Thread by @DaniScotchIrish

@tal7291 @Medscape You’re talking to each other, not your patients! Until you talk to your patients you’ll never understand what this “epidemic” is doing to Chronic pain sufferers 1. These patients reported adequate pain control at varying dosages of opioids. Adequate defined as pain that was (1)

@tal7291 @Medscape under control, allowing them to function semi “normally”. For some this was work for others it was the ability to go about ADLs, grocery shopping, bathing, cooking, cleaning. We’re talking Quality of Life here, independence, & the ability to care for oneself, not earth defying(2)

@tal7291 @Medscape but living a fulfilling life & maintaining independence. 2. “Adequate”pain control came in different drugs and differing amounts of pain meds as we still have no way to judge or report pain that isn’t subjective. Many pts were followed by their family drs primary care (3)

@tal7291 @Medscape physicians & PCPs who had the benefit of a) knowing their patients overall well being b) the ability to treat them overall except for expensive alternative medicines like acupuncture or massage. It was convenient for both dr and patients and it worked. (4)

@tal7291 @Medscape Yes there were some pill mills and yes there were abusers but a low number, 6%, were at risk for abusing prescription pain medications. 3. In comes the CDC between the patients and physician & they plucked arbitrary numbers for dosage regulations & opioid treatment became (5)

@tal7291 @Medscape suddenly wrong. Physicians of course backed away. The CDC & DEA put physicians licenses, therefore their livelihoods on the lines. The PCPs washed their hands in fear of this. Patients were dropped. Care discontinued, referrals to Pain management WHERE AVAILABLE skyrocketed (6)

@tal7291 @Medscape Patients who were stable were suddenly thrown out on their bums. Sorry my Chronic Pain patient but if I do continue to treat you, you’re now considered RISKY, & you either have to be cut back to this arbitrary number or tapered off your meds altogether. (7)

@tal7291 @Medscape Yes we know you’re in pain BUT...you’re pain is no longer a priority, therefore you ARE NO LONGER A PRIORITY, in fact the CDC says you may be gasp an ADDICT! So step back patient, here’s a cup, I need to make sure you’re not engaging in illicit drug use & that you’re (8)

@tal7291 @Medscape actually taking those meds I prescribed! Because you may be an addict? Even though you’ve never asked for early refills, or got your meds from another health care giver or shown any signs of addiction, you see, I HAVE to make sure! (9)

@tal7291 @Medscape In fact, I decided chronic pain patient, because we don’t have a pain management specialist in our area that your pain isn’t worth risking my license! On that note, I’m going to decrease your meds all at once or taper you down but the goal (10)

@tal7291 @Medscape the goal, my chronic pain patient is for me to cover my ass. You understand that right? I mean sure you’re in pain but the CDC and DEA are some bad hombres and I fear them more than I care about you. My hands are tied. You see? (11)

@tal7291 @Medscape Now that we’re on this path as a PCP I feel much better. Sorry you don’t. Yes you must sign this paper consenting to random drug screens because you may be abusing other substances. If you see a specialists don’t take what they prescribe you until you talk to me first! (12)

@tal7291 @Medscape And you must come to your appointments! Miss one and I’m done! It gives me an excuse to get rid of you! Oh come now, don’t complain about the pain! The CDC says your on the HIGH END of the MMEQ! You can’t REALLY be hurting! (13)

@tal7291 @Medscape You must surely be DRUG SEEKING! You know, I’m just not that into treating you anymore. You risk my ability to support myself and all my other patients that aren’t Chronic pain in the ass patients...ok bye now! Take care! (14)

@tal7291 @Medscape This is what Chronic Pain Patients are hearing from people that once cared for them, people that once said their pain was important & life would be better if it were treated. Now, do you providers see? If you believe your patients are addicted I have a question for you (15)

@tal7291 @Medscape When will you tell those Chronic Pain Patients that you’re sorry for your malpractice? Because you see you are the ultimate enablers. You are the ones that made them addicts... yes you can’t create an addict...<end>

@tal7291 @Medscape Addendum: You are telling Chronic Pain Patients that their quality of life now does not matter, that you the provider that cares, no longer cares. You’re diminishing the many benefits these patients have experienced & (1)

@tal7291 @Medscape treating them like criminals for wanting a life not free from pain but reduced pain, a life in which the quality is greatly diminished. You’re creating a no win situation for these patients. (2)

@tal7291 @Medscape With opioids they’re able to do things like ADLs or work, without, many are dependent on family for ADLs & quit work. Can you imagine someone ripping the rug out from under you like that? All of the sudden you’ve become a burden on society, on your family? Depression? (3)

@tal7291 @Medscape Loss of independence & all self worth? Yes! And you wonder why these people are committing suicide? My God what have you done? And then on top of that, you treat them like a criminal while treating addicts like sick people? WTH? (4)

@tal7291 @Medscape Both the Chronic pain patient & addicted patient deserve care & empathy! This isn’t an “OR” situation! They both deserve your care! How do I know? I’ve worked with both & I am a Chronic Pain Patient (5)

@tal7291 @Medscape dx bilateral hip arthroplasty w/failure of left, rheumatoid arthritis, infx arthritis, osteoporosis, osteoarthritis, osteonecrosis & now depression THANKS! @andrewkolodny <end addendum>