Both authors are with the University of Washington Department of Anesthesiology and Pain Medicine, University of Washington, Seattle.
Am J Public Health. 2019 Jan;109(1):66-72. doi: 10.2105/AJPH.2018.304746. Epub 2018 Nov 29.
Pain is a significant public health problem that needs policy at the national and local level to resolve incidents of insufficient, ineffective, and disparate pain treatment while limiting the risk of inadvertently increasing the use of treatment such as opioids that can result in public harm.The National Pain Strategy serves as the first comprehensive approach to address pain and provides a roadmap with substantial broad and specific policy implications. Although much has been accomplished to date, transitions in political power, available data and funding, and the current opioid epidemic continue to have an impact on implementation of the National Pain Strategy.A sustained, coordinated effort with multipronged policies in many forms on both federal and state levels via regulations, laws, and guidelines is warranted. However, research is needed to evaluate the impact and potential unintended consequences of increased legislation and regulation. Nevertheless, policy related to the management of pain may provide the path to new treatments and models of care to reduce the impact of pain as a public health crisis in this country.
疼痛是一个重大的公共卫生问题,需要在国家和地方层面制定政策,以解决疼痛治疗不足、无效和不一致的问题,同时限制无意中增加使用阿片类药物等治疗方法的风险,这些方法可能会导致公共危害。《国家疼痛战略》是解决疼痛问题的首个综合方法,提供了一张具有广泛而具体政策影响的路线图。尽管迄今为止已经取得了很大进展,但政治权力的更迭、现有数据和资金以及当前的阿片类药物泛滥继续对《国家疼痛战略》的实施产生影响。需要通过联邦和州各级的法规、法律和准则,以多种形式持续协调努力,采取多管齐下的政策。然而,需要进行研究来评估增加立法和监管的影响和潜在意外后果。尽管如此,与疼痛管理相关的政策可能为新的治疗方法和护理模式提供途径,以减轻疼痛作为该国公共卫生危机的影响。