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Federal Involvement in Pain Management Policy

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Treating Comorbid Opioid Use Disorder in Chronic Pain

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Abstract

The federal government plays a major role in the issue-formulating policies that affect pain management. With the advent of an increase in overdose deaths associated with the misuse of prescription pain medications, the role of the federal government intensified. Multiple agencies within multiple federal departments influence pain policy, from the regulation of prescription pain relievers, to education of providers, to enforcing laws and regulations that govern the use and availability of pain relievers. No discussion of pain management is complete without a review of the various federal activities germane to this critical issue. This chapter summarizes those federal efforts.

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Notes

  1. 1.

    http://wane.com/2015/01/06/dea-arrests-fort-wayne-pain-doctor/ Accessed 2/5/2015.

  2. 2.

    http://www.cdc.gov/HomeandRecreationalSafety/pdf/HHS_Prescription_Drug_Abuse_Report_09.2013.pdf, Addressing Prescription Drug Abuse in the United States. Accessed 2/10/2015.

  3. 3.

    http://www.er-la-opioidrems.com/IwgUI/rems/home.action. Accessed 2/7/2015.

  4. 4.

    Ibid.

  5. 5.

    http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm334743.pdf, Guidance for Industry Abuse-Deterrent Opioids-Evaluation and Labeling, FDA, January 2013. Accessed 2/7/2015.

  6. 6.

    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm423977.htm, FDA approves extended-release, single-entity hydrocodone product with abuse-deterrent properties, November 20, 2014. Accessed 2/8/2015.

  7. 7.

    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm419288.htm, FDA approves labeling with abuse-deterrent features for third extended-release opioid analgesic, October 17, 2014. Accessed 2/8/2015.

  8. 8.

    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm406407.htm, FDA approves new extended-release oxycodone with abuse-deterrent properties, July 23, 2014. Accessed 2/8/2015.

  9. 9.

    http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/, Accessed 2/15/2015, FDA Adverse Event Reporting System.

  10. 10.

    http://www.fda.gov/RegulatoryInformation/Guidances/ucm126486.htm, Accessed 2/10/2015.

  11. 11.

    http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm220112.htm, “Combating Misuse and Abuse of Prescription Drugs: Q&A with Michael Klein, Ph.D. Accessed 2/19/2015.

  12. 12.

    http://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Provider-Education-Toolkits/Downloads/prescription-opioids-booklet0814.pdf, Drug Diversion Toolkit, Prescription Opioids-An Overview for Prescribers and Pharmacists. Accessed 2/10/2015.

  13. 13.

    http://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaidintegrityprogram/downloads/drugdiversion.pdf, Drug Diversion in the Medicaid Program, State Strategies for Reducing Prescription Drug Diversion in Medicaid. Accessed 2/10/2015.

  14. 14.

    http://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/provider-education-toolkits/downloads/prescriber-role-drugdiversion.pdf, Partners in Integrity, What is a Prescriber’s Role in Preventing the Diversion of Prescription Drugs? Accessed 2/15/2015.

  15. 15.

    http://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/prescription-drugdiversion-resourceguide.pdf, Prescription Drug Diversion Resource Guide, accepted 2/15/2015.

  16. 16.

    http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/Analysis-of-Conditions-Associated-with-High-Opioid-Use.pdf, Analysis of Conditions Associated with High Opioid Use, Accessed 2/10/2015.

  17. 17.

    http://medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-11-2014.pdf, Medication Assisted Treatment for Substance Use Disorders. Accessed 2/10/2015.

  18. 18.

    http://oig.hhs.gov/oei/reports/oei-02-09-00603.pdf, Prescribers with Questionable Patterns in Medicare Part D. Accessed 2/19/2015.

  19. 19.

    http://www.medscape.com/viewarticle/712071, “Use of methadone in Chronic Pain Management—A Video Lecture from CSAT/SAMHSA. Accessed 2/19/2015.

