NIH is allocating $270M additional funding for pain & opioid research. The researchers don't pocket this money. While I don't agree with research at the bedside without the knowledge/consent of patients & then using it to further restrict access, let's not spread misinformation.
Bad things are happening, but let's keep things in perspective. Researchers do not pocket millions in grants. The money goes toward studies which then influence the practice of medicine. This is the detail we should be focusing on. Here is an image detailing the process: Image
The policy driving the response to the OD crisis as it relates to HC is the CDC's 2016 guideline, however, federal research is certainly going to change the way medicine is practiced. That is the point of embedded pragmatic clinical trials & comparative effectiveness research.
There is a real problem but the more people mischaracterize what's happening, the less traction we will have to impact it with a positive result. What we're dealing with is a system with several feedback loops, both positive/reinforcing loops, and negative/balancing loops.
We need to attack this on ethical & other grounds. We can do that by positively engaging the public with facts, not hyperbole, misinformation, or attacks on advocates working hard to improve the situation. This is a system with many moving pieces & is tied to economic health too.
This is a photo Dr. Darnall shared to her timeline about the additional funding provided by Congress to the NIH: Image
This website explains how federal grants work:

grants.gov/web/grants/lea…
This page from the previously linked site explains what entities can apply for federal grants, although individuals rarely receive federal grant funds:

grants.gov/web/grants/lea…
No one person is getting 270 million of federal funding. It was allocated to the NIH for additional studies on pain & opioids. While I don't trust the NIH and I think their ePCTs done without the knowledge or consent of patients are unethical, let's at least tell the truth.
This 270 million dollar fund ends up going to several different NIH projects, NOT people. This is a huge organization. No one person is profiting off of grant funds, many in the future will though because we're talking about a mechanism within the system that drives trends ...
... both in medicine, and the wider economy. I'm on your side folks but let's not spread misinformation because we're angry, tired, and hurting. It's ridiculous to claim Beth Darnall is the sole recipient of 270M because she made an announcement about funding allocation to NIH.
Such claims make us look incompetent and completely ignorant of how this system works. I understand some of you don't like Darnall, but she isn't the boogeyman, the system itself is the problem and all of its weight is currently suffocating us but we must stop conflating things.

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More from @process_x

6 Dec
People with intractable pain are more likely to need LTOT. Things like CBT are NOT going to work and haven't worked for these people and most of them have already tried everything else. Why are we spending billions on research without acknowledging this monumental difference? 🧵
People don't understand that pain is a nuanced topic. There are people who haven't developed chronic pain yet, those with chronic pain at the beginning or middle of their journey, and then there are intractable pain patients. Why isn't research catching onto this?
There should be very structured research strategies taking these differences into account. Maybe @NIH and @PCORI can explain why these differences are not being acknowledged. We need research on LTOT too and what is comparative effectiveness research without a comparison?
Read 10 tweets
23 Nov
In case you weren't aware that the purpose of the electronic health record (EHR) is to leverage patient data for research, check out what the NAM has to say about the learning health model in “Digital Infrastructure for the Learning Health System."🧵

nap.edu/catalog/12912/…
"The ability to draw broadly from anywhere across the globe to provide relevant insights for health and healthcare improvement is a long-term goal for the learning health system."
"Meanwhile, the ability to learn from the experiences of other countries and to apply health information technology (HIT) for biosurveillance can actively facilitate progress toward this and other goals."

Note: It's unclear what these "other goals" are.
Read 11 tweets
15 Nov
On this day 8 years ago, my father died. By the end of his life, he was crippled and homeless, all because those who were supposed to help him wouldn't. When he asked his doctor to treat his pain, he told him "man up, I'm not prescribing you anything." 5 years later he was dead.
He started using a legal drug to control his pain, alcohol. His health quickly declined even further. When his time came, he had to drink just to stave off death. He took Benadryl for an allergy attack and it interacted with the alcohol in his system.
He fell asleep at the wheel of his car, while he was driving, and flipped it off a steep road. He died on impact. I still wonder why his doctor felt it was more just for him to kill himself rather than treat his pain so he could continue being a productive member of society.
Read 6 tweets
15 Nov
What happened to the world? I had to leave the house today because I have a Western Union money order made out to me that my bank won't take via ATM anymore. Leaving my house is incredibly difficult after covid made my dysautonomia intractable & my pain levels aren't much better.
First, I went to @HEB because the website and a customer service rep told us on the phone that they could cash it. I get there in my wheelchair, after quite a bit of effort and discomfort I might add, only to be told they can only cash a Western Union money order FROM HEB. 🙄
I've never heard of such a thing but still, I call Walmart, they say they can cash it. I think to myself, maybe @Walmart will have more sane policies. I get there, get back in the wheelchair, nearly have an attack doing it, & get inside only to be told the same thing HEB told me.
Read 8 tweets
23 Sep
Just got a chance to look more at this which is also from Appriss:

Data Driven Justice Incarceration Report - Identifying Super Utilizers with Incarceration and Prescription Monitoring Data

@maiasz

appriss.com/safety/wp-cont…
If they take this down and anyone wants a copy, let me know. It's already in my repository.
Target them for what, exactly?
Read 11 tweets
22 Sep
Welcome to the algocracy. The social credit system in the West is anything but "soft" and our healthcare system has a big role to play.

#Algocrats

thehill.com/opinion/financ…
"A parallel system is developing in the United States, in part as the result of Silicon Valley and technology-industry user policies, and in part by surveillance of social media activity by private companies."

fastcompany.com/90394048/uh-oh…
"...the challenge posed by China goes beyond the question of who will maintain dominance in the data industry; it asks whether the United States will also choose to test the maximum power of data technology to control and rationalize society."

jpia.princeton.edu/news/social-cr…
Read 4 tweets

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