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4/? Thats why I highlight opioid alternatives where evidence suggests they provide as good or better risk/benefit. Im NOT anti-opioids, but pro better pain management. I want to ensure those who benefit from opioids get them, & those who might benefit from other meds get those.
5/? I understand many chronic pain patients feel unheard- I HEAR YOU- and I am appreciative for your feedback. Whenever I speak on opioids, I ALWAYS discuss the need to protect chronic pain patients/ not pull the rug out from under them. We must NOT target the wrong people!
6/? We must stop swinging the pendulum to extremes, and find a better balance between getting opioids to those who most benefit from them, while minimizing them for those who don’t. Opioids are BOTH being overprescribed to SOME populations, and under prescribed to others.
7/? Eg overprescribing is well documented in OR setting. Many don’t need/take all opioids prescribed & when not properly stored/ disposed of, they can be diverted. It’s why as an anesthesiologist I highlight opioid sparing anesthetics- because for many we CAN 
periop opioids.
8/? Ive also tried to respond to questions/ comments on twitter in real time- a risk as some may feel my entire position is based on 1 reference/ study that is a specific reply to a different person/ question. We review the totality of the data before taking official positions.
9/ I hope we can work together to achieve better pain management for all- those acute and chronic patients who benefit from opioids, & those populations for whom there are reasonable and often better alternatives (both pharmacologic and non pharmacologic). #betterpaincontrol4all
Like my patient this week— she has progressive, metastatic cancer. She has pain; uncontrolled with Lortab & Percocet. When I escalated her treatment to Oxycodone 15 mg, the #Walgreens pharmacist refused to fill the Rx (despite our 10-min convo), because she was “uncomfortable.”
The government is turning us into criminals, flagging us as addicts. When a patient can not get their legal meds at their one allowed pharmacy, they try to find one that will fill. This is called pharmacy shopping, it will go into the PDMP and be flagged as addict behavior.
TOO LATE. We've been in the crosshairs for over a decade.
Siobhan Reynolds was sounding the clarion call long ago.
Since the Gov stepped in, things have only gotten worse. Patients suffering and now dying, MDs imprisoned for DARING to treat their patients pain.
#opioidhysteriapic.twitter.com/rMTghDWcFE
We need action, not just words.
The rug was snatched years ago. Chronic pain, TERMINAL pain, CANCER pain, SURGERY pain, for too many not treated AT ALL. The CDC guidelines, based on FALSE DATA, were expanded, made into law, and arbitrarily enforced by a DEA already enriching local LEO with asset seizures.
Right?! The Surgeon General seems very out of touch if he actually thinks pain patients are still getting adequate medicine to mediate their pain across #america.
This statement proves that he is not listening to everyone here giving him feedback on this subject either. 
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