Joint Commission says critics have 'misconceptions' about pain standards

The Joint Commission, which came under fire this week from critics who said its pain management standards have fostered dangerous prescribing practices by physicians that contributed to the country's opioid crisis, defended those standards in a public statement saying those detractors have many "misconceptions" about what they actually require of healthcare organizations.

"In the environment of today's prescription opioid epidemic, everyone is looking for someone to blame. Often, The Joint Commission's pain standards take that blame," said David W. Baker, M.D., the accreditor's executive vice president for healthcare quality evaluation.

Critics need to look at the pain management standards and what they require healthcare organizations to do when it comes to pain, said Baker. The standards do not push doctors to prescribe opioids and have not caused a rise in opioid prescriptions, he said. Data from the National Institute on Drug Abuse shows the number of opioid prescriptions in the U.S. had been steadily increasing for 10 years prior to the release of pain standards in 2001, he said.

Earlier this week, dozens of healthcare organizations, medical experts and consumer advocacy groups signed a letter to The Joint Commission asking the accreditor to revisit its pain standards. A second letter from the group was sent to the Centers for Medicare & Medicaid Services calling for the removal of questions about pain treatment from patient satisfaction surveys in hospitals that are used to determine reimbursement. Both pressure hospitals and physicians to prescribe painkillers to treat patients' pain, which has helped fuel the opioid abuse epidemic, the groups said. 

In response, Baker said in his statement that Joint Commission standards require organizations to assess patients for pain and then to manage that pain, but they do not require the use of drugs. To clear up misconceptions about the standards, he said, that The Joint Commission does not endorse pain as a vital sign, does not require pain assessment for all patients (a requirement eliminated in 2009), and does not require that pain be treated until a patient's pain score reaches zero.

To learn more:
- read The Joint Commission statement