PAINWeek 2019 Program Guide by PAINWeek

‘19

September 3—7, 2019

The Cosmopolitan of Las Vegas

Program Guide

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PW18 APP 8.10.indd 1

8/10/18 12:52 PM

Make this 1st on your list.

PaiNWeeK would like to thank these organizations for their contribution to the success of the 2019 conference.

BioDelivery Sciences International ● Collegium Pharmaceutical, Inc. ● Daiichi Sankyo, Inc. & AstraZeneca ● Pfizer Inc. and Eli Lilly and Company ● Salix Pharmaceuticals ● Teva ● Theranica LTD

JEFFREY FUDIN

LYNN WEBSTER

FRIDAY SEPTEMBER 6

An imperfect burden on patients

and providers

exploring opioid abuse deterrent methods beatrice setnick from the laboratory to the real user friday ● september 6

contents Administration art direction and graphic design

Darryl Fossa business development

Mike Shaffer client and conference management

Redza Dempster editorial services

Holly Caster finance

Heather Woolf media management and production

Patrick Kelly operations and technology

Jeffrey Tarnoff program development

Debra Weiner program management

Charles Frometa Maya Holmes

PAINWeek 6 Erie Street Montclair, nj 07042 usa

accoutrements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

about us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

conference floor plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

keynote .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

welcome reception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

accreditation .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

faculty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

satellite events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

course descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

exhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

119

T (973) 415–5100 F (973) 233–9383 info@painweek.org www.painweek.org

Please note that PAINWeek staff will be capturing photographs and video onsite in professional settings throughout the conference. By attending PAINWeek, you acknowledge that there is a possibility that you may appear in such photographs and video, which may be used in future PAINWeek conferences and/or materials and publications. Photographs and video will only be taken in public areas of the hotel, and we will not use an identifiable photograph or likeness of you as the focus of an image or illustration. Copyright © 2019, PAINWeek, a division of Tarsus Medical Group. The PAINWeek logo, and “The National Conference on Pain for Frontline Practitioners” are trademarks of PAINWeek. All other trademarks are the property of their respective owners. All rights reserved.

th annual The front of the PAINWeek name badge contains both attendee information and a bar code that can be scanned quickly to capture data. Information that is collected by scanning into PAINWeek core sessions will only be utilized by PAINWeek and Global Education Group for the purpose of processing your cme application and certificate. If you scan your badge at a satellite event or exhibit booth, your contact information (name, address, degree, specialty, company, telephone, fax, npi, and email) will be provided to the respective party who scanned your badge. Please note that to comply with Sunshine Act reporting and corporate policies, third-party program organizers may not allow access to their program without scanning. Name badges must be worn for admittance to all PAINWeek 2019 events. Please return to registration if you have lost your name badge. There is a $50 fee for replacement badges. A photo id is required. Information provided was accurate as of 8/19/2019. For the most up-to-date information please visit m.painweek.org.

welcome ● about us ● conference floor plan ● keynote ● welcome reception ● accreditation

ccoutrements 11

welcome

Kevin Zacharoff md, facip, facpe, faap

Senior Faculty Member, Executive Editor of PWJ

September 3—7 Dear PAINWeek Delegates: On behalf of our entire team, it is with sincere pleasure that I welcome both new and returning attendees to PAINWeek 2019! It has been amazing for me to watch this annual conference—celebrating its 13th year!—grow into the largest in the country devoted to pain and its management. There has always been one guiding principle for me as a physician: every consideration and decision should be able to be reduced to a single common denominator—the good of the patient. Therefore, it can (and probably should) be as unsettling to you as it is to me to watch what is happening in the field of pain management. The “pendulum” from years past has become a virtual tornado of controversy. Now more than ever, the lack/absence of a good, foundational knowledge base for clinicians could be disastrous for patients with pain. Attending this conference means that you have already made decisions about your role not only as a patient advocate and guardian, but also potentially as a vector of pain education to peers and other colleagues in your community and clinic setting. It also means you realize that it really does “take a village” to adequately address one of the most common reasons that people seek medical attention, and you are ready to become a part of the much needed solution to the tragic interwoven problems that we witness in our society. The most complimentary things I can point out about PAINWeek: 1) the breadth of its subject matter, with over 120 hours of ce/cme sessions, and 2) the delivery of education to all of us as a unified group of frontline clinicians and allies looking to address shared relevant goals. With numerous course tracks to explore, you have the ability to navigate the conference in a way that serves you best. Regardless where your interests may lie, there is a tremendous amount of education to be had at PAINWeek: from general topics such as the basics of pain assessment, the role of utilizing a biopsychosocial approach, and safe and responsible opioid analgesic prescribing; to special interest sessions focusing on complementary and alternative treatments, avoiding regulatory scrutiny, issues about public policy, the law as it pertains to us and patients, and future analgesic treatments, just to name a few. A few things to note: PAINWeek 101 on Monday evening is intended for first-time attendees and is a special opportunity to orient yourself and prepare for the most beneficial experience possible. The certified-for-credit Keynote Presentation on Wednesday evening will be followed by refreshments and the opportunity to converse and network with faculty and colleagues at the Welcome Reception in the Exhibit Hall. Don’t miss the scientific poster session and reception on Thursday, with podium presentations on Friday. I have always said that the PAINWeek has a distinct “pulse,” and you are the heartbeat. It is your collective interest and enthusiasm that keep it thriving. In addition to the live interaction that PAINWeek is famous for, share on social media. You made the right choice to come, now make the most of it!

about us The beat goes onâ&#x20AC;Ś

By Debra Weiner

One might be tempted to say that 2019 has been an annus horribilis in the world of pain management. Two long-standing pain organizations dissolved, a media maelstrom continues to flourish, while those who need relief the most have had to do without or, at the very least, with much less. However, something very positive has also emerged: PAINWeek registration has grown approximately 20% from last year. Clearly the current controversy has also strengthened the need and desire for multidisciplinary pain education offering options including, but not l imited to, medication management. So, here we are at our 13th PAINWeek. What you see every September is the result of an enormous team effort, and we have been very fortunate that much of our team has been together longer than most marriages. However, there are a few changes to the family tree. This year saw the departure of Keith Dempster, Steve Porada, and Sean Fetcho, along with the return of Mike Shaffer. Several years ago, Mike started his career with us directly out of college. Since then he has held senior positions at digital agencies and pharma companies, and we are most happy to welcome him back into the fold. We always do things a bit differently, like writing quirky job descriptions that contain questions like â&#x20AC;&#x153;name 3 famous people you would want to invite to a dinner party.â&#x20AC;? Fortunately, this garnered the attention of Charles Frometa, and he has become an indispensable asset in helping to manage sponsored events at the national and regional PAINWeek events. Another serendipitous moment occurred when Maya Holmes came to our shores. She is proactive, eager to learn new things, and happens to have well-developed audience recruitment skills. Maya has been able to turn many phone queries into paid registrations!

We churn out a great deal of content, which necessitates having a very gifted editor—like Holly Caster. Holly handles a broad range of editorial activities stretching across our print, digital, and live activities. She is the one who oftentimes is tasked with transforming fragmented narratives into readable material. An editorial alchemist of sorts. So how did we ever live without Heather Woolf? Heather is a wonder woman who keeps the ship fueled, the shelves stocked, and is the 12-cylinder engine of our PAINWeekEnd meetings. Oh, and she can bench press 400 lbs with her Lululemonclad legs! Patrick Kelly is a tenured crew member who came to us a decade ago and works across many domains: video and web content editing, program management, audience accumulation activities, and at least 10 other critical areas of importance. Suffice it to say that the only way we would ever willingly let him go is if Netflix picked up one of his reality show treatments. Which (gasp) could actually happen! I’ve lost count of how many original pieces of art that Darryl Fossa has produced over the years. Presumably hundreds. Whether he is here at the office or sitting in a Berlin café, he’s working. He sketches on planes, trains, buses, and while waiting at tram stops. While the rest of us work happily in our respective sand boxes, Red Dempster is managing the expectations, victories, and disappointments of our clients. He operates very much like a chief of staff (à la West Wing). Of course, the person I spend the most time with is Jeffrey Tarnoff. We’ve been sitting across from each other for 17 years now, and it remains as fresh as it was when we put the key into the lock of our first office door. He is the engineer to my architect. I come up with new ideas, he kicks the tires. We each play to our strengths and mostly stay in our respective lanes. Through times of abundance and seasons of drought, we have stuck together, and some way, somehow, figured out what we needed to do to keep this enterprise moving forward. This is us.

STEVE PASSIK THURSDAY SEPTEMBER 5

A MODEST PROPOSAL

addressing the components and complexities of coordinated care

conference floor plans Rose. Rabbit. Lie.

level 2

The Chelsea Tower

Opium

Wicked Spoon Buffet

Condesa

1 2

Con

8 7 6

level 2 Boulevard Tower

Holsteins

The Juice Standard

Jason of Beverly Hills Molly Brownâ&#x20AC;&#x2122;s Swimwear Retrospecs & Co

Skin 6|2 Cosmetics

China Poblano

Monogram

All Saints Stitched

CRSVR

Scientific Poster Session

Milk Bar

The Chandelier

Marquee Entrance

7 6 5

Condesa

Block 16

Bellavista Boardroom

Condesa Jardins Boardroom

Condesa

News Stand

Eggslut

Momofuku

REVIV Dry Bar

Please note: The Henry (restaurant) is located on level 1

level 3 The Chelsea

The Chelsea Tower

Elevator to Guest Rooms Business Center

Restroom

Ballroom

PDM Meal Programs

Castellana

On Demand

Brera

Elevator

PaiNWeek

Grac

Commons

Restroom

PDM Meal Programs

Commons

Ent

Grac

Castellana Ballroom

Gracia

Ent

level 3 Scarpetta Red Plate Beauty & Essex

Elevator

Restroom

Jaleo STK

GRACIA GRACIA GRACIA 7 Gracia 5 Gracia 7 8 Entrance

SESSION SESSION ROOM Entrance ROOM

Gracia Commons GRACIA Entrance

Gracia 1

Elevator

Entrance

Gracia 3

Blue Ribbon Zuma

Estiatorio Milos

level 4 The Chelsea Tower Elevator to

ELEVATOR TO Guest GUEST ROOMS Rooms

Green GREEN Room ROOM

Yaletown

Commons Yaletown COMMONS YALETOWN

NOLITA 1

COURSE ROOM

ROOM

Nolita

NOLITA 2

COURSE Nolita ROOM

Nolita COURSE

NOLITA

3 2 1

RESTROOM

Restroom

PAINWEEK STORE Registration REGISTRATION AreaAREA

ELEVATOR Elevator

Mont-Royal Commons

MONT-ROYAL COMMONS 1

Keynote COURSE COURSE & ROOM ROOM Session General

Commons CHELSEA Exhibit Annex COMMONS BOOK SIGNINGS

Mont-Royal MONT-ROYAL MONT-ROYAL Ballroom 2

Belmont

RESTROOM Restroom

CHELS 1, 2, 3

Ent

Bar

BAR

Restroom RESTROOM ELEVATOR Elevator

POOL Pool

Retail RETAIL

Overlook OVERLOOK GrillGRILL

Bar CHELSEA 1, 2, 3 & 5

Entrance CYBER CAFÃ&#x2030;

BAR

POSTER ABSTRACTS

Belmont EXHIBIT Exhibit HALL Hall

CHELSEA 4 COURSE ROOM

ELEVATOR Elevator

Elevator ELEVATOR RESTROOM Restroom

BOULEVARD POOL Boulevard Pool

WEEK RE

level 4

Bar BAR

keynote

Sponsored by Teva Pharmaceuticals

Charles E. Argoff md, cpe Andrew M. Blumenfeld md, fahs

Thursday, September 5 Level 3 Castellana Ballroom

● Coffee will be served

12:30p – 1:30p

Contact: (888) 661–3010 ● cme@rockpointe.com

● Lunch will be served Contact: Jordan Halter (973) 352–6764 ● jhalter@hlxusa.com

PDM-06 Refreshments Novel Remote Electrical Neuromodulation (REN) Device For the Acute Treatment of Migraine Sponsored by Theranica LTD

Charles E. Argoff md, cpe Andrew Blumenfeld md, fash

Thursday , September 5 Level 3 Gracia 7

3:30p – 4:30p

● Refreshments will be served Contact: Scott Szymanski (203) 994–4511 ● s.szymanski@theranica.com

PDM-07 Lunch Opioid Therapy Insights:

A Holistic Approach to Managing Patients Sponsored by Daiichi Sankyo, Inc. & AstraZeneca

Paul Choi md

Friday, September 6 Level 3 Brera Ballroom

12:30p – 1:30p

● Lunch will be served Contact: Ashley O’Berry (212) 885–3973 ● ashley.oberry@prohealthmeded.com

7:00a -8:00a

PLEASE JOIN US FOR AN INTERACTIVE PRESENTATION Sponsored by Daiichi Sankyo, Inc., AstraZeneca, & Inspirion Delivery Sciences

Opioid Therapy Insights: A Holistic Approach to Managing Patients Friday, September 6, 2019 • 12:30 pm – 1:30 pm

L O C AT I O N

Brera Ballroom, Level 3 The Cosmopolitan of Las Vegas Las Vegas, Nevada

F A C U LT Y

Paul J. Choi, MD, DABA Medical Director DaVita HealthCare Partners Medical Group Huntington Beach, California

PROGRAM DESCRIPTION

In this interactive, industry-sponsored presentation, we will discuss when to consider an abuse-deterrent opioid for chronic pain. We will also explore treatment options for opioid-induced constipation in adult patients with chronic non-cancer pain.

This program is being sponsored by Daiichi Sankyo, Inc. The speaker is being compensated for the presentation. The program is not CME accredited and may not be used for CME accreditation. In adherence with PhRMA guidelines, spouses or other guests are not permitted to attend company-sponsored programs. Please be advised that information such as your name and the value and purpose of any educational item, meal or other items of value you may receive may be publicly disclosed. If you are licensed in any state or other jurisdiction, or are an employee or contractor of any organization or governmental entity that limits or prohibits meals from pharmaceutical companies, please identify yourself so that compliance with such requirements can be ensured.

heather poupore-king & kristen slater

using metaphors, mindfulness, and values to promote behavioral change

wed sept 4

CHARLES ARGOFF

FRIDAY SEPTEMBER 6

PARTS 1 & 2 LARRY CHARLESTON SCOTT POWERS NINA RIGGINS

THURS SEPT 5

escriptions

ourse

ACU

MYO

Acute Pain Management

International Myopain Society

AHS

NRO

American Headache Society

Neurology

BHV

PAL

Behavioral Pain Management

Palliative Care

CBN

PEF

Medical Cannabinoids

Pain Educators Forum

CPS

PHM

Chronic Pain Syndromes

Pharmacotherapy

ENC

PMC

Encore

Pain Management Coaching

INT

POS*

Interventional Pain Management

Poster Session

INTG

SIS

Integrative Pain Management

Special Interest Session

IPPS

SYM

International Pelvic Pain Society

Symposia

KEY

VHA

Keynote

Veterans Health Administration

MAS

WRK

Master Class

Workshop

MDL

Medical/Legal

*Not certified for credit

ACU-01 Acute Pain in Patients with Active Substance Use Disorder

per person per year. Acute pain is a consequence of most surgical interventions. Certain procedures result in higher pain trajectories that, if not adequately addressed, can lead to poorer outcomes and increased costs. Clinical pathways are being developed to address improving outcomes in the most cost-efficient manner. This course examines new options on the horizon for the management of moderate to severe in-hospital acute pain management; the impact of scheduled vs not scheduled analgesics related to the management of in-hospital acute postoperative pain management; health economic and outcomes measures related to inhospital acute moderate to severe postoperative pain; and enhanced recovery after surgery.

Debra B. Gordon rn, dnp, faan

Wednesday, September 4 Level 4 Nolita 1

7:00a –7:50a

Opioid use and addiction have soared in the United States over the past 20 years, and drug overdoses have become the leading cause of injury death. Persons with opioid use disorder (oud), particularly those injecting opioids, frequently require hospitalization and encounter need of acute opioid analgesia for trauma, surgery, infection, and other medical conditions. Treatment of acute pain in persons with oud present challenges for acute pain management including altered nociception thresholds, physical dependence and withdrawal, tolerance, impaired immune response, and behavioral issues such as opioid seeking and poor coping skills. Clear goals of care and use of engaging communication methods are essential to deliver optimal inpatient care and smooth plans for hospital discharge. This session will cover key principles to working with this population including 1) improving patient safety and healthcare outcomes by treating underlying oud; 2) optimizing pain relief for necessary surgical and medical treatment by providing multimodal analgesia; 3) facilitating access to medication treatment programs upon discharge; 4) empowering patients and providers by promoting clear, just, and equitable treatment of pain; and 5) protecting communities by promoting discharge opioid prescribing habits that minimize risk.

ACU-03 Case-Based Challenges in Acute Pain Management Debra B. Gordon rn, dnp, faan

Wednesday, September 4 Level 3 Gracia 3

Acute pain is associated with negative outcomes, and

efforts to prevent and control pain are necessary. Goals for acute postoperative pain management include reducing the incidence and severity of pain, particularly that which impacts patient function, such as movement. Also important is minimizing side effects from analgesics, preventing postoperative complications, enhancing recovery, and preventing chronic pain if possible. The purpose of this session will be to discuss common challenges including pain assessment, opioid safety, and individualizing multimodal analgesia. Patient cases will be used to illustrate decision-making when applying basic principles of multimodal treatment to perioperative treatment plans.

ACU-02 The Dynamics of Managing Acute Postoperative Pain in the Current Opioid-Sparing Environment

ACU-04 Enhancing Recovery After Surgery:

Rami Ben-Joseph phd Keith A. Candiotti md

How Certified Nurse Anesthetists Are Improving Outcomes

Joseph V. Pergolizzi, Jr. md Robert B. Raffa phd

Wednesday, September 4 Level 3 Gracia 3

2:40p – 3:30p

10:40a –12:00p

Garry J. Brydges dnp, mba, acnp-bc, crna, faan

Wednesday, September 4 Level 3 Gracia 3

Considering the significant risks of surgery, initiatives to improve safety and outcomes would have a broad impact on public health. The number of surgical procedures worldwide has grown to >232 million annually. Studies report that Americans undergo an average of 9.2 surgical procedures per lifetime: 3.4 inpatient, 2.6 outpatient, and 3.2 nonoperating room invasive procedures. The per capita rate of surgery continues to increase through age 75, peaking at 0.16 operations

4:40p – 5:30p

The healthcare community is at a crossroads as the

opioid crisis rages in America: how to provide effective pain management while preventing opioid abuse and addiction. This session will explore evidence-based opioid-sparing pain management techniques and how they are improving patient outcomes and quality of life while also reducing overall costs.

AHS-01 American Headache Society:

on nurse practitioners and physician assistants: providing greater access to care by easing the restrictions on who could provide mat after completion of continued education. Nurse practitioners and physician assistants caring for patients with chronic pain and addiction need continued education and empowerment to accept this level of responsibility. This session will look at the history of addiction, past therapies, current therapies, and the future of addiction, specifically how it intersects with chronic pain management.

Migraine Education Program (Part 1) Larry Charleston IV md, msc, fahs

Scott Powers phd, abpp, fahs Nina Riggins md, phd

Thursday, September 5 Level 3 Gracia 3

10:40a – 12:00p

Developed by the American Headache Society®, the Migraine Education Program includes new advances and addresses acute and preventive treatment options. In addition, we’ll highlight epidemiologic data on the scope and distribution of migraine with an emphasis on diagnosing chronic migraine. Recent insights into the mechanisms of the complaint will set the stage for improving treatment outcomes for this most disabling of headache disorders. Part 1 will cover Diagnosis of Migraine and Episodic Migraine; Transitions, Risk Factors, and Barriers to Care; and case studies and Q&A.

