Thread by @JillPiggott

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 Exactly. I used to say rx #opioid limits didn't help people w/ addiction & harmed people w/ #pain until I started reading research & saw they're harming EVERYONE. Dose variability itself triples the risk of OD. jamanetwork.com/journals/jaman…

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 “Attempts to discontinue #opioid therapy to reduce the risk of overdose & adhere to prescribing guidelines may lead patients to be exposed to variability in opioid dosing. Such dose variability may increase the risk of opioid overdose” by greater than 3-fold. Glanz, JAMA 2019

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 If people are being pushed off rx #opioids to save their lives, it needs to stop NOW because the practice is KILLING PEOPLE. OD/suicide rates go up A LOT: 3 times (Glanz JAMA 2019), 4-6.8 times (Oliva/Kertesz BMJ 2020). ...

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 James (JnlIntMed 2019): 4.9% of discontinued patients died of OD, while 1.75% of retained patients died of OD. The policy leads to 2.8 times MORE dead people. Involuntary discontinuation puts people at higher risk of dying & 77% of tapers are involuntary. link.springer.com/article/10.100…

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 Med journals, esp in 2018-2020, are repeating the same finding: rx #opioid dose reductions & tapers INCREASE rates of OD, suicide, psychological distress, disability, termination of medical care. If NPR can't package this info for a general audience, who can?

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 European Fed of #Pain 2017: #opioid therapy is “an essential & indispensable tool in achieving & maintaining an optimal level of pain control” for “selected & supervised #ChronicPain patients" as part of a comprehensive treatment plan.

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 European Federation of Pain's 2017 rx #opioid guidelines starkly contrast the CDC's 2016 Guideline but are in keeping w/ recommendations by N. American associations of #pain experts. Excerpts for advocates: docs.google.com/document/d/e/2…

@NitaGhei @amylorrainelong @BrianMannADK @NPR @headsUPmigraine @vicwj @carriefeibel @MPBN @SusanSharon1 European Federation of Pain 2017: "#Opioids are indispensable in our approach to pain management – there are no equivalent alternatives." Read their full guideline for clinicians.
2017toolhttps://onlinelibrary.wiley.com/doi/pdf/10.1002/ejp.970