seek attention? ... Congratulations! You're histrionic! (Cluster B)
Does having continual #pain give you an "excessive need to be taken care of"? Join the 17.4% of #CPPs in Cluster C Personality Disorders!

(17.4 strikes me as a little low, peeps. Who's not having enough pain? We should be in the 20s, if not the 30s on this baby.)
Read 12 tweets
#meded #Thread @nelkassabany starts #AnesGR with his take home points:

➡️ Always think about adding value
➡️ Measure outcomes that matter to patients
➡️ Involve all stakeholders
➡️ Bust silos

#medthread #regionalanesthesia
#regionalanesthesia takes commitment!

@nelkassabany quotes @aboezaart1: "A block is not a one night stand..."
Developing a comprehensive enhanced recovery protocol means considering all phases of patient care. Patient education and engagement are key!

See free materials from @ASRA_Society here: asra.com/page/40/patien…
Read 10 tweets
“The jail is the largest mental health institution in any community,” Sheriff Daron Hall said.

The #OpioidCrisis has thrust the most pressing issue facing jails around the country to the forefront: #MentalIllness. (Thread👇) theepochtimes.com/ohio-jail-to-t…
On any given day, there are about 750,000 people in jails across America.

Drug addiction and mental health-related issues are often coexisting and it’s difficult to parse out which is driving which.
Hall said the deinstitutionalization of #MentalHealth hospitals that started in the 1960s hasn’t worked and instead has sparked today’s problem.

“The reality is we didn’t really deinstitutionalize it, we just re-institutionalized it into jails and prisons,” he said.
Read 18 tweets
The name Marijuana has a “reefer madness “ association.
I’ll use the name Cannabis.
Cannabis has THC and CBD along with other therapeutic properties I find very effective for relief of Pain and Misery of #MultipleSclerosis Unfortunately Federal government says it’s like heroin 🤨
In Vermont, it was initially legal to buy #MedicalCannabis with a $50 card and note from my Doctor, a Board Certified Neurologist who said she’d rather I use Cannabis than use #opioids for my extraordinary pain and suffering. Every year $50 and a note saying I have MS.
Meanwhile, down at the Dispensary, the nice bud tenders laid out the 3.5 gram packages. $50 each. I was stunned. “A nickel sack?” The kid didn’t even know what I meant. I relented, bringing cash because the bank wasn’t allowed to be used due to Federal regulations.
Read 13 tweets
Putting it out there. In the next election cycle i want to see #disability orgs invited by non disability orgs on town halls focused on education, healthcare, environment. We are here (& 20% of your members) even if sometimes you want to forget about us. #CripTheVote
It kills me to watch things like the #PublicEdForum and hear repeated questions about students with disabilities and know we weren’t invited to co-host or partner. #NothingAboutUsWithoutUs #CripTheVote
Folks talking about #PreExistingConditions , #opioids, #MedicaidExpansion , environmental justice, and act like we aren’t the ppl you are TALKING about. Those kids impacted by lead turn into US. We are preex. We are folks needing pain management. But you silence us #CripTheVote
Read 3 tweets
.@AndrewYang's #opioid policy is completely divorced from fact. It would do nothing to reduce ODs, which are driven by illegal drugs, & would exacerbate harm to #pain patients already slammed by unnecessary disability & rising rates of #suicide.
For a #math guy, @AndrewYang has failed to plot reductions in #opioid scripts & rising rates of OD. If he had, he would've found that reducing scripts has done nothing to slow ODs which are driven by illegal drugs.
#AndrewYang's #opioid policy would have "a modest effect, at best, on the number of #opioid overdose deaths in the near future," according to complex mathematical modeling. Yang's campaign is centered on his claim that he'd base policies on statistical evidence.
Read 10 tweets
.@nytimes Ginia Bellafante wrote an essay to say she didn't need post-surgery #opioids, so she didn't take them. That's not news. #Pain patients are being forced off effective, FDA-approved meds, causing #suicide & unnecessary #disability, & OD rates still climb. That's the news.
CDC, FDA, HHS say no one should be forced off #opioids, yet rising # of doctors have practice-wide bans & @nytimes has 1st pg piece by someone who wasn't affected in the LEAST by any of this? People are DYING from untreated #pain & ODs because restricting Rx meds helps no one.
.@nytimes: Bellafante had a CHOICE. She didn't need #opioids, so she didn't take them. I know people who are DEAD & DISABLED because their doctors dumped them off meds they were taking safely for years on the grounds that the same med might harm someone else. That's unacceptable.
Read 8 tweets
Every day, more than 130 people in the United States die after overdosing on #opioids.
The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis.

