Thread by @JillPiggott

Patient deaths & harm led #CDC to clarify in 2019 that people on long-term stable #opioid doses above 90 MME should be tapered "only if the risks [of continuing the medicine] seem to outweigh the benefits." Yet hard dosage caps continue as policy & law. /thread

In 2019, CDC, FDA, HHS, & medical experts also urged doctors to seek patient consent before tapering #opioids.

Forced tapers violate the cardinal rule "Do no harm," as forced & mandatory tapers put people at significantly higher risk of harm, distress, disability, & death.

🟠 #CDC recommends tapers of 10% per wk to 10% per month, noting the latter is better for people on long-term #opioids.

2019 JAMA study of +100k people found 1 in 5 were tapered faster than 40% per month & 5% faster than 60% per month. ncbi.nlm.nih.gov/pmc/articles/P…

⭐️ #ChronicPain People: Read the FDA warning in the package insert w/ your rx #opioid. It warns us not to rapidly taper or suddenly stop b/c we can DIE. Fed'l guidelines suggest top speed of 10% wk, but recommend 10% month for people on long-term. FDA says we set speed, not MD.⭐️

"The rate of fatal #opioid overdose among men is twice the rate among women, & men are more likely than women to misuse opioids." But the 2019 JAMA study found women had a 13% higher rate of dose tapering than men.

2019 JAMA study: "many patients undergo tapering at rapid maximum rates. The downstream effects of #opioid tapering on #pain, withdrawal, mental health, & #overdose risk warrant careful evaluation."

🟠 That's right: risk of overdose goes UP when rx opioids are stopped/tapered.

#MedicalTwitter: I taught writing for decades before going into migraine f/t. When you know people are being KILLED by something their doctors could STOP DOING, this doesn't cut it: "The downstream effects...warrant careful evaluation."

🟠 #Opioid tapers have killed THOUSANDS.

🔴 2,887 of the #vets whose rx #opioid was stopped in FY 2013 DIED of #overdose or #suicide. That's only 90 fewer bodies than on 9/11, and that's just ONE YEAR at the VA.

Start hollering. Save lives. bmj.com/content/368/bm…

@headsUPmigraine @NitaGhei @hope411adcock @JSG_54 @Irishbrat1966 @amylorrainelong @PROPkills Thanks for helping spread the word on this. People need to understand the risk of rapid tapers, even if their doctors & legislators don't.

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