Thread by @purplemamabear

Not sure where to start the discussion on this article. I am very interested in multiple aspects of this paper. First, & this is just related to this paper but the overall current climate of the treatment & care of those with #Chronicpain
#HHS #Chou 1/ nam.edu/best-practices…

So much energy has gone into research looking to define optimal strategies for opioid tapering where is the energy being given to development of other medications that are as effective as opioids with less risk? I know this paper referenced that many #patients tapered 2/

experienced pain relief & increased functioning yet as an advocate I receive regular calls from inds where pain care has been reduced or cut off entirely w disasterous results. My kids benefit from #opioid #pain meds. I am nor are they opposed to the utilization of other meds 3/

or strategies IF they are as effective BUT we have found none. Financially and emotionally the toll of attempting to find other options has been exhausting & detrimental. I find the authors opening statement a bit disingenuous imo ‘Ensuring high quality, respectful & 4/

appropriate management of #chronic #noncancerous #pain #CNCP in the context of the US opioid crisis is a critical & complex endeavor’. First, research has demonstrated increased overdoses while legal #opioid prescriptions at an all time low. Second I am truly curious how 5/

the harms we have seen w the implementation of the #CDC guidelines & the narrative that #opioids are evil & all those on #LTOT should be dx with #OUD or #SUD. We have seen #abandonment, substantial decreases in QoL, depression, PTSD & even #suicidedue2pain, yet the narrative 6/

heavy on the opioid tapering. Again where is the research to develop other meds that are as effective with less risk. This is another area of dispute. Those that have found benefit on LTOT have been often silenced by the utilization of psychology and the DSM. It’s been 7/

unfortunately effective yet if one was to review history, the DSM has been utilized to silence inds often throughout history. Please don’t get me wrong. I believe the DSM can be helpful and that psychology and counseling can be helpful BUT these can be weaponized also 8/

and in the case of those who voice concern about discontuation of #opioid #pain #medication these imo HAVE been weaponized. This is just one counter I have to this paper. I did find elements I agree w yet I struggle w why the push to taper & abandoned so many when THEY/WE 9/

report relief. To me, this does not seem ‘respectful’ as the authors state in opening paragraph. Furthermore the authors also qualify #patientengagement further down in paper with a statement that tapering should be done ‘with as much #patient but in.....’. To me this 10/

statement is highly counter to true #engagement. Truly, to me it seems very parternalistic. I do not understand why the millions of dollars in funding are being provided to do research on tapering when those dollars could go into dev of med with less risk and equal 11/

effectiveness. I believe these groups as well as government entities need to look at true patient and caregiver engagement in ALL areas inclusive of research, YES research. At this point, in most aspects I see #patient & #caregiver engagement no more than tokenism. We 12/

are still truly not at the table and the harms continue @CDCgov @CDCInjury @CMSGov @SeemaCMS we deserve a place at the table 13/