H-2284.1 _______________________________________________
SUBSTITUTE HOUSE BILL 1585
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State of Washington 54th Legislature 1995 Regular Session
By House Committee on Health Care (originally sponsored by Representatives Morris and Dyer)
Read first time 03/01/95.
AN ACT Relating to prescription of controlled substances for intractable pain; and creating new sections.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. Cancer is increasingly prevalent today in America with more than one million newly diagnosed cases annually. Among the most tragic victims are those whose lives are consumed by chronic, intractable pain. Some twenty million Americans suffer chronic pain stemming from a variety of causes. Chronic pain is identified as one of the nation's most costly health problems involving nearly fifty billion dollars in medical and social costs, including severe psychological problems that can destroy the will to live.
While opiates are extremely effective for treating pain, chronic pain is commonly undertreated by physicians because of the fear of addiction of patients. Recent studies however have shown that persons with intractable pain can be treated with narcotics with little risk of developing the self-destructive behavior characteristic of addiction because their motivations and psychological reactions and tolerances are different.
In addition, physicians report that the threat of disciplinary action for overprescribing acts as a deterrent to physicians in treating chronic pain patients with opiates. New clinical guidelines to correct the problem of inadequate treatment of pain in patients with cancer were published this year by a research arm of the federal department of health and human services. In addition, the states of California and Texas have recently enacted policies relating to the treatment of chronic pain.
It is the intent of the legislature that the state medical quality assurance commission develop and implement guidelines for the treatment of intractable chronic pain in accordance with recognized national standards pursuant to this act.
NEW SECTION. Sec. 2. The department of health shall convene a study group to review and recommend guidelines for the use of controlled substances and legend drugs as a method of treatment for chronic pain. The guidelines shall include: (1) Opiate therapy for acute pain, chronic pain associated with cancer and other terminal diseases, and other chronic and intractable pain conditions; (2) an operational definition of intractable pain; (3) recommendations on whether and to what extent such a definition or the practice guidelines should be included in state statutory law or rules; and (4) recommendations for providing information and continuing education on pain management to health care professions with prescriptive authority.
The study group shall include representatives from the medical quality assurance commission, the board of osteopathic medicine and surgery, the podiatric medical board, the nursing quality assurance commission, the dental quality assurance commission, the board of pharmacy, the department of labor and industries, the health committees of the senate and house of representatives, consumers, and other interested parties.
The department shall report to the health care committee of the house of representatives, and health and long-term care committee of the senate by December 1, 1995, on the guidelines and recommendations of the study group.
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