💥 Debunking the Lie: “MME Limits Are a Scientific Concept”

⚠️ THE TRUTH: Morphine Milligram Equivalent (MME) limits are not based on science. They were developed as rough estimates for opioid conversions, not as risk tools, dosing caps, or policy triggers. Yet they’ve been weaponized across healthcare, law, and insurance to justify harmful denials, surveillance, and tapering of stable patients.

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TL;DR 📌

• MME conversions aren’t scientific. They were designed to help switch opioids — not guide laws or treatment.

• There’s no single MME formula. PDMPs, providers, and regulators all use different ones — often without transparency.

• The 90 MME “limit” isn’t evidence-based. It came from a 2007 Washington State guideline based on opinion, not data.

• The FDA rejected a 100 MME threshold. The CDC later included one anyway, and it was misused across the country.

• The CDC reversed course in 2022. But systems still use the 2016 cap, causing patient abandonment and harm.

• Until thresholds are de-implemented, the damage will continue — no matter what the new guideline says.

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📚 Table of Contents

• What Is MME — and What Was It Supposed to Do?
• What the Science Says: How MME Conversions Are Calculated — and Why They Differ
• Where Did 90 MME Come From? The Origins of Arbitrary Thresholds
• How MME Became a Weapon: One Metric, Many Formulas
• How Are MME Thresholds Used in Policy?
• The Real-World Consequences: What Happens When MME Is Misused?
• Selective Use of MME: Pain vs. Addiction Treatment
• The NIH “Research-Only” MME Calculator
• How the DOJ and Law Enforcement Weaponize MME
• Policy Hypocrisy: Buprenorphine, Bias, and Enforcement Gaps
• Call to Action: Stop Using MME to Punish Patients

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1️⃣ What Is MME — and What Was It Supposed to Do?

MME (Morphine Milligram Equivalent) is a tool used to compare the strength of various opioids to morphine.

It was originally developed to help clinicians convert between different opioid medications — for example, during opioid rotation — and to provide a general reference for dosing:

🔹 10 mg of hydrocodone = 10 MME
🔹 10 mg of oxycodone = 15 MME
🔹 10 mg of methadone = anywhere from 30 to 120 MME (depending on the source)

The intention was to standardize conversions, not to assess risk or dictate care.

❌ But That’s Not How It’s Used Today

Over time, MME became a blunt instrument in opioid policy. It’s now widely used to:

• Set legal prescribing limits

• Flag patients in PDMPs

• Deny medications through insurance

• Trigger “red flag” alerts in EHR systems

• Justify pharmacy refusals

• Fuel DOJ investigations of doctors

None of these uses reflect the original purpose of MME — and none are grounded in high-quality clinical evidence.

📎 FDA 2021 Workshop: MME Current Use and Application

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 2️⃣ What the Science Says

🧠 One Metric, Multiple Formulas — None Standardized

Despite how it’s treated in healthcare policy, MME is not a scientific or standardized measurement. Multiple agencies use different formulas — and none are validated across diverse patient populations.

Here are just a few examples:

🔹 CDC — Published its own MME table in the 2016 guideline

🔹 Washington AMDG — Created one of the earliest calculators, still used by PDMPs and licensing boards

🔹 CMS — Applies MME thresholds to Medicare Part D prescribing, but doesn’t publish a formula

🔹 WHO — Offers an equivalency table for palliative care, not chronic pain

These systems can produce conflicting values for the same prescription — sometimes varying by 30% or more depending on the drug, dose, and source.

🧪 Example:

• 10 mg of methadone might be listed as 30 MME in one system

• But 120 MME in another — enough to flag a doctor or patient as “high risk”

📉 The problem? These numbers weren’t built for precision — and they definitely weren’t meant for surveillance, law enforcement, or insurance denials.

🔗 ACSH 2025: “Morphine Milligram Equivalents Metric Obscures the Mission”
“MME is a made-up metric that was never scientifically validated... It’s being used far beyond its intended scope.”

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3️⃣ Where Did 90 MME Come From

⚖️ An Arbitrary Threshold That Became a Legal Weapon

If MME isn’t a validated scientific tool, you might be wondering: Where did the 90 MME cutoff come from — and why is it treated like law?

The truth is, the 90 MME threshold wasn’t based on hard data. It was born out of clinical opinion in Washington State, long before the CDC guideline — and it spread rapidly through policy, law, and litigation.

