We have a pain crisis rolling out across the nation for gravely injured folks with centralized pain due to multiple chronic conditions. While exempted from CDC Guidelines 2016, and in many cases, state regulations due to palliative care, fear of DEA is getting in the way of Rxng.
We're stranding folks without a life raft and causing unnecessary suffering and increased disability. In the last 24 hrs I have fielded 4 calls regarding patient abandonment and suicide from 3 states.
We need an immediate intervention from #CMS and #CDC.
Every state needs a COE set up for the purpose of managing multiple complex chronic care in community practice. It should include a full complement of diagnosis, treatment, rehabilitation supports, pain management, training & mentorship of the full complement of health workers.
These COEs should be located at research institutions, should be set up to collaborate with the federal network of laboratories charged with diagnosis of rare disease, and should be host to patient support organizations.

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More from @tal7291

10 Nov
1/
Community physicians...
Do you know how to code your medical records to support complex chronic care cases?
Do you know how to assess for Palliative (not hospice) care?
effectivehealthcare.ahrq.gov/products/palli…
2/ effectivehealthcare.ahrq.gov/products/palli…

Palliative care: Care that provides relief from pain and other symptoms, supports quality of life, and is focused on patients with serious advanced illness and their families.
3/
National Consensus Guidelines Domains for Quality Palliative Care
1. Structure/Process of care (e.g., continuity, communication)
2. Physical Aspects of Care (e.g., pain, dyspnea)
3. Psychological and Psychiatric Aspects of Care
4. Social Aspects of Care (including caregiving)
Read 9 tweets
7 Nov
Representative government is important. Building inclusive participation that includes rural and urban voices, young & old, & membership across diverse groups will be important for redirecting this nation. I'll say again, this was a referendum on leaving rural Americans behind.
This is my favorite election photo. The Navajo nation experienced more COVID19 deaths than any other subgroup of our population. The Trump admin ignored them. They organized to vote early by horseback. Image
Read 4 tweets
7 Nov
In this election, while white people whined and cried about being robbed, persons of color got down to business and turned out their communities.
Black lives matter a lot to the results, outcome.
#PeacefulProtest
Correction.
Americans of color.
Engaged citizens reclaiming their futures.
Outside the fence erected by the White House to protect @realDonaldTrump from the people, the celebration is in progress
Read 4 tweets
30 Jul
Pharmacogenetic analysis.
What does it look like?
If you are a patient or a prescriber, you have tools to help you make decisions and these tools should be used for folks with multiple, complex chronic conditions that generate pain, psychological distress, anxiety, depression.
Normal response to NSAIDS. Gabapentinoids are processed through the kidneys (N/A)
Normal response to opiates
Read 18 tweets
28 Jun
What fuels public policy? Rhetoric.
It sure as hell isn't data - cause there isn't any.
Why isn't there any data on chronic pain issues? Put simply, we've built NO SYSTEM METRICS to collect this important data or to inform the policy making aspects of this system.
Read 5 tweets
23 Jun
CMS OPIOID GUIDANCE & RESOURCES FOR CONTRACTORS cms.gov/About-CMS/Stor…
CMS OPIOID TAPER GUIDANCE
cms.gov/About-CMS/Stor…
PART D OPIOID OVERUTILIZATION GUIDANCE cms.gov/Medicare/Presc…
Read 7 tweets

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