✔️Fact-checking @CDCgov's telebriefing on the release of the 2016 Guideline (thread) cdc.gov/media/releases…
3/15/2016: CDC Director Frieden said the Guideline would result in “fewer deaths from all sorts of opiates.”

✔️2018: CDC published a paper showing that #opioid overdose deaths go UP as prescriptions go down. CDC has not yet retracted the Guideline.
2) Frieden (3/15/2016): “The prescription overdose epidemic is doctor-driven."

✔️US OD deaths have been "inexorably tracking along an exponential growth curve since at least 1979," a "predictable pattern of growth" that's NOT associated with increases OR decreases in scripts.
3) Frieden (3/15/2016): The risks of rx #opioid use will outweigh benefits "for the vast majority of patients."

✔️Guideline is based on data showing #opioids are SAFE for the vast majority: average 96% unremarkable use; 4% includes non-addictive long use & physical dependence.
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@NitaGhei 2016 CDC press briefing contains comic relief when @DrOz goes AWOL. Which is handy, since otherwise it contains no relief at all. #tb @headsUPmigraine

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More from @JillPiggott

19 Nov
@JulieTheCranky 2019 letter from expert/advocates (thank you @StefanKertesz) & signed by 3 former US “drug czars" & 318 additional healthcare professionals asked CDC to restate what's NOT in the Guideline: no dose cap; no call for forced tapers.

CDC did. 1/
…lthprofessionalsforpatientsinpain.org/the-letter-1
@JulieTheCranky @StefanKertesz .@CDCgov Director 4/2019: The “Guideline does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm.” 2/
img1.wsimg.com/blobby/go/3d70…
@JulieTheCranky @StefanKertesz @CDCgov #CDC Director Redfield (4/2019): the Guideline calls for doctors to reduce or stop opioids “only [in bold] when patient harm outweighs patient benefit” & does not include a dosage cap. 3/
Read 9 tweets
18 Nov
Late in CDC's 2016 Guideline, a table reveals the Agency had no solid evidence for its claim that reducing rx #opioids would reduce ODs without harming people in #pain. In fact, ODs & suicides have spiked in their wake.

Thread: What did CDC know & when did they know it?
In a spring 2016 research paper, the Guideline's authors report that no "rigorous" studies had been conducted on whether dose reductions lower ODs, tho "preliminary results" suggested that high doses are less risky than low doses.

(All references at end of thread.)
CDC conducted its own study using VHA data about vets taking rx opioids. They matched 221 vets who died of OD (some of whom "likely" committed suicide) with 221 vets still living.

They found "dosage was a moderately good ‘predictor’ of opioid overdose death."
Read 21 tweets
18 Nov
#Migraine is the most common & disabling brain disease, but @SocialSecurity still doesn't recognize it as potentially disabling, making it much harder for people to qualify for earned benefits.

🔵Bookmarkable Thread! Info about #SSDI & #disability for migraine.
Globally, #migraine is the #1 cause of disease-related #disability for people 10-24 & the 4th cause for people 25-49. Yet @SocialSecurity still doesn't treat it as a potentially disabling disease. ssa.gov/disability/pro… Image
Severe #migraine is profoundly disabling. The World Health Organization uses objective metrics to determine disease burden & ranks severe migraine in the highest category of disability alongside terminal-stage cancer.

Shame on @SocialSecurity. Image
Read 24 tweets
3 Nov
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

Oliva, Bowe, Manhapra, Kertesz et al. BMJ 2020. bmj.com/content/368/bm…
Read 4 tweets
2 Nov
@ravensspirit68 @funchefchick @NitaGhei @StefanKertesz @AllysonVarley @PainPtFightBack @LelenaPeacock @tal7291 @urbanfatbiker I'm working on a big annotated bibliography of #cpp/rx #opioid research that I'll put online for activists to use. Here are studies I've got on #CPP-associated #suicide. Send me titles & authors for papers I'm missing & I'll add them. I'll link them below.
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.
Read 15 tweets
31 Oct
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.”
Read 51 tweets

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