🧪 Washington State: The First MME Threshold

In 2007, Washington’s Agency Medical Directors’ Group (AMDG) released opioid guidelines that included the first formal dose limit in MME. The cap? 120 MME/day.

According to Dr. David Tauben, one of the AMDG authors:

“We didn’t see anybody doing well on more than 80 milligrams,” he said.
But when it came time to put that into policy, they compromised at 120 milligrams as a practical threshold.
🔗 Seattle Times, “Opioid crackdown brings more pain for some patients” (2016) - article no longer available.

In a 2016 lecture, fellow AMDG author and PROP leader Dr. Gary Franklin further admitted:

“We didn’t have any clear-cut data… We came up with 120 MME. We thought it was a reasonable guess.”
🔗 Franklin Lecture (YouTube)

So the first official MME threshold in U.S. policy wasn’t derived from science — it was based on anecdote, then rounded up to make enforcement easier.
🔗 2010 AMDG Guideline 

📬 PROP’s 2012 Petition: Make 100 MME the Legal Limit

In 2012, PROP (Physicians for Responsible Opioid Prescribing) submitted a citizen petition to the FDA requesting label changes for opioids. Among their demands:

• Remove “moderate” pain as an indication

• Add a daily maximum of 100 MME for non-cancer pain

• Limit use to 90 days for chronic non-cancer pain

🔗 PROP Petition – FDA Docket 2012-P-0818  Here is a pdf copy of the petition.

Signers included:

• Andrew Kolodny (PROP President)

• Anna Lembke and Jane Ballantyne (expert witnesses in opioid litigation)

• Roger Chou (lead author of both CDC guidelines)

PROP’s petition doubled down on the cancer vs. non-cancer distinction and proposed a hard 100 MME cap — even though it wasn’t evidence-based.

🛑 FDA: “No Scientific Basis for a Max Dose”

In 2013, the FDA responded to PROP’s petition and rejected the 100 MME cap outright:

📝 “The scientific literature does not support establishing a maximum recommended daily dose of 100 MME.”

📝 “PROP has not provided scientific support for why labeling should recommend different treatment for [non-cancer] patients.”

📝 “Many professional societies did not support the Petition... and stated that PROP's requests were not supported by scientific evidence.”

📝 “The Agency declines to specify or recommend a maximum daily dose or duration of use for any opioid at this time.”

🔗 FDA Response to PROP Petition (PDF)

Even so, the idea persisted in political circles — eventually making its way into the 2016 CDC guideline, this time with 90 MME as the recommended cap.

🏛️ Why It Stuck: Guidelines, Lawsuits, and Surveillance

Even though the FDA rejected the MME threshold, it became politically useful. The number gave lawmakers and prosecutors a bright line:

•  Used by health systems and insurers to cut off prescriptions

•  Enforced by pharmacies to deny fills

•  Flagged in PDMP databases as “dangerous doses”

• Used in DOJ lawsuits to prosecute providers
  🔗 DOJ Case Example – CVS/Walgreens “High Dose MME”

🏗️ CDC Had a Rollout Plan for 2016 — But None for 2022

The 2016 CDC guideline had an aggressive implementation strategy. States codified the 90 MME threshold into law. Systems built it into EHRs. Doctors were punished if they exceeded it.

But when the 2022 CDC guideline walked back these limits? There was no de-implementation plan.

💬 If CDC were sincere about undoing the damage, they would have asked Congress for funding to help reverse the 2016 threshold policies. But they didn’t — and now the 90 MME cap lives on in systems, insurance rules, and legal precedent.

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4️⃣ How MME Became a Weapon

A Risk Metric Turned Into a Blunt Policy Tool
Once the CDC’s 2016 Guideline introduced 90 MME as a recommended threshold, it didn’t just influence doctors — it transformed MME from a clinical estimation tool into a regulatory weapon.

The result?
Millions of patients were forcibly tapered, denied care, or abandoned entirely — often based on an MME number that was never meant to guide individual care.

🧠 A Tool Without a Brain

MME was developed as a population-level estimation to compare studies — not to dictate individual risk or enforce policy. Even the 2016 CDC Guideline admitted:

📝 “Calculating total daily dosage of opioids in MME can help identify patients who may benefit from closer monitoring, reduction, or tapering.”
🔗 CDC Guideline 2016, PDF

But agencies, insurers, and states quickly began treating 90 MME as a hard cap — with zero regard for patient differences.

