Pain Warriors Unite - (202) 792-5600

Pain Warriors Unite

Calling ALL Pain Warriors, It's NOW or NEVER!

Calling ALL Pain Warriors, It's NOW or NEVER!

Calling ALL Pain Warriors, It's NOW or NEVER!Calling ALL Pain Warriors, It's NOW or NEVER!

Timeline of Events

Source: Joy Johnson Wilson and Rachel B. Morgan RN, BSN


10/22/2015


White House Announcement 2015


The Obama administration issued a memorandum on Oct., 21, 2015, to federal departments and agencies directing two important steps to combat the prescription drug abuse and heroin epidemic:


  • Prescriber Training: First, to help ensure that health care professionals who prescribe opioids are properly trained in opioid prescribing and to establish the federal government as a model, the presidential memorandum requires federal departments and agencies to provide training on the prescribing of these medications to federal health care professionals who prescribe controlled substances as part of their federal responsibilities.


  • Improving Access to Treatment:  Second, to improve access to treatment for prescription drug abuse and heroin use, the presidential memorandum directs federal departments and agencies that directly provide, contract to provide, reimburse for, or otherwise facilitate access to health benefits, to conduct a review to identify barriers to medication-assisted treatment for opioid use disorders and develop action plans to address these barriers. 

The White House will host a Champions of Change event this spring to highlight individuals in communities across the country who are leading the fight to respond to prescription drug abuse and heroin use.


White House Fact Sheet on Public and Private Efforts to Combat Prescription Drug Abuse and Heroin Use


Additional Federal Actions


U.S. Department of Justice 

  • The Drug Enforcement Administration (DEA) announced that it will continue its National Prescription Drug Take-Back Day program events in the spring and fall of 2016.  As the president highlighted in a recent weekly address, Take-Back Day aims to provide a safe, convenient, and responsible means of disposing of unused prescription drugs, while educating the public about the dangers of misusing medications. DEA also finalized a new rule making it easier for communities to establish ongoing drug take-back programs. Read more about the DEA’s drug disposal information.


U.S. Department of Health and Human Services (HHS)

  • The Department of Health and Human Services (HHS) will undertake a review of how pain management is evaluated by patient satisfaction surveys used by hospitals and other health care providers, including review of how the questions these surveys use to assess pain management may relate to pain management practices and opioid prescribing. HHS also launched this site as a one-stop federal resource with tools and information for families, health care providers, law enforcement, and other stakeholders on prescription drug abuse and heroin use prevention, treatment, and response.


  • The Centers for Disease Control and Prevention (CDC) will invest $8.5 million on the development of tools and resources to help inform prescribers about appropriate opioid prescribing; track data on prescribing trends; research, develop, and evaluate clinical quality improvement measures and programs on opioid prescribing; and improve public understanding of the risks and benefits of opioid use. U.S. Surgeon General Vivek Murthy is developing an education campaign for doctors, dentists and other health care professionals who prescribe opioid pain medications. Earlier this month, Murthy also announced that work has begun on the first-ever surgeon general's report on substance use, addiction and health scheduled for publication in 2016.


  • Centers for Medicare and Medicaid Services (CMS) will release an information bulletin to states by the end of the year on steps states can take through their Medicaid preferred drug lists (PDLs) and other utilization management mechanisms to reduce the risk of overdose. This includes a recommendation that they consider removing methadone from their PDLs for pain management. The Centers for Disease Control and Prevention has found that the use of methadone in pain treatment is associated with a disproportionately high number of overdose deaths compared to other opioid pain relievers. This fall, CMS is testing three new Medicare prescription drug plan measures designed to identify potential opioid overutilization, with the goal of proposing publicly reportable measures for Part D drug plans next year. These measures are based on the work of the Pharmacy Quality Alliance.


The Department of Veterans Affairs 

  • The Department of Veterans Affairs will lead a research initiative to evaluate non-opioid alternative approaches to pain management. The Department of Defense (DoD) and VA are developing a standardized pain management curriculum for widespread use in education and training programs.


The Bureau of Indian Affairs (BIA) and the Indian Health Service

  • The Bureau of Indian Affairs (BIA) and the Indian Health Service (IHS)will provide BIA police officers and investigators the overdose reversal drug naloxone and training on its use. In 2016, the BIA, through the United States Indian Police Academy, will provide training to all BIA and tribal police officer cadets in recognizing opioid use disorders and overdose symptoms.


