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3/5: The Guideline does not support abrupt tapering or sudden discontinuation of opioids. This can result in in severe opioid withdrawal symptoms including pain and psychological distress.
4/5: In addition, policies that mandate hard limits conflict with the Guideline’s emphasis on individualized assessment of benefits and risks considering the circumstances and unique needs of each patient.
5/5: The Guideline’s recommendation about dosage applies to use of opioids in the management of chronic pain, NOT to medication-assisted treatment for opioid use disorder. The Guideline recommends offering medication-assisted treatment for patients with opioid use disorder.
Dr: Thank you for all of this. That the CDC, AMA and now your office have spoken to this major problem this past week means so much to the chronic pain patient. I would be remiss if I did not add this though, it's not trickling down to the Dr's office. 1/2
Dr Harris, AMA says, in part, "The guidelines have been misapplied so widely that it will be a challenge to undo the damage. " I am not going to tweet what I was forced to do last week but it was unethical, not appropriate, not medically necessary & demeaning. And I am ok 2/3
https://www.stripes.com/news/us/three-veterans-in-five-days-die-by-suicide-at-va-facilities-1.576761 … all veterans on pain meds were declared opioid use disorder and given no choice but mat suboxone here's the results
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No Shortcuts to Safer Opioid Prescribing | NEJM
