ACMT Joins State Health Officials and Medical Experts in Petition to Change Aggressive Pain Management Rules

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The American College of Medical Toxicology, along with other health care organizations, medical experts and consumer advocacy groups, sent petitions to the Joint Commission and CMS requesting changes to pain management requirements.

American College of Medical Toxicology

The opioid epidemic has been a focus of the ACMT for several years.

In an effort to reduce overprescribing of opioid pain relievers, the American College of Medical Toxicology (ACMT), together with dozens of health care organizations, medical experts and consumer advocacy groups sent petitions to the Joint Commission, an agency that accredits health care organizations, and to the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicare. Petition signers are requesting changes to pain management requirements they believe foster dangerous prescribing practices.

Over the past 20 years, prescriptions for opioid painkillers have soared, leading to an epidemic of opioid addiction, rising heroin use and a record high rate of overdose deaths. Opioid prescribing increased in response to a multifaceted campaign, which called for pain to be treated as if it was a vital sign, a measure of essential bodily function, which includes temperature, breathing rate, blood pressure and pulse. In 2001, the Joint Commission introduced pain management standards requiring health care organizations to ask every patient about pain, leading to use of pain patient scales and hospital policies requiring aggressive pain management. In their April 13th letter to the Joint Commission, petitioners wrote that mandatory pain assessment in all patients and in all medical settings is “unwarranted and can lead to overtreatment and overuse of opioid analgesics”.

The petition sent to CMS calls for removal of the pain questions from HCAHPS, the agency’s patient satisfaction survey used for determining hospital reimbursement rates. In their letter to CMS, petitioners wrote “Aggressive management of pain should not be equated with quality healthcare as it can result in unhelpful and unsafe treatment, the end point of which is often the inappropriate provision of opioids.” The petitioners believe that linking hospital reimbursement to patient satisfaction with pain treatment results in overprescribing of opioids.

The opioid epidemic has been a focus of the ACMT for several years. Recently, ACMT released position statements on the use of methadone as an analgesic and on prescription fentanyl products. “While this epidemic is multifactorial, the important fact is that medical toxicologists can be a part of the solution by participating in advocacy and educating physicians. One of the most successful satellite courses at the ACMT Annual Scientific Meeting was the 2015 Addiction Medicine Academy. “ said Dr. Leslie Dye, President of ACMT. The proceedings from this symposium were published in the March 2016 issue of the Journal of Medical Toxicology, the official journal of the ACMT.

About The American College of Medical Toxicology
ACMT is a professional, non-profit association of physicians with recognized expertise in medical toxicology. The ACMT mission is to advance quality care of poisoned patients and public health through physicians who specialize in consultative, emergency, environmental, forensic, and occupational toxicology. For more information, visit http://www.acmt.net, or follow on Twitter @acmt.

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