APP-02 No Guts, No Glory:

Mystery of the Microbiome

Theresa Mallick-Searle ms, np-bc, anp-bc

Thursday, September 5 Level 3 Gracia 3

Several recent studies have found intriguing links

between gut microbes, rheumatoid arthritis, and other diseases. Additional studies have shown the interactions between the central nervous system, enteric nervous system, and the gastrointestinal tract, suggestive that gut microbiota appears to influence the development of emotional behavior, and stress- and pain-modulation systems. 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 the ways to optimize the health of the individuals’ gut microbes for pain management and overall well-being.

AHS-02 American Headache Society:

Migraine Education Program (Part 2) Larry Charleston IV md, msc, fahs

Scott Powers phd, abpp, fahs Nina Riggins md, phd

Thursday, September 5 Level 3 Gracia 3

9:40a – 10:30a

1:40p – 3:30p

See AHS-01 for course description. Part 2 will cover Pathophysiology of Migraine and Episodic Migraine; Acute Treatment Strategies; and Preventative Treatment Strategies.

APP-01 Medication Assisted Therapy: New Opportunities in Treatment

Brett B. Snodgrass fnp-c, cpe, facpp, faanp

Thursday, September 5 Level 4 Nolita 1

APP-03 Achieving Change from Within:

7:00a – 7:50a

Use of Motivational Interviewing

Medication assisted therapy (mat) for addiction has

Ravi Prasad phd

Thursday, September 5 Level 4 Nolita 3

been available since 2000. Up until 2016, physicians have been the only healthcare providers able to prescribe buprenorphine for opioid addiction. On July 22, 2016, President Obama signed into law the Comprehensive Addiction and Recovery Act (cara). This is the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic. cara incorporated many needed resources to better manage patients with addiction, but one specific aspect of the legislation was focused

11:10a – 12:00p

Motivational interviewing (mi) is a counseling approach that was initially applied to address drinking behavior. At its core, it helps reduce patients’ ambivalence and move them toward action through use of their own intrinsic motivation. Over the years, mi has been applied broadly across different health domains to help shape outcomes. The approach can be particularly beneficial when working

with patients who are perceived to be stuck and not making satisfactory progress in treatment. This presentation will introduce the audience to mi, review the concepts underlying it, and discuss its specific application in pain settings. A video of mi in action will be presented and, as time permits, a live mi demonstration will take place.

starting an acute pain service in the acute care setting, potentially bringing improved outcomes and consumer satisfaction, along with specific challenges. Finally, the value of apps as frontline clinicians on the acute pain service will be discussed.

BHV-01 Moving Beyond the Obvious:

APP-04 Through the Eyes of an Expert Witness:

The Pivotal Role of Psychology in Pain Management

Brett B. Snodgrass fnp-c, cpe, facpp, faanp

Tuesday, September 3 Level 3 Gracia 1

The Importance of Chart Documentation in the Chronic Pain Patient Thursday, September 5 Level 3 Gracia 1

Ravi Prasad phd

4:40p – 5:30p

Recent years have seen an increase in opioid related deaths, resulting in renewed interest in nonpharmacologic treatments for managing chronic pain. Although psychology has a long-standing history in pain care, many clinicians have a limited awareness of its historical and ongoing presence in this arena. This course seeks to fill the aforementioned knowledge gap by providing an overview of the role of psychology in pain etiology and treatment. Different types of psychological therapies and the evidence supporting their use will be reviewed. An emphasis will be placed on the interdisciplinary approach to pain treatment using biopsychosocial rather than biomedical models.

Caring for chronic pain patients in the current landscape is not for the faint of heart and is becoming increasingly more difficult with all the media attention on the “opioid crisis.” Appropriate chart documentation is truly key to keeping yourself and your practice safe in this environment. This session will focus on the use of electronic medical records and associated pitfalls, employing a “case” when opioids are prescribed, and the importance of making an appropriate diagnosis of chronic pain. APP-05 Starting an Acute Pain Service Is Harder Than You Think…

BHV-02 Icebergs, Oceans, and the Experience of Pain

AKA: “OMG Why Did I Agree to Do This Again?!”

Becky L. Curtis nbc-hwc

Mechele Fillman msn, np-c

Thursday, September 5 Level 3 Gracia 1

7:00a – 7:50a

Mel Pohl md

5:40p – 6:30p

Tuesday, September 3 Level 4 Nolita 3

There are no clear guidelines for developing an inpatient acute pain service. Nor are there any guidelines to help determine the mix of services. Who runs it? Anesthesia? Hospitalist? app? Dedicated hospital-based pain services are uncommon except in large academic centers. So what would motivate a smaller hospital to start a new service line? For one, the opioid crisis, where opioids are both in limited supply and overprescribed. There is a national cry for more appropriate opioid prescribing and to limit the number of pills given at any one time. Secondly, the Joint Commission’s requirements surrounding pain states, “The hospital provides information to staff and licensed independent practitioners on available services for consultation and referral of patients with complex pain management needs.” The rationale fulfillment: “Access to specialists through consultation, referral, or use of in-house experts reflects best practice.” This activity will explore the aspects of and rational for

9:40a – 10:30a

Today’s providers are limited by time and must work

with extreme efficiency. And yet for many, 100% of their time is used trying to treat 20% of their patients’ problems. This presentation will address the problem of chronic pain, provide simple tools to use during any office visit, and explain the power of positive and negative thoughts on the chronic pain experience.

BHV-03 The Death of Caesar:

Psychological Stages of Grief and Chronic Pain David Cosio p hd, abpp

Tuesday, September 3 Level 4 Nolita 1

11:10a – 12:00p

Individuals with chronic pain may lack awareness that they are feeling grief. People who suffer from chronic

BHV-05 Pain Catastrophizing:

pain may experience losses in several areas: comfort, sexual function, career, income, self-efficacy, cognitive function, intimacy, pride, joy, self-esteem, self-control, independence, mental health, hope, dignity, and certainty. Providers may overlook a patient’s biggest loss: themselves. While everyone copes in their own way and experiences their chronic pain condition uniquely, there are common feelings that most of us share: denial, anger, bargaining, depression, and acceptance. Elizabeth Kübler-Ross’s five stages of grief outlined in her 1969 book, On Death and Dying, may help patients better understand what they are going through. Frontline providers can help patients better cope with the grief that often has no resolution by understating the limitations of their illness, listening and trying to understand what they are going through, looking for signs and completing a thorough psychosocial assessment, and organizing psychoeducational support groups and other interventions. The goal is to transform their experience into something livable and bearable.

Making a Mountain Out of a Mole Hill David Cosio phd, abpp

Tuesday, September 3 Level 3 Gracia 1

Psychosocial factors have become increasingly recognized as important moderators and determinants of the pain experience. One such factor that has garnered great empirical attention is pain catastrophizing. Pain catastrophizing has been described for more than half a century, yet many frontline practitioners continue to be unfamiliar with the construct. It is conceptualized as a negative cognitive affective response to anticipated or actual pain and has been associated with a number of important pain related outcomes. There are several determinants for pain catastrophizing, including female sex, Asian/African race, age, certain genotypes, and hormonal/neurophysiological phenotypes. There are psychometrically sound self-report instruments that can be readily and reliably used with a variety of pain populations. High levels of pain catastrophizing on these measures should be considered a risk marker for adverse pain related outcomes. The primary treatment for pain catastrophizing is cognitive behavior therapy for chronic pain. Education, relaxation, and acceptance and commitment therapy skills have also shown promise.

BHV-04 Lip Service:

Using Words as the Foundation for Effective Pain Management Jamie Clapp pt, d pt, ocs Heather Poupore-King phd

Tuesday, September 3 Level 4 Nolita 3

4:40p – 5:30p

2:40p – 3:30p

BHV-06 Follow the Yellow Brick Road:

Chronic pain, as one of the most common reasons

adults seek medical care, requires foundational steps to set up treatment success. Patient education on diagnosis, treatment, and prognosis can have huge impacts on the outcomes of an individual seeking treatment. Communication is often believed to be an important component of multidisciplinary care and patient experiences. This session will show how to effectively communicate with patients in chronic pain in order to maximize outcomes. We will discuss potential avenues to provide education and information in a way that focuses on appropriate management of a patient’s diagnosis and resolution of fears they may bring from previous medical advice or personal experience. Understanding the benefits of placebo and nocebo effects, and taking these findings into consideration when providing procedural or intervention counseling and appropriate referral of patients, may have powerful impacts to current practice. Also to be discussed: patient expectation management—a challenging subject related to prognosis and developing tools on how to have those challenging conversations in a way that continues to promote activity engagement and reduce fear avoidance.

Reducing Clinician Burnout Corinne E. Cooley dpt, ocs Heather Poupore-King phd

Tuesday, September 3 Level 4 Nolita 1

5:40p – 6:30p

Providing comprehensive treatment for patients with chronic pain places significant demand on providers. Physician burnout—including emotional exhaustion, depersonalization, and reduced personal satisfaction and accomplishment—has reached epidemic levels for physicians in practice and in training. National surveys show that approximately 46% of physicians report ≥1 symptom(s) of burnout, but rates are as high as 80% in some specialties. Physician burnout and fatigue are independently associated with major medical errors. Despite this, there is limited research and resources available for providers who work with patients in chronic pain. Recognizing the signs of burnout and knowing the steps to take to address and reduce the impact on practitioner performance and quality of life is vitally important. This presentation explores the research on burnout, describes signs and symptoms

that signal emotional exhaustion, and offers strategies to utilize in your clinical practice to improve overall balance and self-care. Covered in this session is the development of a program for physician fellows with the Stanford Pain Management Center that seeks to reduce physician burnout with the introduction of self-care options, such as self-regulation, cognitive behavioral therapy, mindfulness, exercise, and education on restorative sleep, stress management, and communication training.

drug. This lecture will focus on what we know, and what we don’t know, about the efficacy and safety of medical cannabinoids. Specific recommendations regarding the safest and most effective use of medical marijuana as part of a pain management armamentarium will be provided.

CBN-03 The Global Legalization of Marijuana:

A Reasonable Solution to Treat Pain…Or a Pipe Dream? Stephen J. Ziegler phd, jd

CBN-01 Lost in the Weeds:

Friday, September 6 Level 4 Nolita 1

The Past, Present, and Future of Hemp in Pain Management

The United States is struggling with how to deal with

two competing problems: the undertreatment of pain and the abuse of opioids. At the same time, millions of people in third-world countries are dying without access to any opioids, even liquid morphine, due in large part to a variety of barriers relating to distance, regulation, and knowledge. Could marijuana be the solution to both problems? Although marijuana continues to remain prohibited by federal law and treaty, several countries and states in America have defied these prohibitions by passing their own laws and regulating marijuana for recreational or medical purposes. This presentation examines the labyrinth of laws relating to marijuana in the United States, the extent of suffering in third-world countries, and how the global legalization of marijuana may become a viable solution—or is it a pipe dream?

Stephen J. Ziegler phd, jd

Friday, September 6 Level 3 Gracia 3

7:00a – 7:50a

Marijuana and hemp are genetically distinct cousins of the genus Cannabis sativa L., yet they have been erroneously associated with each other for the past 80 years. That all changed in December 2018 when Congress removed hemp from the federal Controlled Substances Act and legalized the plant and its derivatives such as cannabidiol (CBD), a substance which has received a great deal of attention for its potential to treat a variety of medical conditions. This change is historic and has enormous implications in medicine and the treatment of pain. However, although the oversight of hemp has essentially been transferred from the DEA to the USDA and individual states, the FDA still retains its authority “to regulate products containing cannabis or cannabisderived compounds” such as CBD. Accordingly, in an effort to inform healthcare professionals about this rapidly changing field, this presentation will discuss the history of hemp, its legality, derivatives, and its potential future in pain treatment.

CBN-04 Cannabis and Opioids Together:

Syn or Synergy?

Christopher M. Herndon pharmd, bcps, cpe Bradlee Rea pharmd

Friday, September 6 Level 4 Nolita 1

5:40p – 6:30p

Clinical practice varies greatly in terms of chronic opioid therapy in the presence of known or suspected cannabis use. With more states passing legislation for both medical and recreational use of cannabis, previous policies of prohibiting concurrent use of cannabis and opioid pharmacotherapy for chronic pain or medication assisted therapy have become less clear. A chasm has developed between those who choose to define cannabis use as an aberrant drug taking behavior and those who choose to omit cannabis from routine drug screening as part of opioid risk mitigation. This session will review such policies and the data surrounding cannabis efficacy for pain, and present discussion points on the risks associated with concurrent opioid and cannabis use.

CBN-02 Reefer Madness Revisited:

Taking the Insanity Out of Medical Cannabinoids Michael E. Schatman phd, cpe, daspe

Friday, September 6 Level 4 Nolita 1

1:40p – 2:30p

9:40a – 10:30a

Medical and recreational marijuana are sources of great confusion to patients and clinicians alike. A culture of “neuromysticism” around medical marijuana has arisen, leaving patients and clinicians muddled regarding what constitutes “medical” marijuana. This is due in part to the poor quality of the available research on safety and efficacy, which is due, in turn, to the restrictive scheduling of the

MAKING A MOUNTAIN OUT OF A MOLE HILL DAVID COSIO TUES SEPT 3

facial & orafacial pain

meredith barad

tuesday september 3

CPS-01 La Femme Migraineur

CPS-04 Neurogenic Thoracic Outlet Syndrome

Meredith Barad md

Tuesday, September 3 Level 3 Gracia 1

Paul J. Christo md, mba

9:40a – 10:30a

Tuesday, September 3 Level 3 Gracia 5

Despite being one of the more frequently noted triggers for migraine, estrogen and its role in the pathology of migraine is still unknown. This talk discusses the current understanding of the role of estrogen in the headache experience. We will start by touching on the clinical experience the field has gathered and then dig into the fledging science on the role of estrogen in the brain, periphery, and blood vessels, and the hypothesis on how these pathways and interactions might trigger the migraine.

Pain represents a foremost feature of neurogenic thoracic outlet syndrome (ntos). Symptoms include ipsilateral upper extremity pain, sensory loss, shoulder and neck discomfort, arm paresis or edema, headache, and even sympathetic nervous system impairment. This presentation will cover an evidence-based review of the classification, etiology, clinical presentation, diagnostic measures, and surgical treatment of ntos with a focus on nonoperative therapies such as physical modalities, pharmacologic, and the more contemporary, and minimally invasive, cervicothoracic intramuscular treatments with botulinum toxin.

CPS-02 Hanging By a Thread: Facial & Orofacial Pain

ENC-01 Pain Pathways Made Simple

Meredith Barad md

Tuesday, September 3 Level 3 Gracia 1

5:40p – 6:30p

11:10a – 12:00p

David M. Glick dc, daipm, cpe, faspe

Saturday, September 7 Level 4 Nolita 1

Facial pain can be extremely debilitating for the patient,

and the diagnosis can be extremely difficult for the provider. Facial pain often sends patients to many different subspecialties in search of a cure. This talk will review the diagnosis and treatment of the most common facial pain conditions including neuropathic pain syndromes, temporal mandibular dysfunction, and poorly understood disorders such as burning mouth syndrome and persistent idiopathic facial pain.

8:30a – 9:30a

See pef-02 for course description.

ENC-02 Clinical Pearls:

Unraveling the Secrets of Imaging Studies David M. Glick dc, daipm, cpe, faspe

Saturday, September 7 Level 3 Gracia 3

CPS-03 Neck and Upper Extremity Pain Syndromes

11:10a – 12:00p

See pef-05 for course description.

David M. Glick dc, daipm, cpe, faspe

Tuesday, September 3 Level 3 Gracia 3

4:40p – 5:30p

INT-01 Injections, Nerve Blocks, Pumps, and Spinal Cord Stimulation

There are many potential underlying causes for neck and

upper extremity pain. All too often, only the most common conditions such as a disk herniation or carpal tunnel syndrome are explored. The purpose of this course is to review other common problems (such as radiculitis), and not so common (such as rib arthropathy pain syndromes) that can affect the neck and upper extremities. Attention will be given to clinical pearls for recognizing when patients present with such problems, as well as treatments that may prove helpful for both differentially diagnosing and treating various neck and upper extremity pain syndromes, especially those that are often missed or overlooked and easily treatable to resolution when they are identified.

Paul J. Christo md, mba

Tuesday, September 3 Level 4 Nolita 1

7:00a – 7:50a

This presentation will highlight common procedures

used for pain reduction, their evidence base, and a basic description of how each procedure is performed. We will primarily review epidural steroid injections, facet joint blocks and denervation, sacroiliac joint injections and denervation, myofascial pain, spinal cord stimulation, and intrathecal pumps.

INT-02 Spinal Stenosis:

Epidemiology, Pathophysiology, and Treatment

INT-04 Neuromodulation for Advanced Practice Providers

Sean Li m d

Mayank Gupta md

Tuesday, September 3 Level 3 Gracia 3

11:10a – 12:00p

Tuesday, September 3 Level 4 Nolita 1

Degenerative lumbar spinal stenosis (lss) is the most common form of acquired spinal stenosis caused by biomechanical narrowing of the spinal canal and the associated neuroforamen that eventually lead to compression of neural fibers resulting in pain and disability. Neurogenic claudication as a result of lumbar spinal stenosis is a common chronic pain condition that is often difficult to treat due to a paucity of effective minimally invasive options. Patients who exhaust conservative means usually have short-term pain relief with epidural steroid injections prior to being offered open lumbar decompression surgery. lss is a progressive, age related degenerative process that causes narrowing of the lumbar spinal canal. More than 1.2 million patients in the US are diagnosed with spinal stenosis each year, and the number is expected to rise as our population matures. This presentation will focus on the epidemiology, pathophysiology, and treatment options available for spinal stenosis. There will be discussions relating to the health economics of spinal stenosis as it pertains to disability and cost of treatment. We will specifically focus on some of the recently available minimally invasive options such as indirect interspinous decompression and minimally invasive lumbar decompression.

4:40p – 5:30p

Neuromodulation has become one of the important alternative treatment options in refractory chronic neuropathic pain syndromes. However, neuromodulation is relatively expensive and involves surgical intervention. Clinical studies have shown the effective role of neuromodulation therapy in patients who are suffering from chronic pain and who have failed medication management. In the era where we confront issues with scheduled medications, it is important to recognize the role of neuromodulation therapy in chronic pain syndromes. Advanced practice providers plays an important role in the management of patients with chronic pain. The goal of this presentation is to discuss appropriate patient selection criteria and to develop a plan for a patient work-up, including labs, imaging, and psychology evaluations. Also addressed will be current clinical evidence and key indications, and relative contradictions. Strategies to recognize postprocedure complications like infection, lead migration, and hematoma will be covered as well. INT-05 Interventional Pain Management:

Opioid-Sparing Technologies Sean Li m d

INT-03 Stem Cells and Regenerative Medicine for Nonresolving Inflammation

Tuesday, September 3 Level 3 Gracia 1

The ancient Sumerians first cultivated the poppy plant

Jay Joshi m d

Tuesday, September 3 Level 4 Mont-Royal Ballroom

5:40p – 6:30p

1:40p – 2:30p

for its opium in 3000 bc. The analgesic properties of opium were formalized into morphine and later commercialized by Merck Pharmaceuticals in 1827. Morphine and its derivatives have been effectively used for treating acute pain. In recent years, however, the overuse of opioids to treat chronic nonmalignant pain has contributed to the prescription opioid epidemic. As society has recognized this problem and our government has stepped into opioid crisis efforts, we turn to technology in treating chronic pain as an alternative to opioid medications. This presentation is targeted for general practitioners and current pain management physicians. We will explore the evolution of pain medicine leading up to the current and future opioid-sparing interventional pain treatment options. Specifically, we will focus on electroceuticals (spinal cord stimulation, peripheral nerve stimulation, vagus nerve stimulation), minimally

Humans have been searching for the Fountain of Youth for millennia, from Herodotus to Ponce de León. Some people feel that regenerative medicine, a field that encompasses stem cells, growth factors, and other cell mediating proteins, is that magical fountain, while others, including some physicians, members of various regulatory committees, and some in the media, believe it is a fad. As with many emerging topics, there is curiosity and confusion. While the regenerative medicine field is relatively new to most people, there is a wide variety of treatments and technologies available. We will discuss the various stem cell and growth factors in regenerative medicine and conditions, such as neurological, degenerative changes, osteoarthritis, and tendinitis, that have been treated with them.

