Pursuit of Excellence: Can Utah Make the Grade?

Utah has twice earned a middling grade of C+ (A-F rating scale) in an assessment of state pain policies by the Pain & Policy Studies Group at the University of Wisconsin. Sixteen states changed their policies enough during the three-year period to earn a better grade in 2003 than in 2000. Utah was not one of these.

Based on policies in effect as of March 2003, 35% of states earned a grade of C, while 41% scored above a C and about a quarter fell below a C. No state received an A or F.

How do we improve? First, we need to take a look at the criteria used to evaluate state pain policies. They include the following: Are controlled substances recognized as necessary for public health? Is pain management encouraged as part of medical practice? Could certain provisions impede pain management such as the mistaken belief that opioids hasten death?

Utah's policy evaluation found several positive signs. For example, pain management is encouraged as part of medical practice. But problems also exist in Utah policies and statutes as written. For instance, confusion exists among the terms physical dependence, analgesic tolerance and addiction. Medical decision-making is restricted. Ambiguous language appears to set limits on what quantity of prescribing is "medically necessary" without clarifying who makes that determination.