Koa Kai (she/her) 👩‍🦽🏳️‍🌈✌️ @Chronicallykoa

Can you really become “addicted” to dopamine? Are “dopamine hits” really the phenomena we are being told they are? ? An excellent review of the data by @slsatel: drive.google.com/file/d/167QiB5…

More on yesterday's @DEAHQ announcement about 2026 production quotas for controlled medications: painnewsnetwork.org/stories/2026/1…

Anytime somebody talks about lowering drug prices without discussing pharmacy benefit managers, you know they’re not serious about lowering drug prices

Dr. Marty Makary @DrMakaryFDA

a year ago

Let’s bring the different pharma companies to the table and see if they can address this problem. I’ve met with them and they’re well aware that the price of some of these drugs are 5, 10, 12 times higher in the United States than they are in London, and Germany, and France. That

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What percentage of people prescribed an opioid for the first time use a very low dose and end opioid therapy quickly? 97% The remaining 3% who do continue using an opioid long term are characterized as having a higher disease burden, with more complexity, and tend to be older. Learn more in the details from this new study, link in the next post: Five-Year Trajectories of Prescription Opioid Use | Pharmacy and Clinical Pharmacology | JAMA Network Open | JAMA Network Question: What are the 5-year trajectories of opioid use following initiation, and what are the characteristics of different trajectory groups? Findings: In this population-based cohort study of 3.47 million adults, 5 trajectories of opioid use were identified. Approximately 3% of individuals were classified to the sustained use trajectory group, which was characterized by individuals with older age, a higher number of comorbidities, and higher use of psychotropic and other analgesic drugs and health services vs other trajectory groups. Meaning: Findings from this study suggest that, although most individuals who commenced prescription opioid treatment had low, time-limited exposure to opioids, the small proportion of adults with sustained or increasing opioid use had greater clinical complexity and treatment needs.

As #Medicaid cuts loom, #patients, officials defend care for #ChronicPain, behavioral #health & addiction Current Illinois law would automatically end ACA Medicaid expansions in IL state if federal funding is cut, significantly⬇️who qualifies for coverage. chicago.suntimes.com/health/2025/03…

@purplemamabear I was very fortunate to have that experience, and I tried to take advantage of every moment!! I'm so grateful for those adventures before pain!

RANT WARNING: Dear fellow physicians, Please cut the crap with the "opioids are bad" trope. It's simpleminded and harmfully stigmatizes patients with high-impact chronic pain. It's ableist. And - much of the time - it's racist (I see you, sickle cell patients). If you're reluctant to prescribe opioids, fine - then don't. And don't project your fears onto those of us responsibly addressing pain care for patients with serious, life-limiting illnesses. We are not drug dealers. I get paid the same whether I prescribe an opioid or not. I don't take money from pharmaceutical companies for research or to prescribe certain drugs. I am not anyone's shill. If you don't know your state's laws for opioid prescribing, admit it - or look them up and learn them. Don't make up stupid💩about prescribing restrictions that don't really exist (and yes, I know some states have misguided hard dosing limits, but not Florida). Don't lie to your patients to hide your ignorance. Opioid therapy isn't for everyone, but there is clearly a group of patients for whom benefits exceed risks or harms. You're not "protecting them from addiction" when you falsely accuse them of misuse, addiction or doctor shopping. Please, please just stop screwing these people - and stop screwing the physicians willing to help them. Signed - Compassionate pain care physicians everywhere who are absolutely done with the systemic disinformation about opioid therapy #hapc #hpm #PainCareCrisis

New insights into back pain! This research is so helpful because it shares new insights into intractable back pain. If you’ve been suffering with back pain that has been treatment resistant, considering bringing this study to your care team. It could provide an insight that might be beneficial and lead to relief! More of this, please!

