A group of state health officials, doctors and consumer advocates is asking the Center for Medicare and Medicaid Services (CMS) for changes to pain treatment guidelines to reduce the use of opioid painkillers.

The group also has asked the body that accredits hospitals and clinics, the Joint Commission, to re-examine the pain management guidelines it requires institutions to follow, The Wall Street Journal reports.

In the letter to CMS, the group said current standards for treating pain are too aggressive and contribute to overuse of opioid painkillers. The letter urges CMS to stop asking patients about how well their pain was controlled in the hospital. CMS uses the answers in making judgments about hospital performance and to determine payment.

“Medication is not the only way to manage pain and should not be over-emphasized,” the group wrote. “Setting unrealistic expectations for pain relief can lead to dissatisfaction with care even when best efforts have been made to resolve pain. Aggressive management of pain should not be equated with quality healthcare as it can result in unhelpful and unsafe treatment, the end point of which is often the inappropriate provision of opioids.”

In the letter to the Joint Commission, the group wrote, “Mandating routine pain assessments for all patients in all settings is unwarranted and can lead to overtreatment and overuse of opioid analgesics. Healthcare professionals are capable of using their clinical judgment to determine when to assess patients for pain.”

The Joint Commission began to require hospitals and clinics to assess and manage pain in 2001, in response to concerns that many healthcare professionals were neglecting pain, according to David Baker, Executive Vice President of the Joint Commission.

“There was a time where pain wasn’t assessed,” he said. Baker added the Joint Commission is considering “what can we do to decrease inappropriate opioid use.”