INTG-03 Manual Therapies for Pain Management

invasive spinal decompression spacers, and percutaneous sacroiliac joint fusion.

Michael J. Kurisu do, abihm

Saturday, September 7 Level 4 Nolita 1

INTG-01 Acupuncture for Addressing the Intersection of Pain, OUD, and PTSD

This course will provide the principals and practice

of osteopathic medicine, showing anatomical unity, structure, and function, and pathways to innate healing. We will provide exam skills to incorporate kinetic chains of motion with movement restrictions. If time permits, there will be demonstrations of counterstrain techniques for the spine and extremities.

Edward S. Lee md

Saturday, September 7 Level 4 Nolita 3

7:30a – 8:20a

The principles of Chinese medicine as applied to

opioid use disorder (oud) and the history of the use of acupuncture for oud will be presented. The evidence on the use of acupuncture for the treatment of chronic pain, addiction, and ptsd will be presented as well. The presentation will include a review of the literature on the scope of the opioid crisis, including a discussion of the use of opioid therapy for chronic pain, the diagnosis of oud, the social factors that contribute to the development of oud, and the barriers to treatment that patients encounter. It will also cover the neurological basis for chronic pain, addiction, and ptsd. Finally, case reports will be presented to facilitate learning.

INTG-04 Expanding Options for Chronic Pain Treatment:

The Integrative Pain Management Program Emily Hurstak md, mph, mas

Saturday, September 7 Level 3 Gracia 5

2:40p – 3:30p

Socioeconomically vulnerable patients experience high

rates of pain, barriers to care, and greater risks from conventional pain treatments. Multimodal, nonpharmacologic approaches are recommended as firstline treatments for pain but are often unavailable in resource-limited settings. In 2016, we created and evaluated a multimodal pain management program, the Integrative Pain Management Program (ipmp) at Tom Waddell Urban Health primary care clinic (twuhc) in the Tenderloin neighborhood of San Francisco, a community experiencing high rates of opioid overdose. twuhc provides health services for diverse, underserved patients with high prevalence of chronic diseases, chronic pain, and opioid use, many of whom are marginally-housed or homeless. We determined feasibility of the program and assessed its effects on patients with chronic pain. This course will describe the ipmp, briefly review research findings, and give recommendations for starting a similar multimodal program. This talk will provide learners with tangible tools to take back to their workplace and use when setting up a multimodal treatment program and/or one of the nonmedication-based treatment modalities included in the ipmp model. The lived experience of the presenters will provide practical information that providers or other clinical or administrative staff can utilize in real life settings.

INTG-02 Nutritional Pain Management Robert A. Bonakdar md, faafp, facn

Saturday, September 7 Level 4 Nolita 3

11:10a – 12:00p

8:30a – 9:30a

Multiple guidelines have recently emphasized nonpharmacologic interventions for chronic pain, with the role of nutrition strikingly absent. Given pain’s potential coexistence with metabolic dysregulation, including obesity, metabolic syndrome, and nutrient deficiency, nutritionbased interventions hold promise as an approach for improving pain status in multiple patient populations. Unfortunately, nutritional and dietary approaches can be complex and time consuming to implement and daunting for clinicians feeling inadequate to provide guidance. Fortunately, nutrition pain management can often be provided in staged interventions based on patient status. This session will review why nutrition is often overlooked, as well as the foundational science of how it can both promote and relieve pain. The session will discuss how to evaluate nutritional status and initiate foundational anti-inflammatory interventions. Also to be examined is the role of nutritional supplementation in individualized cases including vitamin D, omega-3s, magnesium, and other emerging nutrients. The session will conclude with a discussion of how to combine nutritional interventions as a long-term strategy for improving both pain and metabolic status.

IPPS-01 The Force Is with You:

Mind Tricks for Chronic Pain Patients

Jorge F. Carrillo md

Wednesday, September 4 Level 3 Gracia 1

7:00a – 7:50a

In applying a biopsychosocial model, patient education is considered a treatment strategy to help reduce pain and associated suffering and disability. Original education models focused on anatomical and pathological processes involved in tissue damage. Such models revealed some positive impact in acute scenarios involving injuries or surgeries but did not impact long-term pain reduction, disability, fear, anxiety, and stress that is usually associated with chronic pain. In the past 15 years, different models have been investigated, with therapeutic neuroscience education, Explain Pain, and pain neuroscience education emerging. These can be used to decrease the focus on specific anatomical structures and reconceptualize the patient’s pain to focus more on recovery rather than causes of pain. They apply the biopsychosocial model of pain, integrating treatment of peripheral and central nociceptive components with other contributors of pain. These formats have been delivered one-on-one, in small group tutorial sessions, and large seminars, among others. Randomized controlled trials and systematic reviews exploring these methods favor their use due to improved pain ratings, pain knowledge, disability, pain catastrophization, fear avoidance, attitudes and behaviors regarding pain, physical movement, and healthcare utilization. During this session we will discuss patientcentered educational models and how they might impact behavioral and clinical outcomes.

worsening of symptoms, and increasing risk for developing new pain syndromes, all of which make COPCs more difficult to treat. This presentation will review: ways of identifying patients at higher risk for developing COPCs; underlying disease mechanisms; how to perform a comprehensive biopsychosocial assessment for COPCs that includes nonpain domains such as sleep, mood, fatigue, and physical function; common pharmacologic and nonpharmacologic therapies; and validated tools that can be used in evaluation and treatment.

IPPS-03 Let’s Get Physical!

Musculoskeletal Pelvic Pain Colleen M. Fitzgerald md, ms

Wednesday, September 4 Level 3 Gracia 1

Pelvic floor muscle dysfunction is associated with pelvic pain, physical disability, and sexual dysfunction. Prevalence estimates of musculoskeletal dysfunction in various pelvic pain conditions, including endometriosis, vulvodynia, and painful bladder syndrome, range from 21% to 80%. In addition to being associated with other painful conditions, pain originating from pelvic floor muscles may refer to other body parts such as the lumbar spine, sacroiliac joints, hips, and abdomen. Adding to this complexity is an interplay between muscles and neurons including maladaptive neuronal plasticity associated with widespread muscle pain that may manifest beyond the pelvis. This presentation will provide an overview of key abdominopelvic musculature and contributions to pelvic pain, screening for musculoskeletal dysfunction, and components of a musculoskeletal pelvic pain examination. A focus will be placed on reviewing the pelvic anatomy and hormonal/life states related to sex specific musculoskeletal pain, such as pregnancy, endometriosis, and sexual pain. Additionally, the presentation will discuss the role of different musculoskeletal specialists such as physiatrists and physical therapists in identifying and treating musculoskeletal pain conditions.

IPPS-02 The BIG BANG:

Chronic Overlapping Pain Conditions in Women Sawsan As-Sanie md, mph

Wednesday, September 4 Level 3 Gracia 1

2:40p – 3:30p

9:40a – 10:30a

Pain conditions that often occur together and either solely or predominantly affect women have been recently termed by the NIH as chronic overlapping pain conditions (COPCs). They include: vulvodynia, temporomandibular disorders, myalgic encephalomyelitis/chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis/ painful bladder syndrome, fibromyalgia, endometriosis, chronic tension-type and migraine headache, and chronic low back pain. (Six of these affect ≥50 million people and cost >$80 billion annually in health related costs.) These patients often demonstrate common abnormalities in neural, immune, and endocrine function, which may explain the overlapping nature, as well as increased risk for developing new COPC. COPCs lead to physical and mental disability, poor sexual function, higher rates of drug addiction, and suicide. Despite the societal and personal costs inflicted by COPCs, provider education is lacking. This may lead to a delay in diagnosis and treatment,

IPPS-04 The Golden Girls Dilemma:

Genitourinary Syndrome of Menopause Georgine M. Lamvu md, mph, facog

Wednesday, September 4 Level 3 Gracia 1

4:40p – 5:30p

Genitourinary syndrome of menopause (gsm) is a term

used to describe what was formerly known as vaginal atrophy, atrophic vaginitis, or urogenital atrophy. The older terminology was replaced by this descriptive term with

colleen fitzgerald

musculoskeletal pelvic pain

wednesday september 4

MAS-01 Blinded by the Light:

the goal of more accurately describing the constellation of symptoms experienced by gsm patients, including: vaginal pain and dryness; dyspareunia; urinary incontinence, urgency, frequency; hematuria; and sexual dysfunction. Although gsm-like symptoms occur in 15% of premenopausal women and 40% to 54% of postmenopausal women, the condition is associated with social stigma and often remains ignored or underdiagnosed. This presentation will review the clinical manifestations, pathophysiology, etiology, evaluation, and management of this condition. Specific emphasis will be placed on differentiating gsm from other genital pain conditions such as vulvodynia and vulvar dermatoses. Additionally, the presentation will review the impact of postmenopausal pain on quality of life, mental and physical health, and sexual function. Therapeutic recommendations will focus on multimodal therapies to address what is a complex but treatable syndrome. The importance of early detection and patient education in avoiding long-term risks and complications that compromise quality of life will also be discussed.

The Danger of Idiopathic Intracranial Hypertension Gary W. Jay m d, faapm

Thursday, September 5 Level 3 Gracia 5

Idiopathic intracranial hypertension (formerly called pseudotumor cerebri) is a cause of headache, along with optic nerve edema, and can lead to permanent visual loss. This course will address how to diagnose it, how best to treat it, and other topics including subgroups and issues of “outliers.” This is a frequently missed diagnosis, and important to include in a differential diagnosis. MAS-02 Back Pain: It’s All About the Diagnosis David M. Glick dc, daipm, cpe, faspe

Friday, September 6 Level 3 Gracia 3

KEY-01 Keynote: Are the Monsters Coming to Main Street?

1:40p – 3:30p

The prevalence of back pain continues despite the many

treatments available, without any single treatment being a panacea. In routine clinical practice there has been a tendency of clinical examinations to become more cursory, largely influenced by increasing demands of time and arguably an overreliance upon technology. It has been suggested that the failure to adequately differentially diagnose the cause of back pain can account for clinical failures in treatment. The purpose of this discussion is to assist clinicians in the development of a more problem focused examination to enhance the differential diagnosis of specific pain generators, and therefore lead to more patient specific treatment. Attention will be given to considering all aspects of the examination, including physical assessment as well as imaging studies, and the ability to rationalize when pathologies seen on these studies may or may not be clinically significant. The importance of considering how failed treatments influence the differential diagnosis will also be discussed.

Jennifer Bolen jd Michael R. Clark md, mph, mba Kevin L. Zacharoff md, facip, facpe, faap

Wednesday, September 4 Level 4 Mont-Royal Ballroom

1:40p – 2:30p

5:45p – 6:45p

Newton’s 3rd law of motion states, “For every action, there is an equal and opposite reaction.” This makes sense to us and allows us to frame and predict what will happen in a physical world. When we consider the metaphysical world, we might think that the same rules apply. But they often do not—because thoughts are not objects, and attitudes, fears, and prejudices don’t always follow predictable rational principles. In the face of multiple mindborn, fearful actions, the result can be chaotic or even “monstrous” reactions. We are witnessing this very phenomenon today in every clinical practice involved in the management of pain and the prescribing of opioid analgesics. This is no longer a time where an “opioid pendulum” is swinging in a single physical plane or dimension, one that we can predict accurately. This presentation will focus on how the current opioid climate has fallen on the front doorstep of us all, and how the many different forces—including abuse, addiction, stigmas, fears, and deaths—have created the monster before us, one which can potentially have tragic and unethical consequences for patients with pain who need us to be there for them confidently, intelligently, and, most of all, cohesively.

MDL-01 Inside the Trojan Horse: Addressing Current Legal Actions Against Healthcare Practitioners

Jennifer Bolen jd Michael R. Clark md, mph, mba Douglas L. Gourlay md, msc, frcpc, fasam

Wednesday, September 4 Level 4 Mont-Royal Ballroom

Note: The keynote presentation is certified for credit.

9:40a – 11:00a

Using case examples, this course will address the insider’s view to illustrate the connection between carrying out licensing board directives on using opioids to treat pain and reasonably prudent medical decisionmaking, and documentation. The content presented is designed to engage participants who will work through several short case examples with faculty, all of whom are experienced as medical and legal experts. Covered will be treatment plans including treatment goals and exit strategy; true informed consent and treatment agreements; follow-up encounters and risk monitoring, including the use of prescription drug monitoring databases, drug testing, and adjustments to the treatment plan; and use of consultations and referrals. Attendees will learn about current trends in medical expert assessment of prescribing decisions and how to improve documentation of medical decision-making and opioid prescribing decisions. This session is a must-attend for Main Street Practitioners!

MDL-03 I’m Not a Doctor, But I Play One in DC Michael C. Barnes jd, miep

Friday, September 6 Level 3 Gracia 5

At the 2018 Department of Justice (doj) Opioid

Summit, then-Attorney General Jeff Sessions remarked that opioid prescribing had reached its lowest point in 18 years. Still, the doj is committed to reducing opioid analgesic prescriptions an additional 30% to 33% within the next 3 years. More than ever, prescribers of controlled prescription medications are under intense scrutiny from lawmakers, regulators, and payers. At the same time, some 50 million adults in the US have persistent pain, nearly 20 million of whom experience pain that interferes with daily life or work activities. As noted by the Pain Management Best Practices InterAgency Task Force (pmtf) in its December 2018 draft report, the trend of healthcare professionals opting out of treating pain has exacerbated the shortage of pain management specialists, leaving some patients without access to individualized care. In this session, a partner in a Washington, dc based health law firm will discuss recent legislative and regulatory activity at the federal level and trends in criminal enforcement. He will also discuss noteworthy developments at the state level and analyze the anticipated benefits, drawbacks, and unintended consequences of such actions on people with pain and those who treat them. Topics include: implications of the support for Patients and Communities Act; a draft report of pmtf best practices and pushback against it; and efforts to reform the federal approach to investigating controlled-medication prescribers.

MDL-02 A New Leaf:

A Legal and Medical Perspective on Marijuana Use When Prescribing Controlled Substances Jennifer Bolen jd Douglas L. Gourlay md, msc, frcpc, fasam

Thursday, September 5 Level 4 Mont-Royal Ballroom

7:00a – 7:50a

9:40a – 11:00a

The prescribing of chronic opioid therapy to patients

who contemplate or are already using marijuana, whether medical or recreational, sets up the perfect storm for medical decision-making and risk management conundrums, especially in the current environment of opioid related hospital admissions and fatal overdoses, and the additional challenge of multiple prescribers of other drugs, like benzodiazepines and sleep medicine. The likelihood of a perfect storm is more apparent, and the risks to the prescriber of opioids to marijuana users increased, when opioid prescribing standards lack meaningful guidance. Prescribers must fine tune risk evaluation and monitoring skills and ensure proper documentation of patient evaluations and medical decision-making when treatment or patient choice results in the use of opioids in patients using marijuana. Faculty will present scenarios and show attendees how to evaluate risk and plan for risk monitoring in the treatment plan when marijuana is introduced into the equation. They will also help practitioners sort through patient risk factors that may mean saying “No“ to the opioids or the marijuana. Finally, faculty will provide examples of proper documentation and ideas for controlling risk along the way.

MDL-04 Embrace Changes and Prevent Overdose:

A Basic Blueprint for Legal Risk Mitigation and Response Jennifer Bolen jd

Saturday, September 7 Level 3 Gracia 3

9:40a – 10:30a

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. Too often, prescribers are caught unprepared to respond to licensing board and legal inquiries surrounding overdose events. Many prescribers lack a structured approach to patient education to mitigate the risks associated with

Myopain conditions including myofascial pain and fibromyalgia are among the most common disorders causing chronic pain and are a significant cause of suffering, addiction, disability, and healthcare utilization. More than half of the persons seeking care for these pain conditions at 1 month still have pain 5 years later despite treatment. The good news is that successful treatment of these painful conditions is achievable, and this course aims to teach providers the 2 key factors that clinically make the biggest impact. The first is recognition of the contribution of the fascia to myofascial pain and fibromyalgia, and improving diagnostic skills promoting early recognition. Along with better recognition of myofascial pain, effective treatment will incorporate evidence-based manual therapies and myofascial self-care. The second key to success is utilizing a transformative care approach that integrates comprehensive patient self-management training and coaching to empower patients to address the many risk factors that can lead to delayed recovery and chronic pain. This activity will describe the growing body of evidence for fascial dysfunction contributing to pain in fibromyalgia and myofascial pain, along with research supporting the effectiveness of manual therapies either performed by a therapist or as part of a myofascial self-treatment program. Reimbursement for transformative care with telehealth coaching with online technology will also be covered.

the use of controlled substances, errantly relying solely on a piece of paper to capture what should be a process of informed consent. This program includes lessons learned by the speaker through more than a decade of chart audits and legal case work. 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. Attendees will have access to 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.

MDL-05 Get Your Specimens in Order: The Importance

of Individualized Test Orders and Timely Test Utilization Jennifer Bolen jd

Saturday, September 7 Level 3 Gracia 3

2:40p – 3:30p

2018 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. 2019 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 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.

MYO-02 Transformative Care for Myopain:

Enhancing Long-Term Success in Myofascial Pain and Fibromyalgia (Part 2) James R. Fricton dds, ms Ginevra Liptan md

Saturday, September 7 Level 4 Nolita 3

See myo-01 for course description. NRO-01 An Elusive Villain:

Pain Associated with Lyme Disease and Other Spirochetal Infections

MYO-01 Transformative Care for Myopain:

Charles E. Argoff m d, cpe

Friday, September 6 Level 3 Gracia 1

Enhancing Long-Term Success in Myofascial Pain and Fibromyalgia (Part 1)

9:40a – 10:30a

Spirochetal infection symptoms include muscle

James R. Fricton dds, ms

pain, nausea, vomiting, and abdominal pain. Lyme disease can cause joint pain and stiffness, fatigue, flu-like symptoms, and sleep problems, among others.

Ginevra Liptan md

Saturday, September 7 Level 4 Nolita 3

1:40p – 3:30p

10:40a – 12:00p

NRO-04 Not Glad All Over:

Depending on the species of bacteria involved, symptoms may be quite painful and range from acute to chronic. How are patients infected? What treatments work best? Although an “appropriate” treatment for the various stages of infection is not universally accepted, this course will suggest means for treatment while it reviews causes and types of infection and symptoms.

Chronic Widespread Pain Charles E. Argoff m d, cpe

Friday, September 6 Level 3 Gracia 1

Chronic widespread pain affects up to 1 in 10 adults in the US, with twice as many women experiencing it than men. It can lead to fatigue, anxiety, depression, and other symptoms. In a catch-22, sleep problems in general may also lead to chronic widespread pain. Although complete relief is unlikely, quality of life can be improved through psychological and pharmacological intervention. This course will review the medical conditions associated with chronic widespread pain as well as steps to consider when evaluating a person with complaints. Multiple examples of individual patients with chronic widespread pain will be discussed in an attempt to shine a light on the diverse nature of this condition.

NRO-02 When Darkness Falls:

Managing Pain in Fibromyalgia and Restless Leg Syndrome

Gary W. Jay m d, faapm

Friday, September 6 Level 3 Gracia 1

4:40p – 5:30p

11:10a – 12:00p

In previous presentations, Dr. Jay has discussed the pathophysiology, neuroanatomical, and other aspects of fibromyalgia. In this activity, all of that will NOT be discussed, so the focus can be only on the diagnosis and treatment of fibromyalgia and restless leg syndrome. Treatment will be covered in depth, not the phenomenology that is the complex neuroanatomical and neuropathological backgrounds of these diatheses. The goal is to provide clinicians with practical information to be utilized upon seeing patients following the conference.

