A Single Point of Access for frontline practitioners
PAINWeekEnd Garden Grove 2019 | Saturday 4/6/19 to Sunday 4/7/19
This is a 2-day meeting and will provide 12 CE/CME credits.
Practicing Healthcare Professionals: $199
In order to maintain the clinical nature of the conference, nonclinicians—including, but not limited to, office managers, billing specialists, receptionists, and administrative staff; guests, spouses, friends, and/or family members—may not attend PAINWeekEnd.
Unfortunately, we do not have discounts available on hotel rooms. Please contact the hotel directly should you require accommodations.
Hyatt Regency Orange County
11999 Harbor Blvd.
Garden Grove, CA 92840
Get Directions using Google Maps
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Faculty and courses are subject to change. Please refer to the online agenda below for the most recent course descriptions.
To view the agenda below, click on the + sign next to the day of the conference to expand the conference agenda. Click on the + signs within the agenda to view the course description, UAN number, and AANP pharmacology credits.
*not certified for credit
Coffee will be served.
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.
Breakfast will be served.
Sponsored by Teva Pharmaceuticals.
Despite high prevalence and seemingly continuous attention, the clinical challenges associated with assessing, treating, and managing patients with chronic pain continue to persist. Many different forces are at play and responsible for this frequently frustrating situation and, as is often the case, the person with the most at risk is the patient with chronic pain. There is no deficit of opinions for possible solutions to this problem. In fact, the number of potential solutions seems to increase each year, all with the intent of helping pain care be more safe and effective, and most trying to stem the negative consequences of abuse, misuse, and diversion of prescription pain medications. Clinicians have had to juggle these good intentions along with the fear of regulatory scrutiny. This course will present and detail the variety of current regulatory forces that need to be considered in clinical practice; how they can potentially impact clinical decisions regarding chronic pain; and how they can be negotiated. A number of regulatory agencies are now “sitting at the pain management table” for the foreseeable future and it is critical to navigate the waters without sacrificing that most important stakeholder: the patient.
Through the lens of medical expert testimony and case examples, attendees will learn core areas of risk mitigation with a focus on making electronic medical records and paper charting work for the practitioner to demonstrate prescribing in the usual course of professional practice. Overdose—a small word that packs a major punch, and a big reason for recent legal-regulatory changes in controlled substance prescribing and medication assisted treatment (MAT). Too often, prescribers are caught unprepared to respond to licensing board and legal inquiries surrounding overdose events. Many prescribers haven’t examined their own risk mitigation and documentation processes following changes to prescribing guidelines and rules, or even after learning about a patient’s emergency room visit or demise. Many prescribers also lack a structured approach to patient education to mitigate the risks associated with the use of controlled substances, errantly relying solely on a piece of paper to capture what should be a process of informed consent. Professional licensing board and criminal cases involving overdose events do not usually end well for the unprepared prescriber. Yet, there is much the prescriber can do proactively to signal his/her intent to prescribe for a legitimate medical purpose while acting in the usual course of professional practice and taking “reasonable steps” to mitigate abuse and diversion of controlled medication. This educational program includes lessons learned by the speaker through more than a decade of chart audits and legal case work. Attendees will have access to one or two sample templates that can be used to improve daily charting and to demonstrate adherence to risk evaluation, monitoring, and common documentation requirements. 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. This lecture will help the prescriber demonstrate thoughtful prescribing in the “usual course of professional practice” and improve the prescriber’s chances of minimizing legal liability associated with patient overdose.
Lunch will be served.
Sponsored by SCILEX.
The subject of the medical use of cannabinoids has become an extremely hot topic. Unfortunately, there has been a tendency to equate medical cannabinoids with another very contentious topic: Medical Marijuana. In this presentation, the distinction between medical cannabinoids and medical cannabis will be explored. Specifically, the challenges facing prescribers who are being asked to prescribe medical marijuana will be examined.
Refreshments will be served.
Sponsored by Emergent BioSolutions.
There is a significant amount of media, political, and public attention paid to the opioid crisis/opioid epidemic in the United States today. With the seemingly ever-increasing number of opioid-related overdoses and fatalities, there has been a feverish push by stakeholders to diminish the amount of opioids prescribed in order to help stem these worrisome trends. Unfortunately, there may be a lack of focus regarding the true definition and characterization of the opioid epidemic. There may also be a rush to judgment about the role of appropriately prescribed opioid analgesics in the addiction crisis we face today as well. This presentation will discuss the roles and statistics of both prescription and illicit opioids (namely heroin and fentanyl) in today’s “opioid overdose epidemic” with the intention of clarifying important differences and similarities between these competing epidemics including concerns and clinical considerations specific to each of them. Additionally, this program will examine and identify how these medications and drugs share potentially tragic adverse effect profiles in many cases. However, it is important for clinicians to make sure that appropriate chronic pain patients that may be candidates for opioid analgesic therapy aren’t penalized, and still get the treatment that they deserve.
