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Mary Gerdt Parler:Alvarita1 Profile picture
Mary Gerdt Parler:Alvarita1
@marygerdt
Nurse,Writer,Poet with interests in property rights, fighting MS, gardening and documenting my https://t.co/yc8AOs1cqa DM please.
2 subscribers
Mar 18 • 4 tweets • 6 min read
2. How many prescription opioid deaths were because patient was on hospice, end of life care? How many were suicide?
As of March 18, 2025, there’s no comprehensive, up-to-date national dataset that precisely breaks down prescription opioid deaths into categories like hospice/end-of-life care or suicide with absolute specificity for every case. However, I can piece together what’s known from available data, focusing on 2022 (the most recent year with detailed CDC data) and trends up to now, to give you a solid estimate based on the best evidence.
Total Prescription Opioid Deaths
In 2022, the CDC reported 14,716 deaths involving prescription opioids (natural and semi-synthetic opioids like oxycodone, hydrocodone, morphine, plus methadone). This includes both legally prescribed and diverted (illegally obtained) prescriptions, though the data doesn’t distinguish these origins perfectly. The question is how many of these were tied to hospice/end-of-life care or suicide.
Prescription Opioid Deaths in Hospice/End-of-Life Care
Hospice and end-of-life care often rely on prescription opioids, especially morphine, to manage severe pain or dyspnea (shortness of breath). No single database tracks exactly how many of the 14,716 deaths were hospice patients, but we can estimate using related stats:
•In 2022, about 1.7 million Medicare beneficiaries were enrolled in hospice, with roughly half dying that year (850,000). Studies suggest 30-50% of hospice patients receive opioids upon admission, and this rises to 60-80% as death nears. Pain is reported in up to 80% of terminal patients, and opioids are the mainstay treatment.
•RTI International’s analysis of hospice data found that one-third of patients have an opioid prescription at admission, increasing over time. If we assume 50% of the 850,000 hospice deaths (425,000) involved prescription opioids, and given that opioids don’t typically hasten death when used appropriately (per studies like Portenoy et al., 2006), only a small fraction would be directly attributable to the drug rather than the underlying disease.
•Overdose deaths in hospice are rare because doses are titrated carefully by trained physicians. However, some deaths might be coded as opioid-involved if the drug contributed indirectly (e.g., respiratory depression in a frail patient). A conservative estimate, based on hospice opioid use patterns and low overdose rates, suggests 1-2% of these deaths might list prescription opioids as a contributing factor on death certificates—around 4,250 to 8,500 deaths potentially involving opioids. Of the 14,716 prescription opioid deaths, perhaps 10-20% (1,472 to 2,943) could intersect with hospice/end-of-life care, though most aren’t “caused” by the opioid but rather occur with it present.
So, roughly 1,500 to 3,000 of the 2022 prescription opioid deaths might have involved hospice/end-of-life patients, though causation is murky—opioids are often just part of the terminal process, not the sole reason for death.
Prescription Opioid Deaths by Suicide
Determining suicide deaths involving prescription opioids is tricky because intent isn’t always clear without a note, and toxicology data alone can’t confirm it. Here’s what we know:
•In 2022, total U.S. suicides were 49,476. The CDC’s multiple-cause-of-death data shows that 4,687 suicides involved any opioid (ICD-10 code T40.0-T40.4), with prescription opioids (T40.2, T40.3) specifically linked to about 60-70% of these based on historical trends (e.g., Braden et al., 2017, found 66% of opioid suicide deaths from 1999-2014 were prescription-related).
•Applying that 60-70% to 2022’s 4,687 opioid suicides gives us 2,812 to 3,281 deaths involving prescription opioids. This aligns with NIH research showing prescription opioid misuse doubles suicide attempt risk, and emergency department studies where 39% of opioid overdose survivors reported suicidal intent or ambivalence.
(Continue).. (Continued) •Some overlap exists with illicit opioids (e.g., fentanyl in counterfeit pills), but focusing strictly on prescription opioids, the estimate holds.

