, 13 tweets, 2 min read Read on Twitter
Next session starts now! “What is not working? A discussion of opioids, surgery, and placebo” chaired by my supervisor @Tash_Stanton and featuring @torwager Ian Harris, and Owen Williamson.
First up, Dr. Williamson! “Why blame physicians for the opioid crisis?”
“Are opioids effective in the management of chronic non-cancer pain? Yes, but not for everyone, or no-one”
“Prescribed opioids and the “opioid crisis”” - Dr. Williamson is discussing the difference between prescribed opioids, prescription opioids, and illicit opioids (including those prescribed, obtained, or manufactured illegally)
Some evidence shows that the availability of prescribed drugs correlates to the non-medical use of these drugs by adolescents. Number of opioid prescriptions correlates to number of overdose deaths (in New Zealand). This correlation doesn’t show in US
Williamson is showing data showing that in Canada, deaths due to prescribed opioids has remained mostly consistent since 2007, while deaths due to illicit opioids has increased
Discussing how “The Standard” practice has led patients to pursue illicit opioids when they cannot get prescribed opioids.
“Illicit fentanyl and heroin, not opioid prescribing now fuel the current opioid overdose epidemic”
Again discussing @BethDarnall’s advocacy against over regulation re: forced tapering
“Restrictions on prescribing are more likely to cause the opioid crisis than the prescriptions themselves”
Per Cicero 2017: “the initial source of drugs - a prescription or experimentation - is largely irrelevant in the progression of SUD (overdose)
One thing not much being discussed here, is that many consider there to be a substantial difference between “legitimate pain sufferers” and “drug abusers”. Medication, even self medication, is almost always a treatment for pain. This philosophy will always lead quickly to stigma
That is to say, I don’t think we should legislate, treat, or research, in a way which says some people are worthy of treatment, and others are not. Everyone deserves access to quality pain care, it seems opioids probably aren’t that
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