HJR97-1008 by Representatives Morrison, Dean, and Faatz; also Senator Mutzebaugh--Concerning pain assessment and management education.

WHEREAS, The Sixtieth General Assembly, during its second session, formed the Interdisciplinary Task Force on Intractable Pain, which met four times during the 1996 interim; and

WHEREAS, The task force heard many hours of testimony from persons suffering from intractable pain, health care providers, managed care and other health insurance carriers, educators, a federal drug enforcement agent, and patients; and

WHEREAS, Much of the testimony presented to the task force was that clinical practice in the area of pain assessment and treatment is woefully inadequate; and

WHEREAS, The task force was in agreement that the proper assessment, management, and treatment of patients' pain is a moral and ethical duty of physicians; and

WHEREAS, Recent research findings show that some physicians not only have difficulty in assessing pain, but also seldom ask patients about the pain the patient is experiencing or the effectiveness of treatment for pain; and

WHEREAS, Research has shown that pain medications are often underprescribed as a result of inappropriate medications, inadequate doses, inappropriate frequency of medication, an inadequate duration of medication, or a combination thereof; and

WHEREAS, The task force received testimony that some physicians lack sufficient knowledge of state­of­the­art medications and methods of prescribing such medications as well as sufficient knowledge of alternative treatment methods, other than pain medication, for long­term, nonterminal chronic pain; and

WHEREAS, The task force heard testimony that many health care providers are hesitant to prescribe adequate pain medications because of the fear of disciplinary sanctions from the federal Drug Enforcement Agency or the state Board of Medical Examiners; and

WHEREAS, The task force heard testimony that health care providers are also hesitant to treat intractable pain with medication because they fear that prescribing opioid medications for pain will cause patients to become addicted to those medications; and

WHEREAS, Research shows that there is a low prevalence of addiction in patients suffering intractable pain and that physiological dependence and tolerance are distinct from addiction, which is characterized by behavioral symptoms; and

WHEREAS, The Board of Medical Examiners has recently adopted guidelines for prescribing controlled substances for intractable pain that gives guidance to physicians about what conduct is within the boundaries of professional practice; and

WHEREAS, The task force concluded that a multidisciplinary approach to pain assessment and management, similar to that used in a hospice setting, provides a good working model for treating pain and provides lessons that should be shared with the rest of the health care community; and

WHEREAS, The task force concluded that an effort to educate physicians about the Board of Medical Examiners' new guidelines, as well as pain management in general, would help those patients suffering from intractable pain to receive treatment from their personal physicians or, if necessary, to receive a timely referral to a pain treatment specialist; and

WHEREAS, The task force concluded that medical malpractice insurers could directly influence clinical practice and education more immediately than could a legislative mandate on physicians; now, therefore,

Be It Resolved by the House of Representatives of the Sixty­first General Assembly of the State of Colorado, the Senate concurring herein:

That the General Assembly and the Interdisciplinary Task Force on Intractable Pain strongly urge medical malpractice insurers to grant premium discounts or other incentives to physicians they insure who obtain continuing education in the assessment and treatment of pain for the benefit of their patients.

Be It Further Resolved, That a copy of this resolution be sent to each medical malpractice insurance carrier registered to do business in this state.

Committee on Health, Environment, Welfare and Institutions.