🧾 Who Uses MME to Enforce Policy?

MME is now baked into:

• State laws and medical board rules
  (More than half of U.S. states codified 90 MME into law after 2016)

• Electronic Health Records (EHRs)
  (Auto-alerts flag “high risk” patients at >90 MME)

• Prescription Drug Monitoring Programs (PDMPs)
  (Algorithms like NarxCare score patients in part using MME)

• Law enforcement and DOJ prosecutions
  (Doctors prosecuted based on “high MME prescribing”)
  🔗 DOJ Example – Walgreens/CVS Case Cites “High Dose MME”

🤔 Wait — Which MME Formula Are They Using?

Here’s the kicker:
There’s no single standard for calculating MME — and the formula used can vary dramatically depending on the system or agency.

• The CDC and PDMPs use one formula to estimate overdose risk.

• Insurers and electronic health records may use a different method to track prescription history.

• Researchers have their own approaches — and even those differ.

And now, the NIH’s HEAL Initiative has introduced a new standardized MME calculator — but only for use in chronic pain research, not clinical care.
🔗 NIH Webinar: New Research-Only MME Tool (2024)

In fact, during that NIH webinar, presenters explained that depending on which formula you use, the same patient and dose can yield very different MME results.

📣 So when your doctor, your insurer, the PDMP, and the DOJ are all using different calculations…
Who’s right?
❌ There is no universally accepted formula. Yet these numbers are still being used to deny care and prosecute providers.

🔗 ACSH: “MME Metric Obscures the Mission” (2025)

⚠️ “High MME” = Red Flag

High MME dosages are now treated like criminal behavior — despite:

• No agreed-upon conversion standards

• Wide variation in metabolism and patient needs

• No research proving 90 MME is inherently dangerous

Yet “high MME” is used to:

• 🚫 Justify tapering or stopping opioid prescriptions

• 🚨 Trigger PDMP alerts and pharmacy denials

• 🔍 Flag doctors for audit or prosecution

💬 The Bottom Line

MME was meant to be a rough estimate — not a judge, jury, and executioner.

The continued weaponization of MME shows how a flawed metric can be twisted into a system of pain surveillance and punishment — often with devastating consequences.

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5️⃣How Are MME Thresholds Used in Policy?

Now that we’ve established that there isn’t one standard formula for calculating MME — and that different systems (PDMPs, insurers, EHRs, regulators) may use different conversion methods — the obvious question is:

If MME isn’t consistent, how is it being used to make life-or-death decisions?

The answer is deeply troubling. Despite being inconsistent and unscientific, MME thresholds have been embedded into nearly every aspect of opioid policy, regulation, and surveillance. Here are just a few examples:

🔒PDMPs and Risk Scores

• State Prescription Drug Monitoring Programs (PDMPs) often use MME to determine whether a patient or prescriber is “high risk.”

• NarxCare and similar systems use MME thresholds (e.g., 90 or 120 MME/day) to automatically flag patients, regardless of tolerance, stability, or medical need.

• These risk scores can lead to denial of care, forced tapering, or abandonment — even if the calculations are flawed or opaque.

⚠️ The MME formula used by your PDMP might not match the one used by your doctor, insurer, medical board, or the DOJ.
That means you could be "compliant" in one system and "high risk" in another, based purely on the math.

🏛️ State Laws and Medical Board Rules

• Over half of U.S. states have passed laws or rules that embed hard MME limits into medical practice:

  • A 7-day supply cap for acute pain

  • A 90 MME/day cap for chronic pain

• Doctors who exceed these limits can face disciplinary action, licensing penalties, or even criminal prosecution — even when no patient was harmed.

💼 Insurance Denials and Utilization Management

• Insurers frequently use MME thresholds to deny coverage or trigger prior authorization.

• Patients may be forced to reduce doses or switch medications — not because of clinical need, but because they crossed an arbitrary number.

⚖️ Department of Justice (DOJ) Enforcement

• The DOJ has cited “high MME” prescribing as a red flag in criminal indictments and civil cases.

• In a 2021 lawsuit against pharmacy chains, the government claimed that filling prescriptions above 90 or 120 MME was evidence of unlawful conduct — even when doctors followed legal and ethical standards.

