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headsUPmigraine
@headsUPmigraine
Directors Jill Piggott, PhD Nita Ghei, PhD, JD
Oct 25, 2020 • 15 tweets • 12 min read
.@NBCJoshua Illegal, not medical, #opioid use fuels ODs, which have risen exponentially since at least 1979, predating more liberal prescribing patterns. Addiction & use aren't rising: people are taking increasingly lethal drugs & combinations of drugs. /thread .@TheWeekMSNBC "Overprescription" isn't "fueling the OD crisis." @AmericanCancer says #addiction in medical use is "very rare." #CDC Guideline is based on an average 96% unremarkable use; 4% includes nonaddictive misuse & long use. Large studies put addiction rate under 1%. 2/
Oct 24, 2020 • 10 tweets • 11 min read
Med Schools offer almost no instruction in the world's #1 cause of working-age disability. It'd be like Dental Schools not covering cavities.

7 words diagnose most #migraine: Recurrent #pain w/ hypersensitivity &/or nausea. 60% of patients go undiagnosed. #MedicalTwitter #PCP #Migraine is PROGRESSIVE. A 40% diagnostic rate condemns some to lifelong #disability: Late diagnosis & ineffective treatment of acute #migraine are leading risks for continuous migraine. #PCP #MedicalTwitter mdedge.com/jcomjournal/ar…
Oct 24, 2020 • 10 tweets • 9 min read
Risk of OD to prescribed #opioids is 0.13% (Kaiser, Jnl of Pain 2019), while risk of death by OD increases more than 300% with dose variability of ≥30% (JAMA 2019).

VHA study: discontinuation increases the risk of death by #OD or #suicide up to 6.8 times (BMJ 2020). / thread 0.13% = risk of OD to prescribed #opioids (Kaiser 2019). Dose reduction is "inconsistent" in lowering OD risk. Research found "no support for RSM [risk stratification & monitoring] as a means of decreasing overdose.”

Jnl of Pain 2019;20(1) jpain.org/article/S1526-…
Aug 12, 2020 • 13 tweets • 11 min read
New OFFICIAL Classification of Diseases: #Migraine is not chronic 2ndary pain ("a symptom of an underlying condition") but chronic primary pain ("disability or emotional distress" not "accounted for" by a condition of “known etiology or established pathophysiology") >thread #Migraine & #cluster are now officially classified as chronic primary pain (disability & emotional distress not accounted for by an underlying condition), not chronic secondary pain "where pain may at least initially be conceived as a symptom secondary to an underlying disease."