Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Year of the Locusts: The CDC Guidelines Impact on Practitioners and Patients
UAN 0530-0000-18-072-L01-P
AANP Rx Hours 0.0
Course Description
The CDC guidelines have caused controversy and spurred heated discussion. Produced with a paucity of evidence based medicine, they were never evaluated and iterated in the manner of more appropriate guidelines. In this course, we will examine the guidelines and their effect on practitioners--primary care physicians, pain specialists, etc--and chronic pain noncancer patients as well as some chronic cancer patients. Many functioning patients have had their opioid dosages diminished, either in concert with their physician or forcibly, without any say in the matter. This, along with a marked reduction in the amount of legal opioid medications that can be produced, has led to significant unintended consequences: practitioners are leaving the field; some refuse to even prescribe opioids, mostly due to fear of overregulation; once-functional patients are being abandoned by the medical field; patients are searching for something to return them to functionality, which can lead to overdose and death, particularly from heroin and illicit fentanyl. Indeed, the opioid crisis has now become the heroin and fentanyl crisis. During this presentation, solutions, and the changes necessary to bring them about, will be discussed.
Gary W. Jay, MD, FAAPM, FACFEI
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Teva, Brian Loftus, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - A Comedy of Errors: Methadone and Buprenorphine
UAN 0530-0000-18-032-L01-P
AANP Rx Hours 1.0
Course Description
The most contentious, poorly understood analgesics today are methadone and buprenorphine. This fast paced workshop will equip practitioners with immediately implementable practical tips regarding when and how to use these analgesics, including dosage formulations, routes of delivery, appropriate use in therapy, drug interactions, dosage titration (both up and down), opioid conversion calculations, and more. All discussions will be aimed at enhancing clinical, economic, and humanistic outcomes on the individual patient and health system level.
Douglas L. Gourlay, MD, MSc, FRCPC, FASAM
10:40a - 11:40a - Get Your Specimens in Order: How to Avoid Bad Company and Tame the Paper Beast Associated With Testing Drugs of Abuse
UAN 0530-0000-18-039-L01-P
AANP Rx Hours 0.0
Course Description
The government has ramped up its efforts in 2018 to connect claims of inappropriate opioid prescribing to financial gain, including gain from urine drug testing. While most physicians do not have a financial interest in a clinical laboratory, the government's decision to highlight an opioid prescriber's failure to timely utilize drug test results is significant, and suggests the government is looking at other factors tied to medical decision making. Thus, prescribers should pay attention to licensing board, payer, and professional society guidance on ordering drug tests and how to use drug test results when treatment involves opioid prescribing. Attendees will learn how to identify the core elements of medical necessity and document an individualized testing plan for each patient. This course will cover critical areas of medical record documentation, including the decision to drug test, when and how often; determining which drugs to test and why; and how to coordinate timely review and use of drug test results in connection with the patient's plan of care. Attendees will gain additional insight into these issues through position papers, published late 2017 and early 2018, by the American Academy of Pain Medicine and the American Association for Clinical Chemistry. The overall goal of the course is to assist prescribers in their quest to provide quality pain care to their patients and to document their rationale for drug testing and their treatment decisions.
Jennifer Bolen, JD
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Product, Disease Awareness, Medical Information Program*
Lunch will be served.
Sponsored by AstraZeneca and Daiichi Sankyo Inc., Srinivas Nalamachu, MD
1:10p - 2:00p - Migraines A-Z
UAN 0530-0000-18-070-L01-P
AANP Rx Hours 0.2
Course Description
During this course, we will go over the clinical symptomatology of migraine in a number of its various forms, as well as the pathophysiology of migraine. We will go over the acute as well as prophylactic treatment of migraine using evidence based criteria
Gary W. Jay, MD, FAAPM, FACFE
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - Product, Disease Awareness, Medical Information Program*
Refreshments will be served.
Sponsored by SCILEX, Joseph Pergolizzi, Jr., MD
3:00p - 3:50p - Trainwreck: Addressing Complex Pharmacotherapy With the Inherited Pain Patient
UAN 0530-0000-18-057-L01-P
AANP Rx Hours 0.0
Course Description
The prescription drug problem in America has led to many guidelines and, in some cases, regulations aimed at stemming the tide of prescription drug abuse. Some are evidence based, but most are driven by fear and an overwhelming need to do "something." Unfortunately, while these guidelines have offered suggestions of how to apply this information in a clinical context going forward, they provide little information as to the management of those patients who already exceed these current guidelines. This is where the concept of the "inherited patient" comes into play. Some of these patients are doing well while some are doing quite poorly. The undeniable fact is that as these guidelines are being exceeded, risk of a bad outcome increases while likelihood of achieving therapeutic goals decreases. This workshop will, through the use of representative cases, help participants to recognize irrational pharmacotherapy and, when necessary, address it through a combination of pharmacological as well as biopsychosocial frameworks.
Douglas L. Gourlay, MD, MSc, FRCPC, FASAM
3:50p - 4:40p - Embrace Changes and Prevent Overdose: A Basic Blueprint for Legal Risk Mitigation and Response
UAN 0530-0000-18-045-L01-P
AANP Rx Hours 0.0
Course Description
Overdose--a small word that packs a major punch, and a big reason for many recent legal regulatory changes in controlled substance prescribing and pain management. Too many physicians and allied healthcare practitioners are caught unawares by the legal issues surrounding overdose events, fatal and nonfatal. Often, prescribers are the last to learn about an overdose event and, worse yet, fail to take action once notified. Through a series of case examples, attendees will learn how to develop and implement overdose event policies and protocols. Attendees will receive copies of sample policies and protocols and learn how to tailor them to their respective practices and state licensing board framework. Professional licensing board and criminal cases involving overdose events do not usually end well for the prescriber, but there is much the prescriber can do proactively to signal his/her intent to get things right. While prescribers cannot control what their patients do once they leave the medical office, they are responsible for establishing a safe framework for opioid prescribing, including a proper response when something goes wrong.
Jennifer Bolen, JD
*Not certified for credit.
