Jill Piggott Profile picture
Oct 1, 2020 15 tweets 16 min read Read on X
@DrTomFrieden With all due respect, Dr. Frieden, why didn't you follow science when you directed @CDCgov & you learned in 2018 that fatal overdoses went up, not down, following implementation of the 2016 #Opioid Guideline you promoted? ncbi.nlm.nih.gov/pmc/articles/P…
@DrTomFrieden @CDCgov #CDC-funded research in 2018: “declines in these opioid prescribing metrics ... have not been followed by decreases in opioid overdoses. Instead, overdoses due to illegal opioids ... have increased.” Why didn't CDC retract the Guideline when it saw deaths were going UP?
@DrTomFrieden @CDCgov In 2016, #CDC Director Frieden told the press that the risks of rx #opioids would outweigh benefits for "vast majority of patients.” But the Guideline itself said an average 96% of patients had no addiction or non-addictive abuse, misuse, or long use.
@DrTomFrieden @CDCgov Table 1 in the 2016 #CDC Guideline itemized the “limited number” & “notable limitations” of the “low quality” studies w/ “methodological shortcomings” upon which they based recommendations that continue to cause incalculable suffering and end lives.
@DrTomFrieden @CDCgov NO studies were included in the 2016 #CDC Guideline that evaluated the benefit of #opioids for chronic #pain. See CDC's admission that their evidence was "low quality" in Table 1 following the references.
@DrTomFrieden @CDCgov Researchers tasked with developing Canada's #opioid guideline wrote, “The limitations of the CDC guideline include largely restricting involvement to experts who have been critical of opioid use for chronic noncancer pain, limited involvement of patients..." 1/
@DrTomFrieden @CDCgov "... excessive restrictions on selection of evidence (e.g., insisting on studies with a follow-up of 1 year or more excluded more than 100 randomized controlled trials (RCTs) of treatment w/ #opioids in shorter durations) ..." 2/
@DrTomFrieden @CDCgov "... suboptimal application of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) rating system to address evidence quality; excessive use of strong recommendations in the face of low-quality evidence; and vagueness in some recommendations.” 3/
@DrTomFrieden @CDCgov Anticipated harms of adopting the #CDC Guideline “could include withdrawal reactions, uncontrolled #pain, anxiety for patients and loss of trust in their physicians.” 4/
@DrTomFrieden @CDCgov Evidence from British Columbia, where the #CDC Guideline was adopted as a standard of practice, found patients sought illicit opioids to cope with uncontrolled pain following taper. Given the “profusion of counterfeit fentanyl,” the “consequences could be fatal.” 5/
@DrTomFrieden @CDCgov #Canada's critique of the #CDC #Opioid Guideline:

Busse JW, Juurlink D, Guyatt GH. Addressing the limitations of the CDC guideline for prescribing opioids for chronic noncancer pain. CMAJ. 2016 Dec 6;188(17-18):1210-1. ncbi.nlm.nih.gov/pmc/articles/P…
@DrTomFrieden @CDCgov In 2019, @CDCgov said dosage caps & sudden discontinuation “conflict with the Guideline’s emphasis on individualized assessment of the benefits and risks of #opioids given the specific circumstances and unique needs of each patient.”
@DrTomFrieden @CDCgov #CDC needs to do more than blame healthcare providers & legislators for "misapplication" of the rx #opioid Guideline. Thousands are dying. THOUSANDS. A VA study tracked #vets whose rx was stopped in FY 2013 & found 2,887 had died from #overdose or #suicide.
@DrTomFrieden @CDCgov Oliva, Bowe, Manhapra, @StefanKertesz, Hah, Henderson, Robinson, Paik, Sandbrink, Gordon, Trafton. Associations between stopping prescriptions for #opioids, length of opioid treatment, and #overdose or #suicide deaths in US veterans. BMJ. 2020 Mar 4;368. bmj.com/content/368/bm…

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Jill Piggott

Jill Piggott Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @JillPiggott

Nov 25, 2020
#Migraine is a neurological disorder, not a terrible, disabling #headache," expert @DavidDodick explains. #Pain is "just 1 clinical manifestation deriving from a sensory processing disturbance affecting the nervous system" (Morgan, Lancet 2020). /Thread thelancet.com/journals/laneu…
Billie lost her insurance when #migraine disabled her: “There are days I don't see anything except for shapes." Visual warnings are the most commonly recognized auras, but these symptoms are highly variable, both in different patients & on different days for the same patient. 2/
Difficulty speaking or speaking clearly is another common #migraine symptom, either preceding or during an attack.

