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Medical experts, patients and legislators are supporting a bill by state Assemblywoman Dion Aroner, D-Berkeley, that addresses under-prescribed pain medication. 

Assembly bill 487, introduced by Aroner in February, would require the Medical Board of California to develop a protocol that investigates complaints of undertreatment of pain and tracks the disciplinary actions taken. It would also make it mandatory for new physicians to take courses on pain management. It passed the state senate appropriations committee July 9. 

At a public forum at the North Berkeley Senior Center Wednesday, participants said the under-presciption of pain medication has been an ongoing issue for decades and affects a large number of people in California. 

“The numbers are striking,” said Dr. Robert V. Brody, chief of San Francisco’s General’s Pain Consultation Clinic, referring to a 1997 study of the undertreatment of terminal patients. “Way more than half of the patients who were dying did not have their pain managed in the last period of their lives.” 

One of the main reasons for the persistence of this issue is cultural, Brody and other panelists said. Many in the medical community and the public, they said, tend to confuse pain management with drug abuse.  

“The reality is that the patient who needs the medication will not become addictive,” said Dr. Diana Sullivan Everstine, a clinical psychologist who calls for better education on the psychological consequences of pain. “People who are prescription-drug-seeking are trying to feel a little better. They’re not trying to get high.” 

Sue Hodges, chair of the Oakland Commission on Persons with Disabilities, emphasized how critical the treatment of pain is for the psychological well-being of those, like her, who experience it on a daily basis. 

Hodges used an analogy to explain how depressed and socially isolated individuals with severe pain can feel when they’re undertreated. 

“Visualize the lens of a camera, the lens that you use to focus to take a picture of life, and look at that lens closing and the light getting darker and darker,” she told the audience. “For those of us who live in chronic acute pain for which there is no relief, there is no resting, there is no day off ... pain management can relax the lens of that camera, and allow it to open up again.” 

Sleep depravation, lack of joy, inability to focus and decreased sexuality are only some of the symptoms of untreated pain that affects its chronic victims, Hodges said. 

Dr. Sharon Drager, a local surgeon and president of the Alameda Contra Costa Medical Association, said that one of the difficulties in treating severe pain is the fact that there is no concrete way to measure it. Physicians can only rely on what patients tell them.  

“Pain is not a real vital sign,” she said. “It’s not the same as temperature or blood pressure because you can’t get an independent verification.” 

The best way to address that problem, she added, is to take into consideration all the aspects of pain, including anxiety, and to give patients autonomy.  

“Pain is such a complicated issue,” she said. “It has to be addressed in a global fashion and not only with opiates.” 

Contra Costa County Supervisor Donna Gerber, also a member of the medical board, said that the bill will be reviewed by the board sometime this month. She anticipates that the board will approve it and that the legislation will soon reach the Senate for a vote.  

For additional information on California’s Medical Board visit the web site http://www.medbd.ca.gov/