Achieving Balance in State Pain Policy (2013)

Click to access prc2013.pdf

Pain & Policy Studies Group
University of Wisconsin School of Medicine and Public Health
Carbone Cancer Center
http://www.painpolicy.wisc.edu

Jul 2014

Influence of Drug Abuse Control Policy (Page 11)

Such policies are intended to prevent illicit trafficking, drug abuse, and substandard practice related to prescribing and patient care. However, in some states these policies go well beyond the usual framework of controlled substances and professional practice policy, and can negatively affect legitimate healthcare practices and create undue burdens for practitioners and patients, resulting in interference with appropriate pain management. Examples of such policy language include:

-Limiting medication amounts that can be prescribed and dispensed for every patient,
-Unduly restricting the period for which prescriptions are valid;
-Unconditionally denying treatment access to patients with pain who also have a history of substance abuse;
-Requiring special government-issued prescription forms only for a certain class of
medications;
-Requiring opioids to be a treatment of last resort regardless of the clinical situation,
-Using outdated definitions that confuse physical dependence with addiction; and
-Defining “unprofessional conduct” to include “excessive” prescribing, without defining the
standard or criteria under which such a determination is made.

Further, policies that have been recommended to encourage appropriate pain management are frequently absent from state policies. For example, some states have not yet adopted policies recognizing that:

-Controlled substances are necessary for the public health (as does federal law);
-Pain management is an integral part of the practice of medicine…
-The legitimacy of a practitioner’s prescribing is not based solely on the amount or duration
of the prescription…
-Physicians should not fear regulatory sanctions for appropriately prescribing controlled
substances for pain…
-Physical dependence or tolerance are not synonymous with addiction…

This is the last report from this organization, which has apparently lost its funding.