Pain Task Force Releases Its Final Report

Pain Task Force Releases Its Final Report

Now we’ll see what happens. The chronic pain community has been very loud in its demand for a better federal approach to treating pain.

The latest attempt is now public.

The Pain Management Best Practices Inter-Agency Task Force, a federal advisory committee established by the Comprehensive Addiction and Recovery Act of 2016 released its final report Thursday on acute and chronic pain management best practices, calling for what the HHS described as a balanced, individualized, patient-centered approach.

The Task Force final report underscores the need to address stigma, risk assessment, access to care and education. It also highlights five broad categories for pain treatment: medications, interventional procedures, restorative therapies, behavioral health, and complementary and integrative health approaches.

“There is a no one-size-fits-all approach when treating and managing patients with painful conditions,” said Vanila M. Singh, M.D., MACM, Task Force chair, and chief medical officer of the HHS Office of the Assistant Secretary for Health. “Individuals who live with pain are suffering and need compassionate, individualized and effective approaches to improving pain and clinical outcomes. This report is a roadmap that is desperately needed to treat our nation’s pain crisis.”

The Task Force was created during a national opioid epidemic, but also at a time when an estimated 50 million adults in the United States experience chronic daily pain. As such, the report emphasizes safe opioid stewardship by recommending more time for history-taking, screening tools, lab tests, and clinician time with patients to establish a therapeutic alliance and to set clear goals for improved functionality, quality of life, and activities of daily living. Medication disposal and safe medication storage are also emphasized for patient safety.

The report includes a section highlighting disparities and unique challenges faced by special populations, including veterans, active military, women, youth, older adults, American Indians and Alaska Natives, cancer patients and those in palliative care, and patients with sickle cell disease and other chronic, relapsing painful conditions.

The U.S. Pain Foundation—the nation’s largest pain patient advocacy group, told its members in an email: “Getting Congress to pay attention is vital. To do that, we need you to flood your legislators with emails and calls. It’s especially important we reach out to members of the Senate Health, Education, Labor, and Pensions Committee and members of the House Energy and Commerce Committee’s Health Subcommittee.”

We invite you to read the report and push your Congressman and Senator to listen. You can use this form to contact them.

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Ed Coghlan

28
Leave a Reply

2000
28 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
27 Comment authors
  Subscribe  
newest oldest
Notify of
Signe Topai

Ed you are a true blessing to the chronic pain community! Thank you! Due to a recent break in and my meds stolen from my lockbox, I took a printed copy of the task force recommendations on not doing forced tapering to my doctor’s appointment.
My dear chronic pain patient take the bull by the horns and be your biggest advocate. It my take months or years before doctors get info. Print it! Take it in with you! For myself, I never what to be turned away from Urgent care again or hear “this is our policy”! Fight for your rights. We must blast officials with letters and emails. We can due this!

thomas

How long do we as voting constituents wait for people with no medical background, and no knowledge of pain and its daily restrictive agony that we are now forced to live with to fix the mess they have caused. Alcohol is by far causing more agony and death ,than pain limiting medications taken responsibly, and costing more gold by weight. For twenty years I had no problems with pain reducing medications , other than disabling pain spikes that would flair up. Now that I am elderly I am forced to live without adequate medication for the remainder of my life ,which I can tell you this , it is getting old , no damn pun intended , and if their intention was to have me roll over and quietly die , they are close to achieving their goal….

Rosalind Rivera

It’s a good yet feeble beginning. How long will we pain victims have to continue not to live but to merely exist before our pain issues are validated with the actual decision to treat us as we need and deserve to be treated, with actual pain solutions including pain medications as needed by the individual. We need relief now, not in the many months that it will take to intelligently arrive at the knowledge and decision to institute laws now that will ease our notorious, intractable and life consuming pain. There should at the very least be a temporary solution to bridge now and when final institutes of pain relief are finalized. Let our physicians make the decision to treat his or her patient as he sees and knows the needs of the individual and the community much better that’s the paper shufflers.

