Roll Back of Aggressive Pain Management Rules Recommended by State Health Officials

(Newswire.net — April 13, 2016) Las Vegas, Nevada — In an effort to reduce overprescribing of opioid pain relievers, dozens of health care organizations, medical experts and consumer advocacy groups sent petitions today to the Joint Commission, an agency that accredits health care organizations, and to the federal agency that oversees Medicare. Co-signers include senior health officials from Pennsylvania, Vermont, Alaska and Rhode Island as well as heads of professional organizations including the American Society of Addiction Medicine. Petition signers are requesting changes to pain management requirements they believe foster dangerous prescribing practices.

Over the past 20 years, prescriptions for opioid painkillers have soared, leading to an epidemic of opioid addiction, rising heroin use and a record high rate of overdose deaths. Opioid prescribing increased in response to a multifaceted campaign, which called for pain to be treated as if it was a vital sign, a measure of essential bodily function, which includes temperature, breathing rate, blood pressure and pulse. In 2001, the Joint Commission introduced pain management standards requiring health care organizations to ask every patient about pain, leading to use of pain patient scales and hospital policies requiring aggressive pain management. In their letter to the Joint Commission, petitioners wrote that mandatory pain assessment in all patients and in all medical settings is “unwarranted and can lead to overtreatment and overuse of opioid analgesics”. A recent study found that physicians prescribed opioids, often in high doses, in more than half of 1.14 million nonsurgical hospital admissions.

The petition sent to the Centers for Medicare and Medicaid Services (CMS) calls for removal of the pain questions from HCAHPS, the agency’s patient satisfaction survey used for determining hospital reimbursement rates. In their letter to CMS, petitioners wrote “Aggressive management of pain should not be equated with quality healthcare as it can result in unhelpful and unsafe treatment, the end point of which is often the inappropriate provision of opioids.” The petitioners believe that linking hospital reimbursement to patient satisfaction with pain treatment results in overprescribing of opioids. “As health professionals we have a duty to relieve pain and suffering but these rules are causing us to overdo it. We’re harming patients and fueling an addiction epidemic,” said Dr. Anna Lembke, Chief of Addiction at Stanford University School of Medicine.

Dr. Mel Pohl, Medical Director of LVRC, supports this petition. “Opioids are appropriate treatment for acute pain, but not for being sad, angry, or lonely. These potent drugs have inadvertently ruined many lives in a misguided attempt to relieve suffering. I applaud these efforts and readily signed this letter.”

CMS is also under pressure from Congress to de-link hospital reimbursement from patient satisfaction with pain management. A recently introduced bill called the PROP Act would end use of pain management questions from factoring into Medicare reimbursement calculations. The PROP Act is receiving bi-partisan support in the House and Senate and has been endorsed by the American Medical Association and other professional organizations.