📂 Source: DOJ lawsuit mentioning “high MME” thresholds

🧪 Research, Surveillance, and Public Health Metrics

• Federal agencies (CDC, CMS, SAMHSA) use MME in opioid-related research and statistics, often to track “high-dose” prescribing.

• But because of different calculation methods, a patient shown as receiving 90 MME in one dataset might appear as receiving only 60 MME in another.

🧬 A 2024 NIH HEAL Initiative webinar acknowledged this inconsistency and introduce a new standardized calculator — but only for research purposes, not for clinical care.

🔗 Watch the webinar

The NIH team emphasized:

“This tool should not be used in healthcare settings. It is for research only.”

🚨 So What’s the Problem?

We’re using MME as the basis for prosecution, policy, coverage, and clinical judgment — even though:

• MME is based on outdated and inconsistent conversion ratios

• There is no universal formula

• The NIH and CDC both warn against using MME for individualized clinical care

And yet, patients are being cut off, doctors are being criminalized, and lives are being lost — all because of arbitrary numbers.

This isn’t science. It’s a math trap.

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6️⃣ The Real-World Consequences: What Happens When MME Is Misused?

While debates over MME may seem academic, the impact on real patients has been devastating. When policymakers treat MME like a precise science — instead of the blunt, inconsistent tool it is — patients pay the price.

💔 Patients Are Being Abandoned

Doctors fear disciplinary action, lawsuits, or arrest simply for prescribing above an arbitrary MME threshold. The result?

• Patients with long histories of stable, effective opioid therapy are being forcibly tapered or cut off entirely.

• Elderly and disabled patients are told they’ve suddenly become “high risk” after years on the same dose.

• People in pain are pushed toward alternatives that don’t work for them, or worse — toward illicit street drugs.

🧠 “My doctor told me they had no choice. The computer flagged me for being over 90 MME. I’ve been on the same dose for 12 years without a single issue.”
— Patient, 68, with degenerative spine disease

⚖️ Criminalization of Medical Care

MME has become a weapon in criminal cases:

• Doctors have been prosecuted for “high-dose” prescribing, even when they were following accepted standards of care.

• Pharmacies and providers face civil or criminal liability for simply filling or approving prescriptions above certain thresholds.

• In some cases, the MME was miscalculated — but the damage was already done.

🔗 DOJ Lawsuit vs. CVS– High MME Lawsuit

🧪 Research Misapplied to Clinical Care

The 2024 NIH MME Calculator clearly warns against using its tools in clinical practice. But the reality is:

• PDMP vendors, insurers, and regulators often repurpose these formulas anyway.

• The new NIH system excludes acute pain and opioid use disorder, and it doesn’t apply to medications like Suboxone — raising serious concerns about double standards.

• Even the developers acknowledged the data behind MME is shaky at best:

🗣️ “We don’t have great primary source data. That’s why we need better research.”
— Dr. Meredith Adams, NIH HEAL Initiative Webinar (2024)

🚨 And Still — No Accountability

Despite widespread misuse of MME:

• No federal agency has taken meaningful action to stop forced tapers or patient abandonment.

• No clear guidance has been issued to remove MME thresholds from PDMPs or regulatory policy.

• No apologies or reparations have been made to the millions harmed by bad policy.

In fact, the opioid elimination industry is growing — bolstered by addiction medicine experts and litigation consultants who profit from the very thresholds they helped establish.

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7️⃣ Selective Use of MME: Pain vs. Addiction Treatment

💊 One Standard for Pain Patients, Another for Addiction Treatment

MME thresholds are enforced rigidly in pain care — yet they’re completely ignored when it comes to medications for opioid use disorder (MOUD).

Patients taking full agonist opioids (like oxycodone or morphine) are subject to strict limits, surveillance, and forced tapering. But those on partial agonists like Suboxone (buprenorphine/naloxone) face no such scrutiny — even though buprenorphine is an opioid, too.

🔍 Examples of MME Hypocrisy:

• Full agonists:

  • Must be kept under 90 MME/day in many states.

  • Prescribers face discipline for exceeding this dose.

  • Patients flagged in PDMPs for being “high risk.”

• Buprenorphine (e.g., Suboxone):

  • Often excluded from MME calculations.

  • Can exceed 100+ MME based on equivalency estimates — without consequence.

  • Promoted for long-term use, even off-label for pain.

📄 NIH & CDC warn against using MME to guide individual care — yet these rules are selectively applied depending on the drug and the diagnosis.

