Thread by @JillPiggott

The medical use of #opioids did NOT cause the OD epidemic. But so many people believe it did, that in 2019 even @nytimes agreed with #Kolodny that #racism "protected" black Americans because doctors failed to treat their pain effectively. @afrakt /thread nytimes.com/2019/11/25/ups…

NYT 2019: "African-Americans received fewer #opioid prescriptions, some researchers think, because doctors believed, contrary to fact, that black people were more likely to become addicted to the drugs & would be more likely to sell the drugs."

Black Americans are less likely to receive adequate #pain relief, according to researchers, because there's a lingering (#racist) assumption that black people have a "higher pain threshold" than whites.

#BlackLivesMatter in medicine.

Noted anti-#opioid crusader & @BrandeisU faculty member Andrew #Kolodny told the NYT that "some white doctors were more empathetic to the pain of people who were like them, & less empathetic to those who weren’t."

#Kolodny told @nytimes in 2019 that #racism in medicine "can be unconscious."

🚩 If you're playing along at home, score that as "Props from #PROP for white doctors who practice medicine while unconscious."

In short, anti-#opioid crusader Kolodny told NYT that #racism in medicine causes black people to suffer from under-/untreated #pain but (good news!) this "protects" them from being prescribed the most potent FDA-approved analgesics & NYT endorsed the claim in its headline.

Let's start with the #racism. 1st, "racial bias" is #racism, and 2nd, racism has no "benefits," not even "accidental benefits," which is how #Kolodny & Co. characterized the denial of effective pain medicine based on skin pigmentation.

.@afrakt You said #Kolodny offered a "counterfactual analysis." In fact, Kolodny & #PROP falsely inflate the risk of #addiction thru medical use. CDC's 2016 Guideline cites an average rate of safe use (w/o non-addictive abuse or addiction) of 96.97%.

Because addiction thru medical use is "very rare" (as @AmericanCancer Society puts it; see above), reducing access to rx #opioids has failed to reduce ODs. In fact, multiple studies show that stopping & reducing #opioid treatment increases the risk of death by OD & suicide.

.@afrakt I direct @headsUPmigraine. Our goal is evidence-based policy that treats people with pain & with addiction individually, effectively & compassionately. #Kolodny & #PROP's goal is to get the number of #opioid scripts as close to 0 as quickly as they can.

Rx #opioid discontinuation is killing thousands of people. Literally. This 2020 VA-funded study found that 2,887 #vets died of OD or suicide after being forced off pain med in FY 2013 alone. That's 90 fewer bodies than 9/11. bmj.com/content/368/bm…

People believe medical use of #opioids caused the overdose crisis. It didn't. They believe people are safer if they stop taking opioid meds than if they continue. That's wrong, too. It's hard to counter these beliefs: you accepted them in 2019, too.

You can help.

.@afrakt We need smart journalists to cover the story accurately, and I would be delighted to send you an annotated bibliography of 100+ studies on the subject so you can assess the evidence yourself.

I'd encourage you to watch #addiction specialist @StefanKertesz's TED talk. He coauthored the 2020 VA study & led efforts in 2019 to get #CDC to clarify it's not demanding that doctors force stable patients off meds. But little has changed since then.

.@afrakt People in #pain & people with #addiction are being harmed & many are being killed by a policy intended to save lives. #Suicide prevention is now 1 of @headsUPmigraine's primary goals. I urge you to cover the story or pass the lead on to an editor. Thanks.

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