Caring for Patients With Chronic Pain

CARING for PATIENTS with CHRONIC PAIN Responsible Opioid Prescribing to

ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

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FACULTY

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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Michael J. Brennan, MD FACULTY

Interactive Professor Director, The Pain Center of Fairfield Fairfield, Connecticut Senior Attending Physician Department of Medicine, Physical Medicine, and Rehabilitation Bridgeport Hospital Bridgeport, Connecticut Dr. Michael J. Brennan received his medical degree from the State University of New York Downstate Medical Center, and completed a residency in physical medicine and rehabilitation at the New York Hospital-Cornell University Medical Center, where he served as chief resident. While at New York Hospital, Dr. Brennan also served as chief resident at the International Center for the Disabled in New York City.

After completing his residency, Dr. Brennan was appointed to the faculty of New York Hospital and Cornell Medical College in the Department of Physical Medicine and Rehabilitation. He served as acting chief of the rehabilitation service in the Department of Neurology at Memorial SloanKettering Cancer Center in New York. After leaving Sloan-Kettering, Dr. Brennan became the medical director of the Rehabilitation Center of Fairfield County and Ahlbin Rehabilitation Centers, in Bridgeport, Connecticut, and chief of the section of physical medicine at Bridgeport Hospital, also in Bridgeport, Connecticut. A board-certified physiatrist in private practice in Fairfield, Connecticut, he is a senior attending physician in the Department of Medicine at Bridgeport Hospital and a consulting physician at St. Vincent’s Hospital in Bridgeport, Connecticut.

Dr. Brennan has special interests in the management of pain as well as disability in patients suffering from the acute and long-term effects of musculoskeletal diseases, neurological disorders, and cancer and various cancer treatments. He has published over 30 scholarly articles, abstracts, and textbook chapters on the treatment of cancer- and non–cancerrelated disabilities including lymphedema and pain. He is a reviewer for several medical journals and has served as guest editor for the Journal of Musculoskeletal Rehabilitation and as online editor for Pain.com. Recently, Dr. Brennan was awarded the Dr. Elizabeth Narcessian Memorial Award from Kessler Institute for Rehabilitation in recognition of his commitment to the treatment of patients suffering from chronic pain.

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

Jeffrey A. Gudin, MD FACULTY

Director Pain Management and Wellness Center Englewood Hospital and Medical Center Englewood, New Jersey

Dr. Jeffrey A Gudin received his medical degree from Albany Medical College in Albany, New York. Following a transitional internship in surgery, medicine, and anesthesiology at St. Barnabas Medical Center in Livingston, New Jersey, he completed his residency in anesthesiology at the Yale University School of Medicine and his fellowship at the Yale Center for Pain Management, in New Haven, Connecticut. While in New Haven, Dr. Gudin also trained in addiction medicine and directed a substance abuse treatment center. For the last 12 years, Dr. Gudin has been the Director of Pain Management and Palliative Care at Englewood Hospital and Medical Center, a Mount Sinai University School of Medicine teaching affiliate in New Jersey. He remains active in teaching and research, and has lectured internationally on a variety of topics in pain management, palliative care, and addiction medicine.

Dr. Gudin has dedicated his career to promoting education in pain management. He attends and has presented at the American Pain Society, the American Academy of Pain Management (AAPM), the American Academy of Physical Medicine and Rehabilitation, and many other national venues. Dr. Gudin serves as a consultant to state medical boards on challenging cases, as well as to industry on novel analgesic products and risk management associated with opioids. He recently presented at the 2012 AAPM Safe Opioid Prescribing Course.

Dr. Gudin is recognized nationally as a leader in pain management. He is an experienced researcher, consultant, speaker, and speaker trainer. He has collaborated with numerous initiatives to enhance responsible prescribing and the safe use of opioid pain medications.

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Bill H. McCarberg, MD FACULTY

Adjunct Assistant Clinical Professor University of California, San Diego Founder, Chronic Pain Management Program Kaiser Permanente San Diego Family Practitioner Neighborhood Health San Diego, California Dr. Bill H. McCarberg is Founder of the Chronic Pain Management Program for Kaiser Permanente in San Diego, California. He is on the board of directors of the American Academy of Pain Medicine and was on the board of directors of the American Pain Society. President of the Western Pain Society and adjunct assistant clinical professor at the University of California at San Diego School of Medicine, Dr. McCarberg is also a member of the American Academy of Family Physicians, the American Academy of Pain Medicine, the American Pain Society, and the International Association for the Study of Pain. He is the recipient of several awards including the Shilling Compassionate Care Award and the Elizabeth Narcessian award for leader in the field of pain education from the American Pain Society. In 2008 he was appointed Ambassador of the Year for the National Pain Foundation.

Member Appraisal of Physician Services at Kaiser Permanente has rated Dr. McCarberg in the top 10% from 1998 through the present.

Dr. McCarberg has given more than 250 presentations on pain management issues and is the author or coauthor of 78 articles, book chapters, and books. He is board certified by the American College of Pain Medicine, the American Board of Family Practice, and additionally certified in Geriatrics.