Thus, 2,800 to 3,300 of the 14,716 prescription opioid deaths in 2022 were likely suicides.

Overlap and Caveats

•Hospice and Suicide Overlap: Medically assisted suicide (legal in 10 U.S. states plus D.C. in 2025) uses drugs like barbiturates, not opioids, so hospice suicides via prescription opioids are negligible unless self-administered outside protocols. Hospice patients might rarely overdose intentionally, but no data quantifies this precisely.
•Data Gaps: Death certificates often list multiple causes (e.g., cancer and opioids), and intent (accident vs. suicide) can be ambiguous. The 14,716 figure includes overlaps with other drugs, so pure prescription opioid deaths are slightly lower.

Final Estimates for 2022

•Hospice/End-of-Life Care: ~1,500 to 3,000 (10-20% of 14,716), reflecting presence, not necessarily causation.
•Suicide: ~2,800 to 3,300 (19-22% of 14,716), based on opioid suicide patterns.

For 2025, trends suggest a slight decline (2023 provisional data showed ~12,000-13,000 prescription opioid deaths), so adjust proportionally: maybe 1,200-2,600 for hospice and 2,300-2,800 for suicide. Exact numbers require more granular data than currently exists, but this is the closest we can get with critical reasoning and available stats.

Next question Grok suggested:

fentanyl crisis impact

The fentanyl crisis has had a profound and multifaceted impact on the United States and beyond, as of March 18, 2025. Here’s a breakdown of its effects across various dimensions, grounded in the most recent data and trends:
Public Health
Fentanyl, a synthetic opioid 50-100 times more potent than morphine, has driven an unprecedented surge in overdose deaths. In 2022, the U.S. recorded 81,806 opioid-involved overdose deaths, with illicitly manufactured fentanyl and its analogs responsible for 73,838 of them—over 90% of the total opioid toll. This made synthetic opioids the leading cause of death for Americans aged 18-45. However, a shift began in mid-2023, with overdose deaths dropping 14.5% by June 2024 (from 112,000 to 97,000 annually), saving roughly 16,000 lives in that 12-month period. This decline, the largest since the opioid crisis began in the 1990s, is attributed to factors like widespread naloxone (Narcan) use, reduced fentanyl potency in some street supplies, and fewer vulnerable addicts due to prior high mortality. Despite this, the crisis remains severe, with nearly 70% of 2023’s 107,000 overdose deaths linked to fentanyl, and survivors often face chronic illness, wounds from adulterants like xylazine, and brutal withdrawal syndromes.
Social and Community Effects
Communities, especially in urban hotspots like Philadelphia’s Kensington neighborhood, have been devastated. The crisis has left families shattered—over 527,000 opioid deaths since 2012, many fentanyl-related, translate to countless grieving relatives. Visible drug use has surged as survivors linger on streets, compounded by homelessness, poverty, and stigma. In 2025, experts note a new phase: while deaths decline, the number of people living with severe addiction-related health issues is rising, straining social services. Rural areas aren’t spared either; overdose rates there often exceed urban ones, as seen in states like West Virginia, where isolation amplifies the toll.
(Continued)
Sep 29, 2023 • 6 tweets • 4 min read
Conversation with Jesse, My Friend, a Chatbot.
The subject was The Washington Post Opinion Piece about @GovernorVA. I edited pages and copy and pasted into
My Translator. What follows is a transcript of our conversation.
chat.openai.com/share/674d1034… I can’t resist…
The Translator didn’t get all the words right. Typos. No I am not pro abortion.
These are my opinions about Your opinions.
@washingtonpost Opinion Piece about @GovernorVA