Moving Forward

In 2010, the president released his first National Drug Control Strategy, emphasizing the need for action to address opioid use disorders and overdose, while ensuring that individuals with pain receive safe, effective treatment. The next year, the White House released its national Prescription Drug Abuse Prevention Plan to outline its goals for addressing prescription drug abuse and overdose. This year the administration, through the CDC, launched the Prescription Drug Overdose: Prevention for States Program.


Prescription Drug Overdose: Prevention for States Program

The program provided $20 million to states to support strategies to improve prescribing practices and prevent opioid overdose deaths. Through a competitive application process, CDC selected 16 states to receive funds through the program: Arizona, California, Illinois, Kentucky, Nebraska, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, Vermont and Wisconsin.


Over the next four years, CDC plans to give states annual awards between $750,000 and $1 million each year, subject to the availability of funds, to advance prevention, including in these areas:


  1. Enhancing prescription drug monitoring programs (PDMPs).
  2. Putting prevention into action in communities nationwide and encouraging education of providers and patients about the risk of prescription drug overdose.
  3. Working with health systems, insurers, and professional providers to help them make informed decisions about prescribing pain medication.
  4. Responding to new and emerging drug overdose issues through innovative projects, including developing new surveillance systems or communications campaigns.

States can also use the funding to better understand and respond to the increase in heroin overdose deaths and investigate the connection between prescription opioid abuse and heroin use. 


The president's budget for 2016 includes a request from HHS Secretary Sylvia Mathews Burwell for the resources needed to expand CDC’s state efforts to all 50 states and launch a national program that will focus on prevention and prescription drug overdose surveillance.


Additional Resources

image39

Important LINKS & RESOURCES

Health Care and Medical Organizations


The American Society of Anesthesiologists is an educational, research and scientific association of physicians organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.  


American Medical Association promotes the art and science of medicine and the betterment of public health and continues to be the leading advocate for physicians and their patients.


American Health Care Association provides information on long-term care including  issue papers, links to U.S. Government reports and databases, and more.


American Academy of Family Physicians preserves and promotes the science and art of family medicine and ensures high-quality, cost-effective health care for patients of all ages.


American Health Information Management Association is the community of professionals engaged in health information management, providing support to members and strengthening the industry and profession.


Agency for Healthcare Research and Quality is a home to research centers that specialize in major areas of health care research such as quality improvement and patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care organization and delivery systems. It is also a major source of funding and technical assistance for health services research and research training at leading U.S. universities and other institutions


The American Academy of Medical Management serves as an educational resource in the U.S. for people working in the business side of health care.


The College of American Pathologists, the principal organization of board-certified pathologists, serves and represents the interest of patients, pathologists, and the public by fostering excellence in the practice of pathology and laboratory medicine.


Institute of Medicine is a nonprofit organization for science-based advice on matters of biomedical science, medicine, and health. The Institute provides a vital service by working outside the framework of government to ensure scientifically informed analysis and independent guidance.


Joint Commission on Accreditation of Health Care Organizations (JCAHO), an independent and not-for-profit organization, is the predominant standards-setting and accrediting body in health care.


National Committee for Quality Assurance is a private, not-for-profit organization dedicated to improving health care quality. The organization is frequently referred to as a watchdog for the managed care industry.



Health Law Organizations


The American Health Lawyers Association (AHLA) is an educational organization devoted to legal issues in the healthcare field.


Legislative Information

Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the security and privacy of health data and establishes national standards for electronic health care transactions.


State Legislative Database Search offers key-word searching of all Internet accessible state legislatures.


US Code of Federal Regulations is a consolidation and codification by subject matter of the general and permanent laws of the United States.


Telemedicine, Technology & Health Law is Alan S. Goldberg's site on telemedicine, health law, fraud and abuse and related issues.


THOMAS provides Congressional legislative information via the Internet.


Kaiser Family Foundation provides access to resources and information on major areas of health care policy, including narrated slide lectures, research, data, and policy analysis.


Health Care News and Current Events


America's Health Insurance Plans is the national trade association representing the health insurance industry. Their website provides information about health care news and policy updates.


