Improving state pain policies: recent progress and continuing opportunities.
The National Institutes of Health reports that 100 million Americans suffer from chronic pain, including pain associated with the disease of cancer. Painful conditions can strike anyone, including cancer patients and cancer survivors. Unrelieved severe pain can limit a person's functioning and sometimes even destroy the will to live. When the quality of pain relief provided is inadequate, it is usually the result of failures to apply existing knowledge about pain and its treatment, including the appropriate use of opioids. But pain relief also can be affected by the regulatory environment and fear of being investigated for excessive prescribing. The importance of evaluating and improving policies governing pain management has been recognized by national and international authorities, including the Institute of Medicine and the World Health Organization. A pilot examination of state laws and regulatory policies demonstrated that they contained a number of outdated medical concepts and prescribing restrictions and did not contain key elements of law that can make pain management a priority for licensed medical practitioners. The Pain & Policy Studies Group developed a research program to evaluate US federal and state policy governing the medical use of pain medication. This article describes 3 national policy evaluations and how the results are being used to document improvements in state pain policies. An emerging role for clinicians and their professional organizations to improve their state's pain policies is discussed.
Gilson
Aaron M
AM
US Policy Research, the Pain & Policy Studies Group, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Joranson
David E
DE
Maurer
Martha A
MA
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence / Q000639:trends; D005069:Evaluation Studies as Topic; D033161:Government Regulation; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy* / Q000517:prevention & control; D011050:Policy Making; D013219:State Government; D014481:United States
D000701:Analgesics, Opioid