Thread by @JillPiggott

.@VoteVets You're wrong to make rx #opioids the focus of your anti-Collins ad. #Vets taken off rx #opioids are up to 6.8 times MORE likely to die by OD or #suicide than those who stay on, per 2020 VA study. (thread) bmj.com/content/368/bm…

#Vets whose rx #opioid was stopped after 3 months overdosed or killed themselves at nearly 4 times the rate of those who continued to be treated. Those whose med was stopped after 1+ year ODed or killed themselves at 6.8 times the rate of those still treated (Oliva 2020).

2020 VA study: “Studies have identified a rise in adverse events (death from overdose, suicidal thoughts, self-harm, & hospital admissions or emergency department visits
for substance related events) after stopping treatment with #opioids in patients treated long term” (Oliva).

VA's Nat'l #Opioid Overdose Education Coordinator led the study. The team attributed higher ODs to “unmanaged pain, or symptoms of opioid withdrawal & mood instability" which can led to people taking illegal or sedating drugs to get relief or to self harm (Oliva 2020).

Findings aren't vet-specific: Primary-care patients are 3 times more likely to die from OD if they're taken off rx #opioids compared to those who stay on. Dr-initiation puts people at higher risk & 77% of opioid discontinuation is provider-initiated. link.springer.com/article/10.100…

2017: #Vets who were taken off rx #opioids after showing symptoms of substance use had 2.4 times the risk for suicidal ideation & 6 times the risk for self-harm and #suicide. Discontinuation, not substance use, caused the increased risk. suicideinfo.ca/wp-content/upl…

#Vets have high #migraine rates from TBI. The disease puts people at 4x the risk of #suicide even w/o depression or anxiety. Risk rises 17% with each 1-point rise on 1-10 pain scale. A 30% decrease in pain from an #opioid cuts a person’ s risk of suicide in half (Breslau).

#Migraine and #suicide risk: researchgate.net/profile/Richar…

A 2nd 2017 study funded by the VA: "Evidence on the effect of dose reduction on patient outcomes has not been systematically reviewed."
acpjournals.org/doi/full/10.73…

Study: Very low evidence on all 6 outcomes: pain severity & function, quality of life, opioid withdrawal symptoms, substance use, & adverse events.

Conclusion: there's "very-low-quality evidence that #opioid dose reduction may improve pain, function, and quality of life."

#Addiction expert Maia Szalavitz: "#Opioid addiction is a huge problem, but pain prescriptions are not the cause.” blogs.scientificamerican.com/mind-guest-blo…

#Addiction expert @StefanKertesz is among the authors of the 2020 VA study. In his TED talk, he explains that in the push to reduce scripts, there's been no accountability for patient outcomes, including knowing how many people die from discontinuation.

Forcing people off rx #opioids can push them into risky illegal drug use or lead to suicide. The @VoteVets anti-Collins ad implies opioids are, in themselves, a bad thing. Research shows that assumption has cost lives. This paper suggests solutions. jamanetwork.com/journals/jaman…

I hold @VoteVets in high regard. I direct headsUPmigraine, which has been working to get info about #migraine progression to #vets & help them apply for disability if needed. Let us know if we can help.

@headUPmigraine

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