States to get report cards on chronic pain policies

States will be granted "report cards" on their policies on pain management in an attempt to show how well — or inadequately — U.S. medicine helps cancer patients deal with chronic pain.

Some of the nation's leading information and advocacy groups for people with cancer are funding a three-year grant to the Pain & Policy Studies Group (PPSG) at the University of Wisconsin Comprehensive Cancer Center to examine policies that govern pain management practices for cancer patients in the 50 states and the District of Columbia. PPSG will issue three report cards during the life of the grant that grade states on their pain policies. The first report card was issued in September.

Sponsors of the grant — the Susan G. Komen Breast Cancer Foundation, American Cancer Society, and Lance Armstrong Foundation — say that despite advances in pain therapies, chronic pain remains part of daily life for more than half of all cancer patients and more than three-quarters of those with advanced stages of the disease. Those figures, they say, have needlessly remained unchanged for decades.

"It is essential that cancer patients have access to adequate pain management from the time of their diagnosis, throughout their treatment, and as needed for the balance of their lives," says Mitch Stoller, Lance Armstrong Foundation president and CEO. A spokesman for the American Cancer Society says his organization has long advocated stronger state policies affecting cancer pain control.

While cancer research groups are funding the report card study, the project will evaluate pain polices as a whole.

PPSG implemented a first-of-its-kind study in 2003 comparing pain policies throughout the country. The results of that study showed that more than half of all states had policies that encouraged pain management, addressed physicians' fears of regulatory scrutiny, and drew distinctions between physical dependence or tolerance and addiction.

But the report also showed that more progress can be made. A total of 38 states received a grade of C or lower. The evaluation and grading system has two primary goals: to prevent abuse and diversion of medications, and to ensure their availability for legitimate medical purposes.

Although a variety of treatment options exist and can be effective in reducing cancer pain, PPSG directors say, opioid medications often are both the cornerstone of treatment and therapy that is rendered unavailable to the patients who need it. Part of the reason is that state pain management policies often restrict health care practice — cancer organizations say unduly so — to the point that they can interfere with patient access to treatment.

For more information on the University of Wisconsin's Pain & Policy Studies Group, visit