Does Implementing the National Pain Strategy at the State Level Make Sense?

Does Implementing the National Pain Strategy at the State Level Make Sense?

By Ed Coghlan.

When over 100 California thought-leaders and luminaries in pain management (physicians, payers, administrators, policy makers, etc.)  gather in Los Angeles November 2nd to develop a California Pain Strategy, they will hear from Christin Veasley.

Christin Veasley

Christin Veasley is an important voice in chronic pain—she’s co-founder and director of the Chronic Pain Research Alliance who has been working to attract more research to co-morbid pain conditions.

Chronic pain patients, and especially women, commonly have multiple sites and sources of pain. In other words, it’s not just one thing.

But research tends on focus on specific conditions: migraine, fibromyalgia, failed back surgery for instance and not enough research is being done to advance research on co-morbid chronic pain where patients have more than one type of chronic pain.

Veasley will bring that message to California as the group seeks to localize key recommendations from the National Institutes of Health’s National Pain Strategy in the Golden State.

Veasley, who has suffered from chronic pain since she was in a near-fatal accident in her teens, was on the oversight committee of the National Pain Strategy.

“Huge advocacy efforts on the part of the patients is needed,” she said. “Promoting and investing in rigorous multi-disciplinary pain research should be a priority.

The National Pain Strategy, which was developed with great fanfare, has been hard to implement because “it simply hasn’t been a national priority,” she said.

And she asks, “maybe the United States is too big to do this on a national level, so a key state or two like California could demonstrate that the basic tenets of the National Pain Strategy can work, and other states would follow.”

She believes the National Pain Strategy covers all the bases necessary to improve education about and treatment of chronic pain. She pointed out that over 70 organizations have supported it.

“The federal government’s investment in pain research over many decades has not been commensurate with its public health burden, so we find ourselves in this place,” she said. “We must do better.”

Her message in California will be that the National Pain Strategy is the right recipe for dealing with chronic pain and that efforts to implement it, even at the state level, make good sense for the chronic pain patients and their loved ones.  

Read Can California Lead the Way on Chronic Pain?

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Authored by: Ed Coghlan

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Janice…I could be the one writing your post. I was so stable until these guidelines! I also have sooooooo much anger at my pain Dr for not taking up patients! Take the damn hippocratic oath framed picture off the wall!!!!

Angie H

I read and for some re-read the comments. This is [edit]. Even in other states this has gone way to far. I am in WV but live in the what’s known as the panhandle (basically I can be in 3 other states in 30 minutes depending on road construction). I lived in Md when mine started and had to move because we couldn’t afford our place on 1 income. Its cheaper to live in WV but still close enough to my doctors to travel to 45 min- hr drive every mth. I have CRPS/RSD because of a hospital screw up. I did win in court but didn’t come close to enough to cover me for 5 yrs.
My doctors are only cutting my muscle relaxer back which is bad enough because I have had allergic reactions to all of the rest. My problem is the pharmacy’s. Since my pain management doctors have not reduced my meds the pharmacy’s have decided they will not fill them. I do not understand how they can overrule a doctor’s order but this is the 2nd time in a few mths I have had this problem.
Be prepared if you’re doctor stands up and ignores them, the pharmacy’s will step in. Walmart, Walgreens are 2 of them so far.
For the chronic pain patients I keep my fingers crossed for all of us that this bull stops soon.

Maureen M.

I’m grateful for and wish The best of all to Ms. Veasely, her team and others alongside her for fighting for us.
@Terry Shapiro…right on! I 110% agree with you!

david becker

lol. much ado about nothing. just like i said 3 years ago.


Thanks Barbara for your rants! I’m with you. So all along I’ve been trying to figure out who’s benefiting from this fake crisis. I know the addiction centers, perhaps insurance but since alternative treatments cost more it made no sense to me. But I recently finally got a clue. The local news revealed that Ohio’s mmj program_ not yet even begun has already made John Boehner(former speaker House of Rep.)from Ohio a billionaire, that’s right with a B. It was an aha! moment for me! He’s not alone of course. So is this what drove the CDC and media to create this fake crisis? Political pressure? Kickbacks? We’ve all known it was about money somehow. And we were right. Now all the CPP functioning well on opioids will be desperately trying marijuana. Wow!


