Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Pain Pathways Made Simple
UAN 0530-0000-18-047-L01-P
AANP Rx Hours 0.0
Course Description
In order to successfully clinically manage pain, it is essential to begin with an understanding of the underlying mechanisms responsible for its generation. A skillful approach based upon better knowledge concerning the anatomical structures, pathways, and events that result in pain is more likely to lead to effective clinical management of pain. The discussion will include an overview of medication classes typically considered for pain and the pathways they affect.
David M. Glick, DC, DAAPM, CPE, FASPE
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by SCILEX, Christopher Gharibo, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - Walking the Line: Opioid Dose De-escalation
UAN 0530-0000-18-212-L01-P
AANP Rx Hours 0.0
Course Description
The shift away from opioid use in medication management for chronic pain has changed the dynamic of opioid prescribing in many ways. Now, more than ever, prescribers are under the microscope regarding selection of opioids and doses as well as clinical documentation and appropriate action based on findings during the patient visit. Risks of opioids outweighing the benefits due to lack of effect, adverse effects, or aberrant behavior are just some of the possible justifications when considering opioid tapering. There are other instances when there is outright dangerous or illegal behavior that justifies discontinuation of opioids. This lecture will review different patient situations and discuss when to taper or discontinue opioids and how to implement the change in opioid therapy.
Abigail T. Brooks, PharmD, BCPS
10:40a - 11:40a - The Regulatory Agency Will See You Now
UAN 0530-0000-18-056-L01-P
AANP Rx Hours 0.4
Course Description
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.
Kevin L. Zacharoff, MD, FACIP, FACPE, FAAP
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 Teva, Tanya R. Bilchik, MD
1:10p - 2:00p - Clinical Pearls: Unraveling the Secrets of Imaging Studies
UAN 0530-0000-18-046-L01-P
AANP Rx Hours 0.0
Course Description
Diagnostic testing is an integral component for the differential diagnosis. In routine clinical practice there has been a tendency for clinical examinations to become more cursory, largely influenced by increasing demands of time and patient expectations of technological advances. The end result may arguably lead to an overreliance on technology for basic clinical diagnosis. The purpose of this session is 2-fold. It is meant to provide a review and, for some, an introduction to basic structural and functional studies used for the diagnosis of pain related problems. Attention will also be given to the limitations of such studies and the importance of establishing clinical relevance to their findings. Factors that adversely affect clinical management potentially resulting in failed treatment will be discussed as well as best practices when utilizing such studies to help enhance clinical outcomes for treatment.
David M. Glick, DC, DAAPM, CPE, FASPE
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - Product, Disease Awareness, Medical Information Program*
Refreshments will be served.
Sponsored by kaléo, Anand Thakur, MD
3:00p - 3:50p - What's All the "GABA" About? Pregabalin and Gabapentin Abuse
UAN 0530-0000-18-058-L01-P
AANP Rx Hours 0.0
Course Description
The gabapentinoids are a popular class of medications among prescribers for use in chronic pain and various other neurological conditions. In fact, prescription rates for both gabapentin and pregabalin have increased in the United States and other countries in recent years. However, these medications have a street value to a newer niche of users, including patients taking them at megadoses to enhance the effects of other psychotropic drugs, and other patients taking them to manage or mitigate opioid withdrawal symptoms and possibly even opioid cravings. While pregabalin is already classified as a controlled substance, gabapentin does not yet carry this classification. In response to rising abuse, various states and regulatory bodies are considering changes to enhance patient safety and protect the provider's license. Learn what changes you should make to your practice, if any, in light of the growing abuse of gabapentinoids and how to identify patients potentially abusing them.
Abigail T. Brooks, PharmD, BCPS
3:50p - 4:40p - The Other Opioid Crisis: Fentanyl and Heroin
UAN 0530-0000-18-055-L01-P
AANP Rx Hours 0.0
Course Description
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.
Kevin L. Zacharoff, MD, FACIP, FACPE, FAAP
*Not certified for credit.
