Physical therapists work with pain and its many forms every single day. There are 
still many theories on what pain is, why it exists, and what we can do about it. However, we know that most pain is treated with medication. Whether it is from a recent injury, or chronic pain from a variety of factors, most everyone tries medication as the first treatment to manage pain.
A new bill introduced in the U.S. House aims to change how pain is managed with the “heavy hitters”: opioids, narcotics, benzodiazepines, etc. This bill, H.R. 4641, would create a task force to identify what research shows is best practice for pain management. After being introduced on February 22, 2016, it was sent to the House Committee on Energy and Commerce. The bill’s cosponsors, Susan Brooks (R-IN-5) and Joseph Kennedy (D-MA-4), are both members of this Committee’s Subcommittee on Health.
So, what exactly does this bill entail? Well, the makeup of the task force initiated by this bill is certainly interesting. While there would be representatives from major bureaucratic
agencies (DEA, CDC, VA, etc), there would be other seats filled by healthcare providers who deal with pain. Named in the bill are seats for physicians, dentists, pharmacists, “experts in fields of pain and addiction research,” as well as seats for representatives of pain advocacy groups, addiction treatment groups, and a person with chronic pain. The problem is, that’s as specific as it gets for seat assignment. We do not know how many total seats are available, how many each group will get, or how these individuals will be selected.
The purpose of the task force makes more sense later on in the bill. Once the task force is created, they then meet to modify or update current best practice for pain management. According to the bill language, this task force must take into account “existing pain management resources…recommendations from relevant conferences…as well as pharmacological and medical device alternatives to opioids.”
Another interesting wrinkle is the requirement of this task force to ask the public on their opinion of the changes they make to pain management practice. This may be a way for physical therapists to get involved, since we do not seem to have a seat on the task force. You probably already know, but #PTAdvocacy is a very effective tool for just this purpose. What would YOU say about current pain management practice?
The final piece of this bill, after taking all new research on pain and plans to decrease opioid usage, is a feasibility study on how effective these new changes would be. As of right now, there is no requirement to actually implement these changes. But what if the changes have a negative financial impact on medical groups and hospitals? Will insurance companies chime in to kill this bill?
For now, it looks like we’ll have to wait to find out.
an exercise in politics 