FierceHealthcare provides healthcare management news for healthcare industry executives.



Modern Healthcare provides healthcare business and policy news, research and information


.


Publications


AJPH American Journal of Public Health 


Journal of Health Politics, Policy and Law


NEJM

The New England Journal of Medicine 


PubMed/MEDLINE  


JAMA

Journal of the American Medical Association 


American Journal of Public Health 


Journal of Health Politics, Policy and Law 


PubMed/MEDLINE  



Board of Scientific Counselors 

image40

PATIENT RESOURCES - PAIN MANAGEMENT

PAIN MANAGEMENT


The management of chronic pain is challenging for both patients and clinicians. However, it can be done successfully. Consumers benefit most when their health providers collaborate with other professionals ( e.g., psychologists, addiction counselors, pharmacists) and when they take on a significant role in optimal management of their pain. 


Consumers should discuss with their health providers treatment goals that include reducing pain, maximizing function, and improving quality of life. The best outcomes can be achieved when chronic pain management addresses co-occurring behavioral health disorders (e.g., depression, anxiety) and when it incorporates suitable nonpharmacologic and complementary therapies for symptom management. 


RESOURCES


The American Society of Anesthesiologists (ASA) is an educational, research and scientific society that works to elevate the standards of the medical practice of anesthesiology and improve patient care. Since 1905, ASA has played an important role in American medicine acting as an advocate for all patients who require anesthesia or relief from pain. ASA’s website provides information on treating chronic pain and the potential challenges of treating this condition, opioid treatment for pain management and non-opioid options for treatment.



The CDC Guidelines for Prescribing Opioids for Chronic Pain, provides resources on how to communicate with patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy. Download the checklist for prescribing opioids and browse additional clinical tools to help implement the recommendations. 


HHS’ newly released National Pain Strategy, details steps the Federal government is taking to improve provider education on pain management practices and overcome barriers to improve the quality of pain care. 


The PainEDU website provides numerous resources and information on managing chronic pain. Resources include a pocket guide to pain management, a client workbook and information on cross-cultural pain management.


The Mayo Comprehensive Pain Rehabilitation Center Program is an intensive 3-week outpatient program focused on providing multidisciplinary rehabilitative therapy to patients with chronic pain with the goal of improving quality of life and facilitating a return to regular daily activities.


Cognitive Therapy for Pain by Beverly E. Thorn is a paper that specifically targets the cognitive psychological processes (pain-related thoughts, attitudes, and beliefs) shown to be important predictors of satisfactory adjustment to chronic painful conditions.


The ECHO project done through the University of New Mexico is a telehealth project that allows providers from all over the country to get assistance for difficult pain management cases through virtual consultation with a pain management team at the UNM. This great resource for those practicing in rural areas without pain specialists for referral.


TIP 54: Managing Chronic Pain in Adults With or in Recovery from Substance Use Disorders equips clinicians with practical guidance and tools for treating chronic pain in adults with substance use disorders. This TIP includes information and resources on patient assessment, talking with patients about medication supply, addiction behaviors, opiod misuse measures, and pain treatment agreements. 

Group Health established a major initiative to prevent Opiod abuse and overdose and make opioid prescribing safer while improving care for patients with chronic pain.


Chronic Opioid Therapy Safety Guideline for Patients With Chronic Non-Cancer Pain

The Center for Practical Bioethics-Pain Action Initiative: A National Strategy (PAINS) shares podcasts, reports, and information from various national efforts to improve the treatment of individuals with chronic pain


Disability Issues 


Frequently Asked Questions: Americans with Disabilities Act | The Doctors Company


Tips for Using the ADA - National Fibromyalgia & Chronic Pain Association
The Americans with Disabilities Act and Fair Housing Act can provide legal rights to improved community participation for people with fibromyalgia and chronic pain. How can reasonable accommodation work for you?

Civil Rights Case Gives Hope to Pain Patients — Pain News Network


How Can I Get Reasonable Accommodations For Chronic Pain? - Pain Doctor
Working with chronic pain can be difficult, but it doesn't have to be impossible. You are entitled to certain reasonable accommodations under the ADA.