Thank you Ed for this update.
Thank you Red Lawhern for your awesome post, as always, and for never giving up fighting on your family and our behalf. You are a blessing to us all.
I read the task report and still felt jaded. It still goes on about the ‘opioid crisis’! Geez! This is about us and The Pain Crisis!
And the recommendations thus far are not satisfying to our community whatsoever. As Red stated… It’s just baby steps. So let’s keep strong,fight and pray hard until it is ‘adult steps’ in our favor… To bring things back as they once were, if ever possible. Maureen M.

Laurie

Thanks Red, for trying to help us. We sure need it

Gail Honadle

My US REP could careless he’s to busy with Photo ops, how many businesses can you visit in a week and do any work; senator 1 is retiring, 2 is a former Rep doesn’t care, State is Adjourned till January and they don’t care either.

So now what? Are our doctor’s going to be sent copies of this to read? Are they going to be allowed to practice medicine the way they used to 3 years ago? I heard back from Senator Lamar Alexander last week. He stated what bills have been signed and by who and how much money has been spent on the crisis. Everything I already knew. He did happen to say that our individual states we’re a much better candidate to handle this crisis versus Washington. I’m getting mixed signal all the way around, as usual.

FST

Ouch! I keep getting the message “sorry, internal error” when I try to submit. Darn technology and I don’t feel like trying the 5th time.

See, that’s the nature of chronic pain. How much we’ve lost because of it. Focus and tenacity are two of my losses.

Sigh

They will never get the dealers. I only care that I get what I need. And the Government & law enforcement is responsible for disquinguishing a damn thug & a 60 yr. old woman who is in pain from being hit by a truck!!! I have no shame at all I use meds to LIVE!! I’ll do whatever to live comfortably & not to sit crying in a chair.

Jeanette French

link is not working

Gina Bruton

What we need is for the government to get out of healthcare; which was and should be between the doctor and patient only. CDC needs to retract their erroneous guidelines completely. The DEA needs to stop interjecting themselves into healthcare as they are not doctors and have zero credentials to practice medicine. There is NOT and has never been an opiod crisis in prescription medicine. Overdoses are primarily related to heroin and illicit fentanyl. The overdoses that involved prescription meds were also associated with the use of alcohol, heroin, cocaine, fentanyl or illegally obtained prescriptions. Pain prescriptions are significantly decreasing, overdose deaths are rising, suicides are increasing due to patients being denied pain medication.
This approach has not and will not work.
Please return health care to pre 2016 CDC guidelines.

Walter Strickland

I appreciate the work but the government is the government.They can care less About us in the chronic pain community.Get your selves ready for the worse case scenario.If our government is will to let us suffer daily and not bat their eyes how can they be trusted to allow us to have the relief we desperately need.Their only concern is being able to say hey we are fixing this problem.When in fact the real problems on the streets are not being stopped.Again go after the honest law abiding people as is easier to make their numbers look good.While the whole time the pushers of heroin and fentanyl and other dangerous drugs ,these guys don’t worry about what the law says and is business as usual for them.

Reece

I appreciate the work. We have to get this word out to the Pharmacies and Insurance Companies. United Healthcare is the worst. They are ruining my life and believe it is their job to control everything regardless of what the doctor says. This is the worse situation I have seen in my lifetime. I am 74 years old and treated like a criminal. It is hard to believe this is America.

