Standard setting function
One of FPM’s major achievements is its role in standard setting within the specialty. The Faculty has adopted a strong position in the creation and acceptance of language for classifying and discussing pain, pain clinics, and pain specialists. Prior to the faculty’s foundation there was no consistent language for discussing pain in the clinical environment. This had the potential to create confusion and miscommunication between practitioners.
Initially, FPM defined three types of pain: acute pain, cancer pain, and chronic non-cancer pain which was subsequently expanded to include neuropathic pain, which falls across all three categories. It also formed a definition of a ‘pain specialist’. Once agreed upon, FPM propagated this language, which has allowed for practitioners from all types of medicine and allied health to be aligned in their discussions about pain, and pain management.
It has also functioned to protect the public, by ensuring that those who claim to be experienced in pain medicine are indeed properly qualified, and have the necessary training to treat them adequately.
Through the introduction of formalised and standardised terminology, FPM paved the way for practitioners to be able to talk about and manage pain in Australia and New Zealand, and this should be seen as a major achievement.
The shift from ‘pain management’ to ‘pain medicine’ also gave weight to the specialty in the medical community, and shows how the standard-setting work of FPM has brought the field into prominence. FPM has not only monitored the evolution of the field of pain medicine, but has also actively shaped and constantly stayed at the forefront of the specialty.
Social issues and advocacy
Throughout its existence, FPM has voiced opinions about an array of social issues relating to pain and its management in Australia and New Zealand. This has included direct advocacy on a number of public health issues.
For a number of years FPM has been conducting consultative forums on medical cannabis. These were designed to promote discussion and inform the faculty’s position on the matter. This provided the faculty with the chance to establish a research strategy and develop clinical practice guidance related to cannabinoids and chronic pain.
Another major achievement has been the development of an opioid dose calculator for clinicians who prescribe opioids.
FPM has been involved with the push to make codeine based pain relief a prescription medicine, rather than be available over the counter. It also directly contributed to ANZCA’s recent statement on voluntary assisted dying.
Following Professor Cousins’ instrumental work in founding Painaustralia, the Faculty has continuously had representation on the board. It also has taken part in Global Year Against Pain events.
Partnering with other pain organisations and their events has helped to foster and promote awareness of pain and pain treatments in Australia and New Zealand. These examples demonstrate the role FPM plays in the broader community, and the growing reach of ideas about pain management.
Pain and Human Rights
In 2010, Professor Cousins chaired the steering committee which developed IASP’s first International Pain Summit which was held in conjunction with their World Congress on Pain, in Montreal, Canada.
An important outcome of this summit was the “Declaration of Montreal” which called for “access to pain management as a fundamental human right” published in IASP’s journal Pain. The principles of the declaration have since been endorsed by the World Medical Association.
The association adopted a resolution at their 2011 general assembly that denial of pain treatment violates the right to health and might be medically unethical.
Also in 2010, the Australian National Pain Summit, again with Professor Cousins as Chair, was held in Parliament House, Canberra. This led to unanimous adoption of the National Pain Strategy by the 150 organisations present. The major aim of Painaustralia is to facilitate the implementation of the National Pain Strategy. The strategy is strongly aligned with the aims of FPM.