Is Chronic Pain a Disability? – National Pain Report


PAIN WITHOUT TREATMENT, WRONG WITHOUT REMEDY - doctordeluca.com - Dr. DeLuca's 

Addiction, Pain, and Public Health Website


Your Pain, Your Rights: Dealing With Your Physician And Your Hospital | RSDSA



PAIN IS PERSONAL



NCIL TASK FORCE LETTER TO CONGRESS: 

https://www.ncil.org/wp-content/uploads/2019/06/6-25-19-Chronic-Pain-Sign-On-Letter.pdf

image41

Political Leverage & Legislative Attempts

RESEARCH PROJECTS - Pain Patients are Political Pawns

Research Projects - Politics of Pain 


U.S. House Committee On The Judiciary

Committee Hearing Room
2141 Rayburn House Office Building
Washington, D.C. 20515
202-225-3951



H.R. 5046, the “Comprehensive Opioid Abuse Reduction Act of 2016”; H.R. 5052, the “Opioid Program Evaluation Act”;H.R. 2137, the “Federal Law Enforcement Self-Defense and Protection Act of 2015”;H.R. 5048, To require a study by the Comptroller Ge...
... Scheduled H.R. 5046, the “Comprehensive Opioid Abuse Reduction Act of 2016”; H.R. 5052, the “Opioid Program Evaluation Act”; H.R. 2137, the “Federal Law Enforcement .


Conyers Lauds House Passage of Bill to Help Combat Opioid Epidemic & Save Lives
... applauded House passage of H.R. 5046, the Comprehensive Opioid Abuse Reduction Act of 2016 which passed by a vote of 413-5. The Comprehensive Opioid Abuse Reduction Act of 2016 authorizes $103 million per year from .


AHEAD OF REPUBLICANS’ POLITICALLY DIVISIVE JUDICIARY HEARING TO CONNECT THE OPIOID EPIDEMIC TO ANTI-IMMIGRANT POLICIES & RHETORIC, JUDICIARY DEMOCRATS CALL FOR REAL HEARINGS TO ADDRESS OPIOID CRISIS
... of Sanctuary City Policies on the Ability to Combat the Opioid Epidemic,” House Judiciary Committee Ranking Member Jerrold Nadler ... to hold a real hearing to appropriately examine the ongoing opioid epidemic in America. In their letter, the Members wrote , 


LETTER: NADLER/RASKIN/JUD DEMS TO GOODLATTE RE OPIOID EPIDEMIC IN AMERICA
LETTER: NADLER/RASKIN/JUD DEMS TO GOODLATTE RE OPIOID EPIDEMIC IN AMERICA 

Issues:  Civil Justice , 


Statement of the Honorable John Conyers, Jr. for the Hearing on “Treating the Opioid Epidemic: The State of Competition in the Markets for Addiction Medicine” Before the Subcommittee on Regulatory Reform, Commercial and Antitrust Law
I hope that there are some broader lessons that we can draw ... witnesses should discuss the real-life consequences of the opioid addiction epidemic and the impact of rising prices for medications that ...


Statement of the Honorable John Conyers, Jr. in Support of H.R. 5046, the “Comprehensive Opioid Abuse Reduction Act of 2016”
the “Comprehensive Opioid Abuse Reduction Act of 2016.” H.R. 5046 is an important complement to ... of a major public health crisis caused by prescription and opioid abuse.  It is a crisis that affects Americans of all ages, races, and ...


NADLER’S STATEMENT FOR THE HEARING ON THE “CHALLENGES AND SOLUTIONS IN THE OPIOID ABUSE CRISIS”
“Thank you, Mr. Chairman.  I welcome today’s ... to explore ways we can best address the crisis of opioid abuse in our country.  I believe it is critical that we do so, in order ...


HOUSE COMMITTEE LEADERS ANNOUNCE SUPPORT FOR OPIOID PACKAGE
“We support this bipartisan package as a first step in fighting the opioid epidemic. This final deal includes key priorities that our members ...


The Effect of Sanctuary City Policies on the Ability to Combat the Opioid Epidemic
... of Sanctuary City Policies on the Ability to Combat the Opioid Epidemic Subcommittees:  Immigration and Border ...


Challenges and Solutions in the Opioid Abuse Crisis
Challenges and Solutions in the Opioid Abuse Crisis Witnesses:   Kristen Holman ...


