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Risk of OD in medical use of #opioids is highest in doses ≥100 MME but still less than one quarter of 1% (0.23%).

Canadian Guideline for Opioid Therapy (2017)

thread: 3 studies on #suicide, OD, & rx opioids
ncbi.nlm.nih.gov/pmc/articles/P…
2009 study: moderate to severe #pain triples the risk of #suicide even in otherwise healthy people "independent of poor functional capacity or chronic medical illness.”

Untreated pain can lead to death by suicide "unnecessarily and prematurely.” jpsmjournal.com/article/S0885-…
2016 VA study didn't find evidence to support the claim that increases in med'l #opioid use lead to increases in intentional OD.
ncbi.nlm.nih.gov/pmc/articles/P…
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#opioids #suicide #pain #opioid

More from @JillPiggott see all

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Jill Piggott
@JillPiggott
Study found that head pain (#migraine & #headache) has the "strongest association with suicidality" of all types of #pain. The risk is independent of depression & likely linked to altered functioning of serotonergic systems, not poor coping (Ilgen et al). ncbi.nlm.nih.gov/pmc/articles/P…
"People with chronic #headache or #migraine were 4.3 times more likely to think about suicide, 4.6 times more likely to plan suicide, & 6.5 times more likely to have attempted suicide in the past 12-months than those without chronic headaches" (Ilgen).
Multiple studies report a particularly strong relationship between #migraine & #suicide. But "even after controlling for depression, anxiety disorders, & substance use disorders," most types of severe &/or #ChronicPain are "associated with suicidal thoughts and attempts" (Ilgen).
Read 6 tweets
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Jill Piggott
@JillPiggott
82 people volunteered to taper rx #opioids. In or by the 4th month, 38% dropped out. They were excluded from results. The finding that "Neither pain intensity nor pain interference increased with opioid reduction" is based ONLY on the 62% who stayed in, not all 82. (1/5)
The outpatient study was 4 months long. Oliva (BMJ 2020) found post-discontinuation deaths (OD/suicide) are highest in the 1st 3 months. I assume researchers checked to see whether anyone died, but it's not mentioned in the paper. (2/5)
Here's what the study actually found: For the 62% who successfully tapered, neither pain intensity nor interference increased w/ rx #opioid reduction. No information is available about why 38% of participants did not successfully taper or dropped out. (3/5)
Read 6 tweets
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Jill Piggott
@JillPiggott
Researchers found that policy outcomes can be predicted w/ a high rate of accuracy if they represent the preferences of the wealthy & certain Interest Groups. Inclusion of the wishes of median income voters always reduced predictive accuracy! /thread
America has had a "plutocratic tendency" from the start. (Can you say "plantation economy"?)

New research finds that knowing the policy interests of the 1% & a few interests groups predicts the likelihood of policy outcomes. arxiv.org/pdf/2008.07338…
“Democracy and the Policy Preferences of Wealthy Americans" (2013) captured the policy preferences of top 1% & found they were "much more conservative in such important domains as social welfare programs, taxation, and regulation of the economic system" (link above).
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