PAL-01 That’s Debatable!

Does Cannabis Reduce Opioid Death, and Does Gabapentin Increase It?

Alexandra McPherson pharmd, mph Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Saturday, September 7 Level 4 Nolita 1

NRO-03 The Spider’s Stratagem: Arachnoiditis

The use of opioids to treat chronic pain has become

Charles E. Argoff m d, cpe

Friday, September 6 Level 3 Gracia 1

9:40a – 10:30a

2:40p – 3:30p

quite contentious in recent years. Things get even more confusing when we consider adding an adjuvant analgesic in the mix. Does this reduce or heighten risk? The audience can decide where to throw spitballs when 2 practitioners debate 2 separate topics. First, is the use of cannabis plus an opioid likely to provide an enhanced clinical effect (eg, allow for opioid dose reduction and by extension, harm), make no difference, or possibly cause more harm. The second debate will evaluate the use of gabapentin plus an opioid. On one hand, we have data showing the gabapentinoids may be habituating and result in addiction. Combining gabapentin with an opioid may also increase the risk of mortality. On the other hand, rational polypharmacy, using an opioid and gabapentin, has been shown to result in superior clinical outcomes compared to either analgesic alone. So perplexing. What’s a practitioner to do? Listen to the debate and decide for yourself!

Arachnoiditis is a pain disorder caused by the inflam-

mation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. This swelling can lead to the formation of scar tissue causing the spinal nerves to stick together and malfunction. Neurological problems characterize the condition, along with stinging and burning pain. Although it’s officially listed as a rare disease, arachnoiditis—and patients affected by it—still may appear in clinicians’ offices. It remains a difficult condition to treat, with long-term outcomes being unpredictable. Treatment usually focuses on chronic pain relief and the improvement of daily function through management of symptoms. Physiotheraphy, exercise, and psychotheraphy are often recommended. Pain practitioners need to know the inciting causes, symptoms, physical signs, and mri findings of arachnoiditis, and treatment options. This course will cover recognition of the condition and ways to combat it.

gary jay

managing pain in fibromyalgia and restless leg syndrome friday september 6

psilocybin, ecstacy & ketamine

jessica geiger-hayes alexandra mcpherson mary lynn mcpherson sat sept 7

Youâ&#x20AC;&#x2122;re using

for pain management?

The Pain Educators Forum presents this course because

PAL-02 You’re Using WHAT for Pain Management?

there are so many different levels of practitioner experience with pain management. Specifically, inspiration came from someone who, after attending one of our courses, had a burning question for our faculty: “What do sodium channels have to do with pain?” Yikes!!! After attending this humorous, informative course you will definitely know the difference between paresthesia and dysesthesia, allodynia and hyperalgesia, and how sodium channels confer excitability on neurons in nociceptive pathways. In sum, you’d be a fierce and worthy contestant on Jeopardy!

Psilocybin, Ecstasy, and Ketamine

Jessica Geiger-Hayes pharmd, bcps, cpe Alexandra McPherson pharmd, mph Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Saturday, September 7 Level 3 Gracia 3

1:40p – 2:30p

Well that’s just plain crazypants! Psilocybin is a naturally

occurring psychedelic prodrug compound produced by more than 200 species of mushrooms (and yes, they are magical!). Psilocybin mushrooms have been used to treat a variety of conditions such as cluster headaches, obsessive compulsive disorders, anxiety, depression, and addiction. Most recently psilocybin has been used to treat the existential pain and distress associated with serious illness such as cancer. Another mind-blowing idea is that the fda has allowed the medical use of mdma (ecstasy) for ptsd patients, used in settings supervised by trained healthcare professionals, coupled with months or years of psychotherapy. Last, ketamine (a dissociative anesthetic agent) has enjoyed increased use in the management of difficultto-control pain such as opioid-induced hyperalgesia, and in the management of depression. Ride the wave of the cutting edge by learning about these innovative therapies!

PEF-02 Pain Pathways Made Simple David M. Glick dc, daipm, cpe, faspe

Wednesday, September 4 Level 4 Nolita 1

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. This discussion will include an overview of medication classes typically considered for pain and the pathways they affect.

PAL-03 Doing Business or Risky Business?

Benzodiazepines and Opioids in Palliative Care

PEF-03 Chronic Pain Assessment

Maria C. Foy pharmd, bcps, cpe Tanya J. Uritsky pharmd, bcps

Saturday, September 7 Level 4 Nolita 1

9:40a – 10:30a

2:40p – 3:30p

Michael R. Clark md, mph, mba

Wednesday, September 4 Level 4 Nolita 1

Opioids and benzodiazepines are included on the who

11:10a – 12:00p

list of essential medicines in palliative care. Recent evidence indicating that benzodiazepines increase the risk of slowed or difficult breathing and deaths in patients taking opioids led to a 2017 warning by the US fda. In this session, the risks and benefits of concomitant benzodiazepine and opioid use will be reviewed and applied to those with advanced illness receiving palliative care.

Effective clinical interviewing and pain assessment are critical to the appropriate diagnosis and management of pain. In this presentation, attendees will learn how to apply principles of effective communication and ascertain how to evaluate available assessment tools.

PEF-01 Pain Terminology:

Alexandra McPherson pharmd, mph

PEF-04 Pain Therapeutics Wednesday, September 4 Level 4 Nolita 1

Knowing the Difference Makes a Difference! Jessica Geiger-Hayes pharmd, bcps, cpe

Treating pain is a challenge and requires special approaches. This course will build on information provided in prior sessions and focus on the prevalence and impact of unrelieved pain, pathogenesis,

Alexandra McPherson pharmd, mph Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Wednesday, September 4 Level 3 Gracia 3

1:40p – 3:30p

7:00a – 7:50a

and treatments of pain. Participants will learn about approaches and advances in therapy of common acute and chronic pain syndromes, and evidence-based recommendations for pharmacotherapy of pain will be provided. Pain Therapeutics examines current trends in pain relief, which can be implemented into practice as soon as attendees return to work.

life hacks for positive thinking and self-talk, distraction, relaxation, improved sleep, and much more!

PEF-07 Navigating the OTC Analgesic Aisle:

What a Pain in the Aspirin!

Laura Meyer-Junco pharmd, bcps

Thursday, September 5 Level 4 Nolita 3

PEF-05 Clinical Pearls:

With cutbacks on opioids, patients may resort to the

Unraveling the Secrets of Imaging Studies

pharmacy aisles for pain relief. What’s on those shelves? A whole lot of good, bad, and everything in between. This session will provide an overview of everything from topical products to oral supplements for pain. Efficacy and safety considerations as well as pharmacokinetic information, dosing, and drug and disease interactions will be discussed. In addition, the place of various nonprescription analgesics in the management of common painful conditions will be highlighted. By the end of this presentation, participants will be prepared to navigate the OTC analgesic aisle and provide patients with product selection guidance and counseling. This is your place for OTC pearls and perils!

David M. Glick dc, daipm, cpe, faspe

Wednesday, September 4 Level 4 Nolita 1

4:40p – 5:30p

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 on a practitioner’s time and the patient’s expectations of technological advances. The end result may arguably lead to an overreliance on technology for basic clinical diagnosis. This session is meant to provide a review or, 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.

PEF-08 The Curbside Consult in Pain Management Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Thursday, September 5 Level 4 Nolita 1

1:40p – 2:30p

“Hey, can I ask you a quick question?” I don’t know, can

you? Ah…the curbside consult. They can occur anywhere: the hallway, the parking lot, the bathroom! Who asks for and provides curbside consults? We all do! Why do practitioners request a curbside consult of another practitioner? To confirm what they believe they already know, to get a quick answer to a question, to continue their medical education, to determine if a formal consultation is called for, and to negotiate an appropriate course of treatment for a particular patient. This fast-paced presentation will review the who, why, where, when, and what of curbside consults. Participants will also learn about a best practice model for communication called SBAR: Situation, Background, Assessment, Recommendation. You’ll be such a popular curbside consultant, you’ll be able to set up shop in the parking garage!

PEF-06 Life Hacks to Teach Chronic Pain Patients Laura Meyer-Junco pharmd, bcps

Thursday, September 5 Level 3 Gracia 5

9:40a – 10:30a

7:00a – 7:50a

With ever increasing scrutiny of opioid practices and

limited availability of new therapies for pain, it can be a difficult time to be a pain clinician and a desperate time to be a patient with pain. Fortunately, all healthcare professionals can provide patients with self-management tools for living with pain. In this session, participants will learn how to help patients recognize the impact that negative thoughts, emotions, and poor sleep can have on their experience of pain. Teaching patients a simplified version of the gate control theory of pain is a critical first step for helping patients understand their pain experience. The dialogue for explaining this mindbody connection will be shared in this session, as well as

THURSDAY

SEPTEMBER 5

kate schopmeyer

the unbearable lightness of… the unbearable lightness of… the unbearable lightness of… multimodal treatment plans the unbearable lightness of… the unbearable lightness of… 92

A review of topical analgesics and available evidence in clinical trials

everybody's greasing up, but should you

timothy atkinson

fri. sept. 6

Now more than ever, the opioid crisis and the overwhelming need to treat chronic pain are colliding. It used to just be we worried about opioid use in substance use disorder (sud) patients, but now even some nonopioid pain medications have become drugs of abuse or have been found to potentially increase the risk for opioid overdose. In addition to providing naloxone education and counseling, learn how to balance the PROs and CONs, or risks vs benefits, of using opioids (when appropriate or indicated) as well as nonopioids for patients with active (or historical) sud. This course will include a brief overview of screening tools before launching into the nitty-gritty of medication prescribing in a patient population that often feels voiceless or powerless in their quest for pain relief while also battling addiction.

PEF-09 The Unbearable Lightness of… Multimodal Treatment Plans

Kathryn A. Schopmeyer pt, dpt, cpe

Thursday, September 5 Level 4 Nolita 1

2:40p – 3:30p

One cannot bake a cake with only flour. Clinicians who treat pain understand that it requires teamwork and multimodal treatment plans. How can we get patients on board with this approach? How can we support each other when we work in isolated practice settings? Our healthcare system it disjointed, causing many clinicians to operate in “silos.” We can support each other and bolster our patients’ confidence in their prognosis by confidently communicating all elements of a care plan to them. By using terminology that de-threatens confusing aspects of a plan, and by consistently using common messages in our clinical lingo, we can start to shift the needle toward wellness. With this approach, we can reduce suffering for our patients and ourselves. This course is taught by a Certified Pain Educator (cpe) and is intended for all clinicians who struggle to engage patients in active self-management strategies.

PHM-02 Kratom or Bait’em?

Understanding the Pharmacology of Kratom Jeffrey Fudin pharmd, daapm, fccp, fashp

Thursday, September 5 Level 3 Gracia 1

As clinicians and their patients scramble for opioid anal-

gesic alternatives and ways to blunt opioid withdrawal, kratom (also known as mitragynine) use among desperate patients has surged. Thousands are self-treating, and clinicians are left to carry the bag of benefits vs risks of this natural substance as a single agent and combined as part of a polypharmaceutical regimen. Added to this dilemma is whether or not to include kratom with routine toxicology monitoring. Concerns around health and safety have spurred US regulatory agencies to scrutinize attributes and detrimental effects, variations among products, quality control, and adverse health outcomes. This session will focus on the history of kratom, epidemiology, advocacy among support groups, product inconsistency among manufacturers and related dangers, pharmacology, therapeutic risks vs benefits, and dangerous drug-drug, drugdisease interactions.

PEF-10 Spilled Beans and Hard Stops:

How Legislation, Guidelines, and Reimbursement Policies Impact Patient Care

Jessica Geiger-Hayes pharmd, bcps, cpe

Thursday, September 5 Level 4 Nolita 3

5:40p – 6:30p

Have you found yourself in a situation where you wanted to do what is right by your patient, but came up against so many barriers that it was nearly impossible? Much legislation, many guidelines, and insurance policies have become barriers to appropriately caring for patients for whom opioids are appropriate. Unfortunately, these barriers can ultimately cause the patient to suffer. The goal of this session is to review the barriers to appropriate pain control and promote discussion around what practitioners are doing to overcome them.

PHM-03 Mirror Mirror on the Wall:

Who’s the FDA’s Fairest ADF of All?

PHM-01 Which Came First…

Mark Garofoli pharmd, mba, bcgp, cpe

Thursday, September 5 Level 3 Gracia 1

Pain or Substance Use Disorder?

Abigail T. Brooks pharmd, bcps

2:40p – 3:30p

Challenge accepted. Our country has made numerous strides in advancing patient care, and more particularly conducting efforts to ensure that lives within the

Courtney M. Kominek pharmd, bcps, cpe

Thursday, September 5 Level 3 Gracia 1

11:10a – 12:00p

7:00a – 7:50a

national opioid crisis are saved and/or improved. One of those positive strides involves the fda approval of abuse deterrent formulation (adf) opioid medications, with the aim of preventing the transition from the misuse and/or abuse of prescription opioid medications to illicit (and possibly laced) diacetylmorphine (aka heroin). How do these formulations work, one might ask? Which adf opioid medications are not only available on the US market, but also specifically approved as an adf opioid medication? Are these adfs really foolproof? Well, the street chemists of our country have already accepted the challenge to be knowledgeable on all of the above. Now it’s our turn as healthcare professionals to get up to speed on these risk reduction entities.

assist providers with tough decisions in this area, the available clinical trials supporting use will be reviewed along with formulations, locations, and doses where their use have been shown to the be most effective. This session will review the role of various topical analgesics as well as explore the rationale for “topical polypharmacy” with compounded drugs.

PHM-04 Putting the FUN in Dysfunctional:

Ah… drug math. Those 2 little words can make a strong

PHM-06 Opioid Math Calculations:

Conversions, Titrations, and Breakthroughs Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Friday, September 6 Level 3 Gracia 3

healthcare provider want their mommy. But no fear. Armed with an understanding of conversion calculations, some semisolid facts about equivalencies, and a healthy sense of “Does that LOOK right?”—you’ll be just fine! This lively session will review new and emerging data on opioid conversion calculations, and guidance for methadone dosing, both for chronic noncancer pain, and for patients with a serious, advanced illness. If you want to be able to dose opioids safety and effectively, you don’t want to miss this session!

Pain Management Options in Renal and Hepatic Dysfunction Abigail T. Brooks pharmd, bcps Courtney M. Kominek pharmd, bcps, cpe

Thursday, September 5 Level 3 Gracia 3

5:40p – 6:30p

It’s your worst clinical nightmare: providing dosing recommendations for opioid and/or nonopioid pain medication treatment for a patient with renal or hepatic impairment. Even scarier, a patient with end-stage renal or hepatic disease! Put your panic aside and learn about the INs and OUTs of managing opioid and/or nonopioid pain medications, and why some medications might need adjustment and others may not. From metabolism and metabolites to creatinine clearance and Child-Pugh score, you will leave this course feeling more confident in your ability to provide pain pharmacotherapy to patients with renal or hepatic impairment.

PHM-07 He SAID, She SAID.

What’s the Deal with NSAIDs? Timothy J. Atkinson pharmd, bcps, cpe

Friday, September 6 Level 3 Gracia 1

1:40p – 2:30p

Safety concerns, new warnings, and new formulations

focused on harm reduction have led many providers to question nsaidS place in therapy. nsaidS have been a cornerstone of pain management of inflammatory, connective tissue, and autoimmune disorders for over a hundred years. A historical perspective is key to understanding the role of nsaids in pain management, and a therapeutic update on current evidence will aid providers in practical utilization. The safety of nsaids will be reviewed and compared to risks of other medications including opioids. New fda warnings on cardiovascular risk of nsaids will be placed into context and examples of clinical decision-making provided. In addition, new formulations of nsaids will be discussed including IV nsaids, topical nsaids, and new micronized nsaids.

PHM-05 Everybody’s Greasing Up, But Should You Rub It In? A Review of Topical Analgesics and Available

Evidence in Clinical Trials

Timothy J. Atkinson pharmd, bcps, cpe

Friday, September 6 Level 3 Gracia 1

9:40a – 10:30a

7:00a – 7:50a

Topical analgesics are often recommended in clinical

practice, but differences between formulations and routes of administration lead to confusion. In addition to commercial preparations, compounded topical analgesics are highly promoted and widely utilized from compounding pharmacies with individualized recipes of multiple combined medications, at substantial cost. To

PHM-08 Thug Drugs… Revisited

PHM-10 Testing the Waters:

Urine Drug Screening for the Perplexed Among Us

Mark Garofoli pharmd, mba, bcgp, cpe

Friday, September 6 Level 3 Gracia 3

4:40p – 6:00p

Mark Garofoli pharmd, mba, bcgp, cpe

Saturday, September 7 Level 3 Gracia 1

Will the “War on Drugs” ever end? Perhaps a better

Paging urine experts, all urine experts please report to PAINWeek 2019! Actually, if you and your team believe that you could benefit from a thorough discussion on the complexities of urine drug screening and testing, then “you’re in” luck! One of the multiple strategies to reduce patient risk, and healthcare provider risk, is to incorporate urine drug screening or, perhaps better yet, urine drug testing, into one’s practice. Everyone gets a cup! Everyone fills a cup! But then what? Shouldn’t a practitioner know which crossreactants could create possible false-positives? Shouldn’t a practitioner know which active metabolites are expected for a respectively prescribed opioid medication? Are there methods to “beat the system” and outsmart urine drug screenings and testings? Join us for a lively discussion on the most useful strategies for incorporating urine drug screenings, or preferably testings, into your own practice. If “you’re in” over your head, then this presentation is for you!

question is, “When did the War on Drugs even begin?” Throughout the course of history, mankind has consistently aimed to experience the amplified effects of substances within nature, and even delved into creating or modifying substances to the same accord. In any given culture, the line between clinical and criminal utilization of substances is often blurred. In our society today, we have a very “objective” classification of substances based on generally accepted medical use and a propensity to become habit forming. However, as one can recall with the substance of ethyl alcohol (beer, wine, and hard liquor), a substance may not actually chemically change, yet can move across legal classifications of substances. 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. One may even walk away with a few dozen pointers from “street chemists” that are not easily available in any professional textbook.

PHM-11 Frankie Says RELAX:

PHM-09 Better with Age?

The INs and OUTs of Skeletal Muscle Relaxants

Pain Management of the Older Adult

Amanda M. Daniels p harmd, bcps

Maria C. Foy pharmd, bcps, cpe

Christopher M. Herndon pharmd, bcps, cpe

Tanya J. Uritsky pharmd, bcps

Saturday, September 7 Level 3 Gracia 1

Saturday, September 7 Level 3 Gracia 3

8:30a – 9:30a

7:30a – 8:20a

11:10a – 12:00p

With increased efforts to decrease opioid prescribing for

Pain is common in the aging population. Findings from

chronic pain conditions, nonopioid analgesics and coanalgesics are being more widely utilized. Skeletal muscle relaxants (smrs) are frequently used chronically despite a paucity of data supporting this practice. Without a clear base of evidence, a thorough understanding of the pharmacologic profile of these agents is essential when selecting therapy. This session will present the class of smrs in their entirety, review commonly accepted mechanisms of action, and challenge widely held beliefs regarding the appropriate place in therapy for this drug class when treating chronic pain.

an NIH funded study looking at the impact on pain in the older adult found that over 50% of people surveyed had pain within the last month, often in more than one location. Despite its high prevalence, pain often remains undertreated, resulting in impaired cognition, decreased socialization, sleep disturbances, and a reduced quality of life. Our bodies react differently to medications due to medical comorbidities and metabolic changes due to the aging process itself. Understanding the correct choices of analgesic utilizing a multimodal approach to treatment is important in providing safe and effective pain therapies. Patients with dementia or in the late stages of disease may propose a unique pain control challenge due to difficulty in the ability to verbalize pain. This session will explain the differences in response to analgesic medications due to the aging process and provide recommendations for individualized pain control based on specific patient characteristics.

