Recognizing the Needs of Pain Patients in Substance Use Policy

Reprinted with the kind permission of the PAINS Project
The United States is facing twin epidemics of pain and opioid misuse. Both are challenging, multifaceted problems with numerous comorbidities, treatment gaps, stigma, and increased risk of death. The role of prescription opioids in soaring rates of drug overdose and death has drawn considerable policy attention at the federal and state levels. While the focus on limiting the flow of medications is understandable, it may, intentionally or not, hinder access for patients who rely on opioids as a component of managing chronic or end-of-life pain.
This issue brief outlines the ways in which some of the key policy responses to the opioid epidemic – prescription drug monitoring programs, heightened DEA enforcement, “lock-in” programs, prescriber restrictions, and even guidelines – could affect patients in pain. Important as these policies may be, very limited attention has been paid to minimizing collateral harm to people living with or dying in pain. Additional oversight and monitoring is crucial to ensure that individuals in pain are not harmed by the unintended consequences of various policy responses.
We are pleased to announce the release of Recognizing the Needs of Pain Patients in Substance Use Policy, which is the ninth in a series of briefs profiling policy and educational issues important to improving chronic pain. We wish to thank contributors: Katie Horton, JD, MPH, RN, Naomi Seiler, JD, Greg Dwyer, MPH and Alex Hahn, MPH, and editors: Richard Payne, MD, John B. Francis Chair, Center for Practical Bioethics, Bob Twillman, PhD, FAPM, Executive Director, Academy of Integrative Pain Management and James Cleary, MD, FAChPM, Associate Professor of Medicine University of Wisconsin and Director of the Pain and Policy Studies Group.
This policy and educational brief is a product of the Pain Action Alliance to Implement a National Strategy (PAINS) and the Center for Practical Bioethics.
The Policy & Educational Brief Series is designed as a tool for PAINS members to support their work to improve pain policy. In the spirit of the alliance, the Brief is designed as an “open document” so any member organization or individual can brand it with their name and contact information. The back page of the brief is designed with a space marked “This copy is made available to you by:” for easy personalization.
Everyone can download a master electronic copy. Hard copies of the latest issue can be ordered in a package of 10 or 20 for free and there is a flat rate mailing cost of $5.00. If you want larger quantities, please contact us.

The Pain Action Alliance to Implement a National Strategy (PAINS) is a consortium of leaders working in professional societies, patient advocacy organizations, policy groups, consumers, payers and the private sector working together toward a common vision and mission. For more information, visit

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