ElizabethR

The link to the form did not work for me–maybe for others as well. I will go ahead and contact my reps directly.

dave

The manifest function of this report makes no sense. Why create best practices in pain management which do not have to be followed or enforced? Like the reports on pain management paid by tax dollars by the NAS, AHRQ and NIH- it seems clear to me that Congress isnt interested in promoting new practices in pain management- other then reducing the amount of opioids prescribed to prevent diversion.
So the PMTF is really an effort by Congress and experts in govt and academia to reassert their dominance in pain care. As medicine also functions to allay anxiety regarding medical care- so to does the pmtf allay anxieties of Congress and experts regarding the current thinking in pain care. The PMTF is regressive and reflects past practices and breaks no new ground. It is jaundiced toward stem cells despite recently articles indicating some have been cured of hiv and sickle cell disease by their use. And this is at odds with DHHS goal of curing HIV and sickle cell disease- both of which are painful conditions.
As the old saying goes the more things change the more they remain the same. The PMTF is a thinly veiled effort of government to reinforce experts regressive, uninspired and uninspiring beliefs on pain care. It like the National Pain Strategy is likely to amount to nothing in the real world of pain care.

HOWARD

I WISH THE GOVERNMENT WOULD FEEL WHAT CHRONIC PAIN IS !!!! IT IS CONSTANT 24X7 !!!! IT IS NOT FUN. SO YOU HAVE TO LET OUR PAIN MANAGEMENT DOCTORS TAKE CARE OF US. OR YOU COULD LET ME HIT YOU IN THE BACK WITH A BASEBALL-BAT, AND NOT GIVE ANYTHING TO STOP THE PAIN !!!!!!!

Marsha

This is good news! Credible voices are speaking out for pain patients. I check this newsletter every day because it’s the only place where there are comments from people who sound like me. It’s reassuring to know lots of people are going through the same thing. I have to stay hopeful for my own mental health, otherwise life would just be too hard. Thank you Mr. Coghlan for your dedication writing this for us every day. It must get old and some days there may not be much news but there’s always something in my inbox! I know the legislators are tired of hearing from me, I write them about other topics also, but I will continue to push for common sense actions for pain management and opioid prescribing.

Jody Hoffman

As long as the DEA doesn’t come on board we are not going to see much change. The DEA was created to combat illegal drugs and they have spent a trillion dollars on the so called war on drugs & haven’t made a dent in it. The prescription opiate epidemic was created by them to justify their existence. They have a database that shows exactly what doctors are prescribing opiates & they went after them and while some illegal prescriptions were stopped they harmed more innocent legitimate pain patients then illegal ones. This is the new war on drugs & it’s easier to fight & prove that they are doing something.

In my view, the Task Force final report is progress — but it’s just baby steps and it likely won’t help anybody for years. The Task Force wimped out from doing what is needed most: they refused to challenge the CDC to outright withdraw the 2016 Guidelines, and Congress to repeal sections of public law which make the Veterans Administration “Opioid Safety Initiative” mandatory practice. As I said in my address during the last meeting of the Task Force, “DEA and State drug regulators are at least 50% of the problem” for patients being denied effective and safe opioid therapy.

This summer I will lobby Congress to incorporate as interim policy for CDC, FDA, DEA and DoJ, AMA Resolution 235 from the November 2018 meeting of the AMA House of Delegates.

“RESOLVED, that our AMA affirms that some patients with acute
or chronic pain can benefit from taking opioid pain medications
at doses greater than generally recommended in the CDC
Guideline for Prescribing Opioids for Chronic Pain and that such
care may be medically necessary and appropriate, and be it
further

RESOLVED, that our AMA advocate against misapplication of
the CDC Guideline for Prescribing Opioids by pharmacists,
health insurers, pharmacy benefit managers, legislatures, and
governmental and private regulatory bodies in ways that
prevent or limit patients’ medical access to opioid analgesia,
and be it further

RESOLVED, that our AMA advocate that no entity should use
MME (morphine milligram equivalents) thresholds as anything
more than guidance, and physicians should not be subject to
professional discipline, loss of board certification, loss of clinical
privileges, criminal prosecution, civil liability, or other penalties
or practice limitations solely for prescribing opioids at a
quantitative level above the MME thresholds found in the CDC
Guideline for Prescribing Opioids.”