PMC-01 Pain Management Coaching: Integrative

and Complimentary Strategies for Chronic Pain Becky L. Curtis nbc-hwc

Wednesday, September 4 Level 4 Nolita 3

1:40p – 2:30p

Pain management coaching is a systematized application of techniques, including motivational interviewing, that enable your patients to work through ambivalence and take action to change their lives. One of the primary components is education. Coaches teach skills to enable the patient to regain a sense of control and direction. Working with patients to implement providers’ recommendations, coaches give support and tools to help the patient reframe their perspective hopelessness and safely navigate through the treacherous jungle of complicated pain.

POS-02 Poster/Podium Presentations* Srinivas Nalamachu md Joseph V. Pergolizzi, Jr. md

Friday, September 6 10:40a – 12:00p Level 4 Exhibit Hall/Belmont Ballroom

This session highlights posters selected for oral presentations.

*Not certified for credit.

PMC-02 How Pain Coaching Impacts Patient Outcomes

SIS-01 Status Traumaticus:

Becky L. Curtis nbc-hwc

A Trauma Informed Approach to Chronic Pain Management

Deborah Morrow lcsw, ladc, icaadc, emt

Wednesday, September 4 Level 4 Nolita 3

2:40p – 3:30p

Brian F. Kaufman do, facp, facoi

Tuesday, September 3 Level 4 Nolita 3

Perhaps the single most failure-producing aspect of

chronic pain is its inherent isolation. Add the medical hopelessness faced by many patients, and a perfect storm is created for chronic pain patients to fall permanently out of the workforce and fail to thrive. Pain management coaching provides the bridge between medical care and the patient’s innate will to survive. Pain management coaching pioneer Becky Curtis will share how the latest research on the brain and pain relate to relearning and pain management. Attendees will gain understanding of the role pain management coaching plays in reshaping the learned phenomenon of chronic pain, and how coached clients acquire knowledge and implement effective pain management strategies with the guidance of a coach. Deborah Morrow, Eastern Oklahoma VA Health Care System Pain Program Coordinator, will share the experiences of a VA system that has been working with the Take Courage Coaching program for several years. Attendees will be able to look at Veteran’s outcomes and utilize this VA’s experiences in the implementation of pain coaching with Veterans in their healthcare system.

This session is designed to familiarize learners with

the principles of the neurobiology of the traumatized patient and illuminate the salient concepts that are germane to the presentation and treatment of patients with chronic pain. At the conclusion of this activity, practitioners should be able to identify several key aspects of behavior and presentation in patients with chronic pain who have a history of trauma, as well as utilize these concepts when interacting and treating these patients to improve outcomes and pain scores.

SIS-02 The World According to Cannabinoids: Clinical and Research Updates

Theresa Mallick-Searle ms, np-bc, anp-bc Ethan B. Russo md

Tuesday, September 3 Level 4 Mont-Royal Ballroom

9:40a – 11:00a

Despite the widespread acceptance of medicinal and recreational cannabis use internationally and domestically, marijuana remains federally illegal in the United States. For this reason, there are significant legal implications to clinical practice. Clinicians are unprepared to answer questions regarding legality or safety of cannabis use, and unprepared to counsel their patients on use or abstinence, particularly for pain management. This session will explore legal implications, discuss current science, and define the scope of the problem related to the need for education about risk and safety of counseling patients about cannabis use. Case examples representing real life will be presented.

POS-01 Scientific Poster Session and Reception* Errol M. Gould phd Srinivas Nalamachu md Co-Chair Joseph V. Pergolizzi, Jr. md Co-Chair Robert B. Raffa phd Charles E. Wollmuth

Thursday, September 5 Level 2 Condesa Commons

7:00a – 7:50a

6:30p – 8:30p

*Not certified for credit.

MARIA FOY TANYA URITSKY

SATURDAY SEPTEMBER 7

pain management of the older adult

Gary Jay

Tuesday September 3

SIS-03 The Gang that Couldn’t Shoot Straight: Reconsidering t he cdc Guideline

Gary W. Jay m d, faapm

Tuesday, September 3 Level 4 Nolita 3

10:40a – 12:00p

After last year’s talk about the cdc Guideline, a lot has

begun to change, begrudgingly. While this is encouraging, there are still both medical and nonmedical people who don’t want to see any changes in the weak to very weak (evidenced-based medicine) cdc Guideline, which has gone far from what it was supposed to be— recommendations for treatment in a primary care providers clinic. They have been “taken over, mandatorily” by a number of significant entities including cms, various states, and more. Still, there appear to be political and nonpolitical but nonmedical mandated issues that continue to keep this “Guideline” in force. This presentation will discuss these issues and some possible reasons, both the positive and the negative, including forced tapering and increased suicides.

SIS-05 Insight into Preclinical Drug Discovery and Translational Medicine Joseph V. Pergolizzi, Jr. md Robert B. Raffa phd

Tuesday, September 3 Level 3 Gracia 3

SIS-04 Salt of the Earth:

The Importance of Sodium Channels in

Pain Management Michael R. Clark md, mph, mba

Tuesday, September 3 Level 4 Nolita 1

1:40p – 2:30p

Acute pain signaling has a key protective role and is

human Mendelian pain disorders and to common pain disorders such as small fiber neuropathy. Chronic pain affects 1 in 5 of the general population. Given the poor efficacy of current analgesics, the selective expression of particular vgscs in sensory neurons makes these attractive targets for drug discovery. The increasing availability of gene sequencing, combined with structural modeling and electrophysiological analysis of gene variants, also provides the opportunity to better target existing therapies in a personalized manner.

highly evolutionarily conserved. Chronic pain, however, is maladaptive, occurring as a consequence of injury and disease, and is associated with sensitization of the somatosensory nervous system. Primary sensory neurons are involved in both of these processes, and the recent advances in understanding sensory transduction and human genetics are the focus of this review. Voltage-gated sodium channels (vgscs) are important determinants of sensory neuron excitability: they are essential for the initial transduction of sensory stimuli, the electrogenesis of the action potential, and neurotransmitter release from sensory neuron terminals. Nav1.1, Nav1.6, Nav1.7, Nav1.8, and Nav1.9 are all expressed by adult sensory neurons. The biophysical characteristics of these channels, as well as their unique expression patterns within subtypes of sensory neurons, define their functional role in pain signaling. Changes in the expression of vgscs, as well as posttranslational modifications, contribute to the sensitization of sensory neurons in chronic pain states. Furthermore, gene variants in Nav1.7, Nav1.8, and Nav1.9 have been linked to

1:40p – 2:30p

It is becoming increasingly common to hear a new analgesic drug molecule described as a “biased ligand,” being “peripherally restricted,” or as having been “engineered.” What do these terms mean? How are such drugs designed or discovered, and how do you even know that you have one when you have one? For that matter, how are any modern analgesic drugs designed or discovered these days? It’s definitely not your father’s preclinical drug discovery lab any more. Modern drug discovery labs utilize a variety of approaches such as compound libraries, combinatorial chemistry, fragment based lead discovery, high-throughput screening, in silico modeling, in vitro human receptor assays, crispr and artificial intelligence. This session provides a painless introduction to what goes on in modern preclinical drug discovery and translational medicine. Case studies will illustrate the concepts and the resultant clinical analgesic molecules. SIS-06 Chapter None:

Patient-Centered or Paper-Centered Pain Management? Kevin L. Zacharoff md, facip, facpe, faap

Tuesday, September 3 Level 3 Gracia 1

2:40p – 3:30p

Virtually all healthcare professionals have some degree

of altruism and a strong desire to help patients in need. As healthcare continues to evolve, the burdens on clinicians change as well. While most of us have been taught that providing a “medical home” to patients along with shared decision-making is the most ethical way to provide effective healthcare, many are finding that other stakeholders may potentially derail those worthy

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intentions. While insurers are not often considered to be “regulatory agencies” by most, they indeed have become major players in determining the trajectory of everything from pain assessment to treatment planning and implementation to follow-up and monitoring. Many feel that insurance related paperwork and associated administrative burdens are contributing significantly to clinician burnout and ultimately having a negative impact on patient care. Additionally, navigating these challenges is not part of the standard curriculum of most educational training programs. This session will focus on these topics and the concept of “institutional iatrogenesis” and identify the challenges they present to healthcare providers, as well as strategies to manage them and minimize interference with our primary mission: caring for patients with pain.

SIS-07 Geriatric Pain Management:

position of guilt before proving their innocence through a long and arduous trial. In the end, there are usually no winners. This lengthy process is oftentimes inflamed by attorneys who ultimately profit from the emotionally draining court cases. The practice of medicine by way of our legal system has evolved into “defensive medicine” rather than patient-centric medicine. The words “malpractice” and “lawsuit” are so damaging, most practitioners do not utter them. If a physician decides to practice clinical medicine, it is likely he/she will eventually get sued. Being named in a malpractice case is not only a rite of passage but will forever negatively change the way a physician practices medicine. The feelings of isolation, helplessness, anger, depression, and being cast out are all common emotions that distract from work and family. Having recently experienced a malpractice case, my goal as presenter is to give advice, reassurance, and support to practitioners who have been sued, are going through a lawsuit, or who will get sued.

Minimally Invasive Interventions

SIS-09 Eyes Without a Face:

Mayank Gupta md

Tuesday, September 3 Level 4 Nolita 1

2:40p – 3:30p

Music Therapy and Pain Management in Alzheimer’s Disease

Chronic pain is quite common as well as challenging in geriatric patients. Common pain syndromes reported are back, neck, sciatica, joint, and headaches. Any major surgery for back pain or joint replacement can be high risk secondary to comorbid conditions. Patients are quite sensitive to pain medication side effects such as sedation, drowsiness, constipation, and respiratory depression. As the field of pain management is evolving, many minimally invasive alternatives are available to help the geriatric patient population with chronic pain. During the presentation, various treatment approaches will be discussed including radiofrequency ablation, percutaneous lumbar decompression, endoscopic discectomy, endoscopic foraminotomy, spinal cord and peripheral nerve stimulation.

Joanne V. Loewy da, lcat, mt-bc John F. Mondanaro ma, lcat, mt-bc, ccls Andrew R. Rossetti mmt, lcat, mt-bc

Tuesday, September 3 Level 4 Nolita 3

The assessment and treatment of pain and agitation for

those living with Alzheimer’s and other dementias has been a topic of growing concern for the past 20 years. Pain in the elderly is poorly controlled and contributes to agitation with numerous potential risks. Underreporting of symptoms by patients due to cognitive decline and difficulty in expressivity contributes to ineffective assessment and undertreatment. At the other end of medical intervention lies the danger of overtreatment, such as unwarranted opioid use. Recent interest in aesthetic and holistic interventions have shed light on quality of life issues that are inextricably linked to pain and other symptoms of discomfort. The Louis Armstrong Center for Music and Medicine’s history of treating pain through medical music psychotherapy intervention by licensed, credentialed music therapists affords holistic treatment options integrative to pharmacologic intervention. Skilled assessment of pain and coping strategies through both verbal and nonverbal means afforded in music therapy can lend insight to treatment planning and serve as an effective nonpharmacologic intervention that may enhance standard practices. Music therapy integrative with standard care

SIS-08 Malpractice for Dummies:

Getting Sued and Surviving to Talk About It Sean Li m d

Tuesday, September 3 Level 4 Mont-Royal Ballroom

4:40p – 6:00p

4:40p – 5:30p

The medical legal system in our country is broken. The

legal system should protect both the victim and any alleged criminals, as we should agree that a person is innocent until proven guilty in a court of law. Unfortunately, in healthcare, many physicians are placed in a

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across cognitive, physiological, and psychoemotional domains can enhance cognition, fluidity in movement, tension release, emotional expression, and positive associative experiences. Such intervention can affirm orientation and identity, while alleviating the distress that can exacerbate pain, discomfort, and resultant agitation in patients facing cognitive decline.

learn to deliver. How can we integrate these health determinants into our routine practice? This presentation will describe a simple, systematic approach called a hope (Healing Oriented Practices and Environments) visit, that helps patients tap into their inherent healing capacity. Drawing on the most rigorous scientific evidence available, this session will show that by adding some simple questions and tools to your office practice, you can quickly move toward more patient-centered, integrative healthcare and enhance healing for any patient with chronic pain.

SIS-10 Causalytics —

You’re in Pain, and It’s All Your Fault Kevin L. Zacharoff md, facip, facpe, faap

Wednesday, September 4 Level 4 Nolita 3

SIS-12 Tumbling Dice:

11:10a – 12:00p

Preventing a Benzodiazepine Crisis and Understanding Protracted Withdrawal Syndrome

Assessment, diagnosis, treatment plan formulation,

implementation, and follow-up are processes familiar to clinicians and are the main drivers of safe and effective chronic pain treatment. However, many other things influence our clinical decision-making, including the continuing controversies about the role of opioid analgesics in the management of chronic pain, the “opioid epidemic” our nation faces today, and the fear of regulatory scrutiny just to name a few. Additionally, when formulating decisions about pain treatment, the subjective nature of chronic pain and determining the context of how pain is affecting a person’s life may often be challenging. What we might not be aware of is how other more subtle forces can potentially influence us and have a negative impact on the care we provide for patients— the things that we “bring into the examination room.” This session will focus on how things like precognitive thinking, implicit biases, explicit biases, impressions about patient characteristics and even their demographics may potentially alter our judgment and create disparity. Suggestions will be presented to help recognize and reflect about how we can make sure that the pain care we deliver is not compromised by these things we might not consider, even though they are there.

SIS-11 How Healing Works, and What It Means for Chronic Pain Management

Robert B. Raffa phd Steven L. Wright md, faap, fasam

Wednesday, September 4 Level 4 Mont-Royal Ballroom

1:40p – 2:30p

Physicians are often faced with treating pain and sleep disturbances and/or anxiety at the same time, and perhaps do not recognize the link. Many of these patients may have been prescribed benzodiazepines as sleep aids in combination with opioids as analgesics. After declining for years, benzodiazepine prescribing has increased by more than a third from 1996 to 2013 with scant attention until they were found to be involved in 1 out of 3 opioid-associated overdose deaths. Use among persons on opioids has almost doubled over 10 years to 1 in 6, a rate 3 times higher than that seen in the general population. However, recently the fda released a warning regarding the combined use of opioids and benzodiazepines due to serious risks, including death. There is also increasing severe concern about the development of benzodiazepine dependence and difficulties of prolonged withdrawal. This course will address all these issues. SIS-13 Psych Twister: Using Metaphors, Mindfulness,

and Values to Promote Behavioral Change

Wayne Boice Jonas md

Wednesday, September 4 Level 4 Mont-Royal Ballroom

Joseph V. Pergolizzi, Jr. md

11:10a – 12:00p

Heather Poupore-King phd Kristen M. Slater psyd

Wednesday, September 4 Level 4 Yaletown 1

We now know that most of healing—possibly up to

80%—comes from factors outside of what we usually do in the clinic or hospital. The primary determinants of health involve social, environmental, lifestyle, and complementary medicine factors that few clinicians

2:40p – 3:30p

Chronic pain is much more than a physical sensation. It can be all-encompassing and often impacts an individual in a multitude of ways, spawning discouraging,

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painful, or unwanted psychological experiences such as thoughts, feelings, and memories as well as functional limitations. The natural approach might be to dedicate time and expend energy and resources (emotional, psychological, financial, etc) to controlling or avoiding these uncomfortable experiences. However, increasing evidence suggests that, not only are attempts to control the frequency and form of these types of private experiences often unsuccessful, doing so may result in an increase in their occurrence and an increased sensitivity to their impact, thus, paradoxically exacerbating one’s situation. Additionally, especially with chronic pain, avoidance of discomfort (physical and emotional) often results in isolation and inactivity, thus robbing an individual of participation in valued activities. Acceptance and commitment therapy (act), a 3rd wave spinoff of cognitive behavioral therapy, is now considered an evidence-based therapeutic treatment for chronic pain set apart from other, more commonsense solutions. act poses a useful alternative to control-based treatments and operates on a set of 6 core processes within a unified model called psychological flexibility—“the capacity to be directly, consciously, and fully in contact with the present moment without needless defense and to persist or change one’s behaviors in the service of one’s goals.”

SIS-15 Alcohol as Analgesia:

Does It Really Numb the Pain?

Jennifer M. Hah md, ms Ravi Prasad phd

Thursday, September 5 Level 4 Nolita 1

Chronic pain and alcohol consumption are both very common in the general population, and alcohol is often used to numb both physical and emotional pain. The epidemiology of co-occurring pain and alcohol use will be discussed in this presentation. In addition, we will review the latest evidence surrounding the interaction between alcohol consumption and pain. Moderate alcohol use has been associated with improved pain related outcomes for certain pain conditions. Excessive binge drinking and alcohol use disorder, however, are associated with worsened pain outcomes including increased pain intensity, and alcohol use is associated with specific pain conditions. Pain may also trigger alcohol consumption, and alcohol consumption represents a negative pain coping strategy. The interaction of alcohol with pharmacologic treatments for pain will be reviewed, and behavioral strategies to treat co-occurring alcohol use disorder, however, and chronic pain—and to reduce problem drinking—will be presented.

SIS-14 Maleficent Morphine Milligram Equivalents & Dosing Dilemma Disasters

SIS-16 Buprenorphine: A Molecule for All Seasons Martin D. Cheatle phd

Thursday, September 5 Level 4 Nolita 1

Jeffrey Fudin pharmd, daapm, fccp, fashp

Wednesday, September 4 Level 4 Nolita 3

4:40p – 5:30p

The treatment of chronic noncancer pain (cncp) with

opioid therapy continues to be a controversial topic. CNCP and long-term opioid prescribing has come under regulatory scrutiny with high stake liability for prescribing clinicians and dispensing pharmacists. The presenter will provide background and pearls necessary to narrow the dichotomy between providing acceptable opioid therapy and mitigating risk of morbidity and mortality. Discussions will include gaps between our ability to treat pain due to barriers that stem from numerous sources, some legislated and others through health professional misperceptions. This session will focus on stratifying risks of opioid abuse and misuse, dangerous miscalculated risks of dosing and converting between opioid equivalents, unexpected drug interactions, and pharmacogenetic factors which influence efficacy, toxicity, and drug interactions. Real case examples of how to predict and mitigate such risks while managing pain will be presented.

9:40a – 10:30a

11:10a – 12:00p

Buprenorphine was developed by United Kingdom based Reckitt & Colman Products and released in the uk in 1978. That same year, a clinical study determined that buprenorphine could be helpful in reducing cravings of pure opioids in patients with an opioid abuse disorder. Then, a separate study published in 1982 demonstrated that buprenorphine offered excellent analgesia with a blunted abuse liability. Buprenorphine is a partial agonist at the mu-opioid receptors and an antagonist at the kappa receptors. Mu-opioid receptor activity produces the analgesic effects of buprenorphine, while a strong affinity for the kappa receptors render them inactive. While initially buprenorphine was used as an anesthetic, currently it’s been prescribed for the induction and maintenance in patients with an opioid use disorder. However, buprenorphine is a unique molecule with multiple applications. This presentation will provide an in-depth discussion of the history of buprenorphine and its application for pain control, opioid use disorders, and antisuicide properties in patients with chronic pain.

