Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Falling Down the Rabbit Hole: A Primer for Chronic Pain Management and Substance Abuse Disorders
UAN 0530-0000-18-038-L01-P
AANP Rx Hours 0.0
Course Description
The field of pain management has undergone a circuitous adventure, much like a rabbit hole. As the economic, mental health, and medical consequences of prescribing opioid medications have mounted, the prevailing logic regarding the usefulness of prescribing opioids for chronic pain has shifted. The widespread dissemination of opiates and the lax safety measures placed on their storage has also led to an increase in nonmedical use. Given the high level of comorbidity between opioid use disorders and chronic pain, providers' decisions about how to address treatment with patients who may have or who have been diagnosed with substance use disorders are often complex. The new CDC guidelines will require providers to assess for risk of overdose or development of a substance use disorder, and to be keenly aware of their patients' pain levels and pain management strategies when working as part of a system where opioid medications may be prescribed. Participants will learn how patient and provider education programs and communication interventions may improve outcomes in pain management. Participants will also learn how to select candidates for opioid trials, assess for risk, and initiate opioid therapy, but only after exploring nonopioid and nonpharmacological strategies.
David Cosio, PhD
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Collegium Pharmaceuticals, Emil H. Annabi, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - 3's Company: COX-2 Inhibitors, Medicinal Marijuana, and Opioid Prescribing
UAN 0530-0000-18-031-L01-P
AANP Rx Hours 0.0
Course Description
There is much controversy around many aspects of pain treatment, and compelling arguments have focused on both sides of the fence regarding appropriate opioid use and prescribing, legalization of marijuana, and the safety of cox-2 inhibitors. In all 3 cases, there are issues associated with strong positions, although the evidence, when put into practice, is less black and white. For each topic, we will evaluate current literature and debate the clinical, legal, and ethical controversies surrounding recent developments in pain management. Attendees will get a better understanding as presenters debate evidence based application of the cdc guidelines in various clinical settings, evaluate clinical and ethical concerns regarding marijuana for medicinal or recreational use, and take a critical look at the literature and its application when using cox-2 inhibitors for treating pain.
Alexandra McPherson, PharmD
10:40a - 11:40a - Ketamine Infusion Therapy for Migraine Headaches
UAN 0.0
AANP Rx Hours 0530-0000-18-066-L01-P
Course Description
You can teach an old drug new tricks! In this course, we will briefly review the definition, pathophysiology, and clinical presentation of migraine headaches. We will then review the application of the anesthetic and analgesic drug ketamine. A review of recent literature regarding the use of ketamine and migraine headache will reveal the most useful way this treatment may be used to treat patients with refractory, chronic migraine. We will also cover selection criteria for patients who are good candidates for ketamine therapy and for patients who are not good candidates.
Armen Derian, MD
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 Salix Pharmaceuticals, Maged Mina, MD
1:10p - 2:00p - The Gentle Art of Saying No: How to Establish Appropriate Boundaries With Chronic Pain Patients
UAN 0530-0000-18-054-L01-P
AANP Rx Hours 0.0
Course Description
Effective pain management has been deemed a human right, but some chronic pain patients perceive that to mean they are entitled to opioid analgesics for prolonged pain control. In response to these expectations, providers may feel pressured to say "Yes" and continue prescribing opioids, thereby reinforcing the patient's beliefs and reliance on medication. This has contributed to a dramatic rise in opioid analgesic misuse and deaths from prescription drug overdose. In fact, the CDC has identified opioid misuse as a "public health epidemic" and released new guidelines in March 2016. While a collaborative relationship is optimal for pain management, there may be times when a practitioner saying "No" is the best treatment. Many providers feel uncomfortable setting boundaries; however, boundary setting is important work because rights as a provider are also important. When reasonable limits are placed on a patient and the patient continues to step beyond those limits, it is imperative that providers maintain boundaries and be consistent in their message. Participants will learn about the gentle art of saying "No" and how to use a decision tree when making pain management decisions. Sample cases will be presented along with recommended treatment strategies.
