• Implementing the DEA Multiple Prescriptions Rule: Cautions & Steps
• Joint Commission Issues Draft Palliative Care Standards for Comment
• State Pain Initiatives in Action: Montana Pain Initiative
• Psychosocial Pain Assessment Forms in Spanish
• Pain in the News: Women with Breast Cancer Discuss Pain

Detecting Discomfort in Dementia: Focus on Behaviors
This educational video toolkit is designed to teach nursing assistants to identify the behaviors that cognitively impaired residents may show when they are in pain or discomfort, and to understand the ways they can help cognitively impaired residents get relief of their pain or discomfort.

8 Facts About Cancer Pain
Download a copy of the ASPI's 8 Fact Everyone Should Know About Cancer Pain here, or order print copies from The Resource Center of the ASPI

Cancer Pain Can Be Relieved
In this booklet, you will find information about cancer pain - and how to manage it. Pain medicines are often needed, but other treatments may be helpful as well. You don’t have to “go it alone.” For best results, you need to work as part of a team with family and friends, and your doctor, nurse, pharmacist and social worker. Glossy printed copies and a free downloadable version are available at The Resource Center of the Alliance of State Pain Initiatives. An online version is also available.

Implementing the DEA Multiple Prescriptions Rule:
Cautions & Steps
The recent DEA rule, Issuance of Multiple Prescriptions for Schedule II Controlled Substances, has been heralded as good news throughout the pain community.  This ruling allows licensed prescribers to write multiple prescriptions for Schedule II drugs with staggered fill dates, thus providing patients with the equivalent of a 90-day supply of medication when appropriate.  However, because states can enact controlled substances laws that are more stringent than federal laws, experts have raised concerns that the rule may not be consistent with the laws and regulations in certain states.  For example, in some states prescriptions are only valid for a very limited period of time, such as one week, which would therefore prohibit implementation of the federal rule. 

As the laws and regulations pertaining to the prescribing of controlled substances vary considerably from state to state, the ASPI urges State Pain Initiatives to carefully review their state laws and regulations and to consult with their state medical, nursing, and pharmacy boards and controlled substances authority to determine if practitioners in their state can implement the new federal regulation.  In addition, in states where the federal rule is in accordance with state law, the ASPI urges Initiatives to work with their state licensing boards to ensure that information about the regulation is clearly communicated to all practitioners who are licensed to prescribe or dispense Schedule II controlled substances in their state.

Distribution of 40 mg Methadone Formulation Restricted
The Drug Enforcement Agency (DEA) recently issued an advisory announcing that manufacturers of methadone hydrochloride 40 mg tablets have agreed to restrict distribution of this formulation of the drug. As of January 1, 2008, the 40 mg tablets, which are not FDA approved for use in pain management, will only be distributed to hospitals and facilities that have been authorized for detoxification and maintenance treatment of persons with opioid addiction. The 5 mg and 10 mg formulations of methadone hydrochloride, which are approved for the treatment of pain, will continue to be available to all authorized registrants, including retail pharmacies.

Medicaid Rx Pad Requirement Delayed Until April 1, 2008
The federal law requiring all non-electronic prescriptions for Medicaid beneficiaries to be written on tamper-resistant prescription forms has been delayed and will not take effect until April 1, 2008.  On Saturday September 29th the President signed H.R. 3668, the “TMA, Abstinence Education, and QI Programs Extension Act of 2007,” which provided a six month delay in implementation of the tamper-resistant prescription form requirement.  The ASPI had gone on record requesting reconsideration of or delay in implementation of the rule and is therefore pleased with the additional time this legislation provides for practitioners and patients to be informed of the new requirement and for health care facilities to obtain sufficient supplies of the forms.

State Pain Initiatives Receive Grants for Pain Relief Efforts
The ASPI and Lance Armstrong Foundation (LAF) are pleased to announce the selection of eleven State Pain Initiatives that will receive grants to carry out state and local projects directed at overcoming barriers to pain relief and improving the quality of life for people living with cancer.  The grant funding, made possible through a national partnership between the LAF and ASPI, will improve cancer pain management nationwide while providing infrastructure and financial and programmatic support to individual State Pain Initiatives.  Click here to read the full press release and learn more about the specific projects.