1/? GM twitter! Let’s reset the discussion on pain management and opioid misuse. First, we must acknowledge/ I’ve always felt and said that we have a crisis of un and undertreated pain in the US, and it can lead to suicide, self medication w illicits, and other bad outcomes.
2/? We also have an overdose crisis in our country. It is NOW largely fueled by fentanyl, but there traditionally have been, and still are many people who first become dependent due to opioids prescribed to them – or diverted from others to whom they were over prescribed.
3/? It both can be and is true that many people benefit from opioids, while others who are getting them are seeing more downside than upside. Not either/ or. Examples of the latter are many patients (especially peds) getting dental extractions, and most with migraines.
https://twitter.com/surgeon_general/status/1150004901403123712
4/? Thats why I highlight opioid alternatives where evidence suggests they provide as good or better risk/benefit. Im NOT anti-opioids, but pro better pain management. I want to ensure those who benefit from opioids get them, & those who might benefit from other meds get those.
5/? I understand many chronic pain patients feel unheard- I HEAR YOU- and I am appreciative for your feedback. Whenever I speak on opioids, I ALWAYS discuss the need to protect chronic pain patients/ not pull the rug out from under them. We must NOT target the wrong people!
6/? We must stop swinging the pendulum to extremes, and find a better balance between getting opioids to those who most benefit from them, while minimizing them for those who don’t. Opioids are BOTH being overprescribed to SOME populations, and under prescribed to others.
7/? Eg overprescribing is well documented in OR setting. Many don’t need/take all opioids prescribed & when not properly stored/ disposed of, they can be diverted. It’s why as an anesthesiologist I highlight opioid sparing anesthetics- because for many we CAN
periop opioids.
8/? Ive also tried to respond to questions/ comments on twitter in real time- a risk as some may feel my entire position is based on 1 reference/ study that is a specific reply to a different person/ question. We review the totality of the data before taking official positions.
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I am glad he’s saying chronic patients shouldn’t be thrown under the bus, however, I’m also skeptical because; just like the CDC guidelines or Roswell’s “ultraconservative” opioid protocols- on the surface, they don’t sound bad…in reality, common sense is not prevailing and patients are suffering.
After all I’ve seen done to others & from my own personal experience, I’ve lost almost all trust and respect I’ve ever had for the entire field of medicine.
The current Surgeon General of United States: just another opportunistic boot-licking asshole who obviously does not give a flying flip about chronic pain patients but is only trying to cover his pathetic backside.
That’s the same idiot that said to take ibuprofen or Tylenol after surgery.
How can you even have a conversation on medicine with someone living in a delusional world?
That is our problem. They have taken the “Doctor” out of anything and everything pertaining to pain medication’ And they should be the ONLY ONE’S to discuss and/or implement rules,protocols etc. Not these empty suits that have no experience in treating pain patients or writing prescriptions for pain medicine.. ,
Ok
We can tell by your actions what you actually stand for.
I’m not a Twitter file
But he can come follow me and see the wasteland of Montana pain management
They are called “Puppets”.
I found his comments vomitous and insulting, as usual. And shared my opinion. He’s been glaringly absent in any helpful form, and now he claims to be an advocate for pain management. What a trite little politician he is.
Am I seeing this right??The surgeon general is actually stating as Cpp we have a right to effective medicine,ie opiates,for chronic physical pain due to medical conditions????Im not on twitter,,,maryw