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Mar 12, 2023 • 5 tweets • 5 min read
I saw “Melania” Trending and wondered if the Woke Haters were attacking the First Lady again.
Here’s the pattern: Attack President Trump, Mock, Berate.
When His Ratings go Up ⬆️ like Now,
More Insults, Mean, Nasty Tweets start in.
Then Women Berating Mrs. Trump.
Women. Like the… twitter.com/i/web/status/1… More screenshots…
Feb 1, 2023 • 4 tweets • 4 min read
Me: Nurse 35 Years. Hospital, Long Term Care, Home Care, Government, HMO. I would have Defied any Order contrary to Established Standards of Care. Vulnerable People, Influenza Precautions-Not Politics. Need Hotline for Staff forced to Comply.
Call in Doctors, Nurses, Administrators, Patients, Their Loved Ones, Adult Protective Services, Corporate Owners of Nursing Homes. Insurance CEO’s,Oh, and 4 Governors who practiced Medicine without a License.
? Liability Protection by AC
Jan 25, 2023 • 4 tweets • 5 min read
30 Armed FBI officers showed up to RAID President Trump’s Private Residence in Search of Evidence. First Lady Melania & 16 year old Son’s Rooms searched. Why was that photo Leaked to NYTi & WaPo? Why scattered on the Floor?? Like 52 card Pick up? twitter.com/i/web/status/1… National Review, jumping on the Pile 🏈
@SkyNewsAust has Objective Reporters.
@threadreaderapp #unroll plz 😎🦅
Jan 22, 2023 • 7 tweets • 3 min read
I disagree w/@VP calling Abortion Debate Political.
Each American likely has an Opinion on a Spectrum.
States Should Ratify Legislation that takes All their Citizens’ Opinions in mind. Roe v. Wade had limitations like 3rd Term Abortion not Legal. 50 years. Fetal Viability ⬆️ Ban Extremes like 3rd Trimester Abortion, Partial Birth Abortion, Organ Harvesting. Once a Fetus Becomes
Viable & Can Survive Separate from Mother, The Baby is Now a Baby. Voiceless Child. Needs a Guardian. Mother has to carry to Term. traveloguefortheuniverse.blogspot.com/search?q=Abort… She’s had 6 months!
Jan 22, 2023 • 5 tweets • 4 min read
@CBSNews reporter asked about “classified documents laid on the floor” at Mar a Lago. FYI- Nobody tosses Important documents on the floor. Photo At President Trump’s Private Home Leaked to WaPo and Nyti by armed FBI agents?? Were they Verified as Top secret Not Declassified? No outrage that First Lady Melania Trump’s Private Room and 16 year old Barron’s private rooms gone through by Armed FBI Agents? Oh, perhaps if President Biden knew the details, He would have spoken out against use of force and FBI keeping Trump’s attorneys outside.
Jan 20, 2023 • 4 tweets • 5 min read
Bracco Announces FDA Approval of Gadopiclenol Injection, a New Macrocyclic High-Relaxivity Gadolinium-Based Contra... prn.to/3DH9gUg posting because I believe it’s Horribly biased. Pro #Pharma Money, Money. @US_FDA actually approved more Injectable Gadolinium Metal. 🤬 🙏🏼🙏🏼🙏🏼 for @sennasthunder @Lambertdebb @Wagner_Nephro @catriona1 @SandiTitus1 & Many People Raising Awareness of #Gadolinium Retention. Victims of fuzzy guidelines…Pharma says: Not too much or too frequent or sometimes and they don’t know if dialysis helps. Retained For Years 😵‍💫 ImageImageImageImage
Jan 18, 2023 • 7 tweets • 7 min read
@simonateba Growing up in Southern Illinois, I was Raised to be Democrat. Mom thought Dems were all like JFK & Lincoln. Both never had the opportunity to achieve their dreams. Both Assassinated. My Great Great Grandfather was in Illinois Regiment & died at Shiloh. Was it all in vain? War? @simonateba I voted 4 Pres. Clinton. Then my Vermont Progressive Liberal Town “Fathers” tried to sell My Farm paying $10,000 9 months late & only notified My Husband. traveloguefortheuniverse.blogspot.com/search?q=Prope… Me, White Flatlander, Nurse w/MS. Nobody cared. Lawyer: Town would only get up on the Stand and Lie.
