Senator Kirsten Gillibrand (D-NY) posted a tweet about a proposed opioid legislation earlier this month: “If we want to end the opioid epidemic, we must work to address the root causes of abuse.  That’s why @SenCoryGardner and I introduced legislation to limit opioid prescriptions for acute pain to 7 days.  Because no one needs a month’s supply for a wisdom tooth extraction.”Few would argue with the first part of the tweet concerning the addressing the root cause of the crisis.  We must get to the bottom of the issue and address the problem at its roots.  However, there was a much harsher reaction to the rest of the tweet, starting with "That's why" and ended with "tooth extraction.”

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Here are just some of the reactions:Erin Biba (@erinbiba): This is truly awful and will do extremely great damage to chronic pain sufferers who are already extremely dehumanized by the terrible hardships of US healthcare and I really hope you will research this more before proceeding.Erin Biba (@erinbiba): Surgeries and "Acute" pain don't just wrap up in a neat package of being finished with pain in 7 days. C-sections, for example, aren't just feeling great in a week. The definition of "Acute" is less then 6 months. Imagine having to call your doctor once a week for 6 months.Melissa Jo Peltier (@MelissaJPeltier): I’d be interested in @Peter_Grinspoon’s take on this. IMO it’s an appalling invasion into a doctor-patient relationship & a misunderstanding of the complexities of chronic or recurrent (breakthrough)pain. Meanwhile big pharma, pill mills, get a pass?Jason O'Malley (@jpo_mpls): This seems like dream legislation for insurance and pharma. New doctor visit, co-pay and prescription cost when the pain from a major surgery isn't over after 7 days.Spartek (@sparteksolution): Essentially, the legislation would make it mandatory for weekly visits to the doctor when prescribed potent pain medication. This is beyond dumb! There are only so many hours in a work day.Esther Choo MD MPH (@choo_ek), an emergency doctor and Associate Professor at the Oregon Health & Science University, respectfully tweeted of the responses, "The ratio on this tweet is a good opportunity to get clinical and research experts and patient advocates in the room and talk through this a bit more with evidence and logic on your side."Beth Linas, PhD, MHS (@bethlinas), an infectious disease and digital health epidemiologist, agreed, tweeting, "The #opioidepidemic is STILL misunderstood by policy makers. The sheer number of comments from #publichealth and #health professsionals regarding this tweet should shed light on the importance of having these sorts of experts when developing #evidencebased #healthpolicy #SDOH."Last fall, Gillibrand said, “New York state has been hit hard by the opioid epidemic, and Congress should be doing everything it can to help our communities fight back against this crisis and prevent abuse of these highly addictive drugs."However, it seems as if Gillibrand is oversimplifying a catastrophic problem.  Doctors are only a small piece of a complex puzzle of factors that contributed to the opioid crisis, including underhanded, aggressive marketing tactics and greedy drug makers.  Yes, some physicians have prescribed far too many opioids and some still continue to.  But there are many other variables at play as well and Gillibrand’s misguided interpretation of the problem seems to miss the bigger picture.

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