Stanford Pain Medicine @StanfordPain

a year ago

A Hidden Cause of Low Back Pain What’s new: •Stanford pain scientists Einar Ottestad and Anthony Machi highlight a little-known cause of low back pain: superior cluneal nerve entrapment. •This happens when small nerves near the lower back get trapped, leading to pain in the

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Trump's administration (aka Elonia Musk) has announced it will slash billions of dollars from overheads in #grants for #biomedical #research as a part of broader cost-saving measures, a move some #scientists say will stifle scientific advancements. bbc.com/news/articles/…

Recent PII study, Journavx was no better than a placebo in relieving chronic back & hip pain from lumbosacral radiculopathy Recent report by ICER, an indie non-profit research institute said there were “uncertainties” abt the efficacy & safety of Journavx. painnewsnetwork.org/stories/2025/1…

I finally had the time to look at the data from Suzetrigine, the new non-opioid pain medication, and I'm puzzled by the FDA approval. There was absolutely no effect vs placebo.

Olivier George @brainaddiction

a year ago

Big news for pain management!

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Have you all seen what the AAFP has up on its website? On its page for chronic pain toolkit they state. Y

Oh but they did. They knew exactly what they were doing. They have a publication (I think 2012) on the rules, process, and considerations CDC must consider when writing/releasing a GL. One specific part details this: “guidelines we release may become policies, rules, or laws, and so CDC must be very conscious of this possibility and write any public guideline with this in mind.”

The DEA has not only failed to make things better. It has played a key role in making things worse, even leaving aside the pointless incarceration of people whose only crimes consisted of exchanging politically disfavored intoxicants for money. reason.com/2024/11/14/abo… via @reason

LIES TOLD TO AND ABOUT CHRONIC PAIN PATIENTS: 1. Your pain is not real 2. Your pain is not important 3. God wanted you to have pain 4. Pain is good for you 5. Depression caused your pain 6. Your pain means you’re an addict 7. Pain builds moral character 8. Pain helps you heal 9. You have pain because you want disability benefits 10. Your pain helps you manipulate other people 11. Your pain is due to weak moral character 12. You deserve your pain 13. Your pain is due to your race 14. Your pain is due to your gender. And on and on and on…

Since the early 2000s, a group of self-interested antisocial clinicians has led a vile ad hominem campaign against patients with #ChronicPain. Patients are denied medication, then forced to have invasive procedures that often don’t work. Never in the history of medicine has a patient group been treated so poorly. The dignity and respect due any human being has denied to patients with #ChronicPain. We don’t know the facts of the Mangione case. And violence is never a viable option. However, we need to re-examine how American medicine treats the chronically ill, especially those with chronic pain.

The important article below by Brian Goldstein focuses on pain refugees Early reports raise the possibility that the murderer Luigi Mangione had significant pain The greater risk among persons with severe pain is not that they harm others. Rather it is that they harm themselves. Pain is a risk factor for suicide We health professionals, our regulators and leaders erred grievously three times over.. ✅In thinking that severe pain would be amenable to quick fixes ✅In advocating policies that rejected the perspectives of people with long-term pain and their families ✅In thinking that simply reducing prescription of opioids would make patients with pain better. The opioid nihilists proved themselves just as myopic and short-sighted as the corporations that induced physicians to prescribe as heavily as they did

Brian Goldstone @brian_goldstone

2 years ago

Here's a piece I reported for @Harpers about the plight of chronic pain sufferers in America. It's story of medical abandonment, destructive drug policy, and the nightmare of untreated pain, as insurers refuse to cover essential care. harpers.org/archive/2018/0…

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This @propublica articles suffers from the same problem that affects so many media pieces - it oversimplifies a complex situation for the sake of building a compelling narrative. For example, it mistakenly cites the 2016 CDC Opioid as authoritative (instead of CDC’s 2022 revision) and wrongfully embraces the mythical MME hard limit. While the involved physician was credibly accused of wrongdoing (allegedly treating patients for cancer without a definitive tissue diagnosis), several allegations of impropriety in his opioid prescribing are demonstrably wrong. In an effort to demonize him, prosecutors have created weaknesses in their argument that should impeached by a competent expert witness with expertise in pain care.

ProPublica @propublica

2 years ago

When a travelling doctor questioned why a patient had been receiving dangerous cancer treatments for 11 years, he set off a chain of events that would divide a city and implicate a beloved oncologist in a string of suspicious deaths. propublica.org/article/thomas…

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I had a #surgical procedure today, which is always nerve-wracking, especially while in intense #pain. I used #EmpoweredRelief as an adjunct before and after. It kept my #mind and #body relaxed and my blood pressure down. The procedure went very well! Thank you, @BethDarnall!