Making Pain Relief a Reality for Cancer Patients in Four States

Improving pain management policies through the collaboration of clinicians, regulators, and law enforcement

Field of Work: Improving pain management for cancer patients

Problem Synopsis: More than half of all cancer patients have unrelieved pain. Opioid analgesics have a critical role in management of moderate to severe pain, and in restoring quality of life and functional status. Opioids, however, can be abused. As a result, their production and distribution is regulated.

Synopsis of the Work: In 2002, the Alliance of State Pain Initiatives engaged with the American Cancer Society to ensure that pain management became a core perpetual component of the society's mission. The alliance's focus shifted to collaboration at the divisional and state levels of both organizations over the next few years.

From 2004 to 2007, staff concentrated on working with providers, advocacy organizations and regulatory and law enforcement officials in Florida, New York, Texas and Wisconsin to create a balanced regulatory climate for opioid use and thus reduce barriers to effective pain control.

Key Results: Project staff reported the following state-by-state results in reports to RWJF:

Florida: The project team worked with the Florida Pain Initiative to:

  • Establish the Florida Pain Coalition, an interdisciplinary group of 15 health care organizations working to improve pain management throughout the state.
  • Convene a 2006 statewide pain summit aimed at improving pain education and promoting professional and public awareness of pain's prevalence and impact.
  • Promote development and dissemination of a Joint Statement on Pain Management from the Florida Boards of Medicine, Nursing, Osteopathic Medicine and Pharmacy in 2005.

Texas: The project team helped the American Cancer Society Texas Cancer Pain Initiative to:

  • Convene a 2006 statewide pain summit to foster dialog between health care professionals, regulatory officials and representatives of examining boards about creating a balanced regulatory system. A report on the summit is titled The Politics of Pain: Balancing Vigilance and Compassion. Conduct two surveys-one of Texas residents and another of health care professionals-regarding the prevalence and impact of chronic pain in Texas, and the attitudes towards it. Key findings included:
    • Nearly half of adult Texans experience pain at least monthly, and one in five feel pain every day.
    • At least one out of every five Texas physicians reported that they do not routinely assess their patients' pain.

Wisconsin:

  • The team worked with state examining boards on the adoption of position statements encouraging their constituencies to practice pain management with patients, and to recognize the use of opioids for pain management as part of medical and pharmacy practice. The boards were:
    • The Pharmacy Examining Board of Wisconsin.
    • The Medical Examining Board of the State of Wisconsin.
    • The Wisconsin Board of Nursing.

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