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music therapy and pain management in alzheimerâ&#x20AC;&#x2122;s disease joanne loewy

john mondanaro

andrew rossetti

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tues sept 3

JENNIFER HAH

RAVI PRASAD

THURSDAY SEPTEMBER 5

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SIS-17 The Static Pendulum: Pain, Drugs, and Ethics Kevin L. Zacharoff md, facip, facpe, faap

Thursday, September 5 Level 4 Mont-Royal Ballroom

1:40p – 2:30p

Pain remains one of the most common reasons that people seek medical attention in the United States. Since 2000, pain was designated as the “fifth vital sign” and people were given the right to have their pain assessed and effectively treated by their healthcare professionals. A number of ethical dilemmas have surfaced since, including the increased prescribing of opioid medications for patients with chronic pain, in the face of increasing rates of abuse, misuse, and addiction related to these medications. The “opioid overdose epidemic/crisis” has led us to the challenge of balancing the safe, compassionate, and effective treatment of chronic pain against serious negative outcomes associated with the increased abuse and misuse of these medications. With overdose death rates increasing, tensions running high, a multitude of political and regulatory involvement, and knee-jerk reactiveness, it seems as if the only thing being forgotten is the needs of chronic pain patients and the core ethical principles intended to help clinicians maintain the highest ethical standards of care. This session will describe these principles and clarify their role in determining reproducible courses of action that maximize safety, efficacy, and compassionate pain care, regardless of the direction the “opioid pendulum” is swinging. SIS-18 Understanding Analgesic Trials Rami Ben-Joseph phd

in an analgesic trial. The practical impact of new healthcare measures and the increased importance of comparative effectiveness trials and health outcomes and pharmacoeconomic will be reviewed. At the conclusion of the program participants shall have a comprehensive understanding of analgesic trials.

SIS-19 Back to the Future: Current and Future Opioid Abuse

Risk Assessment and Mitigation Strategies Martin D. Cheatle phd

Thursday, September 5 Level 4 Mont-Royal Ballroom

2:40p – 3:30p

Both chronic pain and the harms associated with prescription opioid abuse, including serious adverse events and fatalities, are enormous public health problems. Opioid therapy has been a cornerstone of a multimodal approach to the management of chronic pain. However, the increased rate of opioid prescriptions has been paralleled by the abuse of prescription opioids in the US, escalating more than 113% between 2004 and 2013. Recent clinical guidelines and professional society position papers for opioid prescribing recommend that, prior to initiating opioid therapy in selected candidates, providers should screen patients to identify those at risk for developing an opioid use disorder and that patients maintained on opioids long term should be routinely monitored for the development of aberrant drug related behaviors suggestive of abuse. This presentation will provide a review of current opioid misuse/abuse risk assessment strategies and outline future assessment strategies including the development of a new assessment tool.

Errol M. Gould phd Srinivas Nalamachu md

SIS-20 A Modest Proposal: Addressing the Components

Joseph V. Pergolizzi, Jr. md Robert B. Raffa phd

and Complexities of Coordinated Care

Charles E. Wollmuth

Thursday, September 5 Level 4 Nolita 3

1:40p – 3:30p

Steven D. Passik phd

Thursday, September 5 Level 3 Gracia 5

There are various types of studies that are necessary to

2:40p – 3:30p

When we practitioners approach complex medical

perform in order to determine their clinical relevance. The process extends from benchtop to bedside side and includes various special populations like pediatrics and geriatrics. This course will address various elements related to the study of analgesics. Novel improved preclinical animal models in analgesic studies will be examined. The unique issues of unusually high placebo and nocebo effects in analgesic, which can lead to confusing results, are to be discussed, along with the role and responsibilities of acting as a Principal Investigator

problems (whether pain, depression, or even gerd) that have psychological and lifestyle components and we do so with minimally monitored drug-only therapies, we may bounce from one “wonder drug” to another and end up bewildered, or worse. These problems need complex approaches that address the component parts and we can’t just rely on finding the next wonder drug. Perhaps it’s part of the American mindset: wanting a pill to fix problems. Part of it is from the perverse incentives

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in a healthcare system that wants to find solutions to complex issues and then implement them on the cheap, running them through primary care on a conveyor belt. In pain we see history repeating itself around the medical cannabis issue. All the same mistakes are being made again and, with poor care coordination, risk management, and assessment, will end up doing harm.

SIS-21 The Elephant in the Room:

Helping Patients to Navigate the “O” Impasse

Jennifer M. Hah md, ms Ravi Prasad phd

Thursday, September 5 Level 3 Gracia 5

4:40p – 5:30p

This session will start with a pain physician review-

ing the current literature related to the use of opioids and the medical challenges associated with weaning individuals off of this class of drug. Current research regarding evidence-based approaches to opioid tapering will be reviewed in the context of improvements in pain, function, and mood. The adverse physiologic effects of opioids including tolerance, physical dependence, immunosuppression, opioid-induced endocrinopathy, and opioid-induced hyperalgesia will be briefly reviewed. In addition, risks factors for nonmedical opioid use and addiction will be discussed in the context of long-term prescription opioid use. Current strategies for monitoring the development of opioid misuse will be presented. A pain psychologist will then discuss the role of evidence-based behavioral treatment modalities that are known to result in improvement in physical and emotional functioning, including their use in the context of opioid weaning. The terms dependence, abuse, tolerance, and addiction are often used interchangeably when discussing opioid medication; however, use of the nomenclature in this fashion is erroneous. The differences between these words will be explained and the implications for treatment discussed. Clinical pathways that often lead to medication escalation will be identified. The role of behavioral interventions for pain treatment and the literature supporting their use will be reviewed, including data from an interdisciplinary clinical program which provides patients such education while concurrently reducing opioid medication.

SIS-22 Central Sensitization and Ketamine Infusions Jay Joshi m d

Thursday, September 5 Level 3 Gracia 3

4:40p – 5:30p

By now, we should all be aware of the prevalence of chronic pain. Astonishingly though, few people are aware of the central pathophysiology of why people develop chronic pain. Central sensitization is one of the key processes in which chronic pain persists. In this presentation, we will explore central sensitization, what it is, what it means, and what can be done to reduce it. We will also discuss ketamine, which has emerged as one of the most useful compounds currently available to mitigate central sensitization. This staple lecture at PAINWeek is a must for anyone who wants to learn about central pain conditions. Dr. Joshi, the presenter, helped create current protocols and philosophies on outpatient ketamine infusions. Ketamine as a treatment is becoming more popular. This lecture will provide top level information from one of the leading experts in ketamine infusions and central sensitization in the country so you can help your patients and evaluate legitimate ketamine infusion centers. SIS-23 Deuces Wild:

Fudin & Gudin Argue the New Rules of the Game Jeffrey Fudin pharmd, daapm, fccp, fashp Jeffrey A. Gudin md

Thursday, September 5 Level 4 Nolita 1

4:40p – 6:00p

Over the last several months, the Centers for Medicare & Medicaid Services (CMS) implemented the Prescriber’s Guide to the New Medicare Part D Opioid Overutilization Policies and the US Health and Human Services posted a draft guidance to the Pain Management Best Practices Inter-Agency Task Force. Both were developed in a backdrop of the 2016 Centers for Disease Control (CDC) and Prevention Guideline for Prescribing Opioids for Chronic Pain. The initial CDC Guideline barely mentions buprenorphine as an analgesic option, CMS focuses on limiting daily opioid consumption, and the Inter-Agency Taskforce, the only group with interdisciplinary pain clinicians, acknowledged the importance of buprenorphine as a safer therapeutic option. So… should the new rules of the game include buprenorphine as a firstline opioid analgesic? And if so, will CMS and third-party payers acknowledge its safety and efficacy advantages over traditional opioids and, if they do, will they support payment for such therapy to enhance patient safety as touted by all three policy-guidance statements? Fudin and Gudin will deliberate on the unique and intricate pharmacological attributes of buprenorphine and how various dosage forms could influence and impact the new rules of the [opioid] game. Discussions will include existing policy mandates,

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commensurate liability, and how regulatory oversight and policy development could help to promote safer options. Case examples of culpability will be examined. As time permits, the doctors will review and debate controversial aspects of pain-related legal cases. As usual, we expect a lively discussion with audience participation!

refused to treat opioid-requiring pain patients, resulting in the patient’s discharge from the specialist’s practice or a consult refusal—the latter of which, by default, often leaves the most medically complex and challenging patients with only their primary care providers to manage their pain. Some patients have chosen to leave their existing providers because of mistrust, cynicism, disbelief, and abandonment, but they then find it difficult to secure any other provider willing to treat their pain. This presentation will chronicle the events that have delivered an unreasonable burden on patients and providers.

SIS-24 Medical Stasi:

The Standardization Proclamation and Its Consequences Jennifer Bolen jd

SIS-26 The Sirens of Titan:

Paul J. Christo md, mba Michael R. Clark md, mph, mba Douglas L. Gourlay md, msc, frcpc, fasam

Friday, September 6 Level 4 Mont-Royal Ballroom

9:40a– 11:00a

Treatment Options for Managing Opioid Withdrawal and Overdose Frank Breve pharmd, mba Joseph V. Pergolizzi, Jr. md

The opioid crisis in America has resulted in many

Robert B. Raffa phd

Friday, September 6 Level 4 Mont-Royal Ballroom

changes and challenges for clinicians who undertake the difficult field of pain management. Specifically, guidelines have been proposed and effectively adopted by regulators and insurers as quasi standards of care. This has created very real barriers to the effective use of an important class of analgesics: opioid analgesics. In this interactive panel discussion, experts from the psychiatric, medical, and legal realms of medicine will offer insights into the difficult practice of managing risk in the treatment of chronic pain, especially in the more complex patient populations where polypharmacy is often the rule, rather than the exception. Using a representative case, panelists as well as audience members will be able to explore these issues with the goal of optimizing clinical care while practicing rational and defensible medicine.

Opioid withdrawal syndrome (ows) is the #1 reason why opioid-tolerant patients avoid discontinuation of opioid therapy. No universally accepted standardized guidelines exist related to the clinical management of ows. Clinicians and patients need to understand ows and how to properly manage it in order to improve chances of successful mitigation of ows symptoms and transition to post-withdrawal treatment. Opioid related overdose deaths continue to rise. Naloxone is currently the only drug commercially available to manage this emergent medical situation; however, alternative drugs are being developed that might provide not just an alternative to naloxone but a superior overall option.

SIS-25 The Visible Few:

SIS-27 Applying Mechanism-Based Classification to Clinical Reasoning for Complex Persistent Pain

An Imperfect Burden on Patients and Providers Jeffrey Fudin pharmd, daapm, fccp, fashp

Miroslav Backonja md

Lynn R. Webster md, facpm, fasam

Sarah Palyo phd

Friday, September 6 Level 4 Mont-Royal Ballroom

1:40p – 2:30p

11:10a – 12:00p

Forced downward titration has been broadly implemented throughout the country as a direct result of the cdc Guideline for Prescribing Opioids for Chronic Pain. Prescribing clinicians feel pressured to follow the cdc’s recommendations of dose limits to avoid regulatory sanctions, and pharmacists feel a corresponding obligation to intervene in accordance with the cdc Guideline and corporate policies. In many instances, prescribers have

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Kathryn A. Schopmeyer pt, dpt, cpe

Friday, September 6 Level 3 Gracia 5

1:40p – 3:30p

Understanding the mechanisms that drive a persistent pain process is critical for effectively treating pain in any patient. While it is common to treat pain from a primary nociceptive perspective, this approach often fails in patients with central sensitization. Pain mechanism based classifications can help clinicians make recommendations that may improve functional outcomes

and enhance patient adherence by identifying primary pain mechanisms. This course will offer practical tips for evaluation of patients with mixed pain mechanism presentations and includes an interactive discussion of multimodal treatment options for each.

analgesic topics such as nmda, trk-a, nos, beta-arrestin, orl-1, kappa, gaba, liposomes, and more!

SIS-30 The Cracked Mirror:

Exploring Opioid Abuse Deterrent Methods from the Laboratory to the Real User

SIS-28 Opioid Moderatism:

Beatrice Setnik phd

Friday, September 6 Level 4 Nolita 3

Seeking Middle Ground Michael E. Schatman phd, cpe, daspe

Friday, September 6 Level 4 Nolita 3

4:40p – 5:30p

Few would question the severity of the prescription

opioid crisis of the early years of this millennium, the causes of which were myriad. Undoubtedly, society needed to address the crisis in an aggressive manner. Unfortunately, the manner in which the problem was addressed has been a classic example of overkill, resulting in a war on opioid analgesia, the patients who require opioid treatment, and the providers who have continued to prescribe. Although many have cast blame on the 2016 cdc opioid prescribing Guideline, it was not necessarily the Guideline itself that caused so much suffering, but rather its weaponization. Irrespective, patients have been the “collateral damage” in this war on opioids. This presentation will address the imperative of physicians exercising more thorough and consistent opioid risk mitigation in order to avoid opioid analgesia from becoming further “legislated away,” as well as the imperative of those who are “pro-opioid” and “anti-opioid” to agree on a rational middle ground that is more “pro-patient.”

SIS-29 Analgesics of the Future Jeffrey A. Gudin md

Friday, September 6 Level 4 Nolita 1

5:40p – 6:30p

Abuse potential is rapidly changing with evolving regula-

tory requirements for clinical methodology. Prescription drug abuse continues to be a great concern and regulatory agencies (such as the fda) require abuse potential evaluation to inform appropriate drug scheduling for novel cns drugs. In addition, many pharmaceutical companies have been developing abuse deterrent formulations to address the concerns of prescription opioid abuse. The methods to deter abuse have evolved over time and include various approaches including mitigating overdose when multiple tablets are combined with various unpleasant excipients such as gelling, strong dyes, or smells or tastes. While most of the exploration of the effectiveness of these techniques is carried out in test tubes or in a limited number of recreational drug users, this session will discuss the challenges and limitations of in vitro and in vivo studies and will engage in a discussion with actual recreational drug users to determine what their experiences are with existing marketed abuse deterrent formulations and what would most dissuade them from engaging with an abuse deterrent opioid. Both the scientists’ and recreational drug users’ perspectives will be openly discussed in this exciting and novel forum. This dynamic session will provide a unique perspective around the behaviors of recreational drug users, and better inform in vitro and in vivo testing approaches.

4:40p – 5:30p

Medicine and science builds and grows on the founda-

tions of what has come before. Although pain management discoveries have been at a relative snail’s pace, there have been recent advances in existing medications and analgesic devices, as well as exciting new molecules and formulations on the horizon. With progressive changes in technology come advances in medicine. Inasmuch, this lecture will discuss newer formulations of older molecules (nsaids, local anesthetics, opioids, gabapentinoids), touch on progress in the abuse deterrent opioid space, and introduce some exciting animal-based, preclinical, and early phase molecules in development. Come hear a discussion of the future of

SIS-31 Let’s Get on the Same Prescribing Page:

Standardizing Opioid Prescribing Practices Among Sickle Cell Disease Patients Collin V. Montgomery aprn Leigh Ann Wilson lcsw

Saturday, September 7 Level 3 Gracia 1

7:30a – 8:20a

This presentation will focus on the development of a

clinical decision tool to standardize opioid prescribing for patients with sickle cell disease. Pain is the hallmark symptom of sickle cell disease, which is often managed by hematologists or primary care physicians.

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jennifer bolen

paul christo

michael clark

douglas gourlay

friday

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september 6

frank breve joseph pergolizzi jr. robert raffa friday september 6

treatment options for managing opioid withdrawal and overdose

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Currently, there is no clinical decision tool or any type of standardization regarding opioid prescribing among these patients. The management of sickle cell disease guidelines, published in jama in 2014, states that there is little evidence related specifically to chronic pain in those with sickle cell disease and most of the recommendations were adapted from general pain guidelines. Therefore, opioid prescribing is not consistent regarding management of chronic pain in this patient population, potentially due to a lack of standardized prescribing practices. In order to mitigate this absence, this pilot project aims to create an opioid prescribing protocol for use in patients with sickle cell disease who are prescribed or may be prescribed opioid therapy. The research was funded and began in January 2019 to develop the clinical decision tool. The tool was implemented in April 2019 and evaluated. The goal is to continue implementation and potentially expand to other sites that treat sickle cell or other chronic pain patients.

Daiichi Sankyo, Inc. This activity is jointly provided by Global Education Group and Rockpointe Corporation. Jeffrey Fudin pharmd, fccp, fashp, ffsmb Jefrey Gudin md

Thursday, September 5 Level 3 Gracia 3

7:00a – 8:00a

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 formulation is altered. Abuse-deterrent formulations can play a key role in optimizing the riskbenefit ratio of opioid analgesia.

SIS-32 Improving Safety of Chronic Opioid Prescribing by Incorporating Clinical Pharmacists on Teams Andrew S. Friedman md Amanda Locke pharmd, mba, bcacp

Saturday, September 7 Level 3 Gracia 5

1:40p – 2:30p

The management of chronic noncancer pain with opioid

medications is controversial. The negative consequences have been described as a public health emergency and the efficacy of chronic opioid therapy remains a subject of significant debate. Despite recommendations that chronic opioid therapy not be utilized until other methods fail, there remains a large population of patients for whom no other therapy has been effective and a large cohort of people who have been treated for years with opioids. Many new patients are still started and maintained on chronic opioid therapy. This course describes one system’s use of clinical pharmacists incorporated into the pain management team to reduce risks. Participants will learn how the pharmacists are utilized in this team-based model. Topics covered will include the nuts and bolts about how to incorporate pharmacists into clinical management, outcomes of the model of care, DEA certification for pharmacists, billing for services, and lessons learned.

“Manage Pain and Minimize Misuse/Abuse: Using Abusedeterrent 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.

VHA-01 Moving Mountains:

Shifting the Pain Management Paradigm

Jessica D. Johnson pharmd, bcacp Judith A. Miller psyd, hbc, cdac Robert Towle p t, ms, cert mdt, cscs

Saturday, September 7 Level 3 Gracia 5

7:30a – 8:20a

In 2010, the Captain James A. Lovell Federal Health Care Center became the first fully integrated facility caring for active duty, veterans, retirees, and dependents in the US. This presented healthcare professionals with unique challenges including how to address pain management in such a diverse population. In 2017, a core team was tasked with the creation of a comprehensive pain management program to address their facility’s need for a cohesive and interdisciplinary approach to chronic pain management in light of the growing national opioid crisis. The emphasis of this new program is to shift the facility’s focus away from a traditional biomedical curative pain management

SYM-01 Manage Pain and Minimize Misuse/Abuse:

Using Abuse-deterrent Opioids to Enhance Patient Quality of Life This program is supported by an educational grant from

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This course will review the scientific evidence for/ against opioid therapy, risk mitigation, and different methods of opioid tapering. Providers need guidance to determine which patients may or may not benefit from opioids. While most pain patients on opioid therapy manage opioids safely, the risks are detrimental to some patients and society. Clinicians are faced with contradictory professional advice and legal mandates/scrutiny. Many patients are exposed to risk due to inappropriately executed opioid tapering. Suicide rates are rising, and illicit drug use including overdose deaths from synthetic opioids continue to rise. How do we maximize benefit over harm? This session will review the scientific evidence and legal requirements that contribute to optimized opioid therapy when clinically indicated and how to discontinue opioid therapy if appropriate.

approach to one that emphasizes a more comprehensive biopsychosocial approach, which can empower patients to take on more responsibility for their pain management and overall functionality. Attendees will learn how this new comprehensive pain management approach has shifted the focus from “fix me” to “teach and empower me.” This journey of “moving mountains” will be illustrated by examining the pitfalls and specific challenges that were faced, as well as the pathways explored, to overcome and rise above these challenges. The end result will reinforce the main goal of realigning the therapeutic relationship to being patient-centered vs provider-driven with the emphasis on improving overall quality of life and functionality. This focus will also speak on the paradigm shift not only for the patients but also for the providers/ staff in order to create a common language that is shared facility wide in the realm of pain management.

