Billie lost her insurance when #migraine disabled her: “There are days I don't see anything except for shapes." Visual warnings are the most commonly recognized auras, but these symptoms are highly variable, both in different patients & on different days for the same patient. 2/
Difficulty speaking or speaking clearly is another common #migraine symptom, either preceding or during an attack.
Poor St. Husband. He watched this clip & said, "Yup, that's you." I spent a lotta years in school to talk like this. 3/
A Yale study of 10 patients found 1 dose of #psilocybin can cut #migraine frequency in half for 2 weeks. Each patient did 1 session with placebo, 1 with the drug. People who felt most high got the least migraine relief. /thread newatlas.com/health-wellbei…
The Yale researchers who conducted the small, but 1st of its kind study suggest #migraine patients might benefit from microdoses or sub-hallucinogenic doses of #psilocybin. Understanding how psilocybin prevents migraine might open new pathways for drug development, as well.
I did 2 #migraine clinical trials. I'm glad someone else took this one for the team. I hated Methysergide (Sansert), now discontinued, which was synthesized from lysergic #acid. A 1965 study said Sansert users experienced a "confused feeling of unreality." Tell me about it.
It's hard to browse #library bookshelves from home. For other homebound readers, NYT best fiction 2009-19 as a thread for non-subscribers. (Your local library might let you read NYT etc on their website.)
Meherrin Outpost is owned & operated by a Mi'kmaq (#Maine) & #Mehrrin (NC) couple. They make jewelry & sell a wide range of products from sage & sweetgrass to hand drums and (aw!) baby moccasins. facebook.com/meherrin/
#DustinHiggs was in his early 20s when he drove a shooter from a crime scene. Prosecutors said the shooter "acted alone," but they failed to get the #DeathPenalty. So they accused Higgs of being the mastermind.
The shooter got life w/ no parole. Higgs is to die on 1/15/21.
Jurors did NOT hear mitigating factors that might've led them to choose death in prison by no parole over execution. They didn't know he was 10 when he was his mother's f/t caretaker as she died of breast cancer. Nor did they know he has learning & developmental disabilities.
@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.
@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/
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."
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.
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
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…
#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/
@louisanamom In 2016, CDC said there wasn't good evidence showing reductions in rx #opioids would reduce ODs. Of their study of 221 #vets (who, sadly, have higher rates of OD/suicide), they said, "caution should be taken in drawing causal inferences from this observational study.” 1/
@louisanamom I don't know why CDC's 2016 paper is titled "a detailed exploration into the association of prescribed #opioid dosage & OD deaths" when it admits there were 2 low-quality studies + their "don't assume anything about cause & effect" study! ncbi.nlm.nih.gov/pmc/articles/P…
@louisanamom In 2016, @CDCgov had NO SOLID EVIDENCE about whether rx #opioid reductions & discontinuation would help or hurt. Here's their review of evidence (table 1). Read the column "Limitations."
@DrTomFrieden@CDCgov#CDC-funded research in 2018: “declines in these opioid prescribing metrics ... have not been followed by decreases in opioid overdoses. Instead, overdoses due to illegal opioids ... have increased.” Why didn't CDC retract the Guideline when it saw deaths were going UP?
@DrTomFrieden@CDCgov In 2016, #CDC Director Frieden told the press that the risks of rx #opioids would outweigh benefits for "vast majority of patients.” But the Guideline itself said an average 96% of patients had no addiction or non-addictive abuse, misuse, or long use. cdc.gov/media/releases…