  20. 20.

    http://www.hawaii.edu/hivandaids/OxyContin%20%20%20%20%20Prescription%20Drug%20Abuse.pdf. Accessed 2/15/2015.

  21. 21.

    http://www.opioidprescribing.com/overview, “Safe and Effective Opioid Prescribing for Chronic Pain”. Accessed 2/19/2015.

  22. 22.

    Ibid.

  23. 23.

    https://store.samhsa.gov/shin/content/MS993/MS993.pdf, Pain Management Without Psychological Dependence: A Guide for Healthcare Providers. Accessed 2/11/2015.

  24. 24.

    http://store.samhsa.gov/product/TIP-54-Managing-Chronic-Pain-in-Adults-With-or-in-Recovery-From-Substance-Use-Disorders/SMA13-4671, TIP 54: Managing Chronic Pain in Adults With or in Recovery From Substance Use Disorders.

  25. 25.

    http://store.samhsa.gov/product/You-Can-Manage-Your-Chronic-Pain-To-Live-a-Good-Life-A-Guide-for-People-in-Recovery-from-Mental-Illness-or-Addiction/SMA14-4783, You Can.

  26. 26.

    http://pcss-o.org/, PCSS-O. Accessed 2/20/2015.

  27. 27.

    http://painconsortium.nih.gov/About/purpose.html. Accessed 2/19/2015.

  28. 28.

    http://painconsortium.nih.gov/PC_Symposia_Meetings/symposiums/pc_symposia_index.html. Accessed 2/19/2015.

  29. 29.

    http://iprcc.nih.gov/index.htm, The Interagency Pain Research Coordinating Committee. Accessed 2/19/2015.

  30. 30.

    Public Law 111-148, Section 409J(b).

  31. 31.

    Ibid.

  32. 32.

    IOM (Institute of Medicine). Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press; 2011.

  33. 33.

    http://iprcc.nih.gov/National_Pain_Strategy/NPS_Strategy_Description.htm. Accessed 2/19/2015.

  34. 34.

    http://iprcc.nih.gov/National_Pain_Strategy/oversight_panel.htm, National Pain Strategy Task Force. Accessed 2/19/205.

  35. 35.

    Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg J E. Monitoring the Future national survey results on drug use: 1975–2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, the University of Michigan; 2015.

  36. 36.

    http://www.drugabuse.gov/opioid-pain-management-cmesces, Opioid and Pain Management CMEs/CEs. Accessed 2/20/2015.

  37. 37.

    http://www.cdc.gov/about/organization/mission.htm, Mission and Role of the CDC. Accessed 2/19/2015.

  38. 38.

    http://www.cdc.gov/fmo/topic/Budget%20Information/FY2015-CDC-Operating-Plan-2-3-15.htm. Accessed 2/20/2015.

  39. 39.

    http://www.cdc.gov/healthyyouth/yrbs/slides/index.htm, Adolescent and School Health. Accessed 2/20/2015.

  40. 40.

    http://www.cdc.gov/nchs/data/hus/2012/047.pdf, Severe headache or migraine, low back pain, and neck pain among adults aged 18 and over, by selected characteristics: United States, selected years 1997–2012. Accessed 2/20/2105.

  41. 41.

    http://www.cdc.gov/nchs/data/hus/2012/032.pdf, Health, United States, 2012. Accessed 2/20/2015.

  42. 42.

    http://www.cdc.gov/CDCTV/ArthritisPain/index.html. Accessed 2/20/2015.

  43. 43.

    http://www.cdc.gov/primarycare/materials/opoidabuse/index.html. Accessed 2/20/2015.

  44. 44.

    http://www.cdc.gov/homeandrecreationalsafety/rxbrief/, Policy Impact: Prescription Painkiller Overdoses. Accessed 2/22/2015.

