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.