New Report Card Shows 24 States Have Improved Pain Policies Since 2012

Press Release – July 15, 2014

WASHINGTON, DC – A growing number of states are enacting policy measures that promote the delivery of effective pain management, according to a report released today. Over almost a decade, states have made considerable progress in enacting policies that enhance access to pain care, including the use of pain medications, and minimizing potential treatment barriers.

The report, Achieving Balance in State Pain Policy: A Progress Report Card (CY 2013) shows the extent that state policies can support pain management and patient care. The University of Wisconsin Pain & Policy Studies Group (PPSG) prepared the report, which was jointly funded by the American Cancer Society, the American Cancer Society Cancer Action Network (ACS CAN) and the LIVESTRONG Foundation.

PPSG researchers evaluated the content of state laws and regulatory policies to determine whether they could enhance or impede pain management. The report assigns each state a grade from ‘A’ to ‘F’ that reflects the quality of its policies that can influence patient pain care. States’ current grades are then compared to their grades from 2012 and prior years to identify changes over time.

The 2014 report found continued improvement in state policies influencing pain management over almost a decade. A total of 24 states changed or adopted new policies to improve access to pain management between 2012 and 2013. The improvement was largely a result of state health care regulatory boards adopting policies to encourage appropriate pain management and state legislatures or regulatory agencies repealing restrictive or ambiguous policy language.

The report also found the following:

  • The number of states that received an ‘A’ grade increased from 13 in 2012 to 15 in 2013. These 15 states represent 22 percent of the total U.S. population.
  • Between 2012 and 2013, 5 states had sufficient policy change to improve their grade.
  • 48 states and the District of Columbia now have a grade above ‘C’, compared to 44 states in 2006.
  • 36 states improved their grade since 2006, and no state’s grade has decreased since 2006.

“The results of this research show a very encouraging improvement in state policies, but more still needs to be done to make sure these improved pain policies are reaching patients and addressing their undertreated pain,” said John R. Seffrin, PhD, CEO of the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN). “Patients, health care providers, and regulators all play a critical role in promoting a balanced approach to pain control policy and treatment.

“While we’re pleased with the uptick we’ve seen, we can’t rest until all 50 states have an ‘A’ grade and cancer survivors no longer have to needlessly suffer due to a lack of medication to regulate their pain,” said Doug Ulman, LIVESTRONG Foundation President and CEO. “Alongside our partners in the cancer community, we will continue to relentlessly advocate on behalf of patients and survivors to ensure that policymakers enact patient-centered solutions to cancer care.”

“The state policies we evaluate are more frequently communicating the importance of pain management and are imposing significantly fewer barriers on health care decision-making and patient care related to pain issues, especially when compared to almost a decade ago. These are very promising findings,” said Aaron Gilson, PhD, Research Program Manager for the PPSG. “In light of this important progress, however, legislative and health care regulatory policymakers must continue to avoid introducing new restrictions or ambiguities when addressing pain care issues in their state. In this way, the progress that we have seen can be maintained.”

Pain is the most common reason Americans access the health care system, and it is the leading contributor to health care costs. Most painful conditions can be relieved with proper treatment, yet patients often face significant barriers that can prevent proper assessment, diagnosis, and treatment of pain. Untreated pain can devastate a person’s quality of life, affecting all aspects of daily functioning, including sleep, work and relationships.

While an integrative approach to patient pain care utilizing medications and non-drug therapies is encouraged, opioid medications can be a beneficial treatment for managing serious, persistent pain in carefully selected patients. But health professionals can be reluctant to prescribe such medications for numerous reasons, including concern about unwarranted sanctions for violating laws governing health care practice. Such policies can unduly restrict healthcare decision-making, contradict current medical knowledge, establish ambiguous practice standards, and fail to communicate appropriate messages about pain management.

The complete report, Achieving Balance in State Pain Policy: A Progress Report Card (CY 2013) is available at the University of Wisconsin’s Pain & Policy Studies Group website: