[Congressional Record Volume 154, Number 129 (Thursday, July 31, 2008)]
[Senate]
[Pages S7946-S7947]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HATCH (for himself and Mr. Dodd):
  S. 3387. A bill to amend the Public Health Service Act with respect 
to pain care; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. HATCH. Mr. President, I rise today to introduce the National Pain 
Care Policy Act of 2008. I am pleased to have worked with my colleague, 
Senator Christopher Dodd, on this legislation which will help to 
address barriers to pain care by enhancing coordination of research, 
improving healthcare provider education and training, and elevating 
public awareness of pain and pain management.
  According to the American Pain Foundation, an estimated 75 million 
Americans suffer from either chronic or acute pain. Pain is the most 
common reason that people access the health care system and persistent 
pain can interfere with everyday life and make ordinary tasks seem 
impossible. Severe chronic pain also can hinder sleep, work, and social 
functions. Due to its very nature as a prominent feature of many 
chronic conditions, pain is said to affect more Americans than 
diabetes, heart disease and cancer combined.
  Most pain can be relieved with proper treatment. This simple fact 
implies that the pain problems of these countless Americans can be 
easily fixed. Unfortunately, many people in pain face considerable 
barriers to accessing proper diagnosis, treatment, and management of 
their pain.
  Health care professionals are, more often than not, inadequately 
trained regarding pain assessment and management, making it difficult 
for them to treat their patients' pain safely and effectively. As such, 
providers may be unfamiliar with current research and guidelines for 
appropriate pain care. Further, health care professionals may be 
hesitant to prescribe pain medications for pain management due to lack 
of knowledge regarding regulatory policies.
  To make worse the problem, the National Institutes of Health, NIH, 
our country's premier institution for biomedical research, currently 
dedicates less than 1 percent of its research budget to pain research. 
Worse yet, this research is spread across multiple Institutes and 
centers without efficient coordination. Effective education is 
contingent upon adequate research.
  Patients may also create for themselves barriers to pain care and 
management. As impractical as it seems, patients often do not tell 
their doctor about their pain because they do not want to complain or 
appear to be a nuisance. They also may avoid taking pain medicines 
because of addiction or dependency concerns which may be based on 
misinformation due to lack of education.
  The National Pain Care Policy Act of 2008 will help to identify these 
barriers by authorizing an Institute of Medicine, IOM, Conference on 
Pain Care to evaluate the adequacy of pain assessment, treatment and 
management. The conference will establish an action agenda by which to 
address barriers and improve education and training.
  The bill also authorizes permanently the Pain Consortium at the 
National Institutes of Health, NIH, to establish a coordinated clinical 
research agenda and promote pain research across NIH institutes, 
centers, and programs. The Consortium will convene annual conferences 
to make recommendations on pain research and activities at the NIH. The 
legislation also establishes a multidisciplinary Advisory Committee
  The National Pain Care Policy Act of 2008 addresses the lack of pain 
care education by creating a grant program for the development and 
implementation of programs to educate and train health care 
professionals in pain assessment and management. It also requires the 
Agency for Healthcare Research and Quality, AHRQ, to collect evidence-
based practices regarding pain and disseminate such information to the 
pain care community.
  This bill also will break down barriers to pain care access by 
raising awareness among people who suffer from pain, and helping them 
and their families find the proper information about pain management. A 
national pain management public outreach and awareness campaign will be 
developed and implemented by the Department of Health and Human 
Services, HHS, to focus on the significance of pain as a national 
public health problem.
  The National Pain Care Policy Act of 2008 contains provisions that 
will help the millions of Americans who live everyday with pain by 
heightening awareness, enhancing coordination of research, and 
advancing education. Similar legislation was introduced in the House by 
Representatives Lois Capps and Mike Rogers last year. The House bill is 
supported by more than 100 organizations in the pain care community, 
including the America Pain Society, the American Academy of Pain 
Medicine, and the American Cancer Society. I thank Senator Dodd for his 
leadership on and interest in this issue, and I urge my colleagues to 
support our bill.
  Mr. DODD. Mr. President, I rise today to join my colleague from Utah, 
Senator Orrin Hatch, in introducing the National Pain Care Policy Act 
of 2008. This important legislation would make significant strides in 
the understanding and treatment of pain as a medical condition. Pain is 
the most common symptom leading to medical care and a leading health 
issue. Yet people suffering through pain often struggle to get relief 
because of a variety of issues. This is why we are introducing this 
important legislation.
  Each year pain results in more than 50 million lost workdays 
estimated to cost the United States $100 billion. Beyond the economic 
impact, pain is a leading cause of disability, with back pain alone 
causing chronic disability in 1 percent of the population of this 
country. In the United States 40 million people suffer from arthritis, 
more than 26 million, ages 20 to 64, experience frequent back pain, 
more than 25 million experience migraine headaches, and 20 million have 
jaw and lower facial pain each year. It is estimated that 70 percent of 
cancer patients have significant pain as they fight the disease. And 
half of all patients in hospitals suffer through moderate to severe 
pain in their last days. As with many medical conditions, this is a 
problem that is likely to become worse as the baby boom generation 
approaches retirement and the population ages.
  Sadly, though most pain can be relieved, it often is not. Many 
suffering patients are reluctant to tell their medical provider about 
the pain they are experiencing, for fear of being identified as a ``bad 
patient,'' and concern about addiction often leads patients to avoid 
seeking or using medications to treat their pain. But even if patients 
were more forthcoming about their condition, few medical providers are 
equipped to do something about it. Often they have not been trained in 
assessment techniques or pain management, and are unaware of the latest 
research, guidelines, and standards for treatment. There is also 
concern among most providers that prescribing treatment for pain will 
lead to greater scrutiny by regulatory agencies and insurers.
  But we can do something about these barriers and help individuals 
suffering from pain. The National Pain Care Policy Act would lead to 
improvements in pain care across the country. The legislation would 
call for an Institute of Medicine conference on pain care to increase 
awareness of this issue as a public health problem, identify barriers 
to pain care and determine action for overcoming those barriers. A 
number of years ago, my good friend Senator Hatch helped establish a 
Pain Consortium at the National Institutes of Health to establish a 
coordinated pain research agenda. This legislation will codify that 
consortium and update its mission. The bill addresses the training and 
education of health care professionals through new grant programs at 
the Agency for Health Research and Quality, AHRQ, and the Health 
Resources and Services Administration, HRSA. And finally this 
legislation creates a national outreach and awareness campaign at the 
Department of Health and Human Services to educate patients, families, 
and caregivers about

[[Page S7947]]

the significance of pain and the importance of treatment.
  I want to thank Senator Hatch for his leadership on this issue and 
urge my colleagues to join us on this important effort to help the 
millions of Americans suffering from severe pain.
                                 ______