⚖️ Two Systems of Care
MME rules punish pain patients while addiction medicine is granted flexibility and prescriber protection. This double standard isn’t just unfair — it’s dangerous.

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8️⃣ The New NIH “Research-Only” MME Calculator

🧪 A New Formula — But Only for Research

In 2024, the NIH HEAL Initiative released a new tool: a standardized MME calculator for use in opioid research. The goal?
To create consistency across studies of opioid prescribing, use, and safety.

But there’s a catch:

“This tool should not be used in healthcare settings. It is for research only.”
— NIH HEAL Initiative Webinar, 2024
🔗 Watch the Webinar (YouTube)

Despite being the most rigorously designed MME model to date, the NIH tool is explicitly restricted to research purposes. Even its developers warn it should not guide medical care, policy, or law.

⚠️ So Why Are We Still Using MME in Clinical Practice?

While NIH urges caution, healthcare systems continue to:

• Use MME thresholds to deny medications

• Require prior authorizations for patients exceeding 90 MME

• Flag doctors for investigation or prosecution based on “high MME” levels

• Label stable patients as “high risk” — without regard for their outcomes, function, or quality of life

🔍 The NIH Calculator vs. Real-World Use:

Feature	NIH Calculator	PDMPs / Insurers / EHRs
Purpose	Research only	Clinical surveillance
Standardized?	Yes	No — varies by system
Transparent?	Yes	Often proprietary or hidden
Includes Suboxone?	No	Sometimes unclear
Considers OUD treatment?	No	Often excluded

Even though the NIH calculator avoids using MME for patient care, the rest of the system continues to enforce outdated and inconsistent thresholds — with no standardized formula and no patient-centered flexibility.

📣 NIH’s Own Words

In the webinar unveiling the tool, NIH researchers acknowledged the limitations of existing data and the misuse of MME:

“We don’t have great primary source data. That’s why we need better research.”
— Dr. Meredith Adams, NIH HEAL Initiative

So why are laws, insurers, and prosecutors still treating MME as a gold standard?

💬 The Bottom Line: The most advanced MME tool available isn’t even allowed in patient care.

Meanwhile, millions of people are being judged, denied, and harmed by crude, inconsistent systems built on outdated formulas.

Until the system stops treating MME as law — while simultaneously ignoring its flaws — we can’t begin to fix the damage.

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9️⃣ How DOJ and Law Enforcement Weaponize MME

🚨 “High MME” = Criminal Suspicion

Once the CDC’s 2016 guideline introduced 90 MME as a red flag, law enforcement agencies began using it as a proxy for criminal behavior — despite the lack of scientific support.

Rather than evaluate each case based on patient outcomes or context, prosecutors began citing high MME prescriptions as inherently dangerous — even in the absence of harm, diversion, or fraud.

⚖️ DOJ Lawsuits Use MME as Evidence of Wrongdoing

In the landmark 2021 case United States v. Walmart Inc., CVS Health Corp., and Walgreens Boots Alliance, the Department of Justice cited MME thresholds as evidence of unlawful conduct.

The civil complaint states:

“Pharmacists filled prescriptions for opioids exceeding 90 or 120 MME per day — doses that were inconsistent with legitimate medical practice and indicative of diversion or abuse.”
🔗 DOJ Lawsuit (2021), Page 98 – PDF Archive

But here's the problem:

• These MME thresholds were not based on science, as acknowledged by the FDA.

• No consistent formula exists for calculating MME.

• Many flagged prescriptions were written by licensed providers for stable, long-term patients.

And yet, high MME alone was used to suggest criminal intent — even without patient complaints, overdoses, or violations of law.

📉 Doctors Prosecuted, Patients Abandoned

The chilling effect has been profound:

• Physicians have been indicted or had their licenses revoked based solely on the volume or MME level of prescriptions.

• Clinics serving high-needs populations were shut down.

• Patients lost access overnight, with no safe tapering plans — pushing many toward illicit drug markets or suicide.

These prosecutions are often celebrated as victories against “pill mills,” but in many cases, they target evidence-based medical care for people with severe, persistent pain.

❗ The Consequences

Using MME as a legal tripwire allows agencies to:

• Sidestep medical nuance

• Ignore patient outcomes

• Substitute math for medicine

Even as the CDC walks back its rigid thresholds, law enforcement has not updated its playbook — and pain patients are caught in the crossfire.

