A Single Point of Access for frontline practitioners
PAINWeekEnd Nashville 2019 | Saturday 6/1/19 to Sunday 6/2/19
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.
DoubleTree by Hilton Hotel Nashville Downtown
315 4th Ave. N
Nashville, TN 37219
Get Directions using Google Maps
Faculty and courses are subject to change. Please refer to the online schedule below for the most recent course descriptions.
To view the schedule 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.
Central poststroke pain (CPSP) is a neuropathic pain disorder frequently described as burning pain associated with allodynia and hyperalgesia over affected regions of the body. The underlying mechanisms are not well understood. It has been suggested that stroke associated loss of inhibitory neurons in the spinothalamic tract causes disinhibition of thalamic neurons, which generate ectopic nociceptive action potentials responsible for the pain experience. However, recent data suggests that pain is dependent on the peripheral afferent input and may be mediated by misinterpretation of sensory input. In this course, we review the pathophysiology, clinical presentation, and symptoms of CPSP. Recent findings may also shed light about future targets for treatment.
Breakfast will be served.
Sponsored by Daiichi Sankyo, Inc.
Throughout the course of history, mankind has experienced heightened effects from natural sources, and even delved into creating or modifying substances to the same accord. In our society we have a very objective classification of materials based on generally accepted medical use and propensity to become habit forming. However, as one can recall with ethyl alcohol (such as beer, wine, and hard liquor), a substance may not actually chemically change, yet can move across legal classifications. How does that happen? Well, join our discussion to learn how numerous illicit substances have similar, if not the same, mechanisms of action as legal prescription medications readily available today. One may even walk away with a few pointers from “street chemists” that are not easily available in any of our professional textbooks.
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.
Pain continues to be a significant public-health problem, affecting more than 100 million adults in the US. The presence of pain causes significant reductions in patient quality of life, along with significant economic issues.
The use of narcotic medications for pain management has increased dramatically in the US over the past two decades, resulting in increased concerns of misuse and abuse. Due to these concerns, patients in need of opioid medications for relief of acute and chronic pain are often undertreated.
Abuse-deterrent formulations of opioid medications have been developed to make opioids more difficult to abuse and/or to reduce the level of euphoria a patient feels when the tablet is altered. Abuse-deterrent formulations can play a key role in optimizing the risk-benefit ratio of opioid analgesia.
Manage Pain and Minimize Misuse/Abuse: Using Abuse-deterrent Opioids to Enhance Patient Quality of Life will discuss the barriers preventing adequate pain management, describe the effective use of abuse-deterrent formulations of opioid medications in clinical practice, and increase clinician awareness of patient engagement tools to optimize care.
Jointly provided by PCME and Rockpointe. This program is supported by an educational grant from Daiichi Sankyo, Inc.
Refreshments will be served.
Sponsored by Legally Mine.
Complex regional pain syndrome (CRPS) is a painful condition localized to a limb or body region, typically in response to trauma or surgery. Although several contributing mechanisms of CRPS have been described, the exact pathophysiology of the condition is not completely known. Graded motor imagery (GMI) is a comprehensive program aimed at sequentially activating motor cortical networks of the disordered limb to improve neural reorganization. GMI includes phases of progressive sensory-motor restructuring beginning with laterality training, guided imagery, and ultimately leading to mirror therapy. In this lecture, leading mechanisms for the development of CRPS will be discussed, along with the role of reorganization of the somatosensory cortex. In addition, treatment algorithms will be included along with medications, injections, and a thorough review of GMI and its outcomes.
Drug testing is part of a complete patient evaluation and ongoing risk monitoring in most medical practice settings when treatment involves long-term use of controlled medication. Today’s licensing board guidelines and rules, and position papers published by professional societies, make clear that drug testing should be performed and test results should be used in a timely fashion to guide medical decision-making prior to initiating controlled substance therapy, especially in the nonterminal, subacute, and chronic settings, and in ongoing patient risk monitoring and corresponding treatment plan adjustments. If a provider has his/her own clinical laboratory, or certain types of business arrangements with an independent clinical laboratory, failure to appreciate a new federal law impacting clinical laboratory or payor policies setting forth documentation requirements for medically necessary testing may spell financial disaster for the provider. Providers should review their current drug testing practices and, where applicable, coverage and reimbursement policies, to improve their ability to demonstrate quality patient care and adherence to the ever-developing body of laws and regulations governing controlled substance prescribing. Providers in business relationships with independent clinical laboratories or laboratory set-up companies should be generally familiar with a new federal law that may render suspect or unlawful certain aspects of these business arrangements, which may potentially expose the provider to allegations of fraud and abuse or recoupment for overpayments. Providers who proactively address any deficiencies or weaknesses in their use of drug testing in the context of controlled substance prescribing will largely minimize the potential for bad patient outcomes and related legal liability associated with controlled substance prescribing and the financial aspects of clinical laboratory. Using a series of “do this, not that” cases, attendees will learn how to distinguish poor workflow and documentation in drug testing from efficient and effective assimilation of standards of care and payor policies on medical necessity into their personal styles of patient evaluation and ongoing care. Attendees will be given two basic tools to reinforce learning objectives: a workflow template and an adaptable form to help the provider make timely and reasonably prudent ongoing treatment decisions, all of which may help the provider minimize the potential for an overdose event.
Coffee will be served.
The Cara Act of 2016 was an important piece of legislation in the fight against addiction and the looming opioid crisis. With NPs and PAs now being given the opportunity to become a waivered prescriber of buprenorphine for opioid use disorder, also comes responsibility and understanding. We will look at the importance of screening for opioid use disorder, the steps needed to become a waivered provider, and FDA approved treatments.
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.
Breakfast will be served.
Every year, thousands of patients go see their primary care practitioner for the treatment of regional pain syndromes. This lecture focuses on regional pain syndromes including acute low back pain, chronic low back pain, cervicobrachial syndrome, cervical dystonia, lumbosacral/ cervical radiculopathy, spinal stenosis, and disk herniation. We will discuss symptoms, the physical exam, diagnostic testing, and pharmacologic/nonpharmacologic treatment options.
In this day and age litigation is always a concern for a prudent provider. It is important to know what elements and what documentation is imperative when caring for the chronic pain patient. This session will focus on elements to include in a patient's record to support your diagnosis, and to build a case for prescribing opioids when and where appropriate.
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.
Every year, thousands of patients go see their primary care practitioner for the treatment of regional pain syndromes. This lecture focuses on regional pain syndromes including meralgia paresthetica, trochanteric bursitis, Baker’s cyst, meniscal injuries, cruciate ligament injuries, osteoarthritis of hip and knee, sacroiliac dysfunction, and piriformis syndrome. We will discuss symptoms, the physical exam, diagnostic testing, and pharmacologic/nonpharmacologic treatment options.
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!