VHA-04 Opioids and Mental Health —

VHA-02 VA’s Stepped Care Model for Pain Management and Whole Health:

Suicide Prevention as Highest Priority

Elizabeth M. Oliva phd

Patient-Centered Biopsychosocial Pain Care

Friedhelm Sandbrink md

Heidi Klingbeil m d

Saturday, September 7 Level 3 Gracia 1

Friedhelm Sandbrink md

Saturday, September 7 Level 3 Gracia 5

9:40a – 10:30a

2:40p – 3:30p

There is an increasing awareness that opioid therapy and suffering from pain and mental health comorbidities are important contributors to a rising number of suicides in the United States. The va Behavioral Health Autopsy Program report indicates that pain is the most common identifiable risk factor in veterans with completed suicides. Suicide prevention is of highest priority to the Veterans Health Administration. We will explore strategies to detect suicide risk, assess it, and mitigate it. This session will review suicide risk related to opioid therapy and opioid medication reductions/tapering.

The Pain Management Best Practices Inter-Agency Task Force identified inconsistencies and fragmentation of pain care as gaps in US healthcare that limit best practices and patient outcomes. The report encourages coordinated care and cites the collaborative stepped model of pain care, as adopted by the Department of Veterans Affairs and the Department of Defense health systems as a best practice. The session will address the challenges and successes of VA’s pain care transformation towards patient-centered biopsychosocial pain care for whole health for veterans. Attendees will learn how to anticipate challenges and minimize risks when implementing a comprehensive pain care transformation away from opioids based on lessons learned from the largest integrated healthcare system in the United States.

WRK-01 Innovations in Pain Medicine Ultrasonography:

Image Guidance, Diagnosis, and Emerging Applications

Jennifer M. Hah md, ms Ming-Chih Kao md, phd Einar Ottestad md

VHA-03 Opioid Therapy and Opioid Tapering:

Scot H. Sarver

Guidance for Clinicians to Improve Outcomes

Tuesday, September 3 Level 3 Gracia 5

Sanjog S. Pangarkar md

The field of pain medicine ultrasonography is continually

A Case-Based Pro/Con Discussion Format

evolving with utility in image guidance, diagnosis or pointof-care assessment, and treatment. Around the world, pain medicine specialists favor the use of ultrasound guidance for its accuracy, portability, direct visualization of

Friedhelm Sandbrink md Robert D. Sproul pharmd

Saturday, September 7 Level 3 Gracia 1

1:40p – 4:30p

1:40p – 2:30p

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Buprenorphine is a partial mu agonist that has been clinically available for many years. It was recently made available for the treatment of opioid dependency in the office-based setting. Even more recently, it is enjoying a renewed popularity as an opioid analgesic for the treatment of chronic pain. In this workshop, attendees will explore problematic and sometimes excessively high opioid prescription levels in the context of a treatable clinical condition; case-based examples will be provided. The basics of buprenorphine pharmacology, clinical utility, and the regulatory status of a variety of currently available preparations will be examined through the prism of current as well as past peer reviewed literature.

vasculature, and decreased radiation exposure. In addition, emerging applications continue to evolve for pain medicine sonography with new developments in peripheral nerve stimulation and regenerative medicine. This session will cover the latest evidence-based rationale for ultrasound image guidance for interventions vs other modalities including fluoroscopy and ct guidance. An introduction to diagnostic ultrasonography will be presented covering common pain conditions. Emerging applications for pain medicine ultrasonography particularly relating to peripheral nerve stimulation, regenerative medicine, cryotherapy, and radiofrequency will be discussed. Note: Requires a separate registration fee of $350.

Note: Requires a separate registration fee of $165.

WRK-02 Hitting the Bullseye in Pain Management: Using All the Arrows in Your Quiver!

Alexandra McPherson pharmd, mph Mary Lynn McPherson pharmd, ma, mde, bcps, cpe

Wednesday, September 4 Level 3 Gracia 5

9:30a â&#x20AC;&#x201C; 12:30p

Rarely is one medication or pharmacologic class of drugs the answer to a medical conundrum, including pain management. While opioids are indisputably valuable in treating acute pain and some forms of chronic pain, they are just one therapeutic option. Participants in this fast-paced, case-based session will learn about the appropriate use of different medications in lieu of, or in combination with, opioid therapy. Along the way we will explore contemporary issues in pain management such as the positive and negative implications of gabapentinoid plus opioid therapy, specific evidence that supports the use of cannabinoids in the management of chronic pain (and does it reduce opioid burden), and other controversial issues. Participants will learn how to deal with difficult pain syndromes including wound pain, complicated neuropathic pain, and functional pain syndromes. Last, we will wrestle with cases that illustrate the need to deploy interventional pain management strategies in lieu of, or in addition to, opioid therapy. Bring your seat belt: this is going to be a crazy ride! Note: Requires a separate registration fee of $165.

WRK-03 Rotate the Molecule! Rationalizing Excessive Opioid Prescribing with Buprenorphine

Douglas L. Gourlay md, msc, frcpc, fasam

Wednesday, September 4 Level 3 Gracia 5

1:40p â&#x20AC;&#x201C; 4:30p

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115

116

117

xhibitors

119

exhibit hall/schedule wednesday 9.4 6:45p – 9:00p Welcome Reception

thursday 9.5 10:00a – 12:30p 2:30p – 5:00p

friday 9.6 10:00a – 12:30p 2:30p – 4:30p Closing Reception

UMB

T19 CME Desk

IMS

Wolters Klewer

T10

T11 T12

Patient Mind, Inc.

USPF

Belmont Commons/exhibit annex level 4

Please note: There are concurrent educational sessions taking place while the Exhibit Hall is open. Exhibit Hall hours are subject to change. Floorplan and listings are accurate as of printing. Please refer to m.painweek.org or the PAINWeek App for most up-to-date information.

Confirm BioSciences/ Prescient Medicine

Rx DestroyerC2R Global Manufacturer

Regenative Labs 405

403

400

402

Mediknox

V.I.P

401

409 404

Aspen Medical Products

TrueMED

406 CPA

Provation

301

305

203

Currax Pharmaceuticals LLC

TerSera Therapeutics

309

205 204

Summus Medical Laser

National Labs NeuroFlow

103

1st Providers Choice

NextGen Labs

410

Pfizer and Lilly

Salix

102

408

105

104 Theranica

107

208

PCL

PMN

109

Royal Bee

111

RealLab

Dr. Reddy’s Labs Inc

Taylor & Francis

411

413

415

412

414

416

Ethos

PAR

MD HEALTH CARE

PCCBD

417

PR Med

COX Net 421 423

419

420

418

Millennium Health

Regenerative Biologics DRUGSCAN Compulink Healthcare Solutions

BioDelivery Sciences International, Inc. 313

319

Emergent

321

316

211 212

PBIO

Multi Radiance

113

106

Nature’s Wonder

Innovida Pharmaceutique

115

108 Fidia

221

216 Teva Pharmaceuticals

220

Image X Erchonia Innovation

110 ReviveMD

119

112 OUP

114

US Army Healthcare Recruiting

Safe Chain Solutions

NovaDX

325

322 Zyla

Pachamama CBD

217

117

424

Galt 323

Medi Lazer

H-Wave

425

Karuna

320

Salonpas

SCILEX

422

Paradigm

222

224

Infinity Massage Chairs

Horizon Therapeutics

RBI

LeadingResponse

SBA Loan

123

121 116 AHS

118

120

Adit

125

122

Sovereign PCSS and Assertio Properties ORN Therapeutics

DTPM

701

700

702

703

705

Aprima

PathLab Services Inc

Appriss Health

Clarity Lab Solutions

600

Skylar

602 601

PW INFUSION by LIVING HEALTHY CORP

PPM

ReCharge Lounge

704

Expert Opinion Live

604 603

Doctor Las Vegas Multimedia HEALS

ReCharge Lounge

michael schatman

friday september 6

(revisited)

taking the insanity out of medical cannabinoids

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JENNIFER BOLEN

DOUGLAS GOURLAY

THURSDAY SEPTEMBER 5

A LEGAL AND MEDICAL PERSPECTIVE ON MARIJUANA USE WHEN PRESCRIBING CONTROLLED SUBSTANCES

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12 5 Adit

701 Aprima, an eMDs company

Accelerate practice growth with Adit's all-in-one solution. We enhance and automate each touchpoint in the patient journey. From the first impression online to the post-visit follow up, Adit makes it easy for healthcare providers to attract more patients, manage online reputation, modernize the patient experience, and automate the front office. Additionally, Adit offers a patient booking guarantee. If the healthcare provider does not book a specific quota of patients, no charges will be incurred for Adit’s services & product offerings. Give us a call today to learn more!

Aprima, an eMDs company, offers EHR, PM, RCM and credentialing solutions tailored for the unique needs of Pain Management practices. Our back-to-back KLAS®award winning EHR is renowned for ease of use. Reduce clicks with pain management productivity and efficiency features that make scheduling and documenting follow up appointments a breeze. Pain templates, EPCS and PDMP for prescribing, and powerful billing make it a complete solution. Decades of expertise working with practices just like yours has helped us craft proven, transformative, solutions that meet the unique needs of pain management and empower you to maximize the impact of your care.

adit.com

www.aprima.com

116 American Headache Society

404 Aspen Medical Products

americanheadachesociety.org

The American Headache Society® (AHS) is the professional organization for the study and management of headache and face pain. AHS activities include an annual scientific meeting, a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, and publication of the journal Headache. AHS established the American Migraine Foundation to raise awareness about migraine and related disorders and raise funds to establish the American Registry for Migraine Research.

www.aspenmp.com

Aspen Medical Products is a leader in the development of award-winning, innovative spinal orthotics providing optimal pain relief, post-trauma stabilization, pre and post surgical stabilization and long-term patient care. Committed to improving patient care, Aspen offers multiple bracing options that deliver unsurpassed motion restriction, superior comfort and an economic advantage, encouraging better patient compliance.

600 Appriss Health

122 Assertio Therapeutics

Appriss Health is the provider of the nation’s most comprehensive platform for opioid stewardship and the early identification, prevention and management of substance use disorder (SUD). We provide state government agencies with the most advanced repository of controlled substance dispensing information, and deliver real-time clinical decision support, critical insights and interventions to physicians, pharmacists, and care team members through millions of patient encounters each year. Our solutions enable healthcare providers, pharmacists, and care team members to assess and manage clinical risk in order to positively impact patient safety and health outcomes. For more information, please visit www.apprisshealth.com.

Assertio's mission is to advance patient care in our core areas of neurology, orphan and specialty medicines

apprisshealth.com

www.assertiotx.com

31 3 BioDelivery Sciences International Inc. BDSI.com

BioDelivery Sciences (BDSI) is a rapidly growing commercial-stage specialty pharmaceutical company dedicated to patients living with chronic conditions. BDSI is utilizing its novel and proprietary BioErodible MucoAdhesive (BEMA®) technology and other drug delivery technologies to develop and commercialize new applications of proven therapies aimed at addressing important unmet medical needs.

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31 3 BioDelivery Sciences International Inc. Medical Affairs

403 Confirm BioSciences / Prescient Medicine

Visit our booth for more information.

Confirm BioSciences is a leader in high-quality pointof-care testing for both the clinical community and individual consumers. The company’s product portfolio ranges from instant and lab-based diagnostic testing solutions for drugs of abuse, including HairConfirm® (hair-based) and DrugConfirm® (urine-based), to the HealthConfirm® line of tests that measure hormones relating to several aspects of health, essential vitamin levels, key neurotransmitters and more, with all results delivered in user-friendly reports. Prescient Medicine empowers a new standard in healthcare delivery, offering expert-driven and evidence-based insights and medication monitoring to drive better diagnostic decisions.

www.confirmbiosciences.com

602 Clarity Lab Solutions

www.claritylabsolutions.com

Visit our booth for more information.

406 Clinical Pain Advisor

www.clinicalpainadvisor.com

ClinicalPainAdvisor.com offers pain medicine healthcare professionals a comprehensive knowledge base of practical pain and pain management information and resources to assist in making the right decisions for their patients. Our mission is to empower pain medicine healthcare professionals with practice-focused and comprehensive clinical and drug information that is reflective of current and emerging principles of care to help clinicians optimize patient outcomes.

421 CoxHealth

coxhealth.com CoxHealth is a Top 100 Integrated Healthcare Network. We are recruiting for a physician to do medication management as part of our Pain Medication Management Clinic. Outstanding benefit and compensation plan. Be a part of a multi-disciplinary team including pharmacy, behavioral health, and experienced advanced practice providers.

1 03 Collegium

www.collegiumpharma.com

Collegium is a specialty pharmaceutical company committed to being the leader in responsible pain management. For nearly two decades, Collegium has been focused on developing and commercializing new medicines for pain management that reflects its Core Values and commitment to people suffering from pain, providers, and its communities. The result of those efforts is a portfolio of meaningfully differentiated medications to treat moderate to severe pain.

41 0 Currax Pharmaceuticals LLC www.curraxpharma.com

Visit our booth for more information.

301 Daiichi Sankyo, Inc.

www.daiichisankyo.com

31 9 Compulink Healthcare Solutions

Daiichi Sankyo, Inc., headquartered in Basking Ridge, New Jersey, is the U.S. subsidiary of Daiichi Sankyo Co., Ltd. Daiichi Sankyo, Inc. is a member of the Daiichi Sankyo Group and is focused on the development of oncology therapies and specialty medicines. Daiichi Sankyo, Inc. medicines approved in the U.S. include therapies for hypertension, pain management, dyslipidemia, diabetes, thrombosis, stroke risk reduction, acute coronary syndrome, opioid-induced constipation, IV iron therapy and metastatic melanoma.

www.compulinkadvantage.com

A leader in specialty-specific, all-in-one EHR and Practice Management solutions, Compulink’s Advantage SMART Practice® uses artificial intelligence to improve clinical and financial results. Designed to maximize your time while seeing patients, Advantage includes everything you need to optimize workflow including pain management-specific EHR, PM, patient engagement, and RCM.

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601 Doctor Multimedia

laboratories since 1993 to provide a comprehensive array of instrumentation, method development, custom assays, laboratory consumables and supplies, and ongoing service and support. We provide a complete laboratory solution. National in scope. Local in service.

doctormultimedia.com

We have graphic designers, WordPress developers, social media masters, content creators, SEO wizards, IT problem solvers, marketing gurus, and all-around ninjas ready to help your medical practice thrive and grow. We’re successful for one simple reason: no one can outwork us. At most, they can do the same, but they can’t do more. We’re open 24 hours a day, 7 days a week, 365 days a year. We do it out of passion, and because that’s when our clients need help. We do it because your website doesn’t stop working and neither do we.

321 Emergent BioSolutions

www.emergentbiosolutions.com Emergent Biosolutions develops, manufactures, and delivers a portfolio of medical countermeasures for biological and chemical threats, existing and emerging infectious diseases as well as opioid overdose.

41 3 Dr. Reddy's Laboratories, Inc.

119 Erchonia Corporation

Dr. Reddy’s Laboratories is an integrated pharmaceutical company, committed to providing affordable and innovative medicines for healthier lives. Through its three businesses—Pharmaceutical Services & Active Ingredients, Global Generics and Proprietary Products— Dr. Reddy’s offers a portfolio of products and services including APIs, custom pharmaceutical services, generics, biosimilars and differentiated formulations. Our major therapeutic areas of focus are gastrointestinal, cardiovascular, diabetology, oncology, pain management and dermatology. Dr. Reddy’s operates in markets across the globe, including USA, India, Russia & CIS countries, and Europe.

Visit our booth for more information.

420 DRUGSCAN

1 08 Fidia Pharma USA Inc.

DRUGSCAN offers timely, accurate, state-of-the-art testing solutions for medication monitoring and addiction treatment, with 24/7 access to the a toxicologist. As a nationally certified SAMHSA and CAP accredited laboratory, our reputation is renowned. In addition, DRUGSCAN CAT.one is a leader in conducting in vitro manipulation and extraction studies for abusedeterrent products which further enhances our understanding of drug use and abuse.

Visit our booth for more information.

www.drreddys.com

www.erchonia.com

www.drugscan.com

412 Ethos Laboratories www.ethos-labs.com

Ethos’s proprietary Functional Biomarkers of Pain panel provides novel, objective information about the biochemical origins of pain. Addressing abnormal biomarker findings with cost-effective, non-opioid therapies provides a valuable adjunct treatment program to maximize the likelihood of successful and prolonged pain management.

www.fidiapharma.us

1 02 1st Providers Choice Pain Medicine EMR Software www.1stproviderschoice.com

IMS for Pain Management is a user-friendly, Fully Certified EMR and Practice Management Solution. Pain Management doctors across the country have helped us to design and customize the software for maximum efficiency and profitability in your practice. Save hours of time on visit notes and documentation with Pain Management specific templates.

700 Drug Testing Program Management www.dtpm.com

DTPM is the leader in providing nationwide laboratory products, services, and solutions. We serve over 750 laboratories in 47 states. We have been partnering with

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323 Galt Pharmaceuticals

22 4 Infinity Massage Chairs

Galt Pharmaceuticals is the first and only pharmaceutical company to implement a unique franchise concept. Galt offers entrepreneurial local ownership opportunities for self-driven individuals. Galt utilizes Independent Pharmacies as the key distributor of our products. We currently have a sleep medication, Doral, on the market, and will launch a non-controlled pain medication, Orphengesic Forte in August 2019. Galt possesses a robust pipeline that will bring products to market that address unmet clinical needs.

When you hear "massage chair" you might not realize the extent to which it can impact your life, but the physical and mental benefits can be truly astounding in unexpected ways. Visit Infinity Massage Chairs, at booth 224 to experience wellness.

www.galtrx.com

220 Horizon Therapeutics

www.horizontherapeutics.com

Horizon is focused on researching, developing and commercializing medicines that address critical needs for people impacted by rare and rheumatic diseases. Our pipeline is purposeful: we apply scientific expertise and courage to bring clinically meaningful therapies to patients. We believe science and compassion must work together to transform lives. For more information on how we go to incredible lengths to impact lives, please visit www.horizontherapeutics.com, follow us @HorizonNews on Twitter, like us on Facebook or explore career opportunities on LinkedIn.

www.infinitymassagechairs.com

115 Innovida Pharmaceutique innovidarx.com

A boutique pharmaceutical company with innovative medical products. We specialize in branded generic products that improve the health of patients and fulfill their medical needs. We have strategic partnerships worldwide to produce innovative products with the patient’s needs as the driving force behind our development. Our products exceed all Current Good Manufacturing Practice (cGMP) regulations enforced by the United States Food and Drug Administration (FDA). We offer a range of branded generic products to bring comfort and pain relief to patients, developed with our pharmaceutical technology and brought to you at a fair price.

T6 International Myopain Society www.myopain.org

21 7 H-Wave

Visit our booth for more information.

H-Wave® is a proven, evidence-based medical device intended to speed musculoskeletal recovery, restore function, and manage chronic and post-operative pain. It’s a non-invasive drug-free treatment prescribed for home use. Patients benefit from personalized instruction and long-lasting, on-demand electronic anesthesia, enhanced regional blood flow and improved lymphatic action. When opioid sparing technique and outcomes drive your treatment focus, H-Wave’s advanced technology and service provide the best opportunity for real results.

www.karunalabs.com

422 Karuna Labs

www.h-wave.com

Karuna Labs is a software company that creates immersive virtual reality experiences designed to address chronic pain. Karuna sells products for both clinical and home use.

603 Las Vegas HEALS lasvegasheals.org

117 Image X Innovation

Visit our booth for more information.