Treating the Opioid Epidemic: The State of Competition in the Markets for Addiction Medicine
Treating the Opioid Epidemic: The State of Competition in the Markets for Addiction ...


Ahead Of Public Meeting Wednesday, Democratic CARA Conferees Call For Addition Of Real Funding To Combat Opioid & Heroin Addiction
... to provide critical resources to respond to the nation’s opioid and heroin epidemic. In a letter to Conference Committee ... and the Senate, and similar funding levels for combatting opioid addiction were included in the president’s FY2016 budget request. 


NADLER: TRUMP BUDGET DOES NOT REFLECT OUR VALUES
... officers to our streets, prevent gun violence, prevent opioid abuse, prevent those incarcerated from re-offending, and guide young ... gaps in the system.           

Opioid Epidemic :   To fight the opioid epidemic, we need to invest more ...


Statement of the Honorable John Conyers, Jr. for the Conference Committee on S. 524, the “Comprehensive Addiction and Recovery Act”
The crisis of opioid abuse and addiction clearly requires our immediate attention.  In ... by opioids and heroin.  Each day, 78 Americans die from an opioid overdose. Fortunately, we now have better ways of addressing issues ...


Chairman Nadler Statement for the Markup of H.R. 2374, the Stop STALLING Act
... resulted in dramatically increasing the cost of combatting opioid abuse, a serious nationwide public health crisis. In 2016, together with ... from its sale of Suboxone film, and it deprived victims of opioid addiction and medical practitioners the benefits of generic competition. ...


This Week in the House Judiciary Committee (September 19-23)
Commercial and Antitrust Law Treating the Opioid Epidemic:  The State of Competition in the Markets for Addiction ...


Chairman Nadler Statement for the Markup of H.R. 5133, the Affordable Prescriptions for Patients Through Promoting Competition Act of 2019
... case, a drug manufacturer with a life-saving medication for opioid addiction, changed the form of the treatment from tablets to a ...


House Judiciary Committee Approves Bipartisan Prison Reform Legislation
... evaluation of the current pilot program to treat heroin and opioid abuse through medication assisted treatment. 


image42

Timeline of the Crisis

Here's a list of Facts, Statistics, Studies, and Links explaining the TIMELINE of Events Leading up to Today's ILLICIT FENTANYL Abuse & Overdose   Crisis. 

PAIN WARRIORS UNITE FACTS (pdf)

Download

SUICIDE PREVENTION RESOURCES

RESOURCES FOR PATIENTS/CONSUMERS AND FAMILIES


The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. 

Follow this link or call 1-800-273-TALK (8255) to access immediate assistance.


National Suicide Prevention Lifeline’s “With Help Comes Hope” website has information for survivors, friends and families, and clinicians. It has survivor stories, self-care tips, “7 things attempt survivors wish their friends and families knew,” a therapist and support group finder, videos, and more.

VETERANS PRESS "1"


CRISIS TEXT LINE:


Text 741741 from anywhere in the USA to text with a trained Crisis Counselor. Crisis Text Line serves anyone, in any type of crisis, providing access to free, 24/7 support and information via the medium people already use and trust: text.



Family & Youth Services Bureau's Family Violence Prevention Services Program exists to ensure that all victims of domestic violence have access to the services and supports that they need to live a life free of abuse. 


A Guide for Taking Care of Yourself after Your Treatment in the Emergency Department is a brief brochure designed to support people in recovery from a suicide attempt. This resource guides individuals moving forward following emergency department treatment and coping with thoughts of suicide. A Spanish version is also available.


A Guide for Taking Care of Your Family Member after Treatment in the Emergency Department is an accompaniment to the patient guide designed for families coping with a relative’s suicide attempt. It reviews treatment processes and typical follow-up arrangements. A Spanish version is also available.


A Journey Toward Health and Hope: Your Handbook for Recovery After a Suicide Attempt guides individuals through the first steps toward recovery after a suicide attempt. Includes personal stories from survivors who share their experiences as well as strategies, such as re-establishing connections and finding a counselor to work with.


Stories of Hope and Recovery is a video guide for suicide attempt survivors and features inspiring stories from three people who survived an attempted suicide. Told through their voices and those of their families, the stories recount their journeys from the suicide attempt to a life of hope and recovery. Includes a video guide.

image43