Poor St. Husband. He watched this clip & said, "Yup, that's you." I spent a lotta years in school to talk like this. 3/
Read 7 tweets
Nov 25, 2020
A Yale study of 10 patients found 1 dose of #psilocybin can cut #migraine frequency in half for 2 weeks. Each patient did 1 session with placebo, 1 with the drug. People who felt most high got the least migraine relief. /thread newatlas.com/health-wellbei…
The Yale researchers who conducted the small, but 1st of its kind study suggest #migraine patients might benefit from microdoses or sub-hallucinogenic doses of #psilocybin. Understanding how psilocybin prevents migraine might open new pathways for drug development, as well.
I did 2 #migraine clinical trials. I'm glad someone else took this one for the team. I hated Methysergide (Sansert), now discontinued, which was synthesized from lysergic #acid. A 1965 study said Sansert users experienced a "confused feeling of unreality." Tell me about it.
Read 7 tweets
Nov 24, 2020
“[W]idespread & variable dysfunction of the nervous system…comprises the aberrant brain state of a #migraine attack” (Charles 2017).

Daily/near-daily migraine is continuous migraine. Imaging shows our brains *always* look like brains during an "attack" (Brennan 2018). >thread
Recurrent #migraine & #pain aren't benign. “Long-lasting &/or repetitive pain over years leads to profound functional as well as structural changes in the brain networks" (Brennan).

Ineffective treatment is a leading risk of progression to continuous migraine. #MedicalTwitter
Brennan & Pietrobon's paper "A Systems Neuroscience Approach to #Migraine" (Neuron 2018) is @headsUPmigraine's favorite. I excerpted it for others like me who aren't fluent in #neurochemistry:

Read 4 tweets
Nov 23, 2020
It's hard to browse #library bookshelves from home. For other homebound readers, NYT best fiction 2009-19 as a thread for non-subscribers. (Your local library might let you read NYT etc on their website.)

Public libraries are my #SacredPlaces. #books nytimes.com/article/top-bo…
2018: ASYMMETRY Lisa Halliday. THE GREAT BELIEVERS Rebecca Makkai. THE PERFECT NANNY Leila Slimani. Translated Sam Taylor. THERE THERE Tommy Orange. WASHINGTON BLACK Esi Edugyan.
Read 12 tweets
Nov 22, 2020
Holiday shopping from home? Support #Maine #Wabanaki businesses. The Wabanaki are the Maliseet, Passamaquoddy, Penobscot, Mi'kmaq, and Abenki People of the Dawn. #mepolitics #indigenous <thread>

#Passamaquoddy handmade moccasins facebook.com/PassamaquoddyF…
Who doesn't love a little syrup in their stockings? #Passamaquoddy maple syrup from #Maine. passamaquoddymaple.com/?fbclid=IwAR1V…
Meherrin Outpost is owned & operated by a Mi'kmaq (#Maine) & #Mehrrin (NC) couple. They make jewelry & sell a wide range of products from sage & sweetgrass to hand drums and (aw!) baby moccasins. facebook.com/meherrin/
Read 10 tweets
Nov 21, 2020
Even if they support the #DeathPenalty, most people think that only people who've killed should be killed.

🔴Prosecutors never claimed #DustinHiggs killed anyone, but #Barr has scheduled him to die 5 days before inauguration. Deeply moving video: /thread vimeo.com/194702182
#DustinHiggs was in his early 20s when he drove a shooter from a crime scene. Prosecutors said the shooter "acted alone," but they failed to get the #DeathPenalty. So they accused Higgs of being the mastermind.

The shooter got life w/ no parole. Higgs is to die on 1/15/21.
Jurors did NOT hear mitigating factors that might've led them to choose death in prison by no parole over execution. They didn't know he was 10 when he was his mother's f/t caretaker as she died of breast cancer. Nor did they know he has learning & developmental disabilities.
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!