1/ Another patient being tapered off of opioid therapy, another hash mark for PROP!

20’s male, with Duchenne Muscular Dystrophy, on non-invasive mechanical ventilation, dilated cardiomyopathy. Pain from broken hardware following failed fusion. Opioid x 10 yrs. 300 MME. 2/ Some finger movement, able to work in graphic design, but requires attendant care 24/7. Care transferred to PM group affiliated w/ hosp. This MD stated it was “illegal to continue opioid w/o functional improvement.

@daveys35 @Faithgirlee @SpicyPurritos @CarolKennon4 @lil23rdss @plwin49 @KatMelcher @crystalmurphy28 @RogueWolf2001 @ASanchezs65 @ezmirellda @Shadybug60 @MartineBeaumie8 @ThomasKlineMD @MaryinKansas @TerryColey5 @sexton_cecilia @Irishbrat1966 @sureuwanttoknow @shdwstar @Bilked2TheBrink @kaake_rn @bitchin_p @CContrarus @shounenrobot @ladiekerrie @OpioidHysteria @PainSteals @KatTwisted @kirsten_klang @WizardPuzzle @humanedrug @VIoletTailor @SpartanRyan13 @JSG_54 @PainPlayhouse @RachaelHorning @katman_steven @ForensicMHSA @WandaMoCats @BlkBettyALBurn @Madeinavalon @VelaRosieZazu @Pain_Speaking @VintageVamp17 @puppyluvr312 @Mary86802059 1/ David, I apologize for not seeing this sooner. I had commented on another thread, it was kind of long-winded but I’ll try to be more concise & focus just on what you asked here. I’ve read the FTCA and I know you have too - along w/ putting tons of time & effort into this. @daveys35 @Faithgirlee @SpicyPurritos @CarolKennon4 @lil23rdss @plwin49 @KatMelcher @crystalmurphy28 @RogueWolf2001 @ASanchezs65 @ezmirellda @Shadybug60 @MartineBeaumie8 @ThomasKlineMD @MaryinKansas @TerryColey5 @sexton_cecilia @Irishbrat1966 @sureuwanttoknow @shdwstar @Bilked2TheBrink @kaake_rn @bitchin_p @CContrarus @shounenrobot @ladiekerrie @OpioidHysteria @PainSteals @KatTwisted @kirsten_klang @WizardPuzzle @humanedrug @VIoletTailor @SpartanRyan13 @JSG_54 @PainPlayhouse @RachaelHorning @katman_steven @ForensicMHSA @WandaMoCats @BlkBettyALBurn @Madeinavalon @VelaRosieZazu @Pain_Speaking @VintageVamp17 @puppyluvr312 @Mary86802059 2/ I’m basing this on the (a) reading I’ve done, (b) input from several attorneys (including 1 who has won FTCA cases), and lastly (c) the written explanation Mr. Chapman provided you. His opinion should carry the greatest weight of the 3 sources.

@daveys35 1/ I so wish you had the grounds for FTCA and that you had attorneys fighting over your case left and right. Attorneys are hyperfocused on avoiding malpractice (docs aren’t the only ones who have to worry about this) or bar complaints. @daveys35 2/ At large firms it’s often a paralegal or very new atty that reviews a case. They would be unwise to say someone doesn’t have a case (esp if a paralegal), this is “legal advice” and attorneys are held responsible for the counsel their firm provides.

@aander1987 1/
Ferreira & colleagues (2023) found that antidepressants aren’t the panacea for pain many of us hoped for. 11 /42 studies showed benefit. 31/42 studies failed to find benefit or results were inconclusive. (cont’d)
bmj.com/content/bmj/38… @aander1987 2/ From their research, SNRI’s seem the most likely to be beneficial, but prescribers need to select pts with diagnoses likely to be responsive:
back pain
post-op pain (this one surprised me)
neuropathic pain
fibromyalgia
bmj.com/content/bmj/38…

1/ @WKRG used a stock image of transdermal fentanyl for their Facebook posting of their report on the tragic death of 15 yo Adrianna Taylor & the arrest of a 17yo who alleged supplied her w/ the IMF that led to her death from illicit fentanyl poisoning.
m.facebook.com/story.php?stor… 2/ Illicitly manufactured fentanyl is driving the current overdose crisis - not strictly regulated pharmaceutical fentanyl which is used during anesthesia, pain, & as a transdermal patch for patients w/ severe chronic pain that's refractory to other treatment. @WKRG

So thanks to pain med shortages, I've had crazy high BP at times (think 180-200+/100+) even though mine is usually ~ 100/70.
I'm only 41, have really healthy cholesterol levels, and no atherosclerosis. This is causing a-fib. At 1st, this was only happening if had to cut back to avoid running out, but now it's a daily thing. Rx'd beta blockers, but they aren't doing enough so now on blood thinners too (really NOT a good thing for someone that's constantly bumps in to stuff).

@jnicky63 Oh yeah, you know our healthcare system has burned its moral compass when it alllows CHILDREN to suffer. @jnicky63 I received an email last week from the mom of a child who has cerebral palsy, is non-verbal, has an intellectual disability, and a congenital heart defect (she can cry and make other sounds, but not speak) recounting her daughter's nightmarish surgical experience.

1/ Thrilled that the Opioid Work Group's report, which expressed grave concerns re: the CDC's non yet public draft, was adopted by the Board of Scientific Counselors of @cdcgov's @CDCInjury

drive.google.com/file/d/1OHndXm… 2/ I was very much encouraged by the tone and text of this OWG report's vs the one issued by the OWG convened for the original Guideline. There really is no comparison.

@lisaling

For the most part, I love your show, but there are some issues with the way that you cover the opioid crisis that I would like to bring to your attention I’m proud to be part of #ChangingTheNarrative is an effort organized by @maisz, a journalist, @LeoBeletsky, an attorney, and @DrSarahWakeman, an addiction medicine physician.

changingthenarrative.news

I can’t remember who asked for this, but I found my pdf of the abstract w/ notes on it that you had wanted for:
“Assoc of Opioid Prescribing Patterns w/ Rx Opioid OD in Adolescents and Young Adults.”

Abstract w/ notes:
drive.google.com/file/d/1NfZAOq…

Study:
jamanetwork.com/journals/jamap… This is from last year so not new but still good to bookmark.
Of 2,752,612 pts ages 12-21 who weren’t being treated for cancer & filed at least 1 opioid Rx from 7/1/2009 to 10/1/2017, there were:

-4,686,355 ins claims for opioid meds (aka prescriptions)