  45. 45.

    http://www.cdc.gov/psr/prescriptiondrug/index.html, Prescription Drug Overdose. Accessed 2/20/2015.

  46. 46.

    http://www.cdc.gov/fmo/topic/Budget%20Information/appropriations_budget_form_pdf/FY2016_CDC_CJ_FINAL.pdf. Accessed 2/15/2015.

  47. 47.

    http://integrationacademy.ahrq.gov/aboutus.

  48. 48.

    http://www.effectivehealthcare.ahrq.gov/ehc/products/557/1971/chronic-pain-opioid-treatment-report-141205.pdf. Accessed 2/20/2015.

  49. 49.

    http://www.hrsa.gov/about/index.html, About HRSA. Accessed 2/22/2015.

  50. 50.

    http://www.hrsa.gov/opa/index.html, 340B Drug Pricing Program. Accessed 2/22/2015.

  51. 51.

    http://www.integration.samhsa.gov/, SAMHSA-HRSA Center for Integrated Health Solutions. Accessed 2/22/2015.

  52. 52.

    http://www.integration.samhsa.gov/clinical-practice/pain-management Accessed 2/22/2015.

  53. 53.

    http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/ndcs_2014.pdf, National Drug Control Strategy, 2014. Accessed 2/22/215.

  54. 54.

    http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/prescription-drugs/rx_abuse_plan.pdf, Epidemic: Responding to America’s Prescription Drug Abuse Crisis. Accessed 2/22/2015.

  55. 55.

    http://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit-Updated-2014/SMA14-4742. Accessed 2/22/2015.

  56. 56.

    http://www.dea.gov/about/mission.shtml, DEA Mission Statement. Accessed 2/22/2015.

  57. 57.

    http://www.ihs.gov/, Indian Health Service. Accessed 2/22/2015.

  58. 58.

    http://www.bia.gov/cs/groups/webteam/documents/document/idc1-029026.pdf, Department of the Interior, Bureau of Indian Affairs, Indian Entities Recognized and Eligible to Receive Services from the United States Bureau of Indian Affairs, Federal Register, Vol. 80, No. 9, January 14, 2015, pp. 1942–1948.

  59. 59.

    http://www.ihs.gov/painmanagement/, Pain Management. Accessed 2/23/2015.

  60. 60.

    Policy for Comprehensive Pain Management from the Assistant Secretary of Defense, March 30, 2011. Accessed 2/23/2015 via google.

  61. 61.

    http://www.regenesisbio.com/pdfs/journal/pain_management_task_force_report.pdf, Pain Management Task Force, Final Report May 2010. Accessed 2/23/2015.

  62. 62.

    http://www.dvcipm.org/, Defense & Veterans Center for Integrative Pain Management. Accessed 2/23/2015.

  63. 63.

    http://www.healthquality.va.gov/, VA/DoD Clinical Practice Guidelines. Accessed 2/23/2015.

  64. 64.

    http://www.healthquality.va.gov/guidelines/Pain/cot/OpiodManagingSideEffectsFactSheet23May2013v1HiResPrint.pdf, Managing Side Effects and Complications of Opioid Therapy for Chronic Pain. Accessed 2/23/2015.

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Authors and Affiliations

  1. Public Health Program, Santa Clara University, Kena 110, 500 El Camino Real, Santa Clara, CA, 95053-0269, USA

    H. Westley Clark M.D., J.D., M.P.H.

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Correspondence to H. Westley Clark M.D., J.D., M.P.H. .

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Editors and Affiliations

  1. Oregon Health and Science University, Department of Psychiatry, Portland, Oregon, USA

    Annette M. Matthews

  2. Maine Medical Center, Department of Psychiatry, Portland, Oregon, USA

    Jonathan C. Fellers

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Clark, H.W. (2016). Federal Involvement in Pain Management Policy. In: Matthews, A., Fellers, J. (eds) Treating Comorbid Opioid Use Disorder in Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-29863-4_13

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