Arianne Profile picture
Feb 1 15 tweets 5 min read
1-Tx of pain & the role of opiate class medicines has gone from pain being inadequately treated across the board to abject insanity.
This was done in an orchestrated but convoluted way, taking pain and making it a 'bio-psycho-social' issue tied inexorably with addiction.
2-For those unfamiliar with CHOIR, it's one of Stanford's projects. It was promoted with the National Pain Strategy (when it was a thing) alongside PROPs opioid 'guideline' as a model for technology driven optimization of pain care through research and data mining.
3-The screenshot above in tweet #2 is from this link. iprcc.nih.gov/sites/default/…
4-Looking at a snapshot of CHOIR in practice-
This is the type of data that now plays a primary role in deciding basically what type of treatment a pain patient will or will not receive based on risk assessment.
The higher the 'risk' the less chance opiates will be recommended.
5-Link to above screenshot. All about CHOIR.
Please take a look around.
choir.stanford.edu/clinical-pract…
6-Another snapshot on CHOIR and pt 'scoring' process.
"CHOIR displays the factors that have been found in the literature to be a predictor of outcome after procedures or surgeries. These include Substance Use, Adverse Childhood Experiences..."
'Outcome' like risk of addiction.
7-Anyhoo, basically there are systems in place now being implemented that use 'pain perception' as well as a psycho/social profile to determine your 'risk' & decide proper treatment based on said 'risk'.
Fundamentally the 'risk' of you taking opioids due to the 'opioidcrisis'.😔
8-In other words, "PREDICTIVE MODELING'.
Like the role and service of the pre-cogs in Minority Report. They base your future probability of action on your past through a scoring system.
Not because you've done anything 'aberrant' or have issues w/addiction but because you MIGHT.
9-NARXSCORE system of APPRISS ('Bamboo Health) is yet another tool along these lines. This system, as of today, is being tied into the PDMP, at least here in California. Yet another data mining tool for 'risk assessment' & 'predictive modeling' to determine what's right for you.
10-Another feature of APPRISS' system is the data mining on MDs 'prescribing habits'.
The 'opioid RXing report card' referenced in that NEW YORK meeting I linked yesterday. A meeting with ideas heavily influenced by none other than Andrew Kolodny, Addiction Psychiatrist.🤔
11-Billions of $ later we come full circle back to pre-PROP guideline agendas resulting in what we're facing today.
Pain being inadequately treated across the board for those w/chronic pain and ODs continuing to skyrocket.
Because this was NEVER really about RX opiates at all. 😔
12-This was a very inadequate overview of a very complex and convoluted process that's been in the works since the early 2000s. Siobhan Reynolds sounded the alarm, but no one was listening.
It's time people wake up. We need to put a stop to this madness.
I did want to add, the pilot programs conducted through Kasier Permanente and the VA are not just conjecture, on my part, it happened, and is still happening.
This is PRE cdc 'guideline' info. chcf.org/opioid-safety-…
I will say too that IMO the 'National Pain Strategy' per se is sort of irrelevant at this point, though important to note that NPS objectives were absorbed into different applications of 'opioid response' applications & are being achieved through other programs/practice/policy.
*strike the second word 'applications' in above tweet. 🙄 #Twitedit

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More from @ravensspirit68

Jan 27
I hear a public comment period is coming next week on CDC opioid 'guideline' revisions. This link shows who was involved in the 'opioid' revision workgroup, and what topics of concern were discussed. 😔
#GetLawEnforcementOutofHealthcare
#ChronicPain
cdc.gov/injury/pdfs/bs…
2-Listed in this thread the people who are influencing 'guidelines' for chronic pain treatment and pain treatment in general.
Dr. Wilson M. Compton serves as the Deputy Director of the National Institute on Drug Abuse.
nida.nih.gov/about-nida/org…
3-Anne Burns, BSPharm Vice President, Professional Affairs, at the American Pharmacists Association
Responsible for the Association’s strategic initiatives focused on advancing pharmacists’ patient care services in team-based care delivery models,
ahip.org/speaker/anne-l…
Read 23 tweets
Jan 26
Petition to Congress.
Public Comments (15,444)
This comment was posted 3 years ago.
Things have only gotten worse.
#RxOpioidsSaveLives #Veterans #GetLawEnforcementOutofHealthcare Image
Petition to Congress.
Public Comments (15,444)-
This comment was posted 3 years ago.
Things have only gotten worse.
#RxOpioidsSaveLives #GetLawEnforcementOutofHealthcare Image
Petition to Congress.
Public Comments (15,444)-circa 2019.
Things have only gotten worse.
#RxOpioidsSaveLives #GetLawEnforcementOutofHealthcare Image
Read 4 tweets
Jan 26
And I want to RT this to stand on it's own merit.
Just in case it gets buried in the thread.
#ChronicPain #Addiction #DrugUseForGrownUps
#Overdose #Opioids
2-A patients need for opiate pain meds should not be determined on addiction treatment issues. Nor should it necessitate recreational drug advocacy. Those are NOT our fights.
People in pain have been deemed acceptable collateral damage in an ongoing, doomed to fail drug war.
3-And here we are. Tens of millions of people in pain told that we should be helping get access to #MAT for thoes w/addiction issues, and help legalize recreational drugs, all while we watch our frends in the pain community dying due to lack of needed legal/safe MEDICINES.
Read 4 tweets
Jan 26
This was the "Pain Patients Bill of Rights" in 1997.
Let me repeat that date.
1997.
MDs already had the right to REFUSE pain meds-
LE to go after illegal use.
The whole 'everyone getting opioids like candy' is & was BS.
#GetLawEnforcementOutofHealthcare
search-california-law.com/research/ca/HS…
2-This is the business code info referenced in the above linked 'Patients Bill of Rights'-Cal. Health & Safety Code §124960.
Yet today, few can get proper pain care in CA to literally save their lives.
#StopPainParole #GetLawEnforcementOutofHealthcare
leginfo.legislature.ca.gov/faces/codes_di….
3-Most #chronicpain pts are told to just 'follow the rules' and/or agree to go to 'pain management' clinics to get care, yet Pain Clinics are targeted by LE/DEA & shuttered.
Patients abandoned.
'No opioid Interventional Medicine' has become standard of tx.
visaliatimesdelta.com/story/news/202…
Read 5 tweets
Jan 16
Covid #LongHaulers please take note.
Those in the #MEcfs community has been down the Post Viral Sydrome road for decades now.
The CDC is fully aware of our plight, but has done little in the way of research or help.
#ThisNeedsToChange
Thread...
2-It begins, usually, with an infection.
For the majority of #MyalgicEncephalomyelitis pts it was the Epstein Barr Virus. But there are other infections that lead to #MEcfs as well. In almost every case the person knows that from that point, they were never the same again.
3-For some the progression is slow, fits & starts of decline.
Many continue with some sense of 'normalcy' in life for years. For others the onset of their post viral syndrome happens immediately and functional decline deterioration of all body systems is rapid.
#LongCovid #MEcfs
Read 10 tweets
Jan 16
We've lost too many in this insane '#opioid' war.
The sick & injured are spending the last years of their lives fighting, suffering, begging MDs & GOV for the medicines they need to mediate their pain.
They say taking our medicines away is to 'save' people.
No one is being saved.
Death due to #Untreatedpain or #Undertreatedpain is death by a thousand cuts.

#RxOpioidsSaveLives
#PainKills
Read 10 tweets

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