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Barriers To Effective Pain Management Still Remain In States

Armen Hareyan's picture

New report on pain management shows seven states have improved Pain Policies in the Last Year, but some barriers still remain.

States continue to make steady progress in adopting balanced policies that help people with pain to alleviate their suffering, according to a report released today that evaluates state policies to improve pain management and patient care. However, only five states have received a grade of 'A' for enabling health care professionals to effectively alleviate the suffering of their patients without encountering barriers in legislation or regulation.

The report, "Achieving Balance in State Pain Policy: A Progress Report Card," was prepared by the University of Wisconsin Pain & Policy Studies Group (PPSG) and jointly funded by the nation's leading information and advocacy groups for people with cancer: the American Cancer Society, the Lance Armstrong Foundation (LAF) and Susan G. Komen for the Cure®.

PPSG researchers evaluated whether state pain policies and regulations enhance or impede pain management. The report assigns each state a grade from 'A' to 'F' that reflects the quality of its pain policy. PPSG also evaluated state pain policies in 2000, 2003, 2006 and 2007 to determine what changes have been made over time. The results from this year's report show continued momentum for positive policy change during the last year.

Highlights of the 2008 Grades
* Seven states (Georgia, Maine, Minnesota, Oregon, Rhode Island, Utah and Washington) had policy change sufficient to improve their grade.
* Oregon received an A, joining Kansas, Michigan, Virginia, and Wisconsin with the highest grades.
* Georgia showed the largest grade improvement, increasing from a D+ to a B.
* Forty-four states now have a grade above C.
* The five states achieving an A comprise 10 percent of the total U.S. population. States with a B or B+ make up approximately 50 percent of the U.S. population. Another 39 percent of the U.S. population lives in the 18 states that have a grade of C or C+.
* No state's grade decreased.

"A growing number of state health care regulatory agencies have recognized the importance of adopting policies that encourage pain management, palliative care and end-of-life care," said Aaron Gilson, Ph.D., director of the U.S. program of the PPSG. "However, states need to continue to eliminate restrictive or ambiguous legislative language in order to improve pain management for patients with cancer, HIV/AIDS and other diseases."

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"The results of PPSG's research show a very encouraging improvement in state pain policies, but more needs to be done to effectively address the national health crisis of undertreated pain," said John R. Seffrin, Ph.D., CEO of the American Cancer Society. "States must effectively inform the medical community about improved pain policies so people with pain can benefit from them. Patients, health organizations, health care professionals, regulatory officials, licensing boards, and policymakers all have a role to play to promote a balanced approach to pain control policy and practice."

"Cancer survivors deserve to have their pain managed effectively so that they can focus on living life on their own terms," said Doug Ulman, president of the LAF. "We must ensure that policies are in place to help people obtain medical care to promote the highest quality of life possible. We know that many states still have work to do to remove barriers to effective pain management, and we are proud to join in that critical work."

"Effective treatment of pain is a key element in ensuring a good quality of life for cancer patients and other people faced with life-threatening illness. We are committed to making sure remaining barriers to effective pain management are removed and that health care workers are adequately informed of recent policy changes that can positively impact the lives of their patients," said Hala Moddelmog, president and CEO of Susan G. Komen for the Cure.

Balanced Policies Necessary

Pain is the most common reason Americans access the health care system and is the leading contributor to health care costs. Most painful conditions can be relieved with proper treatment, yet people in pain often face significant barriers that can prevent proper assessment, diagnosis, treatment and management of their pain. Untreated pain can devastate a person's quality of life, affecting all aspects of daily functioning, including sleep, work, and relationships.

While there are several effective medications and non-drug therapies available for pain treatment, opioid pain medications are often the best treatment for managing serious, persistent pain. But health professionals can be reluctant to prescribe such medications because of the risk of violating laws aimed at preventing trafficking and abuse of controlled substances. Such policies can unduly restrict healthcare decision-making, contradict current medical knowledge, and fail to communicate appropriate messages about pain management and using pain medications.

The complete report, Achieving Balance in State Pain Policy: A Progress Report Card (Fourth Edition) is available at the University of Wisconsin's Pain and Policy Studies Group Web site.

About the Pain & Policy Studies Group
The U.S. Program of the University of Wisconsin's Pain and Policy Studies Group (PPSG) is headed by Aaron M. Gilson, PhD, an expert on pain control policy who implemented a first-of-its-kind study in 2003 comparing pain policies throughout the country. The results of that study, reported in Achieving Balance in State Pain Policy: A Progress Report Card, showed that more than half of all states had policies that encouraged pain management, addressed physicians' fears of regulatory scrutiny and drew distinctions between physical dependence or tolerance and addiction. However, most states also had restrictive or ambiguous policies that could create barriers to the effective treatment of pain.