The headline is not mine. It is from a tweet this week from U.S. Surgeon General Dr. Jerome Adams who is the 20th Surgeon General of the United States.
“First we must acknowledge that we have a crisis of ‘untreated’ and undertreated pain in the U.S. and it can lead to suicide, self-medication with illicits and other bad outcomes.”
But Dr. Adams warns, “we have also have an overdose crisis in our country. It is now largely fueled by fentanyl, but there traditionally have been and still many are people who first become dependent due to opioids prescribed to them or diverted others to whom they were overprescribed.”
Dr. Adams made an important point for chronic pain patients.
“It can be and is true that many people benefit from opioids while others who are getting them are seeing more downside than upside. It is not an either/or. Examples of the latter are many patients (especially peds) getting dental extractions and most with migraines.”
“That’s why,” said Dr. Adams, “I highlight opioid alternatives where evidence suggests they provide as good or better risk benefit.
“I am not anti-opioids, “he said, while capitalizing NOT, “but am pro better pain management. I want to ensure those who benefit from opioids get them, and those who benefit from other meds get those.
Dr. Adams admitted that many chronic pain patients feel underheard and said, “I hear you”.
“Whenever I speak on opioids, I always discuss the need to protect chronic pain patients and not pull the rug out from under them.
We must not target the wrong people, he emphasized.
“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 for them who don’t. Opioids are both being over prescribed to some populations and under prescribed to others.
He continued, “We review the totality of data before taking official positions.”
He added “I hope we can work together to achieve better pain management for all those—acute and chronic paitnets—who benefit from opioids and those popuilations for whom there are reasonable and often better alternataives.
If you would like to respond directly to Dr. Adams on Twitter his handle is @Surgeon_General. Please include @natpainreport in your tweet to let him know the source of your inquiry.
If you’d like us to send him comments, please email me firstname.lastname@example.org and I’ll forward to him and report on his responses.