2017 Regular Session ENROLLED
SENATE CONCURRENT RESOL UTION NO. 21
BY SENATOR MIZELL AND REPRESENTATIVE WHITE
A CONCURRENT RESOL UTION
To urge and request Louisiana medical schools, prescriber licensing boards, and prescriber
trade associations to take all necessary steps to eliminate pain as the fifth vital sign
and to increase prescriber education and awareness on assessing, identifying, and
treating the symptom of pain.
WHEREAS, according to the United States Centers for Disease Control and
Prevention, the opioid epidemic has seen pain pill overdoses quadruple nationwide since
2000 and triple in Louisiana since 1999, with Louisiana ranking sixth in the nation for
volume of pain pill prescriptions, generating more prescriptions per capita on an annual basis
than actual residents; and
WHEREAS, in the 1990s, due in part to aggressive advocacy from the
pharmaceutical manufacturers and misinformation that opioids were not as addictive as other
drugs, pain was recognized as the fifth vital sign, giving pain equal status with blood
pressure, heart rate, respiratory rate, and temperature as vital signs; and
WHEREAS, in clinical practice, pain as the fifth vital sign has proven to be more
complex to assess, evaluate, and manage than originally anticipated, as pain is a subjective
description by a patient based on prompts, often in the form of pain scale faces or other
imagery of unpleasantness, as opposed to the statistical tangible metrics generated by
assessing the other four vital signs; and
WHEREAS, establishing pain as the fifth vital sign has had serious consequences,
which although not necessarily intended, must be addressed at every level to prevent the
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unprecedented number of Americans becoming addicted to prescription opioids,
transitioning to heroin to sustain their addictions, and dying untimely and unnecessarily; and
WHEREAS, the American Academy of Family Physicians and the American
Medical Society have both issued statements of position on this matter calling for the
removal of pain as the fifth vital sign.
THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
commend the American Academy of Family Physicians and the American Medical Society
for taking a strong position on this matter and formalizing their commitment to remove pain
as the fifth vital sign.
BE IT FURTHER RESOLVED that the Legislature of Louisiana does hereby urge
and request Louisiana medical schools, prescriber licensing boards, and prescriber trade
associations to take all necessary steps to eliminate pain as the fifth vital sign and to increase
prescriber education and awareness on assessing, identifying, and treating the symptom of
pain with the goal of reducing utilization of opioids to treat patient reported pain when
alternative forms of pain management would be sufficient.
BE IT FURTHER RESOLVED that the Legislature of Louisiana does hereby urge
and request The Joint Commission, a nonprofit that accredits hospitals and other U.S.
healthcare organizations, to discontinue use of pain management as a measurement of
provider success and patient satisfaction, as such practice has directly contributed to the
increase in opioid prescriptions as well as resulted in a Medicare funding formula that
rewards high prescribers while penalizing those that attempt to reduce use of these highly
addictive and deadly drugs through arbitrarily contrived patient satisfaction surveys.
BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
dean of the Louisiana State University School of Medicine at New Orleans, the dean of the
Louisiana State University School of Medicine at Shreveport, the dean of the Tulane
University School of Medicine, the executive director of the Louisiana State Board of
Medical Examiners, the executive director of the Louisiana State Board of Dentistry, the
executive director of the Louisiana State Board of Optometry Examiners, the executive
director of the Louisiana State Board of Nursing, the executive director of the Louisiana
Medical Society, the executive director of the Louisiana Academy of Family Physicians, the
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executive director of the Louisiana Dental Association, the executive director of the
Optometry Association of Louisiana, the executive director of the Louisiana State Nurses
Association, and the president and chief executive officer of The Joint Commission.
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
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