Lewis Nelson

Emergency Medicine, Medical Toxicology, Addiction Medicine. Pain Medicine. The dose makes the poison.

[Lewis Nelson @LNelsonMD]

An impassioned story of a tragic loss compounded by misinformation and contempt. This commentary could not have been more spot on. Opinion | The Nonsense Over Secondhand Fentanyl Overdoses Must End - https://t.co/i8kBc3EbEi @acmtmedtox @toxicologist12 @JMPerroneMD

[Joseph D'Orazio @JDOrazioMD]

Xylazine Adulteration of the Heroin–Fentanyl Drug Supply: A Narrative Review: Annals of Internal Medicine: Vol 0, No 0 @JMPerroneMD @LNelsonMD @HarozR and Rachel Wightman. https://t.co/omaghdaXFk

[Lewis Nelson @LNelsonMD]

Amazing insight from @JMPerroneMD highlighting misconceptions of xylazine risk and the damage caused by stigmatization of substance use. @ASAMorg @acmtmedtox @JLoveMD @RutgersTox @JDOrazioMD #xylazine https://t.co/2H5WTztgiu

[Lewis Nelson @LNelsonMD]

Even though we like their product, they are still just a business. Trying to convince regulators that bup tablets were not safe but their new strips were so as to prevent generic tablets from staying on the market is anticompetitive.
https://t.co/rmqifrP7GX

[Lewis Nelson @LNelsonMD]

Agree. In fact, I've generally thought it's great that the precipitated withdrawal from naloxone is so short lived...

[Andrew Stolbach, MD, MPH @toxicologist12]

Naloxone is short acting. That’s a good thing. Withdrawal will pass quickly.

When naloxone wears off, we can give more if we need to.

I have been treating opioid overdoses for nearly two decades, and I have never, ever thought we needed a long-acting reversal agent.

[Lewis Nelson @LNelsonMD]

What the officers and others experience is real to them. The issue is with the messaging and the reporting. https://t.co/ejU1XQW7oP @acmtmedtox @toxicologist12 @JMPerroneMD

[Lewis Nelson @LNelsonMD]

I guess it depends what "less than" means? $49.99 is not going to be good (cheap) enough. @JMPerroneMD @acmtmedtox @toxicologist12 @DrDianeC
https://t.co/13a0USGKHB

[Lewis Nelson @LNelsonMD]

Well done. Words frame our perception, and perception allows us to choose our words. Changing either is hard especially when the consequences are overlooked or minimized. https://t.co/cvAVkks1Bk @ASAM @JMPerroneMD @emupdates @kathryn_hawk

[Lewis Nelson @LNelsonMD]

A thoughtful and inspiring story with a wonderful perspective about why opioids are not the answer to chronic pain (read the comments too).
https://t.co/o36GOw8IeH

[The Washington Post @washingtonpost]

Today, internal records of Mallinckrodt, the largest opioid maker at the height of the prescription pill crisis, have been made public, a first-of-its-kind release to come from years-long litigation over the drug epidemic.

Here’s a look at the documents: https://t.co/Wb0pV1Rvit

[Lewis Nelson @LNelsonMD]

Although there were misinterpretations of the 2016 CDC opioid guidelines, it is unfortunate when info is quoted out of context. See refs 1-4: do these "enforcement actions" have anything to do with the guidelines? (no: doctor shopping, pill mills, etc)
https://t.co/jDEG21t98o

[Lewis Nelson @LNelsonMD]

@PharmERToxGuy @petermullins @JMPerroneMD @DrJessePines @DavidJuurlink So many clinicians (incorrectly) believe tramadol is not an opioid. This has led to unintended (but predictable) opioid use disorder and consequences.

[Lewis Nelson @LNelsonMD]

In the spirit of holiday fun, what can we learn from this story?
A. Babies are immune to fentanyl
B. You can drive under the influence of opioids if you are an officer
C. Narcan can be used as a verb ​(narcanned)
D. Counterfeit prescription opioids can contain fentanyl
(Ans: D)

[Lewis Nelson @LNelsonMD]

Another unfortunate misleading story about fentanyl exposure.
https://t.co/ph6rTvRNZJ
The officer rightly thought what happened was real. But we know it is the nocebo effect not poisoning, and still very real.
https://t.co/RKnRniCFU2 @JMPerroneMD @acmtmedtox @toxicologist12

[Lewis Nelson @LNelsonMD]

The irrationality of dealing with fentanyl (non)-exposure. Who is making these decisions? Do reporters do any background? @acmtmedtox @toxicologist12 @JMPerroneMD
Sequoyah High School student in custody after fentanyl found | WATE 6 On Your Side https://t.co/9sPo0t1Ix9

[Lewis Nelson @LNelsonMD]

A fairly comprehensive catalog of opportunities available through HHS to address SUD/OUD. Worth some of your time to review. https://t.co/NmDsTFmo6H
@opioidsCOBRE @JMPerroneMD @emupdates @HarozR @acmtmedtox

[Lewis Nelson @LNelsonMD]

Not to forget either that going from a 0.4 to 5 mg dose will put a further strain on the troubled naloxone supply chain.
https://t.co/PG7T1IIfbo

[Lewis Nelson @LNelsonMD]

This is misguided and shows a lack of understanding about opioid (and specifically fentanyl) overdose and naloxone.
https://t.co/nyoluLV4XZ

[Lewis Nelson @LNelsonMD]

https://t.co/fy008vZ5hu

[Lewis Nelson @LNelsonMD]

The NYT piece highlights why this is not possibly fentanyl intoxication. The officer was clearly deeply affected (nocebo effect) but not poisoned. Some reasons detailed here https://t.co/wSvDnhyCjP
https://t.co/DjpKlauiAP