Beth Steckler (she/her) Profile picture
Jul 17, 2021 19 tweets 25 min read Read on X
I am perplexed how #RogerChou can not only sit on the #CDCOWG but is a lead author. He recused himself at the #CDC meeting due to #COIs bc of his work as ‘expert witness’ in Purdue litigation but is lead author 🤷🏻‍♀️ @CDCDirector @CDCInjury could you explain how this is ethical? 1/
Listening to the #CDCOWG from perspective of #caregiver & advocate was disheartening. For me @CDCDirector assurances that #patients voices were heard was meaningless. She may say that we’ve been heard but then how are so many feeling as we haven’t been? Why are the #legislation 2
of these guidelines continuing? Why are those who have benefitted from #opioid #pain medications being removed, shamed & stigmatized? Why is care not individualized? It’s very clear our #voices have not been heard. There is nothing that was said that eased my concern for 3/
my kids future, for #pediatric #patients w #pancreatitis or #sicklecell or other #painful conditions. They have been impacted by the guidelines even though this #population was not a focus. The #trauma of children due to unaddressed #pain is life long. No, our #voices have 4/
not been heard. Listening to all the funding going into efforts to address SUD & all the efforts but I see NO hurried efforts or funding allocated to those harmed by #CDC guidelines nor efforts to intervene. While many of those who provided public comment were #patients 5/
or #caregivers i absolutely see it as #optics. Just like the #stakeholder interviews were #optics. Harm will continue & that harm will be a the feet of the #patients & #caregivers. Where is the strategies to ‘educate’ #insurance companies that #CDC guidelines should not be 6/
used as policy? Where is the education to @CMSGov that implementation of a measure of ‘decreasing opioid prescriptions’ demonstrates nothing but that. It does not reflect the outcomes of those removed from #opioids or not provided #opioids. @CMSGov is not the only entity that 7/
has implemented these ineffective & flawed measures. A little over a month ago at our state #Medicaid meeting this measure was shared as well as the ‘progress’. I verbalized my concerns as always. The decrease in opioids does not illustrate the impact on #patient. Is that not 8/
what #healthcare should be about? The outcome of #patient. If @CDCInjury @CDCDirector @CMSGov @DEAHQ looked at the lives behind this they’d see deaths from #suicide, they’d see decrease in #QoL, they’d see loss of employment, decreased functioning, death due to u -treated 9/
impact on #patients health. But, this information seems not to matter. Again, @CDCDirector assurances mean little to me. I see no action attempting to remedy the harm, I see #RogerChou sitting on #CDCOWG & lead author although he has huge conflicts of interest. I see 10/
@supportprop and others given valuable time for comment when they have had ample influence on the guidelines but when #patients & #caregivers have only this as their form. #Individualized care for #patients w #pain has been eliminated because of the #CDC guidelines. 11/
The focus of many such as @supportprop #Chou #Lembke @DEAHQ @CMSGov @CDCInjury has been to eliminate #opioids. You know what, my kids would stop #opioids in a minute if there was any other option that addressed their pain as effectively. There is not. In 2015 at the IPRCC 12/
meeting I heard all the ‘wonderful’ options proposed by #CDC & #HHS such as self paced ‘self management’ courses 🤦🏻‍♀️. Most people with #chronicpain that are #prescribe #opioids utilize multiple strategies. The absolute ignorance by many that this has and is not being done 13/
is baffling. IF our #voices were heard I think 🤔 I should have gotten an email or call. We should have been aware of the process, the discussions, the authors. Again the #CDC lacked transparency. I do want to do a shout out to @speakingabtpain and @BethDarnall bc I believe 14/
that all recommendations that focused on balanced, individualized, patient centered care came from their voices. I trust both of them & am appreciative of their #voices. I believe their focus was/is on those with #pain & the harms they have & are experiencing. I am thankful 15/
for the many voices raised today with concerns of the harms of guidelines but I am sorely disappointed in the @CDCDirector @CDCInjury & the continued actions I find questionable if not #unethical. These guidelines were rushed in & multiple actions taken & billions 16/
spent to reduce #opioid overdoses & deaths. The overdoses & deaths have continued to increase. Additionally so many with #chronicpain harmed. @CDCDirector @CDCInjury @POTUS @VP @NIDAnews @NIHPainResearch @NIH @DEAHQ when a strategy is implanted, and does NOT meet the 17/
identified goals and in fact the issue becomes worse and great ‘collateral damage’ is done, when is the plan scrapped? When is there recognition that it is the ‘wrong’ path? I have to say as a measly state employee, if I implanted something as infective & harmful as #CDC 18/
guidelines the strategy would be scrapped, I’d most likely be fired. I am so angry at the #Inequity. So angry that those NOT impacted are given such access and authority. I have no less concern after todays meeting for the future of my kids. I remain fearful. 19/

