Approximately $120 billion dollars is spent each year on treatment, lost revenues, and wages for chronic pain patients in the United States. Approximately 28-30% of the U.S. population suffer from some chronic pain condition, and a June 2000 Gallup Survey of “Pain in America” indicates that 42% of adults say they experience pain daily.

 The Joint Commission of Accreditation of Healthcare Organizations (JCAHO) announced in August, 1999, new standards for the assessment and management of pain in accredited hospitals and other health care settings. Acknowledging that pain is a co-existing condition with many other diseases and injuries, the standards make pain management an integral part of all treatment plans.

The new standards are published in the 2000-2001 standards manual for the affected JCAHO accreditation programs, and will first be scored for compliance in 2001. The standards apply to nearly 18,000 organizations involved in the direct provision of care.

JCAHO published Pain Assessment and Management: An Organizational Approach to provide an overview of their new pain management standards. The book also provides examples of ways various organizations have successfully implemented pain assessment and management strategies. The book is available through JCAHO's Customer Service Center, (630) 792-5800.

According to the book, the intent of the new standards is to acknowledge that “unrelieved pain has adverse physiological and psychological effects” and state that a pain assessment should include a psychosocial assessment, along with a detailed patient history, physical examination and diagnostic evaluation.

 The book also suggests that:

• If a patient has pain, the effects of the pain upon the patient's functioning in daily life, i.e. sleep, appetite, relationships, emotions, concentration, etc., should be explored and that patients should be reassessed regularly.
• The pain and the effectiveness of the pain management plan should be evaluated at every assessment and documented.
• A 0-to-10 pain scale should be utilized to assess pain intensity of adult patients.

Chapter 9 provides various case studies of organizations which have successful pain assessment and management strategies in place. One such organization is the Pain Management Center of Paducah. Read about this organization.

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