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🔟 Policy Hypocrisy: Buprenorphine, Bias, and Enforcement Gaps

⚖️ MME Rules for Some — But Not for All

If Morphine Milligram Equivalent (MME) thresholds are supposed to protect patients from overdose, why are they applied only to some opioids — and not others?

Why are stable pain patients flagged as dangerous, while buprenorphine (also an opioid) is exempt from the very same scrutiny?

This isn’t just a scientific inconsistency. It’s a policy double standard — one that favors addiction medicine models while punishing pain care.

🔄 Same Drug Class, Different Rules

Buprenorphine is a partial opioid agonist, but it’s still an opioid — with real risks and significant withdrawal potential.

In fact, studies and patient experience show that buprenorphine can be:

• Harder to taper than full agonists like morphine or oxycodone

• Less effective for treating chronic pain

• Associated with dental decay, hormonal effects, and other complications

Yet in policy:

✅ Buprenorphine is heavily promoted for opioid use disorder (OUD)
✅ Often used off-label for chronic pain
✅ Excluded from most MME calculations and PDMP red flags

Meanwhile:

❌ Pain patients on full agonist opioids face tapering, surveillance, or abandonment
❌ Elderly, cancer, and palliative care patients are flagged as “high risk” based on MME
❌ Providers are criminalized for prescribing medications that buprenorphine may not replace

🧪 The Evidence Problem

If one justification for MME thresholds is that “opioids haven’t been studied long-term,” then what about buprenorphine?

• Suboxone (buprenorphine/naloxone) was approved for OUD after three short-term trials — all under 24 weeks

• Belbuca (buccal buprenorphine) was approved for chronic pain based on 12-week trials

• Butrans (patch) was approved for chronic low back pain with trials lasting 12 weeks or less

There are no long-term randomized controlled trials proving that buprenorphine is safer or more effective than full agonists for chronic pain — yet it’s now the default substitute being pushed on patients who were stable on other medications.

📣 It’s Not About Safety. It’s About Narrative.

This isn’t about putting one medication against another. It’s about recognizing how policy has been manipulated:

• “Full agonists are too risky” — except when they’re buprenorphine

• “Long-term opioid use is harmful” — unless it’s lifelong Suboxone

• “We need to reduce MME” — but don’t count buprenorphine, even when used for pain

This double standard doesn’t protect patients. It punishes them.

It allows systems to cut costs, avoid liability, and serve political talking points — while claiming to follow science.

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 Call to Action: Stop Using MME to Punish Patients

📉 MME was created to help clinicians rotate opioids — not to control policy, prosecute doctors, or dictate who gets pain relief.

But today, this unscientific, inconsistent number is being used to:

• ❌ Cut patients off their medications

• ❌ Flag doctors as criminals

• ❌ Deny coverage through insurance

• ❌ Justify prosecution, licensing action, or dismissal from care

And all of it is based on an arbitrary threshold that major health agencies now admit is flawed.

🚨 We’re Not Asking for Special Treatment — We’re Asking for Evidence-Based Policy

If MME isn’t reliable, then it shouldn’t be the foundation for life-or-death decisions.
If long-term opioid therapy is going to be restricted, then the same standards must apply to all opioids — including buprenorphine.
If agencies admit MME should not guide individual care, then it must be removed from:

• PDMP risk scores

• Insurance prior authorization rules

• DOJ and DEA enforcement protocols

• EHR alerts and automated flags

• Medical board and state laws

🧠 Science, Not Surveillance

The NIH, CDC, and even some addiction medicine leaders now admit the obvious:

✅ There’s no standard MME formula
✅ The 90 MME threshold was never evidence-based
✅ Forced tapering causes harm
✅ Chronic pain care cannot be guided by math alone

So why is this system still in place?

The answer: liability fears, and politics.
But patients deserve better — and so do the doctors trying to treat them.

✊ Join the Movement

At DPF, we’re calling for:

✔️ Immediate de-implementation of MME thresholds in PDMPs, state laws, and EHRs
✔️ HHS guidance prohibiting forced tapering and requiring individualized care
✔️ Regulatory reform to ensure PDMP and NarxCare algorithms are transparent, validated, and not used to discriminate
✔️ Equal scrutiny of buprenorphine and other MOUDs when used for pain
✔️ Funding for reversal — not just rollout — of harmful opioid reduction policies

This is not a fringe issue. This is a public health emergency — and one that demands immediate attention.

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