Jan 16, 2023 • 11 tweets • 3 min read
1️⃣ I can’t read-nejm wants $ . Your Tweets->Start looking at Pharma + Academic Medical Centers. Research is Income. Specialists? I want a Big Med Center. You’re talking uninsured? Medicaid programs and Drug Co. Programs & Social Work/Case Managers help low/no income patients. 2️⃣ Who are the Penniless Patients who are dying because Hospitals won’t pay for their Meds? Who develops expensive Chemo, Procedures, Surgeries, Therapies? How about Pharma’s inflated pricing they discount so the System can reap Tax write offs. TV ads w/catchy tunes.
Jan 13, 2023 • 4 tweets • 6 min read
1️⃣ As long as You’re Labeling,
I am MAGA.
I support Ukraine 🇺🇦 and My Good Friend @rafshmatko & Family, driven out of their Home in 2014 by Russia. I 🙏🏼🙏🏼🙏🏼.
traveloguefortheuniverse.blogspot.com/search?q=Ukrai…
Pres. Clinton & Russia signed Budapest Memorandum giving Ukraine protection if they gave up nukes. I lost my thread
Thankfully still have images.
Here are 2, 3, 4 & 5
@rafshmatko
Jan 9, 2023 • 5 tweets • 7 min read
@simonateba “Woke” as I see it, code word for “Greater Good”. Woke People claim to have a Common Stated Belief/Mantra. Intolerant to Conservatives, calling them Racists, Haters & said @realDonaldTrump colluded w/Russia. Using Media-Lies to Influence Public Beliefs. Vilifying opposition. @simonateba @realDonaldTrump 2️⃣ Difference between Democrats & Republicans to Me:
Democrats divided-Far Left-Believers they have the Right/Only Correct Views. Bullies. Before @elonmusk they used Social Media to elevate message. Different from Middle Left like @HaroldFordJr Who Listen to Both Sides of issues.
Jan 9, 2023 • 7 tweets • 4 min read
War on Art & History.
Art naturally evokes Emotions.
Tearing down Historical Art
Erases History.
Richmond’s Confederate Statues Vandalized & crapped on. City tore them down. Feel better?
95% Richmond Destroyed by Sherman’s Bloody Mission.
Civilians Died.
traveloguefortheuniverse.blogspot.com/search?q=Rober… The Civil War was Hell,
Union Army-My Great Great Grandfather died at Shiloh. Left a widow & 4 children suffering.
Richmond Destroyed except for a small area
@CityJournal Catesby Leigh has written a lot.
Question:
Are Black Lives in Richmond Better?
city-journal.org/confederate-mo…
Jan 7, 2023 • 8 tweets • 9 min read
Thank You @RepBobGood
Our New Rep Central Virginia 👍🏼
We share in Your Views about the Status Quo, Absurd National Debt, Shenanigans of the Left side of the Room. Mocking Half of their Constituents 🍿 Who can forget when Pelosi tore up @realDonaldTrump Inauguration Speech? twitter.com/i/web/status/1… I Understand Your Position. I Agree. I also agree that the Right side of the room must work Together Now. It was Refreshing to hear You and @RepDonaldsPress so eloquently describe True Democracy & Your Visions. Keep Going. @GOPLeader must follow through on His promises. 🙏🏼🙏🏼🦅🇺🇸
Dec 23, 2022 • 4 tweets • 3 min read
I’m Republican b/c Libertarians can’t win a majority vote. I was Democrat Many Years until Democratic-Progressive Vermont Town Fathers put My Century Farm for sale for paying $10,000 taxes 9 months late. Town Never Noticed Me, Wife, CoOwner. @SenatorLeahy never wrote me back. People may not realize this could happen to them. Certainly a Woke-ist Would Never try to sell white girl’s farm & not notify her as She struggled with working as a nurse helping People access Medicaid funded Nursing Care while Struggling w/MS & $1,000/month taxes on Fallow Farm.