We seek to improve access to the best available therapies which significantly improves patient’s discomfort. We offer wellness and relaxation services for attendees and exhibitors and management.

www.leadingresponse.com

121 LeadingResponse

www.imagexinnovation.com

LeadingResponse has marketed more than 1,000,000 consumer seminars for financial advisors. Our Seminar-

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Success® program is now being successfully utilized by medical practices looking to attract more large fee-based cases. Practices utilizing our program are consistently filling 3-6 events with 30 affluent and pre-screened attendees per event. Our targeted approach is fueled by millions of responder records and prior local event data to give you an edge in your area.

to obtain objective information about patients’ recent use of prescription medications and/or illicit drugs and helps monitor the effectiveness of treatment plans. Our evidence-based, guideline-driven genetic testing services, including pharmacogenetic testing, help clinicians make informed medication choices for their patients. Processing hundreds of thousands of patient specimens each year allows us to provide meaningful insights into emerging drug use trends.

604 Living Healthy Corporation www.elevare.com

A new and vibrant company based in Las Vegas, with the idea of Living Healthy through the use of high quality skin care products and LED light therapy, along with CBD products made from non-GMO hemp. On their own, each of these products is valuable. It's when these products are combined and infused together, that the maximum benefits are achieved. Come by our booth for a free sample and then you too will understand what Living Healthy is all about.

113 Multi Radiance Medical www.multiradiance.com

41 9 MD HEALTH CARE

Multi Radiance manufactures FDA-cleared super pulsed laser devices for non-invasive drug-free pain relief; the new answer for chronic pain without opioids. Multi Radiance lasers are used by multiple healthcare disciplines as well as professional and college sports teams, for managing injuries and maximizing recovery; and are the only therapeutic lasers validated in-vitro, in-vivo, in laboratory trials, and clinical trials. Console models for the clinic, and cordless models for anywhere, including home care patient rentals.

Visit our booth for more information.

1 05 National Labs

mdhealthcaresupplies.uk

www.nationallabs.com

400 Mediknox

mediknox.com

Mediknox works with the most advanced medical devices, and simplifies professional medical technology for home use. This technology is clinically proven and FDA cleared medical devices, and currently carried, used and sold by medical professionals, including those within this field.

320 Medi Lazer

www.medilazer.net

NATIONAL LABS: THE LAST LAB CHANGE YOU’LL WANT TO MAKE. NATIONAL LABS is an industryleading clinical reference laboratory providing advanced high-complexity urine and oral fluid drug testing. Value of services include: Unique Drug and Metabolite Test Panels, Customized Reports, Lowest Cost Point of Care Testing Devices, Web and EMR-Reporting Capabilities, Exceptional Ancillary Services and Patient-friendly Billing Practices. NATIONAL LABS is positioned to meet all your medication monitoring needs and become a committed partner to your Pain Management Practice. We welcome you to stop by Booth #105 to learn more.

1 06 Nature's Wonder

Visit our booth for more information.

41 6 Millennium Health

natureswonderus.com

www.millenniumhealth.com

Visit our booth for more information.

Millennium Health is a highly accredited specialty laboratory with over a decade of experience delivering timely, accurate, clinically-actionable information through our nationwide medication monitoring and drug testing services. Drug testing is used by substance use disorder and pain management providers

1 07 NeuroFlow

www.neuroflowsolution.com NeuroFlow is a healthcare technology and analytics company enabling behavioral health access and

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221 Pachamama CBD

engagement across the continuum of care. Combining validated techniques, data science, and behavioral economics, NeuroFlow helps leading pain clinics, health systems, and providers objectively assess, track, and engage patients to support their mental health.

www.enjoypachamama.com

Based in Denver CO, Pachamama CBD focuses on providing educational insights and crafting holistic products that work to restore balance in the body. Rather than masking the experience of pain, we created integrative formulas that address the underlying sources of discomfort. Feeling comfortable when using CBD is the first step in unearthing all the therapeutic value that the hemp plant has to offer. That’s why we will be at PAINWeek continuing to build our awareness of all forms of pain and answering questions that arise about our mission or products.

408 NextGen Laboratories nextgenlabs.com

NextGen Laboratories offers you high-impact diagnostic results derived from our next generation technologies. Our dedicated staff provides personalized customer service to every patient with technical expertise and patient care that will exceed your expectations for a clinical laboratory. Our capabilities give you access to better technology, faster turnaround times, and excellent quality assurance.

1 09 Pain Medicine News

www.PainMedicineNews.com

32 5 NovaDX

Pain Medicine News, the best-read pain publication in the United States according to Kantar Media, is mailed 10 times per year to 46,450 pain-treating physicians and 3 times per year to 46,760 pain-treating nurse practitioners and physician assistants. It offers extensive coverage of major scientific meetings affecting the specialty, feature articles on topics relevant to practicing provider, in-depth clinical reviews, practice management articles, medical education, as well as a full line of digital media, including the PainMedicineNews.com website, e-Newsletters, and multimedia content.

www.novadx.com NOVADX ENFD TESTING FOR SMALL FIBER NEUROPATHY. NovaDX is a leading histopathology lab designed to assist our physicians in diagnosing small nerve peripheral neuropathy using epidermal nerve fiber density (ENFD) testing. NovaDX offers a national lab to better assist providers in specimen referral and turnaround times. At NovaDX it is our goal to facilitate faster reporting times and better outcomes for patients. Our services can reduce overall healthcare costs, unnecessary surgeries and treatments, and improve patient care.

42 5 Paradigm

www.paradigm.healthcare

1 12 Oxford University Press

Paradigm Labs is an independent laboratory specializing in clinical toxicology. Paradigm has developed a new and unique method for drug testing in response to payor policies requiring presumptive testing (a drug screen), which is typically performed using EIA point of care test cups or a chemistry analyzer. Paradigm’s Benchmark Presumptive LC-MS/MS test allows the provider to evaluate more than 50 specific drugs in a timely and cost-effective fashion; providers can drug screen within medical necessity guidelines and eliminate high patient bills. Paradigm’s Benchmark Presumptive LC-MS/MS test puts the information in the provider’s hands and eliminates guesswork associated with patient care.

global.oup.com/?cc=us

Oxford University Press is the world’s largest university press with the widest global presence and strives for excellence in scholarship, research, and education. Since its creation in the 1600’s OUP has published award winning material such as dictionaries, children’s books, journals, sheet music, and textbooks to a range of audiences. In addition to traditional publishing, OUP offers support to teachers, delivers digital learning and assessment platforms, creates online research tools, and provides free digital language resources. Today, OUP has locations in 50 countries and publishes over 6000 titles a year for audiences ranging in age, experience, and field of study.

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michael barnes friday september 6

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208 Parkway Clinical Laboratories

212 Predictive Biotech

Parkway Clinical Laboratories (PCL) is a College of American Pathologists (CAP) accredited, CLIA certified, specialty toxicology laboratory. PCL has been delivering in-vitro diagnostic services for almost five decades. We are a global provider of addiction screening and opioid prescription monitoring services including designer drugs focused on serving behavioral health, addiction and chronic pain management specialists.

Predictive Biotech, Inc., a Salt Lake City, Utah life sciences company formed in 2015, is a leader in human cell and tissue products for use in regenerative medicine. A growing national network of clinics, health systems, researchers and physicians leverage Predictive's four main placental-derived and Wharton's jelly umbilical cord-derived products.

parkwayclinical.com

www.predictivebiotech.com

41 4 PRISKA (Pain Assessment Resources)

703 PathLab Services Inc.

www.priska.io

Visit our booth for more information.

T9 Patient Mind, Inc.

www.patientmind.org

Patient Mind Inc., a 501 (c)3 non-profit organization, is on a mission to improve clinical dialogue, merging science, healthcare expertise, and patient education. We offer education on multiple conditions for patients, clinicians, and families. We are a portal for patients seeking answers to healthcare topics to improve communication/ confidence during their next clinical visit. Patients with pain or mental health conditions can go to PatientMind. org to learn from real stories, with real solutions and hope. Current science is explained by a specialist in an understandable manner. Participants of the education will find resources available, including specialist finders and smartphone communication guides.

205 Pfizer and Lilly

www.chronicpaindrivers.com

PFIZER AND LILLY: WORKING TOGETHER TO ADVANCE THE UNDERSTANDING OF CHRONIC PAIN. The collaboration between Pfizer and Lilly reflects the commitment of both organizations to scientific innovation in pain. Pfizer and Lilly colleagues around the world are devoting their passion and scientific expertise to advancing the understanding of chronic pain with the goal of improving patient treatment, care, and outcomes.

Priska™ suite of online tools bridges the communication gap between doctors and patients. Our assessments and surveys give doctors the tools they need to make informed decisions and provide patients with insights to better understand their unique pain. Pain care protocols are as unique as each patient. Priska™ tools are designed to help you make fast, informed decisions. Customize your patients’ pain management solutions through our easy-to-use online opioid and psychosocial risk assessment. Cloud-based questionnaires provide immediate insights. Priska™ Online Patient Risk Assessment Tools are designed to make pain care management easier.

423 PR Med Net

www.prmednet.com/about

Our experience spans the complete spectrum of care – from hospitals to CCRCs, SNF/Subacute centers, AL/IL, outpatient, schools, and home health. We believe it’s important to foster environments that support growth and encourage fulfillment – for both our therapists and the patients we serve. PR Met Net is one of the largest independently owned, diversified therapy and related service providers in the country.

305 Provation

www.provationmedical.com Provation is a leading provider of clinical productivity software for healthcare professionals, with solutions for multispecialty procedure documentation (Provation® MD and Provation® Apex), order set and care plan management (Provation® Order Sets and Provation® Care Plans), and nursing documentation (Provation® MultiCaregiver). Our software helps providers increase

704 Practical Pain Management

www.practicalpainmanagement.com

Visit our booth for more information.

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operational efficiency, business profitability and regulatory compliance by improving quality, streamlining workflows and enabling insights. We serve 1,500 hospitals and 1,000 ambulatory surgery centers (ASCs) specializing in gastroenterology, pain management, orthopedics and more. Provation is headquartered in Minneapolis, MN. More information is available at www.provationmedical.com.

120 Providers Clinical Support System and Opioid Response Network

www.opioidresponsenetwork.org & www.pcssnow.org

Providers Clinical Support System (PCSS) and the Opioid Response Network (ORN) are two SAMHSA-funded federal grant initiatives awarded to the American Academy of Addiction Psychiatry and a large coalition of national professional organizations to address the opioid crisis. PCSS offers free trainings, resources, and mentoring to primary care clinicians in the evidencebased treatment of opioid use disorder. ORN provides free technical assistance to single state agencies, healthcare systems, clinics, and individuals in evidencebased prevention, treatment, and recovery of opioid use disorder. Together, these initiatives work in tandem to help mitigate this healthcare crisis.

From preventative medicine to complex wound and scar care, we work with physicians to find solutions. We work with dermatologist, diabetic specialist, orthopedists, surgeons, sports medicine physicians, and more to prevent or treat all types of conditions.

41 8 Regenerative Biologics: Stem Cell Therapy www.regenerativecellmedicine.com

Regenerative Biologics is recognized as a leader in regenerative medicine and stem cell research. We work directly with one of the top FDA regenerative IND university research and processing labs in the United States. This guarantees that your patients can trust that the regenerative products they receive from you are the highest in quality, purity, safety and efficacy available today; and it guarantees that you will always be up to date on cutting edge research and new developments in regenerative cell therapy. Our reasonable pricing structure provides an extra bonus for you and your patients. Regenerative medicine changes lives everyday!

222 Regenesis Biomedical www.regenesisbio.com

Regenesis Biomedical is a medical device company dedicated to improving human welfare through the research, design, manufacture, and sale of energybased medical products and services that alleviate pain, restore health, and improve quality of life. We offer the Provant Therapy System, which is electromagnetic energy. Provant is safe, non-drug pain management.

41 1 Real Lab

www.myreallab.com

RealLab is a true diagnostics and risk management partner to our providers, healthcare organizations, the community and above all the patients. RealLab prides itself with experienced and certified medical technologists who are committed to providing superior quality and service through advanced technology and personal attention. Our services include: qualitative and quantitative results, access to medical director, results interpretation, defining and understanding drug interactions, developing drug testing policies or programs, and unusual specimen collection or handling.

405 Regenative Labs

110 ReviveMD

www.revivemdcbd.com

ReviveMD was created to be the healthcare industryâ&#x20AC;&#x2122;s gold standard cannabidiol (CBD) product. Our mission is to provide the safest and most efficacious form of CBD oil for use only by licensed healthcare professionals directly with their patients.

regenativelabs.com

111 Royal Bee

Regenative Labs strives to process our products in conditions above AATB requirements. PROVIDING OUR PARTNERS THE HIGHEST QUALITY. Using human tissue under AATB and FDA guidance, we work with physicians, hospitals, and surgery centers to improve patient outcomes in virtually all facets of medicine.

We vend raw honey products, candles, skin creams, pillows, and the raw honey itself in jars. We stand on three pillars of usage for the raw honey: Aromatherapeutically: with candles to wind down stress, burlap pillows filled with beads of raw honey for a better night sleep; Topical: using creams to sooth dry skin,

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123 SBA Loan Group

treat wounds and burns, eczema and psoriasis, etc; and finally, Ingestion; to sooth a sore throat and improve gut health. We also offer unique pain relieving led devices that work on target areas of the body to relieve muscle stress, joint pain, as well as migraine.

www.sbaloangroup.com

SBA Loan Group is a private company that helps small business owners obtain financing for Working Capital and Real Estate through the United States SBA government loan program.

409 Rx Destroyer - C2R Global Manufacturer www.rxdestroyer.com

21 1 SCILEX Pharmaceuticals

Rx Destroyer™️ Drug disposal solutions is a safe, ready to use, drug compliance bottle technology. Our patented wet liquid slurry combined with activated carbon deems controlled and non-controlled substances nonretrievable and into a non-medicine form. EPA and DEA compliance is the law. The EPA new no sewer requirement, and the DEA non-retrievable requirements are our business. Rx Destroyer™️ will help determine your drug disposal compliance process, procedure, training, and implementation plans.

www.scilexpharma.com

Scilex Pharmaceuticals, located in Mountain View, California, is focused on becoming the global pharmaceutical leader in pain management. Scilex’s marketed product (launched in the United States in October 2018) is ZTlido® (lidocaine topical system 1.8%), a branded lidocaine topical system formulation for the treatment of relieving the pain of post-herpetic neuralgia (PHN), also referred to as after-shingles pain. We are also focused on the development and commercialization of best in class novel non-opioid pain therapies. Our lead program, SP-102, is a non-opioid novel gel formulation administered epidurally in development for patients with moderate to severe chronic radicular pain/sciatica.

42 4 Safe Chain Solutions www.safechain.com

Safe Chain Solutions is a full-service pharmaceutical wholesaler serving a diverse network of healthcare facilities nationwide. We provide the safest and most secure range of wholesale pharmaceutical and healthcare products to independent retail pharmacies, Surgery Centers, Urgent Cares, compound specialty pharmacies, hospitals, International Research and Government managed facilities as well as Physicians. Headquartered in Cambridge, MD, we have sales offices in Miami and Annapolis, MD, and operate warehouses in Cambridge, MD, and St. George, UT.

702 Skylar Labs

www.skylarlab.com

Dvorah Oral Tablet 325-30-16 MG (APAP-Caf-Dihydrocodeine): Packaged as a 3-day dosage for the management of pain severe enough to require an opioid analgesic for which alternative treatments are inadequate.

118 Sovereign Properties

203 Salix Pharmaceuticals

www.sovereignprop.com

www.salix.com

Sovereign Properties, led by Russ Krivor, is a fullyintegrated real-estate development and asset management firm. Since 2004, Krivor has been engaged in the concept, development, construction, and project management of income generating real estate in the strongest job-growth markets across the United States. As a result of this conservative approach to real estate, Krivor and Sovereign Properties has assembled over $300 million in equity under management, resulting in over 4,000 completed and leased apartments. We are focused on development and acquisition in high-growth sunbelt markets where population growth and job-growth continue to significantly outpace the broader US.

For 30 years, Salix Pharmaceuticals has been committed to the prevention and treatment of gastrointestinal diseases. Salix licenses, develops and markets innovative products to improve patients' lives and arm healthcare providers with life-changing solutions. Salix is headquartered in Bridgewater, New Jersey.

31 6 Salonpas

salonpas.us

Visit our booth for more information.

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204 Summus Medical Laser

41 7 The Physician's Choice CBD

Summus Medical Laser is the pioneer in Class IV laser therapy and a global leader developing the next generation laser technology to relieve pain and aid healing. Our research is guided by physicians, our clinical training ensures our customer's success, and our equipment stands apart for its durability, ease of use and safety. We offer a non-surgical solution for providers while delivering the most effective, powerful therapeutic laser used in medicine.

Visit our booth for more information.

summuslaser.com

41 5 Taylor and Francis Group taylorandfrancis.com

pccbd.com

1 04 Theranica Bioelectronics theranica.com

Theranica Bioelectronics, founded in 2016, is dedicated to combining advanced neuromodulation therapy with modern wireless technology to develop proprietary electroceuticals that address prevalent medical conditions and diseases. Nerivio™, Theranica’s first FDA authorized to market device, is a low-cost, wearable for the acute treatment of migraine. Theranica will continue to use its proprietary technology to develop additional solutions to other pain disorders.

Taylor & Francis partners with researchers, scholarly societies, universities and libraries worldwide to bring knowledge to life. As one of the world’s leading publishers of scholarly journals, books, eBooks and reference works our content spans all areas of the Humanities, Social Sciences, Behavioral Sciences, Science, Technology, and Medicine.

401 TrueMED

www.truemedcbd.com

Visit our booth for more information.

T8 University of Maryland Baltimore

309 TerSera Therapeutics

www.graduate.umaryland.edu/palliative

www.tersera.com

TerSera Therapeutics is a specialty pharmaceutical company headquartered in suburban Chicago with a focus on select therapeutic areas, including oncology and pain & inflammatory disorders. Our mission is to develop products which truly make a difference for patients. Our focus is to bring intelligent solutions to our customers that go beyond the therapy itself in order to provide improved patient outcomes. We look forward to meeting you!

21 6 Teva Pharmaceuticals

The Online Master of Science and Graduate Certificates in Palliative Care program is designed to meet the educational needs of individuals currently working in hospice and palliative care who want to gain a deeper understanding of the physical, psychological, spiritual, and social needs of patients and families affected by serious illness, and those professionals who wish to learn more about this field. This interprofessional program is entirely online, and designed for the busy working adult! There are multiple elective opportunities, allowing you to customize your learning experience! Application deadlines December 15 for Spring; July 15th for Fall.

114 US Army Healthcare Recruiting

www.tevausa.com

recruiting.army.mil/mrb

Teva Pharmaceuticals is a global leader in generic medicines and biopharmaceuticals. Building on more than a century-old legacy, Teva delivers high-quality products to patients in nearly every therapeutic area, has an established presence in generics, specialty, OTC and API, a fully integrated R&D function, strong operational base and global infrastructure and scale.

Las Vegas MRS/U.S. Army.

T11 U.S. Pain Foundation uspainfoundation.org

An independent 501(c)(3) organization, U.S. Pain is the leading organization for people with pain. Our mission:

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to empower, educate, connect, and advocate for those living with chronic illness that causes pain, as well as their caregivers and clinicians. U.S. Pain not only helps improve the lives of people with pain through its multiple programs and services, but is also dedicated to improving patient outcomes, addressing access and affordability issues, and increasing awareness about chronic pain.

402 Veterans In Pain, V.I.P. - A 501c3 Nonprofit www.veteransinpain.org

Veterans In Pain, Inc. is a 501c3 nonprofit providing pro bono medical solutions to Veterans suffering from chronic pain. This is only possible due to our national network of dedicated physicians specializing in the field of Pain Management, embracing an opportunity to give back to those who have sacrificed their health for our freedoms.

T5 Wolters Kluwer shop.lww.com

Visit our booth for more information.

322 Zyla Life Sciences

zyla.com

Visit our booth for more information.

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genitourinary syndrome of menopause

georgine lamvu

wednesday september 4

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see you in 2020.

The early bird is in the nest for only 5 days.

2020 *This offer will expire at 11:59 pm on 9/7/19