NEW YORK—State regulators and medical boards are adopting new pain management policies favorable to physicians and patients even at a time when drug abuse issues are at the forefront of national attention, according to policy researcher Aaron M. Gilson, PhD.
"Government and regulatory policy to encourage pain management in the United States has increased at a phenomenal rate," said Dr. Gilson, assistant director of the University of Wisconsin Comprehensive Cancer Center Pain & Policy Studies Group (PPSG), Madison.
The PPSG report Annual Review of State Pain Policies: 2001, released at a media briefing held by the American Medical Association, shows that state pain policies easing constraints on use of opioid analgesics are being adopted at a steady rate. In 1989, the PPSG identified only six state policies addressing appropriate use of controlled substances for pain; in 2001, there were more than 80 in 44 states.
"It appears that state health care regulatory boards continue to recognize that pain management needs to be encouraged, that physician concerns about investigation and discipline do need to be addressed, and that effective patient care needs to be maximized," said Dr. Gilson, describing the findings of the report.
Notably, the 2001 review showed that, for the first time, policies are being drafted that contain explicit statements that efforts to control drug abuse and diversion must not interfere with patient care. "We are especially pleased to see that West Virginia had such a policy in 2001, despite this state being involved in recent drug abuse issues," Dr. Gilson said.
In addition, the PPSG did not identify any "panic policies" developed in 2001—in other words, policies designed to address the drug abuse issue but instead result in restrictions in the use of these substances for the treatment of pain.
However, according to Dr. Gilson, many policies contain language that can impede pain management. "They contain language that can restrict medical decisions, increase physician concerns about regulatory scrutiny, and, ultimately, impede patient access to effective pain relief," he noted. Only two states—Alabama and Maine—do not have any regulatory policies with restrictive language.
