In this Twitter thread on Oct 8, 2018 from Stefan Kertesz (@StefanKertesz), he urges all health professionals (on both sides of the opioid debate) to sign a letter protesting the forced tapers being instituted as a reaction to the CDC Opioid Prescribing Guideline.

1/Health professionals, please sign our letter asking the CDC to act to reduce harm from inappropriate misapplication of its 2016 #opioid guideline. We are Health Professionals for Patients in Pain https://healthprofessionalsforpatientsinpain.org 2/We crafted a letter to assure common ground among people who might, in part, disagree.

Here, he’s taking the unusual step of trying to include some of those that would like us all to taper to zero eventually by simply urging all to protest the misapplication of the guideline, not the guideline itself.

Whether you favor urging careful, negotiated taper by experts, or not, take a look. The one thing we ALL do not want is abandonment of patients, or trauma to them. 3/Our requests align with CDC’s written commitments & its Guideline: (a) open, inclusive evaluation of the Guideline’s implementation in real world practice;

(b) vigorous clarification from the Director of what the CDC’s Guideline states re: #opioid taper & discontinuation

The guideline itself says the outcomes of applying it should be studied. Instead, the document is being used as an indiscriminate cudgel to take away opioid pain relief from chronic pain patients.

4/Misapplications usually involve bureaucracies that prioritize getting a number (MME) down, absent consideration of human outcomes. Results, mostly anecdotal: lives upended by forced, rushed, unsupported opioid #taper by clinicians who see vulnerable patients as liabilities. 5/Patients who wish to express support for our letter, or describe their story on this matter,you can do so on this Supporters’ page: https://docs.google.com/document/d/17uDel9qphd7EeBwHDRyOWdNCnoEbH9cw-PUGPjp1J1E/edit

This Google Document is a bit of a mess because anyone can edit the whole document when they add their comments. (To display this lengthy document correctly, I had to use the Google Doc menu to deselect the “Print Layout” option under the “View” menu)

6/Who are we? 4 doctors and a pharmacist who wrote a letter. We offer all conceivable disclosures on our website. We don’t take donations.https://healthprofessionalsforpatientsinpain.org/about-us 7/A scholarly take, written with @AJ_Gordon, on how today’s opioid correction emerged from yesterday’s too-torrid #opioid embrace is here: A Crisis of Opioids and the Limits of Prescription Control Please DM me if you are having trouble with access.

Here’s the header of the Supporters’ Page:

SUPPORTERS’ SIGNATURES and COMMENTS Health Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation The formal letter to be signed by health professionals is here. Word of Explanation: Health professionals with degrees may sign in their own name on the official letter page. Individuals wishing to register their solidarity with this effort, who are not health professionals, should sign on this page. Personal stories or comments are appropriate for the Supporters’ page.