,
7 tweets,
3 min read
Read on Twitter
The carrot (financial incentives) and the stick (new legal mandates) are aligned in a full-throttled assault on opioid prescribing, which fell 74.4% according to the CDC betw. 2015). # of prescriptions filled at retail pharmacies is already at a 15-year low.
Laws in half the states, proposed federal legislation, pharmacy and insurer mandates (which are financially incentivized with compensation packages to lower opioid use) place one-size-fits-all limits on the number of days or dosage at which opioids can be prescribed.
It's a well oiled machine in which a single prescription is subjected to multiple, conflicting levels of overside - so many points of failure for patients who use these essential medications.
@hrw @AmerMedicalAssn have raised alarm - as liability rules the day, doctors abandon patients or forcibly taper them off of medication even against their better medical judgment.
Meanwhile overdose deaths skyrocket. The relentless focus on pills has not been accompanied by concern over heroin & illegal fentanyl which have driven deaths for 5 years (no @npr the third wave did not just begin). Borrowing @StefanKertesz's chart. 
We really need to address the fact that access to naloxone is not widespread, barriers to buprenorphine have actually increased and funding for and access to adequate treatment is abysmal.
How about we take a breath - consider the needs of both the pain and addiction communities - and come up with real, comprehensive solutions?
