The Senate Health, Education, Labor, and Pensions (HELP) Committee Feb. 12 held a hearing to discuss managing chronic pain during the opioid crisis.
In their opening statements, both Chair Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) emphasized their interest in ensuring that efforts to address the opioid crisis would not lead to unintended consequences for patients with chronic pain. Both noted that 50 million people nationwide suffer from pain that persists for weeks or years and highlighted steps that Congress has taken to improve research and clinical care associated with both addiction and chronic pain.
Specifically, Chairman Alexander highlighted efforts at the National Institutes of Health (NIH), including new flexibility authorized in bipartisan legislation enacted in 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT P.L. 115-271), intended “to spur research and development of new non-addictive painkillers.” He continued, “We have backed up those new authorities with substantial funding – most recently $500 million to help the National Institutes of Health find a new non-addictive painkiller…[and] the new law requires experts to study chronic pain and report to the Director of the NIH how patients can better manage their pain.”
The witness panel included Halena Gazelka, MD, assistant professor of anesthesiology and perioperative medicine, and director of the Mayo Clinic Inpatient Pain Service; Andrew Coop, Ph.D., professor and association dean for academic affairs at the University of Maryland School of Pharmacy; Anuradha Rao-Patel, MD, lead medical director of Blue Cross and Blue Shield of North Carolina; and Cindy Steinberg, national director of policy and advocacy at the U.S. Pain Foundation.
Dr. Gazelka reminded the committee of the complexity of the issue, stating that, “Policies considered and implemented should recognize that no surgery—or patient—is identical to any other. As such, prescribers must have the flexibility to develop a care plan that best meets the need of his/her patient while simultaneously prescribing opioids in a responsible manner.” She also described access barriers patients face due to a “paucity of pain management providers and resources.”
Ranking Member Murray also emphasized the contribution of workforce shortages to the problem, asking, “How can we tackle the workforce shortage and make sure people in pain are able to find a care provider that can serve them close to home?” Sen. Maggie Hassan (D-N.H.) reiterated the concern about shortages leading to access challenges, specifically highlighting the role of graduate medical education in training the next generation of physicians and the need for additional residency slots, particularly in fields like pain management, addiction medicine, and addiction psychiatry.