Policy Harm reduction and the chronic pain patient

[npage148]

I originally put it in pain med but it’s probably better here.

I thought I understood the core tenets of harm reduction and strongly support them but I was “educated” on Twitter a bit ago about HR in setting of chronic pain. The CPPs and some HR providers feel it is inappropriate to have these patients to taper off/down on opiate doses or switch to MAT. HR principles support maintaining these patients on large doses of opiates because they are stable on them These are obviously the most vocal patients/advocates and they are the exception to the statistical conclusion. They referenced a new NEJM paper showing tapers result on suicide and other negative outcomes.

Maybe my thinking is dated but AFAIK opiates for chronic pain are not supported especially for things like EDS and Fibro, and it’s reckless to allow them to continue on large doses opiates despite a lack of clinical support.

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[properexercise]

I really can’t put into words how disgusted I am that the field of pain management has degenerated into a bunch of virtue-signaling dinguses whose goal in life is nothing more than to put on elaborate public displays of themselves “fighting the opioid epidemic” at patient expense. They can’t treat the cause of pain, nor can they prescribe the drugs to palliate it, so they rationalize their worthlessness by treating pain patients as hypochondriacs and drug seekers.

 

[SeniorWrangler]

A lot of those advocacy groups enjoy heavy support from Big Pharma, which is hoping for another golden age of opioids.