109th Congress

Pain Legislation

H.R. 1020, S. 999

Background

In 1931, the French medical missionary Dr. Albert Schweitzer wrote that “pain is a more terrible lord of mankind than even death itself.” Pain has become a common disorder; a serious and costly public health issue; and a challenge for family, friends, and health care providers who support individuals suffering from the physical and emotional consequences of pain.

While progress is being made toward understanding the physiological mechanisms involved in pain, understanding an individual’s pain experience presents unique scientific challenges. The levels of pain experienced by different people and their reactions to pain vary widely, perhaps due to their psychological state, age, gender, social environment, and cultural background, as well as genetic or physiological differences. Consequently, the pain experience needs to be examined at all levels of basic and clinical research, including behavioral research, with the goal of developing interventions to prevent and manage pain.

To address this challenge, the National Institutes of Health (NIH) created a Pain Consortium, which promotes collaboration and coordination among researchers at 18 Institutes and Centers with programs and activities addressing pain. The NIH Pain Consortium is actively working to identify key research opportunities, particularly those that provide for multidisciplinary NIH participation, and it is also linked with the NIH-wide Blueprint for Neuroscience.

The goals of the Consortium are to:

• Develop a comprehensive and forward-thinking pain research agenda for NIH
• Identify key opportunities in pain research, particularly those that provide for multidisciplinary and trans-NIH participation
• Increase visibility for pain research, both within the NIH intramural and extramural communities and with pain advocacy and patient groups who express their interests through scientific and legislative channels
• Pursue the pain research agenda through public-private partnerships, wherever applicable. This underscores a key dynamic that has been encouraged by the NIH Roadmap for Medical Research.

In March 2005, Representative Michael J. Rogers (R-MI) introduced H.R. 1020, the National Pain Care Policy Act. The bill was identical to legislation introduced by Representative Rogers in the 108th Congress. It called for a White House Conference on Pain Care, a National Center for Pain and Palliative Care Research within NIH, a pain care initiative in military and veterans’ health care facilities, and pain care standards in TRICARE and Medicare Advantage plans.

In May, Senator Ron Wyden (D-OR) introduced S. 999, the Conquering Pain Act of 2005, which also addressed the treatment of people experiencing pain. The bill would have provided for a public response to the public health crisis of pain, including a Web site containing evidence-based practice guidelines for pain treatment, a Surgeon General’s report on the state of pain and symptom management, and grants to establish National Family Support Networks in Pain and Symptom Management, among other provisions. The bill also included a provision that would have required NIH to convene a national conference to discuss the translation of pain research into the delivery of health services, including mental health services, to chronic pain patients and those requiring end-of-life care.

Congressional interest in pain and palliative care research was also demonstrated at the House Energy and Commerce Subcommittee on Health hearing held on December 8, entitled “Improving America’s Health: Examining Federal Research Efforts for Pulmonary Hypertension and Chronic Pain.”

Provisions of the Legislation/Impact on NIH

H.R. 1020 would have declared adequate pain care research, education, and treatment as national public health priorities and would have established the National Center for Pain and Palliative Care Research within NIH to conduct clinical and basic science research into the biology, causes, and effective treatment of pain. Six regional pain centers would have been created to facilitate and enhance the research, research training, and related activities that would have been carried out by the Center. New programs for research quality and education as well as training programs for pain and palliative care would have also been established, and public awareness of pain and palliative care research and treatments would have been emphasized.

S. 999 would have required NIH to convene a national conference to discuss the translation of pain research into the delivery of health services, including mental health services, to chronic pain patients and those requiring end-of-life care.

Status and Outlook

H.R. 1020 was introduced by Representative Rogers on March 1, 2005, and was referred to the House Energy and Commerce Subcommittee on Health. On April 3, the bill was reported out favorably by the House Committee on Energy and Commerce without amendment. No further action occurred on this legislation during the 109th Congress.

S. 999 was introduced by Senator Wyden on May 11, 2005, and was referred to the Senate Committee on Health, Education, Labor and Pensions. On May 11, the bill was reported out favorably by the Committee without amendment. No further action occurred on this legislation during the 109th Congress.