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n INTRODUCTION
n Rationale
for This Program on Opioids and Usage
Pain is a worldwide
problem causing needless suffering along
with a significant economic burden. Opioid
drugs are the cornerstone to addressing
this problem but are often underused and
misunderstood. The goal of this conference
is to provide a remedy to understanding
opioid management for acute and chronic
pain. Education, both from a medical and
regulatory view, is the lightening rod to
start this process.
n Drug
Use and Enforcement: A National Perspective
This lecture will
present an overview of the federal and
state enforcement efforts to mitigate the
illegal use and abuse of controlled
substances. Particular attention will be
put on the efforts to control the misuse of
prescription drugs by physicians,
pharmacists, and particularly Internet
scams.
n Drugs,
Documentation and the DEA
Many practitioners
fear repercussions from the DEA when prescribing controlled
substances to treat pain. Living in fear of
the DEA or any other legal/regulatory
entity will not help pain professionals
care for patients in pain, but
understanding the interplay of law and
medicine will encourage a proper
perspective and quality medical care. The
goal of this lecture is to give pain
professionals some perspective on
legal/regulatory issues and provide them
with tools and resources to assess the
current state of their compliance with
federal and state legal/regulatory
materials on prescribing controlled substances
to treat pain and make necessary
improvements in medical record
documentation.
This lecture will
cover recent DEA enforcement activity,
current federal and state legal/regulatory
material on prescribing controlled
substances to treat pain, and common
challenges pain professionals face in daily
practice.
n Legal
and Ethical Standards for Palliative Care
n Involving Opioid Use
This presentation will
explore the various factors that help
influence the development of legal
standards of care regarding the provision
of palliative care to patients experiencing
physical pain and emotional suffering, with
special attention to the role of opioid
prescription as a component of palliative
care. By comparing legal standards of care
with the ethical requirements of good
palliative care, this presentation will ask
whether the law can exert a positive,
therapeutic influence on medically
effective and humane patient
treatment
in this context.
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n Managing
Your Practice: One Physician’s
Viewpoint
Federal laws allow for
appropriate physician prescription of
opioids for the management of chronic pain.
Governing regulations can both help and
hinder the physician in the practice of
pain therapy. This session will briefly
give one physician’s viewpoint
regarding the appropriate use of
opioid
therapy using current guidelines and
regulations. Specific patient examples will
be used to engage audience participation.
n Psychopharmacology,
Antidepressants, Drugs,
n Opioids:
Acute and Chronic Pain—A
Pharma-
n ceutical
Overview
The clinician,
following this presentation, should be able
to discriminate acute pain from chronic
pain and somatization presenting as pain.
The clinician will be able to utilize pharmacotherapeutic
(pharmacology, pharmacodynamics, pharmacokinetics)
differences among analgesics, NSAIDs (Cox I
and COX II), opiates/opioids, antiepileptic
drugs (AEDs), antidepressants, centrally
acting agents, skeletal
muscle
relaxants, anxiolytics, and
sedative/hypnotics in
a patient specific
manner.
n Pain—How
to Deal with It
Pain is a complex
neurophysiologic response to a noxious
stimulus which is screened and adapted by
each person’s brain. Younger persons
express pain differently from older persons
due to the filtering effect of lifelong
experiences. Culture has a significant
modulating influence on the perception of
pain as well. There certainly are other
factors, both internal and external, which
in combination or singly must
be
appreciated to manage any person with pain.
Physicians tend to
underestimate a person’s pain
intensity by a third. Part of this under
perception is often related to a failure to
understand these complicating external
factors. Therefore, it is important to
educate physicians, both young and old, in
the recognition and management of
confounding issues in pain management.
n PANEL
DISCUSSION
n Case
Studies: A Multidisciplinary Approach
Representative case
studies will be presented by a team of
experts in a multi-disciplinary approach to
alleviating pain with opioids in various
disease entities. The panel will discuss
several cases including neuropathic pain,
cancer pain, and chronic nonmalignant pain.
This will be an interactive session with
audience participation encouraged.
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