A Single Point of Access for frontline practitioners
PAINWeekEnd San Diego 2019 | Saturday 6/22/19 to Sunday 6/23/19
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.
San Diego Marriott Mission Valley
8757 Rio San Diego Dr.
San Diego, CA 92108
Get Directions using Google Maps
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 most contentious, poorly understood analgesics today are methadone and buprenorphine. This fast paced course 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.
Breakfast will be served.
Sponsored by Legally Mine.
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 opioid and dose 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 to consider 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.
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.
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.
Nonopioid analgesics are considered first-line therapy for most chronic pain syndromes. A strong recall of these agents’ safety and efficacy profiles is paramount for today’s pain practitioner. This course will provide an in-depth look at each of the agents within these drug classes, their potential role in pain management, and available data supporting their use. Additionally, clinically relevant monitoring will be discussed.
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.
Coffee will be served.
West Virginia continues to lead the nation, and world, in drug overdoses, which makes one ponder what is being done at the “ground zero” of the opioid epidemic to save and improve lives. Where better than where it’s worst should some of the possible solutions come from? In 2016, an interprofessional panel of experts in pain management—ranging from medicine, osteopathy, nursing, pharmacy, dentistry; public health; the state PDMP; and representatives from insurance providers—was put together with aims of finding possible solutions. The West Virginia Safe & Effective Management of Pain (SEMP) Guidelines (www.sempguidelines.org) were developed to facilitate the shift of the best practices in pain management becoming the new standard of care. The SEMP Guidelines include 2 main components including the risk reduction strategy and the clinical treatment algorithms. Pain management algorithms are not available anywhere else in the entire world! So we would like to welcome you to “the West Virginia Way” and see just how the “wild and wonderful” state of West Virginia is approaching the opioid epidemic from a true ground zero. After all, if it works where it’s worst, how could it not help your state or your practice?
Breakfast will be served.
Sponsored by doctor.com.
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.
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.
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.
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.
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!