Kolodny laid out a detailed plan in how to reduce opioid Rxing in a meeting in NY, before guideline was even published.
@jmkillingnyc has so much information on how insidious this anti-opioid agenda was from inception in early/mid 2000s and even earlier I believe.
#PainCareCrisis

https://twitter.com/ravensspirit68/status/1858158515380265283

2-In order to fight back against draconian prescribing protocols, we need to understand how we got here & what's preventing change.
Changes in Standard of Care requires MDs to stay withing the bounds of restrictions.
Law enforcement in medicine has created a chilling effect.

Thread...1-Prescribing practices should never have gotten to the point where some of the most vulnerable people in our society-the sick/injured/elderly-are left in agony, driven to the point of desperation with little to no hope in sight of things changing.
#PainCareCrisis

https://twitter.com/StefanKertesz/status/1856559200052146527

2-People with serious illnesses and injuries have been being told every year for over a decade to 'hold on', that change is coming. I know from having boots on the ground in the chronic illness community that for most, things have only gotten worse.
#PainCareCrisis

1-What I've noticed over 14 years of advocating for people in pain is when you make it clear you're not anti-opioid, MDs, legislators, media, and GOV officials become rude then dismiss you. If you still don't go away, they'll then attack your character/ignore you.
#PainCareCrisis 2-Even when presenting facts-like the extremely low incidence of 'addiction by prescription'.
Or if we explain the safety/efficacy of opiate medicines when taken as prescribed, or the real dangers of leaving someone without effective pain control, including death- we are ignored.

Thread-There's probably more to unpack here than X or my current flare will allow me to elaborate on.
From deflection to gaslighting and than on to dismissal of anything we #chronicpatients or even professionals say.
#ChronicPain #PainCareCrisis @DEAHQ
federalregister.gov/documents/2024… 2-Section 306 of the Controlled Substances Act (CSA) (21 U.S.C. 826) requires the Attorney General to establish aggregate production quotas for each basic class of controlled substance in schedule I and II...
Maybe next letter writing campaign to the U.S. A.G?
#PainCareCrisis

1-The most idiotic & insulting things those with #ChronicPain face is the implication or direct accusation that we 'just want opiates'.
The truth is, we ARE 'seeking' the meds from MDs we require for pain relief but usually ONLY AFTER trying almost everything else already. 2-When one is ill or injured they usually try the old standby's first vs before going to a doctor.
Ice, heat, OTC meds like Ibuprophen or Tylenol-Even both. Some try herbal supplements, massage, gentle exercise, diet, even acupuncture before seeking help from an MD.
#ChronicPain

1-Objective: SAVE LIVES.
Recently I said a #SafeSupply is the pinnacle of saving lives but I realized it's not; it's the FOUNDATION, upon which we build policies to actually save lives.
I'm going to refer to this moving forward as the GOLD STANDARD in reducing #DeathsOfDespair. 2-Drugs would be legalized. A safe, known potency supply of substances created by existing drug manufacturers. It would include supply for RX'd medicines as well as for OTC public, adult, sales and consumption. Similar to how alcohol is sold & consumed now.
#SafeSupply

1-#ChronicPain patients knew that the opioid 'guideline' re: prescribing practices was not law.
But as intended, PROP's 'guideline' shaped the Standard of Care re: #opioid prescribing practices so it might as well have been law.
Why?
Tort law.
Let's try and break it down. 2-Once PROP's ‘opioid guideline’ was published through CDC, prescribing practices started to formally change nationally and altered how doctors were to treat pain; altering the Standard of Care. This was crafted around an ‘opioids are dangerous drugs' narrative.
#ChronicPain

Let's break down #TheGreatOpioidLie.
1-"Over-prescribing was the cause of the opioid crisis."
First according to the Medical Board of CA, there is no legal definition of 'overprescribing'.
Second, it is a THEORY that the mandate to treat pain led to the overdose crisis
cont... 2-The Gov's own stats disprove the access theory. As access to RX meds declines we continued to see a steady increase in drug deaths.
Seems something else might have been a the heart of why we saw a rise in ODs and continue to see record numbers of PEOPLE dying.
#ChornicPain

1-How is the #WarOnPainPatients being waged, let us count the ways...
You're probably seeing an MD because OTCs aren't working.
You're told ibuprophen works well for pain & offered an RX for ibuphropen.
You decline as you've been taking it OTC for months.

You just refused meds. 2-If you counter any aspects of #TheGreatOpioidLie, citing facts vs fiction...

It's can be charted that you're emotional-hostile-agitated.
'Drug seeking' behaviors.
*Women are often labeled hostile just for being in assertive when dealing with people in positions of power. 😔

1-VERY early on we warned about 'pain contracts', the weaponized PDMP, & probable ramifications.
Some of us predicted that opioid policies would metastasize to other meds; suggested that a palliative care exemption for chronic pain patients and MDs who treated them was needed. 😔 2-We sounded the alarm about suicides in our community, real harms to people already sick and injured due to 'opioid policies'.
We were told that our accounts were anecdotes, that 'studies' would be needed for 'proof'.
We continue to suffer & watch friends/loved ones suffer/die.

