The U.S. program of the Pain & Policy Studies Group is primarily involved in the collection and evaluation of state policies (see glossary for definitions of terms such as statutes, regulations, and healthcare regulatroy guidelines) that govern pain management, especially prescribing controlled substances to treat chronic moderate to severe pain. Evaluations are conducted periodically to identify potential barriers to adequate patient pain care, as well as language that promotes safe and effective treatment. This objective is accomplished through the development of a criteria-based research methodology to analyze national and state policies, and a methodology to grade and compare states based on the quality of their policy content. From this information, we provide recommendations and technical assistance to those who want to improve the content of drug control or professional practice policies in their state.
The U.S. program also is involved in survey research concerning healthcare practitioners' and regulators' knowledge, attitudes, and practices about pain management and policy-related issues, as well as research examining trends in the medical use and abuse of prescription pain medications.
The U.S. program collaborates with such national organizations as the Alliance of State Pain Initiatives, the American Academy of Pain Medicine, the American Cancer Society Cancer Action Network, the American Pain Foundation, the American Pain Society, the American Society of Addiction Medicine, the Federation of State Medical Boards, the National Association of Attorney's General, and the U.S. Drug Enforcement Administration. We also collaborate with legislators, drug regulators, healthcare practitioners, and members of associations for pain and palliative care in numerous states.
The Pain & Policy Studies Group has been designated the World Health Organization (WHO) Collaborating Center for Pain Policy and Palliative Care since 1996. Its International Program, which guides the activities of the WHOCC, has been involved with evaluation of legislation, policy analysis and development, demonstration projects, outcomes monitoring, education and communications. The PPSG participates in international and national meetings for health professionals and government officials, provides technical assistance to government and non-government organizations, and promotes better understanding of the principle of balance that should guide national narcotics control policy to ensure availability of opioid pain medications under adequate control to prevent abuse and diversion.
The International Program develops methods, models, and resources to examine opioid availability trends, identify barriers to opioid availability in national laws, regulations and distribution systems, develop collaborative national projects to diagnose barriers and develop action plans to improve national policy, and monitor outcomes.
The PPSG led the creation of "Guidelines for Achieving Balance in National Opioids Control Policy," issued by the WHO in 2000. Formally endorsed by the International Narcotics Control Board, this important tool, consisting of 16 Guidelines, provides the background and rationale for national policy and systems evaluation and revision to improve availability and patient access to opioid analgesics.
An important PPSG product is its signature opioid availability workshops, which convene stakeholders in regional action planning workshops to identify and address barriers to opioid availability and access. Since 2000, the PPSG has hosted or taken part in numerous regional opioid availability workshops for more than 50 countries.
Another critical PPSG product is the International Pain Policy Fellowship (IPPF), inaugurated in 2006 with funding from the International Palliative Care Initiative (IPCI) of the Open Society Institute (OSI), and sustained by IPCI and Livestrong. This program trains competitively selected experts in pain management and palliative care from developing countries how to evaluate and improve opioid availability policy and distribution in their country. Following a 5-day training session in Madison, Wisconsin, the Fellows return home with partial salary support to implement their action plan with close technical assistance from PPSG staff and other volunteer expert mentors.
The PPSG accomplishes its international communications work in several ways, including an extensive website, news alerts, and through social media outlets like Twitter, Facebook, and our blog. The PPSG website includes individual Country Profiles that provide data and trend graphs for the national reported consumption of principal opioids.