Oregonian Metro Section, May 3, 1999 

Advocates of better treatment of pain seek legislative cure

Bills aimed at relieving suffering make progress at the state level, but those with a price may fail


Oregon lawmakers are slowly waking up to the need for better pain treatment.

A half-dozen pain control bills are advancing in the Legislature. As in Washington, D.C., eagerness to eliminate pain as a motivator for physician-assisted suicide is creating momentum, along with a growing realization of the plight of people living with chronic pain.

But this awareness in the Oregon Legislature is unlikely to be enough to push through bills that have significant price tags, several lawmakers said.

Symbolic measures -- such as Senate Joint Resolution 28, which affirms the rights of pain patients to get treatment, and House Resolution 62 which encourages better education for doctors and medical students in pain management --passed easily. While they don't mandate anything, they send the message that Oregonians should not have to live or die with ongoing, unrelieved pain.

"Itís time we recognize this as an issue," said Dr. Grant Higginson, the state health officer for the Oregon Health Division. Higginson served as chairman of the state's Pain and Symptom Management Task Force, which devised many of the bills.

Sen. Joan Dukes, D-Astoria, who began working on pain issues in 1993, said other lawmakers are beginning to understand that chronic pain is inadequately treated, that aggressive pain control at life's end is appropriate, and that while people who need medication for pain may depend on the drugs, they are not addicts.

The Pain and Symptom, Management Task Force, created by the last Legislature, has sparked awareness and given chronic pain -- the kind that lasts or recurs for more than six months and hinders everyday activities -- the same significance as pain at the end of life.

Bills under consideration include Senate, Bill 1027, which gives universal access to hospice care. But this bill faces a tough battle because it comes with a price tag as high as $2.8 million per biennium. Senate Bill 1141, which creates a state advocate for people with pain and their caregivers passed a Senate committee last week. It is less expensive, at $94,000 for the biennium.

"Any significant increase in health care budgets I just don't think really has a prayer at this point," said Rep. Jeff Kruse, R-Roseburg, whose House Human Resources Committee is likely to be assigned some of the pain bills that pass the Senate.

Kruse said Senate Bill 1140, which passed the Senate last week, may have a better chance because it relies on grant money to set up a pilot project. Teams of health practitioners -- from nurses and pharmacists to naturopathic physicians and acupuncturists -- would work with doctors who want assistance with chronic pain patients covered under the Oregon Health Plan.

The team would help assess and treat the patients' pain for one year, educating both the doctors and the patients.

You can reach Erin Hoover Barnett at 503-294-5011 or by e-mail at ehbarnett@news.oregonian.com