The PRPA, by expanding the authority of the Controlled Substance Act, will disturb the balance that we have worked so hard to create. Physician surveys by the New York State Department of Health have shown that a strict regulatory environment negatively impacts physician prescribing practices and leads them to intentionally undertreat patients with pain because of concern of regulatory oversight. In the last five years, there has been increased attention to the inadequate care of patients at the end of life, and to the inadequacy of pain management in patients throughout the course of their medical illness. Five studies have consistently shown that we have a health care system that prevents patients from obtaining appropriate pain assessment and treatment and appropriate palliative care. Minorities are particularly impacted by the undertreatment of pain and lack of access to palliative care.
Studies show that minorities are undertreated for their postoperative, traumatic, and cancer pain.
Complicating this undertreatment is the lack of availability of opioid drugs in pharmacies that serve minority neighborhoods. This lack of access leads to needless suffering. I am emphasizing these studies only to suggest that the current Pain Relief Promotion Act will do little to alter the current system of care that impedes particularly vulnerable populations such as children, the elderly, and minorities from receiving adequate pain management and palliative care. The PRPA and the Hatch amendments establish a program for pain and palliative care research and quality within the Agency for Healthcare Research and Quality to develop and advance scientific understanding of palliative care and to collect, disseminate and make available information on pain management, especially for the terminally ill, professionals and the general public. This is clearly a laudable endeavor.