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More from @purplemamabear

Nov 1, 2023
I just want to let out my frustrations w the #healthcare system & how assembly healthcare does NOT work. I think back about programs my kids went to. One being a renowned #painprogram. My focus was to assist in developing tools they could utilize in life to deal w #chronicpain 1
& their #illnesses. I wanted a #balance, I wanted a plan that was based on their individual needs. Their #pediatrician at 1st stated she had concerns w #program & not an #option for them. The #clinic called #pediatrician back saying they’d modify it for my kids. There really 2
were not a lot of options. The program promised individual care so off we went.
Nope started #titrating all #painmeds to align w time of #program vs Ind need. Then denied my daughter right to go to walk in #clinic when she was having issues saying this is what youth did 3
Read 10 tweets
May 24, 2023
Just doing some digging. #Pain is extremely nuanced. And the approach should also. W my kids #health & #pain there has been continued lack of knowledge, assumptions, & unwillingness to understand.
➡️#Anatomy of those that had #TPAIT & lack of understanding
by many docs 1
how this can impact #pain
➡️ Not identify or understanding impact of #MalabsorptionSyndrome
➡️Assumption that removal of #pancreas should immediately ‘solve’ issue of #ChronicPain
➡️ #GastricEmptying issues
➡️ Age of my kids (too young to have #pain)
➡️ Lack of 2
understanding & identification of #MedicalTrauma
➡️T3c #Diabetes
➡️ Impact of #NASH on #pain & options for #care

There are numerous factors that are critical in #Treating an #ChronicPain in #Individuals. They list of few listed above that are factors w my kids, have often 3
Read 8 tweets
May 24, 2023
Reviewing some #NorthDakota information surrounding #prescribed #opioids.
#OpioidPrescriptions #declined 34% from 2006 to 2020

Statement in poster ➡️ ‘Since 2007 every state has been working to address the #opioid epidemic & best practices are now understood’

Are they? 1
In the #Conclusion
➡️ nothing that addresses the #harm of #patients that struggled with #chronicpain. #Nothing re #outcomes of those #abandoned by #physicians & removed from #prescribed #opioids. Nothing about the looming disaster of last #physicians that #prescribe in 2 Image
#NorthDakota leaving. #Patients having no recourse. #NorthDakota absolutely has growth in area of serving those w #SUD yet in their pursuit to do this, they have #harmed those w #chronicpain & continue to exclude them in discussions or acknowledge these #harms. @hhsndgov 3
Read 5 tweets
May 24, 2023
#Apologies can be steps towards assisting in #healing #medical #trauma. When my daughter was in @SanfordHealth for 2 months, virtually #secluded bc of accusations by #hospital administration that she causes her diabetic crisis a #hospitalist & #diabetic counselor accused 1
her of ‘stashing’ #Insulin in room. All visitors searched. No items in room unless searched - camera in room 24/7 YET she is accused of injecting #Insulin. My daughter again attempted to educate on post #TPAIT. After additional days, the #Diabetic #Counselor came back & 2
#apologized acknowledging how hard it was to control her #diabetes. It’s hard control when she is at #Baseline but if she is sick nightmare. That #apology meant the world 🌎 to my daughter. She continued to work w this #counselor throughout stay & after. YET #PatientRelations 3 Image
Read 4 tweets
May 24, 2023
#Pain is nuanced
The difficulty with articles such as below example, is nuances not recognized.
For example, I could identify as someone with #chronicPain I have a few conditions that are accompanied by #pain.
My #pain is NOT unrelenting, it’s there ‘hovering’ in the 1 Image
background. I do #yoga 🧘‍♂️ & #meditation & for ME, for the #pain I experience, it provides benefit.
However, take my kids; NASH, kidney disease, gastroperisis, T3, scar tissue neuropathy etc. #mindfullness #meditation is not going even touch it. Not in anyway
2 example of 2
#pain experiences.
It’s understandable that many in nation that are not in #medical profession struggle w the #nuances
What I struggle w & what I believe #harms those w #ChronicPain is the generalization of #pain by #medicalprofessionals & lack of individualizing care based 3
Read 4 tweets
May 24, 2023
#BuzzWords in #Healthcare that often mean nothing: #PatientEngagement, #PatientCenteredCare #SharedDecisionMaking
Studies have demonstrated for years that IF #patients are #authentically involved in #care outcomes are better, yet, too often the above words thrown out to 1
attract, yet no actions follow.
How often have you been asked your desired outcome of #Healthcare?
How often are you asked about barriers to healthcare or recommendations?
How often are plans focused only on med issue?
How often do you feel your #voice is truly #valued in 2
your own #careplanning?
How often do you feel there is collaboration between all doctors OR do you feel at times doc have competing or conflicting recommendations?

#Patients voice should be central. #LetMeHearYourVoice 3
Read 4 tweets

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