I have to hand it to you
How can you be calm when so many have forced to suicides with thousands more in months to come?

Terry Shapiro

I have been reading this site for several years now. I am going to give as brief a run down of my condition as possible. In 1996 I had a car accident. Broke my neck C1 and C2. After a fifteen hour surgery I woke up no feeling from neck down. After a year of intense physical therapy I had regained 95% of my mobility. VERY FORTUNATE! In 98 I had two other neck surgeries. All seven cervical disc are either surgically fused or auto fused no mobility in it at all. TERRIBLE HEADACHES .In 1999 I hurt my back in a work accident. After several cat scans and M.R.I.’S. I was told I had a growth on my spine. After no joke about fifteen spinal injections and several biopsies which yealded nothing finally approved for a anterior posterior lumbar fusion of L, 3-4&5. In the first part of the two part surgery (THEY LITERALLY CUT YOU IN TWO) The so called growth was a hole in my back bone size of a silver dollar. My orthopedic surgeon told me it was all the sign’s of bone cancer. That I was actually fixing to break in half. To make a long story short. I had the second part two days later. Was not bone cancer was not a bone infection. They could not figure it out what had attacked my back bone. I developed R.S.D. due to the venture through the sympathetic nervous system. Developed Neuropathy in feet and legs. That needs no explanation to a pain patient. In 2002 was diagnosed with Ankylosing Spindolitis. Have been scheduled twice for bilateral hip and knee replacement twice. NOW THE SO CALLED OPIOID EPIDEMIC. I now take tylenol for pain. Every step I take ever or movement is HELL. MY OPINION IS TO HOLD THE DOCTORS ACCOUNTABLE. THEY WENT TO SCHOOL TO TREAT US. QUIT CRYING ABOUT IT START FILING LAW SUITS. ON THE DOCTOR. NOT NO CLASS ACTION. BOMB THEM WITH INDIVIDUAL SUIT’S. THE FED’S INDIVIDUAL STATES CAN’T TELL A DOCTOR HOW TO RUN HIS OR HER PRACTICE. The only was for this to end is to force the pain doctor’s to start fighting for their patients.


For starters, it seems to me that there needs to be a clearer understanding of terminology. Even given the possibility of minor overlap in some areas, there is a huge difference between legitimate chronic pain patients (who largely use medication responsibly, as prescribed) and drug addicts (who, by definition, do not). Older people, especially, may need pain-mitigating meds to live independently, remain functional and retain some quality of life.

Unfortunately for the former, they are misclassified en masse with the latter. Chronic pain patients need access to effective treatment for their pain, which may include appropriately prescribed and monitored opioid medications. Otherwise-healthy people in their 20s and 30s who are misusing drugs (and most often overdose on street drugs) need rehabilitative services including treatment for their addiction. Health care professionals-not the government-need the ability to determine which is which.

It is a legal fiction to call the United States a “nation”, the Pledge of Allegiance notwithstanding, because the US, like the European Union, is a union of member States that each hold their own powers, while surrendering others to the union. The power to license, unlicense, regulate and punish medical professionals resides in each of the 50 US States. The power to command those professionals to give free care away to the poor, likewise resides in the States. The federal Congress can only step in to regulate interstate commerce in medicines and healthcare products, or may volunteer to step in and give away money (as it did by creating Medicare and Medicaid).

Since California makes the rules under which it’s doctors practice, it’s essential that California’s rules protect patients from dishonest, cruel, and harmful actions by people who pretend to work for patients but actually work against us. I hope 49 more states take up the issues affecting their residents who suffer pain.


The nail was hit right on the head with the statement “pain management is not a national priority”. IF it was the “experts” in medicine, our elect and their family members issue it would be a priority. When never ending, lifetime, un managed pain for some 10 million people, citizens, tax payers in the US is not a priority, I am not sure if “chronic” pain will ever be a priority. Our politicians who can change the idiotic “one same dosage” of medication when that is ALL that helps manage pain are only interested in re-election. People are killing themselves to escape pain when our records positively indicate that we have not diverted our medicine, broken no laws, hurt ANYONE, and lived productive lives as best we can. How many must die before something is done about the rogue DEA agents and their current criminal acts against our doctors and resulting worsened suffering of the sick and permanently injured due to totalitarianism/ “communistic” thinking?


