New Report: Utah Gets a B+ in Enacting Balanced Pain Management Policies for Cancer and Other Chronic Diseases

Utah is doing well, but needs improvement when it comes to enacting balanced policies that enhance the delivery of effective pain management for patients battling a chronic disease such as cancer, according to a new report issued by leading researchers and patient advocacy groups.

Nationwide, the findings showed that while states have made considerable progress over the last decade in enacting policies that enhance access to pain care, including the use of pain medications, and minimizing potential treatment barriers, this progress has slowed, and in some states declined, in recent years. The report gave Utah a letter grade of B+ in measuring the quality and balance of its policies to make pain treatment available to patients.

The report, Achieving Balance in State Pain Policy: A Progress Report Card (CY 2015), shows the extent that state policies can support pain management and patient care. The University of Wisconsin Pain & Policy Studies Group (PPSG) prepared the report, which was jointly funded by the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN).

“Utah is implementing sensible policies that make the treatment of pain available to people with cancer and other life-threatening diseases, but could do more. Through effective regulations we can continue to address the serious problem of untreated and poorly treated pain and, at the same time, establish a system to mitigate drug abuse,” said David Woodmansee, associate director of state and local campaigns for ACS CAN. “Patients, health organizations, healthcare professionals, regulatory officials, licensing boards and policymakers all have a critical role to play to promote a balanced approach to pain control policy and practice.”

PPSG researchers evaluated the content of state laws and regulatory policies to determine whether they could enhance or impede pain management. The report assigns each state a grade from ‘A’ to ‘F’ that reflects the quality of its policies that can influence patient pain care. States’ current grades are then compared to their grades from the 2013 and prior years to identify changes over time. According to the findings, Utah showed no change in effective pain policies over that time period. These grades are reflective of policies in place and don’t reflect actual practice, so patient experiences may be changing even if regulations aren’t, based on changing societal concerns about use of pain medicines.

Nationwide, the 2016 report found that while there is some continued improvement in states enacting policies that help ensure patients who need pain treatment have access to it, this progress is stalling and in some states even declining. Only six states changed or adopted new policies to improve access to pain management between 2013 and 2015, while five received worse grades than two years ago. The improvements that were seen are largely a result of state health care regulatory boards adopting policies to encourage appropriate pain management and state legislatures or regulatory agencies repealing restrictive or ambiguous policy language. On the other hand, declines are likely a result of well-intended policies to rein in opioid abuse that failed to consider the unintended consequences.

“There is a growing movement to rein in opioid abuse in this country, but we have to be careful when considering some of these stringent prescribing guidelines,” said Woodmansee. “While ACS CAN supports the effort to address this serious public health issue, it is critical that any measures put in place stress the need for balanced policies that do not impede access to pain relief for those who need it, such as people with cancer or other chronic diseases.

Pain is the most common reason Americans access the health care system, and it is the leading contributor to health care costs. Most painful conditions can be relieved with proper treatment, yet patients often face significant barriers that can prevent proper assessment, diagnosis, and treatment of pain. Untreated pain can devastate a person’s quality of life, affecting all aspects of daily functioning, including sleep, work and relationships. 

While an integrative approach to patient pain care utilizing medication and non-drug therapies is encouraged, opioid medications can be a beneficial treatment for managing serious, persistent pain in carefully selected patients. But health professionals can be reluctant to prescribe such medications for numerous reasons, including concern about unwarranted sanctions for violating laws governing health care practice. Such policies can unduly restrict healthcare decision making, contradict current medical knowledge, establish, ambiguous practice standards, and fail to communicate appropriate messages about pain management.

The complete report, Achieving Balance in State Pain Policy: A Progress Report Card (CY 2015) is available