Thread by @JillPiggott

@JulieTheCranky 2019 letter from expert/advocates (thank you @StefanKertesz) & signed by 3 former US “drug czars" & 318 additional healthcare professionals asked CDC to restate what's NOT in the Guideline: no dose cap; no call for forced tapers.

CDC did. 1/
…lthprofessionalsforpatientsinpain.org/the-letter-1

@JulieTheCranky @StefanKertesz .@CDCgov Director 4/2019: The “Guideline does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm.” 2/
img1.wsimg.com/blobby/go/3d70…

@JulieTheCranky @StefanKertesz @CDCgov #CDC Director Redfield (4/2019): the Guideline calls for doctors to reduce or stop opioids “only [in bold] when patient harm outweighs patient benefit” & does not include a dosage cap. 3/

@JulieTheCranky @StefanKertesz @CDCgov .@CDCgov 4/2019: 90 MME threshold "focuses on initiation." As Redfield notes, the rx #opioid Guideline was meant to help PCPs decide when & how to begin long-term opioid therapy. It recommends treatment begin at a dose below 90 MME. 4/

@JulieTheCranky @StefanKertesz @CDCgov CDC Director 4/2019: The Guideline was meant to provide doctors information about how to best decrease dosages "if a patient would like to taper." 5/

@JulieTheCranky @StefanKertesz @CDCgov CDC Director's 4/2019 letter isn't news. The Guideline does NOT call for #opioid bans much less forced tapers. I quoted those sentences back in 2016 or 2017 when I testified against Maine's bill to set a 100 MME cap by law. (I lost.) 6/

@JulieTheCranky @StefanKertesz @CDCgov In 2019, the fed gov't published a clinician's guide to patient-centered dose reduction, which again says forced tapers should be restricted to life-saving emergency situations. It again says risk/benefit should be done case by case (no bans). 7/ jamanetwork.com/journals/jama/…

@JulieTheCranky @StefanKertesz @CDCgov CDC waited too long to "clarify" the policy. Policymakers "believe" medical use fuels illegal use & therefore ODs. It does not. They "believe" rx cuts have saved lives. In fact, they've accelerated deaths.

@JulieTheCranky @StefanKertesz @CDCgov @threadreaderapp unroll

@headsUPmigraine @NitaGhei #tb