David Cosio, PhD
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - Product, Disease Awareness, Medical Information Program*
Refreshments will be served.
Sponsored by ADAPT® Pharma, George Avetian, DO
3:00p - 3:50p - The 411 on Nonprescription Analgesics: When to Hold 'Em, When to Fold 'Em
UAN 0530-0000-18-052-L01-P
AANP Rx Hours 0.7
Course Description
Pain is the number one reason why patients seek advice from their pharmacist or primary care provider. Patients very often seek to use a nonprescription analgesic to self-treat a painful complaint, yet often do not understand the exclusions to selftreatment or how to select the best analgesic. Participants in this presentation will learn what nonprescription analgesics are available, indications for use, appropriate dosing and duration of therapy, appropriateness of candidates, and how to monitor and educate patients about their nonprescription analgesic. At this presentation, participants will learn the mechanism of action, indications, adverse effects, and precautions of oral and topical nonprescription analgesics, along with patient counseling points when recommending a nonprescription analgesic.
Alexandra McPherson, PharmD
3:50p - 4:40p - Peripheral Neuropathies
UAN 0530-0000-18-065-L01-P
AANP Rx Hours 0.0
Course Description
The pathophysiology of peripheral neuropathies will be reviewed in detail. We will review the anatomy of the nervous system to better understand peripheral neuropathies, and go over their clinical presentation. In addition, we will pay particular attention to the criteria that differentiate one neuropathy from anothe, review the most common causes of peripheral neuropathy, and discuss the best diagnostic tools and the best treatments for painful peripheral neuropathy.
Armen Derian, MD
*Not certified for credit.
Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - 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
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Supernus Pharmaceuticals, Eric Eross, DO
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - Get Your Specimens in Order: The Importance of Individualized Test Orders and Timely Test Utilization
UAN 0530-0000-18-039-L01-P
AANP Rx Hours 0.0
Course Description
2016 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. 2017 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.
Jennifer Bolen, JD
10:40a - 11:40a - Ain't Misbehavin': Decreasing and Managing Pain Patient Aberrant Behavior
UAN 0530-0000-18-033-L01-P
AANP Rx Hours 0.0
Course Description
Practitioners routinely wrestle with the issue of medication aberrant behavior (MAB)--What should I do about this? Should I discharge the patient? Will I get in trouble if I don't discharge this patient? Often there is no one right answer, and practitioners struggle with what to do in the face of a failed drug screen or some other evidence of MAB. This session will help prescribers decrease and prevent MAB in their practice as well as be more comfortable making clinical decisions when faced with MAB. The session will address such issues as universal precautions, assessing risk of MAB, clinical decision-making with regards to MAB, and deciding when to discontinue opioids. The session is designed to move practitioners from a simple "I'll discharge anyone who does anything wrong" to a more balanced and clinically sound decision-making practice.
Ted W. Jones, PhD, CPE
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:00p - Trainwreck: Addressing Complex Pharmacotherapy With the Inherited Pain Patient
UAN 0530-0000-18-057-L01-P
AANP Rx Hours 0.50
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
1:00p - 1:10p - Break & Exhibits
1:10p - 2:00p - The Five Coping Skills That Every Patient Needs
UAN 0530-0000-18-053-L01-P
AANP Rx Hours 0.0
Course Description
This session will teach participants the 5 core pain coping skills that all pain patients need: understanding, believing, calming, balancing, and coping. By knowing these skills providers will have a better idea of how they can plan treatment and intervene with patients more effectively. Participants will also learn how they can teach these skills to patients in individual sessions or in a group setting. By learning these core skills and simple ways to teach them to patients, providers can add to their treatment armamentarium in helping patients deal with their pain.
Ted W. Jones, PhD, CPE
2:00p - 2:50p - 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&mdah;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.
*Not certified for credit.
