OPIOID OVERDOSE DATA 1999-2019. Showing the true makeup of "prescription opioid deaths" both with and without fentanyl or methadone as compared to total opioid overdose deaths.

Spreadsheet: drive.google.com/file/d/1xqA4f5… T40.2 is "other natural and semi-synthetic opioids," or basically prescriptions. T40.3 is methadone. I calculated their polypharmacy rates separately. I then calculated the % makeup of overdoses for all types as well as "prescription" opioids with and without polypharmacy.

Hey uhm @drugdealermd I'm gonna need your source on your claim here that pill form methadone is the predominant source of methadone ODs... because we do not delineate that data just like we don't delineate prescribed fentanyl from IMF.
Methadone doses for clinics are rec to be AT LEAST 60mg/day. This is roughly a 5.5x higher than would be 90 mme threshold pushed for pain (11mg). pubmed.ncbi.nlm.nih.gov/16186081/ Additionally high dose methadone is more efficacious so the likelihood of >60 is good. pubmed.ncbi.nlm.nih.gov/10086434/

Addiction denialism is such a negligent and pervasive concept such that it has been profoundly weaponized. If a med pro is absolutely convinced based on laughably vapid criteria that you're "addicted," there's literally no defending yourself especially under recreational use. Yes, some will deny even when their drug use is clearly leading to causative harms, but not every person refuting an allegation of SUD is in denial. Many, many ppl with substance use disorders self-refer to themselves as addicted based on THEIR lived experiences, not a doctor's.

Sorry @DrSeanMackey the very claim that there are "professional patients" and the suggestion that people NOT seek medical help for problems that impact their lives from a psychiatrist by itself bars her from being "an outstanding physician."
@DrSeanMackey Oh boy there's that "patient role" again.

oh gross, Dr. Mackey calling Lembke a great physician doesnt sit right with me at all. Denialism plain and simple. There is no world at present where Lembke is a compassionate and good physician. In this she speaks against abandonment w/ OUD & yet her OWN CME ADVOCATES FOR IT. Props to Lembke for recognizing opioid refugees, but her suggestion to blacklist pts w/ a chart dx is just gross endangerment knowing damn well diagnoses of addiction are not complexy carried out. They are immediate value judgements based on misuse & then biases of the doc.

*whispers* You don't have to, but consider that most people going to a doctor and spending the money probably aren't lying. Getting accurate past substance use history helps immensely, and to do so trustingly you be COMPASSIONATE and non-judgemental.
washingtonpost.com/outlook/some-p… Also ensure that past drug abuse does NOT mean you won't help their pain, just that you may need to monitor that person closer. Do not be afraid to titrate them to workable doses. The faster you get them to a good regimen the faster you know aberrancy is recreation vs supplement.

@u2fellowcitizen I said IF you take EVERY SINGLE DEATH that has an ICD code for a prescription type opioid and called them direct Sackler deaths, but most were not and over half in most of tbe critical years were HEROIN and/or ILLICIT FENT deaths who HAPPENED to also take some oxy. @u2fellowcitizen It's absolutely fucking bonkers that you think nobody recreationally used prescription types opioids before OxyContin and so every prescription death is "obviously a medical case turned addict." You're a damn idiot.

Absolutely lmfao that I'm being accused of plagiarism by someone who joined the patient cause AFTER me (and from what I know NOT a patient) bc we have similarly radical drug views. You can't own an opinion.

You also have more reach than me lmfao so what's this anonymous shit? You are literally *in* that conversation. They can refer to you if they wanted to, but I can also reply reinforcing what you said.

Of the 11,886 deaths associated with "other opioids" in 2019 (more or less prescription), 5,709 of them, or 48%, were also attributed to heroin and/or fentanyl.

It ain't prescription pain medication. #opioidcrisis

w/ wonder.cdc.gov/controller/sav…
w/o wonder.cdc.gov/controller/sav… The "opioid crisis" is fixated on #Purdue and #OxyContin... when prescription opioids, on their own (presumably with or without benzos), only account for 12.4% of the 49,860 opioid related deaths in 2019... marvelous work, USA.