You’ll hear more from me on this subject!

Pain is the issue the abusers are making us in pain carry there mistakes falls back on us not our fault doctors prescribed wrong people do we are paying for both we been forgotten falling through the cracks

LRH

I’m glad to see that the HHS Task Force Report has emphasized that a “one size fits all” mentality does not belong in the Pain Management world. Now, someone needs to tell the DEA because I still can’t get my medications above 90MME nor can I get my Benzodiazepines from my pain management doctor because he can no longer prescribe it for my CRPS if he prescribes my opioids for the pain. Without the Benzodiazepines, my flareups are so severe with no relief that I suffer with excruciating pain when I walk or try to climb steps of which are in every room in my house. The government has no idea what it is like for people who have so many pain causing chronic illness that have to be treated with other medications along side of the Opioids. I now have to find a psychiatrist to prescribe what I need to help with the most excruciating disease I have and I have 6 pain causing disease and a destroyed spine, joints, muscles and nerves. So, I’m glad this report is finally out, but someone has to push the DEA to read it because our doctors are running scared to prescribe what we need to have any quality of life and I’ve lived half of this year in bed and we’re only in May.

Gary Raymond

Finally, words that make sense: “Our nation’s pain crisis.”

Gail Honadle

That is the Problem They DON’T LISTEN. Michigan’s Top Medicaid Doc Over Prescribed Pain Meds, no mention of the type patient or condition. Cancer patients at Stage 3 require higher doses, https://www.detroitnews.com/story/news/local/michigan/2019/05/30/michigan-top-medicaid-doctor-accused-over-prescribing-opioids/1284722001/?fbclid=IwAR1MtjyKvV65EgJZLDqGlthpiQDqjsPRbDSxuqhmmDvvxIgk2yzq-hrwDYI The complaint alleges that Neff prescribed higher doses of opioids to some patients than recommended by the U.S. Centers for Disease Control and Prevention. The federal agency urges doctors to limit most patients to no more than 50 morphine milligram equivalents per day for most patients or “avoid or carefully justify” doses of 90 MMEs or more.

Arachnoiditis Spinal Injury from a bad surgery or Nerve Blocks requires high doses of Morphine. This is Canada, and we don’t hear a lot reported. Shannon MacLeod is DYING that is the main thing you need to know, but he is being TORTURED by his Government: Glace Bay man with incurable condition can’t find a doctor https://www.capebretonpost.com/news/local/glace-bay-man-with-incurable-condition-cant-find-a-doctor-174052/?fbclid=IwAR3Sf0zlH4a2Qsb4CQfx66NJ0EvMsVPpqgVU4bArYUJHfliEdVS-Q7ZkjpI

The Legislature in my own State of Tennessee is ADJOURNED until January.

Cathy Feldhausen

Tried to use your letter to send to my congressman. Not able to find my congressman. This is a new building that just opened in Sept/Oct 2018

David W Cole

Thanks Ed, all I’ve ever got back from these State officials is form letters telling me they’ll get back to me with a more prepared response later. LOL I’ve been waiting for about 2 years now. Now is the time to push hard that’s for sure.

Sherri

We must never give up hope…

Lady Mary Ellen

Last night my painndoc called me to drop kick me off his practice! He wished me the best.
So, am I healed? Does my arthritis and broken bones now go away? Does my fibromyalgia resolve cos he won’t serve? Do my 8 years with no dirty pee tests mean nothing? And all the payments to his practice mean nothing?
So, no, no, yes, yes, for the answers to my rhetorical questions. I know he sleeps at night. I do not.

Thomas Wayne Kidd

Thank you for this. But I still see that an imaginary opioid national crisis is still implied. The crisis was and still is the unrestrained influx of illegal drugs which was applied to chronic pain patients and others who had nothing to do with this mess. We have suffered and at the present time continue to suffer because of insane policies from the government and the medical field. When will the madness cease?