2,887 #vets died of #overdose or #suicide after they were taken off #opioids meds by the VA to adhere to guidelines. @StefanKertesz & colleagues found stopping meds increases the risk of death up to 6.8x (study in linked tweet). @headsUPmigraine thanks him for his work.
2,887 #vets died of #OD/suicide after their rx #opioid was stopped in FY2013, only 90 fewer deaths than on 9/11.
Stopping treatment was associated with increased risk of fatal OD/#suicide regardless of the length of treatment (Oliva et al BMJ 2020). 1/3
#Vets whose #opioid med was stopped were 1.67 to 6.77 times more likely to die than those who continued to be treated. Deaths were highest in 1st 3 months after treatment was stopped. 2/3
VA study (BMJ 2020) found stopping #opioid meds increased the risk that they'd die of OD or suicide up to 6.8x. Leaving stable patients on meds saves lives: studies consistently find rate of OD to a prescribed opioid is 1/10 to 2/10ths of 1%. FACTSHEET: docs.google.com/document/d/e/2…
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Tang et al 2006 review: Risk of death by #suicide at least doubled in #ChronicPain patients. Ideation is 3 times more common; lifetime prevalence of about 20%. 8 risks for suicidality in chronic pain were identified, half are physical. researchgate.net/profile/Cather…
Tang et al: 8 risks for #suicide in #ChronicPain patients: 4 are physical, including type, intensity & duration of pain & sleep-onset insomnia co-occuring with #pain; 4 are psychological. CP is a neurological suicide risk AND a psychological risk.
2 dozen senior Trump admin officials fear he'll use gov't power to refuse to leave office or "create favorable terms for negotiating his exit." They worry too about foreign adversaries using the internet to undermine the election. thread> nytimes.com/2020/10/30/opi…
NYT sources: most senior officials w/ Senate-confirmed jobs, regular access to Trump & highest-level briefings; some still serving. Several are currently in Intel, law enforcement, nat'l security & are focused on violent, far-right white supremacy groups encouraged by Trump.
Officials: "in 1st debate, when the president offered one of the most astonishing performances of any leader in modern American history--bullying, ridiculing, manic, boasting, fabricating, relentlessly interrupting & talking over his opponent: that’s really him.... That’s Trump.”
Of 133 million w/ preexisting conditions, 54 million will be permanently uninsurable if Trump wins his Supreme Court case & the #ACA is overturned. For others, any gap in coverage, no matter how short, could forever bar them from insurance. <NYT: thread> nytimes.com/article/suprem…
If Trump wins in Court, 165 million Americans will again face annual & lifetime caps for costs, including both those who get their insurance thru work & those who buy it on the exchanges.
Employers will negotiate which conditions, therapies, drugs they'll cover in their plans.
If Trump wins his case, being female will again be considered a preexisting condition; insurers will be free to increase premiums for women.
60 million #Medicare beneficiaries will face changes to medical care and possibly higher premiums.
#Kushner wasn't "successful" til he got a WH job. He & #Ivanka owed $1.4 BILLION on their #mortgage til foreign investors prepaid nearly a century in rent. They got a self-serving taxcut into law & raked in $90 mil from undisclosed overseas sources, most Saudi Arabian. >thread
By the time #Jared & #Ivanka became White House Senior Advisers, they were a little late on their #mortgage. The Washington Post reported that by March 1, 2018, they owed $1.4 billion on 666 5th Avenue.
2 months after WashPost reported #Kushner owed $1.4 billion, a company "swooped in & agreed to take a 99-year lease on the building, paying a near-century’s worth of rent upfront." The #Qatar Investment Authority was a leading investor in the company. >3 nytimes.com/2018/05/17/nyr…
.@headsUPmigraine spoke w/ a rural #PCP hounded out of the profession by relentless pressure to stop rxing #opioids. She was the only PCP in +100 miles willing to accept patients on opioid therapy. Most were over 70. 2018 #AMA statement shows many share her frustration. >thread
In 2018, #AMA passed a resolution against “misapplication” of the CDC Guideline by “pharmacists, health insurers, pharmacy benefit managers, legislatures, & governmental & private regulatory bodies in ways that prevent or limit patients’ medical access to #opioid analgesia.” 2/
#AMA: "physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing #opioids" above CDC's recommended dose. 3/
.@mareasachs The good news is that you're at the peak of #migraine prevalence! Preventive treatment is always important, but especially so in people with childhood onset & women within a decade +/- of peak. n.neurology.org/content/68/5/3…