American Academy of Pain Medicine

The American Academy of Pain Medicine appears in the book as a professional organization that advocated expanded opioid use for long-term chronic pain while receiving millions of dollars from companies that made opioids. Reporting on that relationship helped prompt a 2012 Senate investigation, but the investigation’s results were sealed, leaving a consequential public inquiry without a disclosed account of its findings.

Advocacy amid changing standards

The Academy’s advocacy took place during a broad redefinition of pain’s place in medical care. When OxyContin was introduced in 1996, doctors, hospitals, and accreditation bodies were adopting the idea of pain as the fifth vital sign, alongside blood pressure, heart rate, respiratory rate, and temperature. In 1999, the Joint Commission on Accreditation of Healthcare Organizations approved mandatory standards for pain assessment and treatment. This institutional shift made pain management an increasingly prominent measure of care, but the book does not attribute those standards to the Academy.

The new emphasis also coincided with changing incentives in health care. Patient satisfaction surveys, including those conducted by Press Ganey, influenced how doctors and hospitals were evaluated, while reimbursement pressures encouraged more liberal treatment of pain. The meaning of adequate relief, however, remained unsettled. Pain scales made subjective reports easier to standardize, yet a score could not reliably distinguish experiences as different as labor and a stubbed toe. The book notes that reliance on such scales did not correlate with better patient outcomes and was associated with increased opioid prescribing and abuse. This is the clinical and institutional climate in which the Academy’s support for broader long-term opioid use mattered.

Advocacy and industry relationships

Journalist John Fauber reported that the American Academy of Pain Medicine and the American Pain Society pushed for expanded opioid use to treat long-term chronic pain while taking in millions of dollars from companies that manufactured the drugs. The book presents the organizations’ advocacy and their industry funding together as a relationship warranting scrutiny. It does not specify the Academy’s exact receipts, the particular form of its advocacy, or the decisions through which the funding may have affected its positions, so those details cannot be established from the account.

The commercial context was expansive. Purdue Pharma promoted OxyContin as safe and reliable for chronic pain, repeating an addiction-risk estimate of less than one percent and directing sales representatives to physicians across the country. As pain assessment gained formal standing, Purdue’s own planning described an opportunity to be seen as a leader in helping hospitals meet accreditation requirements; the company budgeted for branded materials, including wall charts, clipboards, binders, and pens. Those were Purdue’s promotional efforts, not actions attributed to the Academy, but they show how the wider movement to improve pain care could intersect with pharmaceutical marketing.

Investigation and undisclosed findings

Fauber’s reporting on the pain organizations’ industry ties prompted a 2012 investigation led by Senators Chuck Grassley and Max Baucus. The inquiry targeted the American Pain Foundation and Purdue Pharma as well as the American Pain Society, the Academy, and other nonprofit organizations and pharmaceutical companies. The investigation therefore examined a wider field of relationships rather than the Academy alone.

Its results were placed under seal in the Senate Finance Committee’s office and remained undisclosed despite periodic calls for their release. The book records disappointment among people who had welcomed the investigation, noting that it was never followed up on publicly. The sealed findings leave the Academy’s role within the inquiry’s broader subject matter visible, while preventing readers from knowing what conclusions the Senate reached about its funding or advocacy.

Significance in the book

The Academy’s significance is chiefly institutional: it is one of the professional organizations through which the book traces the convergence of chronic-pain advocacy and pharmaceutical money. The surrounding history shows why that convergence carried weight. New assessment standards elevated pain treatment; patient and hospital incentives encouraged attention to pain scores; and commercial promotion presented opioids as appropriate beyond end-of-life care. Yet the evidence also describes unresolved questions about how pain could be measured and whether expanded opioid prescribing improved outcomes. The Academy is thus part of the contested history of opioid policy, while the sealed Senate record marks the limits of what the book can establish about the organization’s precise conduct.