1-
Every pain patient should know our history and know who Siobhan Reynolds was.

#ChronicPain #RememberingSiobhanReynolds 2-

#ChronicPain

1-Husband established w/a clinic in our town-
Same one that refused to treat my pain a few yrs ago after exacerbating my neck injury carrying firewood.
MD had told me I'd need a referral to a pain clinic as my pain was related to a chronic condition. 🤨
Husband given a brochure. 2-He then saw this in the exam room.
He took photos for me of all of this as he knows how they treated me in the past and he also knows about all the hypocrisy of what they say vs what they actually do when it comes to CPPs.

'PAIN TREATMENT ISN'T BLACK AND WHITE'

1-I now have ppl searching for me on FB after reading my article.
One person put a link on one of my posts about how to 'get hooked up with doctors who will give people the pills they want'.
I'm tired.
No, I'm beyond exhausted and I'm really over all of this.
#ChronicPain 2-I deleted his 'pill hook up' link, he also posted a link to his own article in which he regurgitated the tired THEORY of how- 'over prescribing started the opioid crisis' and how 'prescription pills are now being laced with Fentanyl'.
#TheGreatOpioidLie

1/
Makes me sad-
The same arguments/facts we were making back in 2014 when Share Our Pain was one of the few E-advocacy groups here are the same things new people are just realizing.
Siobhan Reynolds-way before that.
GOV KNOWS the HARMS.
All the anti-opioid PROPagandists know. 2/EVERY #chronicpain pt needs to know our history re: our advocacy. Siobhan Reynolds was a lion, hunted down by GOV, cut down in the prime of her life.
Her voice will echo through time, forewarning the atrocities we see rapidly increasing in real time now. doctorsofcourage.org/siohban-reynol…

Thread-I've asked the pain community to write letters to the @WhiteHouse ATTN: @FLOTUS or @Potus.
This is my own letter already sent re: how MY family's been impacted.
Now an #OpenLetter.
It will take all of us writing for #PainAwarenessMonth to make an impression.
#ChronicPain @WhiteHouse @FLOTUS @POTUS Page 2

1-Stop the, 'Over prescribing caused the opioid crisis.' narrative. I read article after article where 'liberal prescribing' is ascribed as the cause of the so called #opioidcrisis.
Many articles are written by people in our own community, self proclaimed pain pt ‘advocates’. 2-To this, I’d like to point out that in OC even a judge recently ruled:
"There is simply no evidence to show that the rise in prescriptions was not the result of the medically appropriate provision of pain medications to patients in need,"
#RxOpioidsSaveLives
#ChronicPain

Thread...How people in pain are being abused.
Let us count the ways.
1-Emotional Abuse:
Invalidation of person's lived experience
Distrust
Gaslighting
Ridicule
Threats
Constant monitoring of activities
Judgment/punishment
#ChronicPain #WeWillNotStaySilent 2-Intellectual Abuse
Being forced to prove your abuser wrong
Mind games
Making the person in pain feel stupid
Attacking the person in pain's ideas or wishes
Manipulation of information, even in medical records
Power Imbalance

Thread...
My daughter Desiree.
Forever 35
#IllicitFentanylPoisoning
#DrugWarCasualties
#SafeSupplySavesLives 2-Cut down in the prime of life.
Victims of #IllicitFentanylPoisonings.
Deaths happening due to a deadly drug supply, deaths that could have largely been prevented.
These are people, people who were loved, not statistics.
#SafeSupplySavesLives

1- I remember way back when advocacy for pain pts started merging with the addiction community's advocacy.
Pushed back on ADX community's mantra of opioid 'over prescribing' & stated that drugs don't cause ADX.
Maia Szalavitz chastised me, told me to basically stay in my lane. 2- In fact, many in the 'upper echelon' of advocacy still embrace the #PainParole status quo & the 'over prescribing' narrative.
Usually if one pushes back, we're blocked or put on the blacklist of CPPs, and now there's even a blacklist for 'rogue' addiction advocates. 🤔🤫

I commented on the CDC's rewrite.
For whatever that's worth.
I'm exhausted, angry, & now grieving a loss that no parent should ever have to face.
I've had my health & ability to live stolen and lost far too many people I love and care about to this #OpioidInsanity.
Thread...👇🏼 2- My comment?
You have no intention of ending this atrocity. You have had people in the pain community chasing their tails for years while asking for our input and 'comments'.
#Chronicpain

1-Tx of pain & the role of opiate class medicines has gone from pain being inadequately treated across the board to abject insanity.
This was done in an orchestrated but convoluted way, taking pain and making it a 'bio-psycho-social' issue tied inexorably with addiction. 2-For those unfamiliar with CHOIR, it's one of Stanford's projects. It was promoted with the National Pain Strategy (when it was a thing) alongside PROPs opioid 'guideline' as a model for technology driven optimization of pain care through research and data mining.