Chad D. Kollas (he/him) Profile picture
Sep 20 4 tweets 2 min read Twitter logo Read on Twitter
Seeing #OpioidReductionists tripling-down on their failed trope that reduced opioid prescribing will fix the #OverdoseCrisis.

They seem annoyed that the 2022 Revised @CDCgov Guideline could undermine settlements in state lawsuits against opioid manufacturers & distributors.
Ironically, @CDCInjury was compelled to revise the flawed 2016 Guideline because of patient harms from excessively rapid or nonconsensual opioid tapers that were championed by #OpioidReductionists, like PROP & its allies. Shouldn't they be GONE from this policy space?
@CDCInjury The latest extremist rhetorical argument from #OpioidReductionists blames the #OverdoseCrisis on palliative care #hapc #hpm for viewing the relief of pain and suffering as "a legitimate target of medical attention and therapy."
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@CDCInjury But at least they're finally being open & honest about their conflicts-of-interest. 🙄

(It's always about the money; in this case, those sweet expert fees for consulting on opioid litigation... 💰
But at least they're finally being honest about their conflicts-of-interest. 🙄 Image

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More from @ChadDKollas

Apr 23, 2022
@ibdgirl76 The anti-opioid crowd also knows there are ethical problems with a control group in a long-term study in which opioids are beneficial (excluding controls a benefit is unethical).

They cite a “lack of data,” knowing it’s disingenuous - but knowing policymakers don’t know better!
@ibdgirl76 This is like saying there is no data from RCTs showing that parachutes are effective, then insisting on doing those studies to justify parachutes’ use.

It would be unethical to make controls jump from flying planes without parachutes, as they would certainly be harmed, right? 🤔
@ibdgirl76 But it turns out that there *IS* an RCT of parachutes that shows they are no more effective than empty back packs when jumping from a plane!! 😱

That is, when the plane is stationary and on the ground!!

bmj.com/content/363/bm…
Read 7 tweets
Jun 6, 2020
Rather than just ranting about social justice, I’ve been thinking about tangible ways to create public policies that would help dismantle systemic racism and rebuild the justice system, so that #BlackLivesMatter. (1/10)
As a physician, I have a special, societal privilege that creates a disparity in power in my relationship with my patients.

(For example, what other profession else can boldly ask strangers about their sexual histories as a routine part of its work?)

(2/10)
Because of this power disparity, physicians’ relationships with their patients are fiduciary; we are obligated to protect our patients’ best interests when providing their medical care.

This - in part - is why the axiom, “First, do no harm,” is a core value in medicine. (3/10)
Read 10 tweets
Oct 18, 2019
Latest opioid idiocy:

I prescribe opioid analgesics for a 30-day supply, taking patients' individualized care into account.

Pharmacies & health insurers are now ALTERING my Rx instructions, so that the quantity prescribed fits their auto-calculation. #hapc #hpm (1/_)...
For example, if I prescribe oxycodone 5 mg orally up to every 4 hours AS NEEDED for severe cancer pain (QTY #90 for 30 days, based on the patient's usual usage), then the health insurer or pharmacy calls to request we change to a quantity of #180 or TID dosing. #hapc, #hpm (2/_)
This means that the patient either receives an excessive quantity (i.e. over-prescribing) or incorrect dosing instructions, just to accommodate the auto-calculation used by the health insurer or pharmacy to fit into the state PDMP. Neither option is correct! #hapc #hpm (3/_)
Read 4 tweets

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