Thread by @JillPiggott

.@headsUPmigraine spoke w/ a rural #PCP hounded out of the profession by relentless pressure to stop rxing #opioids. She was the only PCP in +100 miles willing to accept patients on opioid therapy. Most were over 70. 2018 #AMA statement shows many share her frustration. >thread

In 2018, #AMA passed a resolution against “misapplication” of the CDC Guideline by “pharmacists, health insurers, pharmacy benefit managers, legislatures, & governmental & private regulatory bodies in ways that prevent or limit patients’ medical access to #opioid analgesia.” 2/

#AMA: "physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing #opioids" above CDC's recommended dose. 3/

#AMA's 2018 resolution directed the organization to contact pharmacy chains & insurers to “recommend that they cease and desist with writing threatening letters to physicians" when they prescribe #opioids for patients in #pain." 4/

#AMA's 2018 resolution directed the org to tell pharmacy chains & insurers to "cease & desist" with policies, procedures, & directives that set blanket bans on #opioid prescriptions above a predetermined dose in the absence of any clinical information. 5/

Rx #opioids are the most effective class of FDA-approved analgesic. #CDC's Guideline is based on an average 96% rate of unremarkable use (4% includes non-addictive misuse & "long use"). For many, opioids are the only treatment that allows them to work & care for family. 6/

A 2019 JAMA study found 40% of #PCPs refuse to accept patients who take an #opioid for #ChronicPain (link below). If patients can get a doctor & a script, they often can't find a #pharmacy willing to fill it, & humiliating pharmacy experiences are common. 7/

The OD epidemic is fueled by increasingly lethal illegal drugs. Taking medicine from a stable patient doesn't prevent someone else from using dangerous street drugs, & it increases the risk the patient will die of suicide or OD by as much as 6.8 times (Oliva). #Enough

American Medical Association House of Delegates. Inappropriate use of CDC Guidelines for prescribing opioids. Resolution 235. 2018. ama-assn.org/system/files/2…

40% of #PCPs refuse patients rx'ed #opioids. Lagisetty PA, Healy N, Garpestad C, Jannausch M, Tipirneni R, Bohnert AS. Access to primary care clinics for patients with chronic pain receiving opioids. JAMA Network Open. 2019 Jul 3;2(7):e196928-.
jamanetwork.com/journals/jaman…

Stopping rx #opioids is associated with up 6.8 times the risk of fatal #overdose or #suicide. #vets

Oliva, Bowe, Manhapra, Kertesz, Hah, et al. Associations between stopping rx opioids & overdose or suicide deaths in US #veterans. BMJ. 2020 Mar 4;368. bmj.com/content/368/bm…

@headsUPmigraine @NitaGhei @PROPkills @JSG_54 @LelenaPeacock @Irishbrat1966 @Chronic_FLKeys See AMA Resolution at top of thread. Doesn't matter that MDs have had it, too. CDC/PROP's a fat #Frosty getting bigger by the second as he careens downhill. #snowball #ffffffffffSPLAT

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