To Barbara - I liked your “rant”. I’m also feeling uncertainties about what to expect. All this talk but no one is hearing our voices for RIGHT NOW!
And I am not seeing how each entity or group is coordinating with each other about the issue.
It’s complicated and in the meantime my world has been turned upside down and the underlying anxiety that has been created, works against and exacerbates my pain issues. I was doing fine for the last 10 years, no increase in my meds, content with the life I’ve made dealing with chronic pain and then this comes along and uproots my well-being. It’s difficult enough to deal with pain day in and day out, even on the opioid meds, without the fears this has caused. It’s the fear of being taken off or cutting back the meds I know have helped me. I no longer sleep well at night. I panic about every doctor appointment I go to. I’m not as functional as I once was before all of this started. And I did well on these meds which flies in the face of what is being discussed. My doctor saved my life by prescribing what I needed for the pain. I would still be fine if all of this was between my doctor and myself. I resent the intrusion to my life and I’d like to be allowed to live out what I have left for a life in peace. I can’t fight anymore. It’s not in me. I hope others still can.


Barbara- I am also so frustrated as you are! Your not alone.

I can’t see how this can be handled at a state level because it’s a National crisis! Although it’s good to see some great people advocating that truly understand- I fear that it’s gotten so bad Nationally and to reverse the damage that has caused the Doctors to abandon their medically fragile and suffering it’s going to take a huge shift- I see that is exactly what we are up against. I personally think about how long it takes in politics to get things done! I look at the seatbelt issue- how long did it take to implement the regulations and implement manufacterers to simply install seatbelts in cars! When all the data and evidence clearly showed that having a seatbelt saved lives! The evidence of the use of pain medications is not the debate! Well it shouldn’t be! But clearly we just went back in time- the addiction issue needs to be separated from quality of life care! This issue needs more attention- because the drug treatment is the new focus. Following the money I see that they have geared up- with legislation and insurance companies the whole works to make money off of the people who have successfully used medications to have relief and even had quality of life- I pushed on as if my body wasn’t falling apart for over 20 years- anyways!

I look back to when they wanted to put a pain pump in me! I’m so glad I didn’t qualify- I wasn’t going to let them do that anyways- but I didn’t qualify because at that time I was on to high of medications for them to put me on a pain pump! But now I’m just treated as if that never happened! Oh I had really good insurance back then??? Follow the money- I digress.

Barbara Snow

I really think leaving it up to States to make their own pain strategies is not the way to go at all. Look at what a mess they have made already. We could all end up like Tennessee, where they have made it impossible for people to even get to a clinic. Unless of course they have plenty of money and a good working car. And someone to drive them once a month. It needs to be a nation wide whatever. People are suffering now, this minute. People are weary of fighting to be functional. Heroin is easier and cheaper to get. And they also will not care if it’s the one and only time they will do it. Death is by far better than this slow death that has arrived or is arriving. Congress went the wrong direction as to is the CDC and DEA. That’s all for now, except maybe overturn Congress in till everyone has had a chance to tell their story and decisions have been made.

judy vitton

I agree whole-heartedly with Barbara! And I think that so much emphasis (and federal and state funding) is placed on the ‘opioid epidemic’, but what about the people who need those meds in order to just function? Not thrive, or even have a life…just barely get by. I would and have tried anything other than prescription meds to help with the pain (fibromyalgia for 20+ years) as I hate the meds and what they do to my body, but I’m still in horrible pain. More research needs to be done to help the thousands of people in pain every minute of every day with no hope of an end. God bless, Judy


What does all this mean for us? I sit here getting more frustrated, confused and angry as time goes by trying to figure out what exactly is going on. I keep hearing conflicting stories about who to trust and who to be wary of. With everybody at each others throats re politics are we, the chronic pain patients, even being heard at all? I’ve heard so many horror stories of people losing their meds and those who have ended their lives I don’t know what to think. People are suffering and dying. How much more serious can it get? When is this crap going to end? It’s really hard to have hope that we’re going to matter to these people who are deciding our fate. There’s anti opiod zealots in both parties of government. We’re not children who need adults to make decisions about our lives. Listen to us. Acknowledge our suffering! Let doctors and their patients make these decisions. Sorry for the “rant”. I’m just so very tired of all of this. God Bless us all.