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American Pain Society
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Glenview, IL 60025
June L. Dahl, PhD, Department Editor
June L. Dahl, PhD
The seventh national meeting for State Cancer Pain Initiatives (SCPIs) took place last April in Austin, TX. There were 125 participants, representing 30 states and Australia.
The meeting's theme, "A Decade of Progress," was the subject of the keynote address given by Charles Cleeland, PhD, president of the American Pain Society. Nearly 10 years have passed since the first SCPI was formally organized in Wisconsin. Dr. Cleeland's address gave participants an overview of major advances since then and reminded them how much we still must do to make pain relief a reality for all people with cancer. David B. Morris, author of The Culture of Pain (1994), challenged meeting participants to think about the meaning of suffering. At a special international session, Dr. Liliana DeLima provided an overview of the status of cancer pain management in Colombia.
Workshop sessions and informal gatherings provided important forums for sharing information and networking among representatives of SCPIs and other organizations. The workshop topics included patient education, regulatory affairs, institutionalization of pain management, healthcare reform and patient advocacy, strategies for engaging Native Americans in cancer pain education and research, successful fund-raising, and other topics relevant to the challenges faced by the state organizations. Strong links were forged between the Washington Cancer Pain Initiative and the fledgling SCPI in Alaska, which was represented at the meeting for the first time.
The meeting was dedicated to Robert T. Angarola, Esq., whose death in early March was a tremendous loss to the cancer pain community. Bob was a very special friend of the SCPI movement. He had participated in every national meeting and was always available for consultation on regulatory affairs and drug availability. Bob certainly would have been pleased that participants unanimously endorsed a recommendation from the regulatory affairs workshop. The recommendation stated that SCPIs oppose adoption of controlled substances monitoring programs that require prescribers to use special government-issued prescription forms. Bob had argued forcefully that such requirements reduce the availability of opioids to persons in pain without necessarily diminishing abuse of controlled substances.
Participants unanimously supported the creation of a national organization of SCPIs. At the 1995 national meeting, the Texas Cancer Pain Initiative proposed the development of an organization to support national program efforts and to assist SCPIs in all 50 states to work collaboratively with each other and with other organizations dealing with cancer pain-related issues. During the past year, Wisconsin's Resource Center for SCPIs and the Texas SCPI worked with a 26-member committee to develop an organizational framework. The stated purposes of the new American Alliance of Cancer Pain Initiatives (AACPI) are as follows:
A 12-member group, the Advisory Council, will serve as the AACPI's policy-making and decision-making body. The Council will articulate and support national program goals and directions annually. It will set timelines pertaining to national goals in patient care, research, and education. In addition, the Advisory Council will establish national standards for SCPIs and determine eligibility for use of the trademarked term Cancer Pain Initiative. Staffing for national activities is currently provided by the Resource Center.
The committee that recommended formation of the AACPI concluded that the approach and principles under which the SCPIs have functioned are sound and effective. The AACPI is, in part, an articulation of the participants' desire to preserve and continue these core values and to extend them to a wider group. For the present, the AACPI will retain its focus on cancer pain. This is in recognition of the AACPI's limited resources and the benefit for all pain problems from increased attention to cancer pain.
There is clear recognition that to be maximally effective, the AACPI should strengthen existing relationships with other organizations committed to improving cancer pain management and should seek out new collaborative opportunities. Individual SCPIs will continue to determine for themselves the nature of their affiliations with other organizations.
The ultimate goal is to make the cancer pain initiative movement and the AACPI catalysts for change in the American healthcare system. This goal will be achieved only when effective management of cancer pain is a priority in all care settings. In reality, that goal may not be achieved for many years to come.
Morris, D.B. (1991). The culture of pain. Los Angeles and Berkeley, CA: University of California Press.
June Dahl is professor of pharmacology at the University of Wisconsin Medical School in Madison, WI, chair of the Wisconsin Cancer Pain Initiative, and director of the Resource Center for State Cancer Pain Initiatives.
