An Urgent Call for Action

(Written for the ICN by Lee Sampson) The Pain Relief and Promotion Act is a misguided bill that ends up throwing the baby out with the bath water. In its attempt to draft legislation to nullify the Oregon's assisted -suicide statute, the authors of this bill have put in provisions that will seriously threaten access to pain medication by those with chronic pain. Both the doctor and the patient will be dangerously compromised in their bid to seek pain management treatment. There is nothing wrong with the current Controlled Substances Act. The Pain Relief and Promotion Act seeks to amend the CSA and introduce DEA officers as overseers of appropriate medical regimens and force doctors to be second guessed by a government agency.

On the one hand, the Pain Relief and Promotion bill states that doctors can use controlled substances to alleviate pain, even if the use of such a substance may unintentionally increase the risk of death. However, the bill also states that DEA agents are empowered to interpret and decide a physician's intent: "Nothing in this section authorizes intentionally dispensing...a controlled substance for the purpose of causing death.." This manipulates legislative language, and in practice, will only lead to a dangerous and divisive relationship between doctors, patients, and law enforcement agents.

How does a doctor prove his intent? Doctors will document their innocent intent by establishing their history of minimal pain prescriptions. The result will be the under use of pain medication. Doctors, who have spent years gaining medical education and experience to allow them to deal appropriately with each patient on a case-by-case basis, would have DEA agents empowered and able to call into question the intent behind every prescription. This bill will force doctors toward the necessity of proving their innocence to agents who have graduated from a short course on pain management. This bill will result in practices more strict than the Controlled Substances Act currently allows.

The politics behind the Pain Relief and Promotion Act have created a destructive diversion to the recent advances in the compassionate treatment of pain. Last year, some legislators tried and failed to pass federal legislation that would topple the Oregon assisted suicide act. That version was viewed by many doctors as so stringent a law it would hamper appropriate patient care and the bill was defeated.

This year, the authors tried a new approach. The Pain Relief and Promotion Act limits its focus to those in need of palliative care. Disarming with use of compassionate terms, The Pain Relief and Promotion Act seeks to amend the Controlled Substances Act. The bill uses the cover of amending this existing federal legislation to include language that injects Federal authority into an arena previously left to the States.

There are better alternatives to the Pain and Relief Promotion Act whose focus is limited to palliative or end-of-life care. The Advanced Planning Act affects Medicare coverage of certain chronic pain patients, the frail elderly, and the dying. The Conquering Pain Act will affect those under federal health plans having either chronic intractable pain or an incurable illness.

To garner support from medical groups, the Pain Relief and Promotion bill offers a $5 million training program. But that training program pales when compared to the Conquering Pain Act which will set up the $18 million Family Support Networks and comprehensive, substantive multidisciplinary educational programs on both chronic intractable pain and pain from an incurable illness.

The Conquering Pain Act gives greater access to better health care. It would also establish ongoing studies, development of measures and standards of quality control, a national demonstration programs and reports that will lead to a national forum on ways new research can be implemented to further good pain management. The Advance Planning and Compassionate Care Act expands Medicare coverage to include oral drug therapy where it is now limited to medications administered by portable pump.

Interstitial Cystitis patients, along with the other 50 million suffers of chronic pain, want nothing more than to get their lives back. We don't want to see patients suffering with more restricted access to pain medications.

Phone or write your Senators!. Tell them to vote NO on the Pain Relief and Promotion Act. Urge your legislators to co-sponsor the bills that focus on allowing people to live better lives with more appropriate pain management: The Conquering Pain Act and The Advance Planning and Compassionate Care Act.