drugabuse.gov/drugs-abuse/op…
What is the Florida Shuffle?
Unscrupulous individuals who profit off of the misery of addiction.  Although there are many good drug treatment and sober living providers, the rogue rehab and sober home owners encourage relapse over recovery.
fixthefloridashuffle.com/florida-shuffle
My Years in the Florida Shuffle of Drug Addiction
Cycling through relapse and recovery, and the industry that enables both.
#OpioidCrisis

newyorker.com/magazine/2019/…
Read 5 tweets
Purdue Pharma returns to the news. If you are not aware, they developed the opioid pain killer Oxycontin & through various misdeeds made it extremely popular. Fueling the #opioidepidemic
Now we get a look at how they used the media to protect themselves from criminal charges...
For a background on some of the crimes they used to get rich selling dangerous opioids, you can see this thread.
threadreaderapp.com/thread/1166843…
The Sackler family that runs Purdue Pharma was busted for tax evasion when HSBC was forced to flip on them by DOJ...
The family donated heavily to Democrats while the company donated to the Republican half of the Swamp.

Read 31 tweets
#WAACP today and tomorrow and time for another string of #clinicalpearls! 1/
@WashACP @WashACP @HollonMD
First up: The Microbiome. The microbiome is all viruses, fungi, bacteria, and their products. No two microbiomes are the same. And for every 1 gene of ours, there are 250 bacteria genes. 2/
Dysbiosis is a maladaptive change in our microbiome. Even a few days of constant pressure (like poor sleep and diet) can change the microbiome. 3/
Read 60 tweets
It's time to do another one of my dumb threads, so here goes:

I'm SO GLAD life is so simplistic for you. Guess where I was this morning? At the #PainClinic with my elderly mother who suffers from #dementia. She had an early AM appointment, which is unusual for her. Mom is
more confused earlier in the day. She often has trouble getting to sleep because of pain & the dementia. We had to plan carefully, bathing her, & laying out clothing yesterday. Despite this, mom changed back into her nightgown 3 times, then finally put the gown on OVER her
street clothes. ANYWAY, we arrive ON TIME & the shenanigans begin. The kind receptionist greets us warmly, & I explain that mom is especially confused this AM. The mean receptionist (on a massive power trip) attempts to prevent me from accompanying mom to the appointment. She
Read 15 tweets
💣Proffer💣

Cohen has signed a "proffer agreement" with SDNY, agreeing to cooperate in their inv’n of the Trump Org re whether they falsified business records.

Hannity’s HRC obsession

During Trump’s presidency, Hannity has mentioned HRC on 86% of his episodes

WhySoScared?🤔
💣Proffer2💣

Judge sentences 3 Blackwater guards to prison for 2007 Iraqi attack

Trump tried to ease Iran Sanctions, Prompting Bolton Pushback

Sanctions move aimed at securing Rouhani meeting this month

In foreign policy, Trump gets points for creativity. Results, not so much
💣Proffer3💣

Trump’s trade war has killed 300,000 jobs

Former Mattis Aide at Center of Dispute Over Pentagon Transparency

Some contend that the department’s delay in approving his memoir was due to longstanding protocol, not ill will
Read 67 tweets
1/n #opioïds Je conseille encore une fois de lire le resumé de l'actualité de l'été par @docteurdu16 docteurdu16.blogspot.com/2019/08/ce-que…. Dans ce resumé, un document qui a une valeur historique: la déposition filmée de Richard Sackler en 2015.
2/n Richard Sackler est le fils d'un des fondateurs de Purdue Pharma. Sa famille est devenue la 19ème famille la plus riche des USA grâce au succès de l'Oxycontin, que Purdue a admis avoir promu de manière trompeuse en 2007. statnews.com/2019/08/27/pur…
3/n Après plusieurs années de combat juridique ce document a donc été rendu public et STAT en a publié des extraits. En février 2019, @propublica avait obtenu le procès verbal de cette déposition.
Read 8 tweets

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