Dr. McCarberg received his medical degree from Northwestern University’s Feinberg School of Medicine in Chicago, Illinois. He completed a medical internship and a residency in family practice at Highland Hospital in Rochester, New York.

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

David M. Simpson, MD, FAAN FACULTY

Professor of Neurology Mount Sinai School of Medicine Director, Clinical Neurophysiology Laboratories Director, Neuromuscular Division Director, Neuro-AIDS Program Mount Sinai Hospital New York, New York Dr. Simpson is currently Professor of Neurology at Mount Sinai School of Medicine in New York. In addition, he is Director of the Clinical Neurophysiology Laboratories and Director of the Neuro-AIDS Program at Mount Sinai Hospital.

Dr. Simpson received his medical degree from State University of New York (SUNY) at Buffalo School of Medicine. He completed an internship in Internal Medicine at University Hospitals of Cleveland, Case Western Reserve University in Cleveland, Ohio, and a residency in Neurology at Cornell University Medical Center in New York. He completed a fellowship in Clinical Neurophysiology at Massachusetts General Hospital, Harvard Medical School, in Boston, Massachusetts.

An author of over 325 publications, Dr. Simpson is the principal investigator for many studies, including the treatment of neuropathic pain in patients with painful neuropathy and treatment of spasticity with botulinum toxin.

Dr. Simpson recently led research studies demonstrating the safety and effectiveness of the high concentration capsaicin patch in the treatment of certain types of painful peripheral neuropathy.

Dr. Simpson is a member of the American Neurological Association and the American Pain Society. He is a Fellow of the American Academy of Neurology, the American Academy of Neuromuscular and Electrodiagnostic Medicine, and the Royal College of Physicians. He is on the editorial boards of AIDS Patient Care and Current HIV/AIDS Reports.

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

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CARING for PATIENTS with CHRONIC PAIN

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CLINICAL TOOLS »» Brief Pain Inventory (Short Form) A multidimensional pain assessment instrument that can be used to characterize several aspects of a patient’s pain experience, the short form is also widely used for clinical trials and has been translated into multiple languages.

»» Opioid Risk Tool This five-question clinical interview or patient questionnaire helps stratify patients based on their risk for opioid-related misuse and abuse.

»» Current Opioid Misuse Measure (COMM)® A 17-item assessment questionnaire, the COMM focuses on current behaviors and cognition rather than character and personality traits associated with risks for substance abuse.

»» Pain Assessment and Documentation Tool (PADT™) Completed via clinician-directed interview, this instrument provides a consistent and structured method to document progress with opioid therapy over time.

GUIDELINES »» American Pain Society and American Academy of Pain Medicine: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain

SUGGESTED READING

Chou R, Fanciullo GJ, Fine PG, et al. J Pain. 2009;10(2):113-130.

»» Department of Veterans Affairs and Department of Defense: Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain The Management of Opioid Therapy for Chronic Pain Working Group.

Washington, DC: Department of Veterans Affairs, Department of Defense; 2010.

»» A Clinical Guide to Opioid Analgesia. 2nd edition Fine PG, Portenoy RK. New York, NY: Vendome Group, LLC; 2007.

»» Responsible Opioid Prescribing: A Clinician’s Guide. 2nd edition, revised and expanded Fishman SM. Washington, DC: Waterford Life Sciences; 2012.

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CARING for PATIENTS with CHRONIC PAIN

Responsible Opioid Prescribing to ACHIEVE INDIVIDUALIZED FUNCTIONAL GOALS

SUGGESTED READINGS »» Abuse rates and routes of administration of reformulated extendedrelease oxycodone: initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment Butler SF, Cassidy TA, Chilcoat H, et al. J Pain. 2013;14(4):351-358.

»» Establishing “best practices” for opioid rotation: conclusions of an expert panel Fine PG, Portenoy RK; Ad Hoc Expert Panel on Evidence Review and Guidelines for Opioid Rotation. J Pain Symptom Manage. 2009;38(3):418-425.

»» Universal precautions in pain medicine: a rational approach to the treatment of chronic pain Gourlay DL, Heit HA, Almahrezi A. Pain Med. 2005;6(2):107-112.

»» Urine drug testing in pain medicine Heit HA, Gourlay DL. J Pain Symptom Manage. 2004;27(3):260-267.

»» Substance misuse treatment for high-risk chronic pain patients on opioid therapy: a randomized trial Jamison RN, Ross EL, Michna E, et al. Pain. 2010;150(3):390-400.

»» Assessment and treatment of abuse risk in opioid prescribing for chronic pain Jamison RN, Serraillier J, Michna E. Pain Res Treat. 2011;2011:941808.

»» A review of abuse-deterrent opioids for chronic nonmalignant pain Moorman-Li R, Motycka CA, Inge LD, et al. P T. 2012;37(7):412-418.

»» Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics

SUGGESTED READING

Schaeffer T. J Med Toxicol. 2012;8(4):400-407.

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