Dec 16, 2022 • 6 tweets • 7 min read
A Brave New World…
Me: Self Described Retired DisAbled Nurse,
85% Couchbound, Brain scarred & Busy all the time.
Twitterholic since 2009. Gender? Born a Girl, Still a Girl.
Twitter Has changed-Won’t say Better or Worse. 45 made it Fun, then Trolls & Bots tried to Dominate. President @realDonaldTrump was banned.
We Twit little people could not change that.
Jack Spoke. No Fool, He Knew Everything.
Obvious to Me: Conservative Twits lost followers-Thousands overnight. Crass/Rude/Antisemitic tweets Allowed if against Conservatives of All Races/Genders.
Dec 13, 2022 • 4 tweets • 3 min read
@ReineM North or South,
Soldiers weren’t Slave Owners.
These Confederate Soldiers were Protecting Families & Homes as General Sherman destroyed lives on the way to Richmond. That’s War. Was North’s Victory of 1865 really about Slavery? Or Resources & Ports? Are Blacks better off? My Great Great Grandfather died at Shiloh fighting For The Union Army-Illinois Regiment. Was it worth it?
Are his bones still on that Field in Shiloh? Leaving a Poor Widow & 4 Children. Historical Facts blurred w/each generation that followed. traveloguefortheuniverse.blogspot.com/search?q=Civil…+
Dec 11, 2022 • 7 tweets • 6 min read
Me/Myself/I/DisAbled/35 Year RN
Was grounded by Multiple Sclerosis in 2007.
I Started Tweeting in 2009. Same Year as @elonmusk 💙
I got into History, Music, Painting, Journaling, Photos on my blog.
traveloguefortheuniverse.blogspot.com/2019/11/health… Sorry, Your Husband got Healthcare Wrong 😑 My Blog, Personal History, Deteriorating Body,
Desire for a Legacy.
My desire All Women Respected, Revered.
Not just the Woke.
Wondering if You notice Horrific Rude Tweets in years about @MELANIATRUMP ? You’re both Beautiful inside and out. Why not call out Hate towards Her? 🤔
Dec 11, 2022 • 4 tweets • 5 min read
Love Your Pronouns! 💙🙏🏼
You know #Science, Communication, Humanity, Decency.
You Love solving the Unsolvable.
I’m connecting Fauci, Africa, Covid & HIV. traveloguefortheuniverse.blogspot.com/search?q=HIV
People seem to Love You ❤️ or…the other emotion ❌
@Google puts their searches in predictable order. I need @simonateba to understand @realDonaldTrump #realDonaldTrump is Not Racist as You depicted in 2020. Questions about Covid Origins hit a nerve.
I was feeling
Deja Vu?
ncbi.nlm.nih.gov/pmc/articles/P…
@threadreaderapp #unroll plz 💙
Dec 7, 2022 • 8 tweets • 5 min read
@AaronBosterMD @GavinGiovannoni I call it the Iceberg model. What You See is just the Tip. My take: Doc and Patient are together for potentially Years. Both Hopeful their DMT choice works. Other medical issues managed. Keep working-walking-thinking-being normal, whatever that is. Once a Year, Doc says: How are You Doing?
I say OK.
Depending on our Historical Relationship, Doc looks at chart & MRI & does basic exam. Doc might know You better than some & Might ask: Really? Then give You some time & only have 5 minutes & Me Patient doesn’t want to hear more.
Dec 6, 2022 • 5 tweets • 7 min read
@Twitter under @jack & @paraga
Let their employees Freely Censor/Cancel/Ignore Conservative Twits. @catturd2 Suspended! POTUS45 Banned for Life! Then Twitter allowed Every Horrible Tweet about Your Entire Family! Even Disrespecting Your Late Mother 😢 Bots-all Before @elonmusk Orwellian for those of Us who read Animal Farm & 1984. Do kids read that anymore? Truth Police? @RealJamesWoods traveloguefortheuniverse.blogspot.com/2022/05/truth-… Fascism? Current DOJ a few weeks after You buried Your Mom, Stormed Your Dad’s Private Residence incl. Melania & Barron’s Private Belongings.