2018 was not a good year to be on the wrong side of medical necessity when it came to drug testing and ongoing prescribing of controlled medication or substance abuse treatment programs. 2019 is likely to be an expensive year for those who do not proactively take steps to understand medical necessity for drug testing, prescribing controlled medication, and ongoing substance abuse treatment, as payers continue to carefully scrutinize these areas. Using a series of case hypotheticals, attendees will learn how to identify the elements of medical necessity, efficiently and effectively document medical necessity for drug testing and use of drug test results in the ongoing care of the patient, and locate and use payer medical policies and coverage determinations. Attendees will be given 3 tools to reinforce learning objectives: a checklist for medical necessity documentation, sample summaries of payer medical policies, and templates for documenting use of drug test results and tailoring ongoing treatment decisions to the individual patient.
Coffee will be served.
The current opioid epidemic has resulted in numerous professional and society guidelines focused on safe opioid prescribing. In addition, policymakers have focused on state legislation to limit the duration of opioid prescribing for acute pain. As a result of the increased scrutiny, prescribers have shifted their focus to limiting opioid prescribing for patients with chronic noncancer pain. Now, more than ever, evidence based behavioral treatment modalities are essential for fostering pain coping skills and providing support as part of optimal interdisciplinary pain management. This course will begin with a brief review of the opioid epidemic. Current opioid prescribing guidelines will be discussed with a particular emphasis on indications for opioid tapering. Strategies for the medical management of opioid tapering will be presented, along with a detailed discussion of evidence based psychotherapeutic interventions known to result in improvements in physical and emotional functioning while promoting opioid tapering.
Breakfast will be served.
Sponsored by kaléo.
Burnout, a phenomenon closely linked with depression and characterized by emotional exhaustion, depersonalization, and reduced self-efficacy, has increased at a disproportionate rate in physicians compared to the general us working population. While interventions have been developed to address factors that contribute to burnout among practicing physicians, there is a strong need to focus on prevention for all clinicians involved in the delivery of healthcare services. This presentation will provide information about burnout statistics, factors that contribute to it, and ways it can be prevented. Pathways to developing a work-life balance and promoting self-wellness will also be reviewed, as will a novel resident and fellow wellness program developed at Stanford University.
In the age of modern medicine, it is easy to forget that we change our body chemistry every time we eat. The quality and composition of our food has the power to increase or decrease body wide inflammation and modulate pain. Our relationship to food and the way we eat is also cultural and influenced by stress and our environment. The research evidence is robust for dietary interventions and improved health. The changes needed are simple, but not necessarily easy. This lecture will focus on the role that modulation of the microbiome plays in pain, and ways to optimize the health of the individuals’ gut microbes for pain management and overall wellbeing.
Lunch will be served.
Sponsored by Daiichi Sankyo, Inc.
Per the department of Health and Human Services, opioid related overdose deaths have increased almost 400% over the last 18 years. This shift has yielded heightened scrutiny of prescribing practices, and opioids have subsequently fallen out of favor as a first-line treatment for chronic pain. In this changing landscape of pain care, it is more important than ever for clinicians to identify treatment pathways that will maximize patient outcomes while minimizing medication load. This presentation will review current literature related to use of opioids and medical challenges associated with weaning individuals off this class of drug. The role of evidence based behavioral treatment modalities known to result in improvement in physical and emotional functioning will be discussed in detail, including their use in the context of opioid weaning. The terms dependence, abuse, tolerance, and addiction are often used interchangeably when discussing opioid medication; however, use of nomenclature in this fashion is erroneous. The differences between these words will be explained and the implications for treatment discussed. Clinical pathways that often lead to medication escalation will be identified. The role of behavioral interventions for pain treatment and the literature supporting their use will be reviewed, including data from an interdisciplinary clinical program which provides patients such education while concurrently reducing opioid medication.
The opioid epidemic has caused many patients, clinicians, and payers to seek nonpharmacologic options to assist with managing pain. Psychology has a well-established role in the treatment of pain conditions but familiarity with the range of pain related interventions varies widely among clinicians. The Psychology Toolbox seeks to fill the knowledge gap by briefly explaining the role of psychology in pain treatment and reviewing a range of evidence based interventions to assist this burgeoning clinical population. Although cognitive behavioral therapy based interventions are the most frequently studied and applied paradigms, a number of other treatments also have demonstrated efficacy in pain care, but are lesser known. Thus, cognitive behavioral therapy for pain will be discussed, followed by an overview of several other pain treatment modalities: biofeedback training, mindfulness based stress reduction, and acceptance and commitment therapy. At the conclusion of the session, participants should possess a greater awareness of the vast array of evidence based treatments that can be used to help this group of individuals.
The endocannabinoid system (ECS) is now recognized as an important modulator of many physiological processes. Even more recently, an increasing body of evidence has been accumulated to suggest the antioxidant, anti-inflammatory, neuroprotective, and antinociceptive roles of the ECS. In 1997, the Office of National Drug Control Policy commissioned the Institute of Medicine (IOM) to conduct a comprehensive study of the medical efficacy of cannabis therapeutics. The IOM concluded that cannabis is a safe and effective medicine, patients should have access, and the government should expand avenues for research and drug development. This course will discuss cannabis as it relates to effective pain management.
To accompany and enrich your experience at the PAINWeekEnd conference, be sure to attend one or more of the sponsored programs, which are scheduled during breakfast, lunch, and afternoon "Brain Food" time slots in the schedule. There is NO ADDITIONAL CHARGE to attend these program sessions!