Another crazy aspect of kolodny lecture with @Pharmed_Out yesterday was when he stated in the beginning of his lecture that one of the wrong ways to frame the opioid crisis is to focus mainly on overdose deaths and the drugs involved. As a pharmacist who works in the hospital I
Cringed so hard at that statement.. When a patient comes in the ER with an OD situation its kind of important to know what drug is involved so we can give proper treatment (opioids, beta blockers, Tylenol etc).. Also its very important to know what drugs are involved because
Its important to understand what source, and the nature of the overdose.. Is it from an illicit or an Rx source? Also how many drugs were involved.. A person may have uses an Rx but also combined many other illicit drugs that ultimately caused the death.. Also
Its important to know if they were diverted as well, because with diverted meds the formulation of the drug is changed in order to get more potent effect.. Also its important to know what drugs are involved because its not only opioids involved as i stated earlier..
You have stimulants, heroin, antidepressants, benzos, alcohol, etc which all are contributing.. For this man to say that shows me he truly has a narrative he wants to spin.. Its time to redirect the conversation to a more accurate depiction of what is going on during this crisis!

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More from @GhanaboyPharmd

25 Mar
Looks like more people are asking all the right questions.. Image
👀 👀 Image
Read 4 tweets
1 Mar
***Thread***

Are medications like oxycodone and hydrocodone essentially heroin pills??

Kolodny recently did a townhall discussion last year on the opioid crisis and COVID... and he made some interesting assertions regarding the semi synthetic medications like oxycodone
He stated when you make molecules like oxycodone, hydrocodone you’re essentially making drugs that cross the BBB easier and are more lipophilic. He continued in the video clip above and stated that they are like heroin in creating a rewarding effect due to it crossing the BBB
His assertion that semi synthetic pain medications such as hydrocodone, and oxycodone are essentially “heroin pills” I think is somewhat hyperbolic and I will try to explain why below...

Molecules like heroin, hydromorphone, oxycodone, etc even though they are made to target
Read 10 tweets
26 Feb
Interesting study done last year looking at the toxicology OD data in British Columbia, Canada.. “They identified by the BC Coroners Service in 2015–2017, were linked to the prescription drug histories of individuals as recorded in BC’s PharmaNet database”
What I like about this descriptive analysis is that they disaggregated the OD data in order to see what drugs were involved in Overdose deaths.. Usually a lot of times you see reported in the media this number so and so died of drug overdose, but what you don’t see reported is
The data disaggregated in order to figure out what drugs were involved.. The chart below shows that from the sample only about 2% of deaths involved prescribed opioids alone in the absence of non-prescribed opioids. The majority of OD deaths involved non prescribed stimulants, Image
Read 6 tweets
25 Feb
***Thread***

Dependence vs Addiction

I have been seeing this flyer around social media and i wanted to do a quick thread on the difference between the 2.. I think alot of times we tend to mesh these two concepts together or often conflate these terms which can
Cause issues as well.. To start off this flyer states "If you get prescribed opioids, you may end up wishing you hadn't. That's because anyone could become dependent on painkillers like hydrocodone, oxycodone, and fentanyl which can ruin your relationships, health and career"
So this flyer states that dependence can happen when taking opioids Which can cause you to ruin your relationships, career, etc.. So what is dependence? It is considered when you have physical or physiological dependence it is indicated by tolerance and withdrawal symptoms.
Read 8 tweets
25 Feb
Its interesting even during the time of the mid 90s and the whole Purdue Pharma fiasco that it was mainly fueled by shady, and illicit activity (whether it was shady Pharma practices, pill mills, non medical use, etc) Patients who use pain medications medically based on the
data don't tend to OD.. Throughout the whole history of this opioid crisis its always been fueled by illicit activity.. Having a legal safe supply regulated market can prevent black market activity.. Imagine if we had sensible drug policy i believe we could have
avoided alot of the OD deaths that we have seen throughout the history of the opioid crisis.. We have a chance to implement sensible drug policy. What will the next 10 years look like regarding OD deaths?? Who knows, but i know if we continue on the trajectory were on now
Read 4 tweets
14 Feb
The Drug War here in the U.S and abroad has always been intricately linked with racism and racial tropes against blacks and other minorities as well...

1. In 1914 Dr. Edward Huntington Williams wrote an article in the
NYT titled NEGRO COCAINE "FIENDS" NEW SOUTHERN MENACE. in his piece he argued how cocaine made the negro more savage, and made him a uniquely murderous individual

2. Harry Anslinger the 1st commissioner of the U.S. Treasury Department's Federal Bureau of Narcotics in the 30s
linked drug use like marijuana among others to the black musicians during that time like Billie Holliday etc, and said how the drugs they would use made them make freakish music like jazz and as some reporters mentioned he stated he longed to see them behind bars
Read 7 tweets

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