Health officials call for less aggressive treatment of pain

In a sign of growing alarm about painkiller addiction, a group of U.S. state health officials, doctors and consumer advocates is calling for a stricter approach to treating pain in hospitals and clinics.

The group of 60, including senior health officials from Pennsylvania, Vermont, Alaska and Rhode Island, is recommending new guidelines for pain treatment, saying current standards are too aggressive and contribute to overuse of addictive painkillers.

In a letter sent Wednesday to the head of the Centers for Medicare and Medicaid Services, the group urges the agency to stop surveying patients about how well their pain was controlled while in the hospital, a set of questions the agency uses to help judge hospital performance and determine payment. The group argued that the pain questions “have had the unintended consequence of encouraging aggressive opioid use” because hospitals aim for high scores on the surveys.

CMS said it would respond to the letter. It added that the Department of Health and Human Services, which oversees CMS, already announced in October it would review how hospitals’ patient satisfaction surveys influence pain treatment and opioid prescribing.

In a separate letter, the health officials and doctors are asking a nonprofit body that accredits hospitals and clinics to “re-examine” the pain management standards it requires its accredited institutions to follow. The letter to the president of the Joint Commission, a body funded by the health-care industry, says these standards “encourage unnecessary, unhelpful and unsafe pain treatments.”

The letters add to a growing chorus of concern about addiction to prescription opioid painkillers and heroin, a chemically similar drug. President Barack Obama and members of Congress have proposed measures to combat the crisis, which health officials say is causing more Americans to die from drug overdoses than from traffic accidents.

The Joint Commission standards for treating pain, adopted in 2001, require hospitals and clinics to assess and manage pain as part of their routine care. The Joint Commission developed the standards amid concern in the 1990s that too many doctors and nurses were neglecting pain, David Baker, executive vice president of the Joint Commission, said.

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