Pain Management Resources
Feature Focus
Alex Cahana testifies before Senate panel on prescription-painkiller abuse epidemic
(The following is an adaptation of the article 'Senate panel struggles to get pain treatment right' by John Reichard, CQ HealthBeat editor, that appeared in CQ.com, March 23, 2012.)
Alex Cahana, UW professor of anesthesiology and pain medicine, was among the witnesses who testified at a Senate hearing Thursday addressing the national epidemic of prescription-painkiller abuse.
Lawmakers said the testimony would help guide Medicare and Medicaid officials in developing new measures to help curb the abuse of pain treatments, such as hydrocodone and oxycodone, as well as anti-psychotic medications.
Sens. John D. Rockefeller IV, D-W.Va., and Charles E. Grassley, R-Iowa, said that abuse of the drugs harms patients and their families and drains Medicare and Medicaid financially by making the programs the target of fraud. Rockefeller has introduced legislation (S 507) to better educate patients about prescription drug abuse and better train doctors about prescribing controlled substances.
Cahana, chief of the Division of Pain Medicine, said doctors need to move away from simply prescribing painkillers.
“Take care of the disease, and the pain goes away,” he said. “However, when pain becomes the disease, when there is nothing broken to fix, [no] infection to cure or tumor to operate upon, treating pain as a symptom doesn’t work. It actually makes things worse,” he said. “This is why we are seeing so much harm with prescription pain drugs.”
“There is virtually no evidence,” Cahana said, “that high-dose opioids relieve pain or improve function in chronic noncancer pain,” and “there is growing evidence that shows that opioid treatment over 90 days is usually a commitment for life.”
Since November 2008 the UW Medicine Pain Center has used a patient assessment and screening tool during every clinical encounter, he said. The tool allows patients to describe how pain affects key aspects of their lives, including the way it interferes with essential activities. It also assesses the status of the patient’s physical functioning and his sense of emotional well-being.
Read the entire article at CQ.com (subscription required) or watch the hearing.
Spokane County Medical Society
Washington State Medical Association
- Pain Management Guidelines
- Question and answer summary of the new MQAC rules [PDF]
- MQAC Rules for the Management of Chronic Non-Cancer Pain [PDF]
- Decision Chart - CME for MQAC Pain Rules [PDF]
Washington State Department of Health
- MQAC Pain Management Website
- Requesting Patient Prescription Information from Prescription Review (WA State Prescription Monitoring Program) [PDF]
- Rules concerning management of chronic noncancer pain
American Medical Association
- Pain Management Series
- EPoCH CME: Prevention of Prescription Drug Misuse and Diversion (American Medical Association)
University of Washington
CME Courses
- The Medical Quality Assurance Commission Pain Rules: What Washington State Physicians Need to Know…and All Prescribing Physicians Will Benefit From (Physicians Insurance e-learning)
- COPE - Collaborative Opioid Prescribing Education (UW School of Medicine)
- Opioid Dosing Guideline and DOH Pain Management Rules Online CME Activity (WA DOH Agency Medical Directors' Group)
- EPoCH CME: Prevention of Prescription Drug Misuse and Diversion (American Medical Association)
- Project ROAM Upcoming CME and Webinar Courses
- Washington State Osteopathic Association, Pain Management Update for the Primary Care Provider, April 21, 2012
