I agree; ‘fog lifting’ and being able to think clearly described often by patients after a successful slow weaning off strong opioids but with GP and pain clinic support and a slow, very very slow step down regime over weeks and months rather than days. ht
I have seen this with most of the patients who went through a slow and structured #opioid wean https://t.co/U7SjFfCIA8
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
Amen. More voices need to be added. It’s the biggest misconception and a major inhibitor to taper - fear of unbearable pain. It’s counter intuitive the pain will improve once you are off the opiates. But it’s often true. Keep writing about it. https://t.co
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
Opioid use is a major problem in maternity. If c/s is The most common operation (around 100,00 in Australia/year) and upwards of 1% of users become dependent, there is a significant morbidity . Rarely is this discussed as an outcome measure in #unnecceasar
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
RT @DavidJuurlink: As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that som…
As I wrote here https://t.co/Z1wStL5xaS "For patients who taper from high-dose opioids, it's only in hindsight that something once unimaginable sometimes becomes apparent: opioids weren't making life better, they were making it worse." https://t.co/q7zSV3
@dakami @drbknight ("This point it often not warmly received.") The difference in our views is easily explained: uncritical acceptance of anecdote vs. reflection on the pharmacology underyling the anecdote. Happy to email a more thorough exposition of t
@Rob_Tarzwell @galtwilson Ideally, patients on high doses (including those deemed "stable") would be tapered gradually, each at his or her own pace, to improve balance of benefits vs. harms. https://t.co/Z1wStKNWjk
@theacpa #educating each side #Doctors & #people living with a #chronic condition this is what would #empower the #healthcare field https://t.co/qdYTPefIWZ
Rethinking “doing well” on chronic opioid therapy https://t.co/yb6DaqmBMr
@JoshBloomACSH Who knows, maybe you’re starting to reflect on pharmacology. More here https://t.co/JWrdDk79fn
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
@KateNicholson14 @andrewkolodny As with all drugs, goal should be that benefits > harms. With opioids, this calculus can be difficult, especially at higher doses. Harms are dose-dependent and often occult, while "benefit" is sometimes (not always) obfus
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
The hubris of zero pain marketing. RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hoping they don't replicate our mistakes. https://t.co/Mq4iPn6BNc https://t.co/imjbNP
RT @DavidJuurlink: UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hop…
UK physicians have always seemed more sensible than us when it comes to opioids, especially for chronic pain. Here's hoping they don't replicate our mistakes. https://t.co/Z1wStL5xaS https://t.co/u0dDupf82F
@AdamJShriver @rogercfr @DavidJuurlink 3) opioids improve the quality of life - can you pls expand on this; 4) "Rethinking 'doing well' on chronic opioid therapy https://t.co/xMsvnaUpQJ by @DavidJuurlink is a great CMAJ piece on this issue.
Rethinking "doing well" on chronic opioid therapy: https://t.co/qnHA32vxfl @DavidJuurlink @CMAJ #OpioidWisely
Dr. @DavidJuurlink's 2017 commentary in @CMAJ: https://t.co/ffbtddkkeN #OpioidWisely
RT @DavidJuurlink: @JohnTuckerPhD They’re both issues https://t.co/JWrdDk79fn
Doing well - patient defined, potential for a rich and fulfilling life - on their terms. Medical judgement is sometimes at odds with the patient lens. https://t.co/X4KvCRD9ou
@JohnTuckerPhD They’re both issues https://t.co/JWrdDk79fn
@headdock Agree, but that’s a separate issue. The corollary of my earlier points is that “benefit” may not be what it seems. https://t.co/JWrdDjPxQN An important if unwelcome concept. https://t.co/dX9EBirpku
@DrEricHoskins #opioids for chronic pain https://t.co/iECW7OgJgo
@janephilpott #opioids for chronic pain https://t.co/iECW7OgJgo
@CDNMinHealth #opioids for chronic pain https://t.co/iECW7OgJgo
@MedicalPost #opioids for chronic pain https://t.co/iECW7OgJgo
@EvidenceNetwork #opioids for chronic pain https://t.co/iECW7OgJgo
@cpso_ca #opioids for chronic pain https://t.co/iECW7OgJgo
@DavidJuurlink @JasonWBusse My letter in CMAJ critiquing Rethinking doing well about opioids & #chronicpain https://t.co/VOKDNsZK9b
@DanLairdMD Agree CPPs have been mistreated, especially by prescribing of high-dose opioids. https://t.co/fyjk7QKkS9
RT @reversechapter: We should listen to a drug addict and accept what they're saying to be true, unless there's incontrovertible evidence t…
RT @reversechapter: We should listen to a drug addict and accept what they're saying to be true, unless there's incontrovertible evidence t…
We should listen to a drug addict and accept what they're saying to be true, unless there's incontrovertible evidence to the contrary. We should also take patients who say they're in pain and "benefit" from a treatment at their word. Why wouldn't we treat
@headdock Problem arises when patient (or MD) has erred in benefit/harm assessment. Very easy to do if anecdotes of “benefit” are accepted without considering underlying pharmacology. Unpacked here https://t.co/JWrdDjPxQN (I get that this claim sometimes u
@LeoBeletsky No, I'm saying the only evidence of "benefit" we have at present is anecdote, and there seems to be a widespread unwillingness to acknowledge the pharmacology behind those anecdotes. https://t.co/Z1wStKNWjk
RT @PainHQ_Mac: Article: Rethinking “doing well” on chronic opioid therapy via @CMAJ https://t.co/LPRX9oSPH6
Article: Rethinking “doing well” on chronic opioid therapy via @CMAJ https://t.co/TpNt5T7UoW
Article: Rethinking “doing well” on chronic opioid therapy via @CMAJ https://t.co/LPRX9oSPH6
@DanLairdMD Wrong nightmare. From https://t.co/fyjk7QKkS9 https://t.co/1U0JLv2q2S
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
RT @DavidJuurlink: @medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.c…
@medicalaxioms Even if we had such an instrument, it remains very easy to harm the "legitimate pain patient" https://t.co/fyjk7QKkS9 https://t.co/DgP4mu2CNt
Rethinking "doing well" on chronic opioid therapy. https://t.co/cdMtocAvUC
Patients on chronic opioid therapy can easily be harmed by the medicine they perceive as helping https://t.co/6myV2V3g7k *gated #chronicpain https://t.co/QAVpxjKuTv
RT @CMAJ: We need to rethink what “doing well” on chronic opioid therapy really means https://t.co/aNDUddQvYC *gated #chronicpain @DavidJuu…
We need to rethink what “doing well” on chronic opioid therapy really means https://t.co/aNDUddQvYC *gated #chronicpain @DavidJuurlink https://t.co/iZ2kizShcR
"Doing well" on Chronic Opioid Rx- Balancing risks with benefits... https://t.co/9Sa5oVyGi4