1. science
2. medicine

the American Academy of Pain Medicine
the governing voices of pain:
medicine, science, and government
M a r c h 2 4 – 2 7 , 2 0 11
Gaylord National Hotel
& Convention Center
National Harbor, MD
AA P M 27 TH A n n u a l M e e t i n g • p r o g r am b o o k
Join us for an Official Independent CME Satellite Lunch Symposium
OSTEOARTHRITIS
From Biomarkers to New Strategies for
Pain Management
Friday, March 25, 2011
NOON to 1:15 PM
Woodrow Wilson Ballroom A
Hotel Ballroom Level 2
Gaylord National Hotel & Convention Center
Program Chair
F. Michael Gloth III, MD, FACP, AGSF
Associate Professor of Medicine
Division of Geriatric Medicine & Gerontology
The Johns Hopkins University School of Medicine
Adjunct Associate Professor of Medicine
Department of Epidemiology and Preventive Health
University of Maryland School of Medicine
Baltimore, Maryland
Registration
There is no registration fee for attending this symposium; however, seating
is limited. Preregistration may be available on-site, at the AAPM registration
area, space permitting. Preregistration does not guarantee seating. We
recommend arriving at the symposium location early.
AMA Credit Designation
This activity has been approved for AMA PRA Category 1 Credits TM.
This educational activity is jointly sponsored by the Postgraduate Institute for
Medicine and Miller Medical Communications, LLC.
MM
Miller Medical Communications, LLC.
An official independent satellite symposium held in conjunction with The American
Academy of Pain Medicine’s 27th Annual Meeting.
COMP image courtesy of The PyMOL Molecular Graphics System, Version 1.3, Schrödinger, LLC.
This activity is supported by an educational grant from Endo Pharmaceuticals Inc.
AAPMed ad-012111_Layout 1 1/31/11 2:41 PM Page 1
Rational Selection of Adjuvant Analgesics
in Chronic Pain Management:
MOVING FROM SYMPTOM CONTROL TOWARD A MECHANISM-BASED APPROACH
Wednesday, March 23, 2011
Washington, DC • Gaylord National Hotel and Convention Center • Woodrow Wilson Ballroom A
Registration/Lunch: 11:30 AM-11:45 AM • Symposium: 11:45 AM-1:00 PM
Faculty
Scott M. Fishman, MD
Chairman
Professor and Chief, Division of Pain Medicine
Vice Chair, Anesthesiology and
Pain Medicine
University of California, Davis School
of Medicine
Sacramento, California
Ajay D. Wasan, MD, MSc
Director of Clinical Pain Research
Brigham and Women’s Hospital
Assistant Professor of Anesthesiology
and Psychiatry
Harvard Medical School
Boston, Massachusetts
Agenda
11:30AM-11:45AM
11:45AM-11:50AM
Registration/Lunch
Welcome
Scott M. Fishman, MD, Chairman
11:50AM-12:00PM
Overview of Chronic Pain and Effective Pain Assessment as the
Cornerstone to Optimal Management
Scott M. Fishman, MD
12:00PM-12:20PM New Insights in the Neuropathology of Chronic Pain: The
Good, the Bad, and the Ugly
Ajay D. Wasan, MD, MSc
12:20PM-12:45PM Adjuvant Analgesics in Chronic Pain Management: A
Mechanism-based Rational Approach
Scott M. Fishman, MD
12:45PM-1:00PM
Question and Answer Session
All Faculty
Register Now at www.symposiareg.org/aapm
or contact Cathy Rickert at (847) 375-4798
or carickert@connect2amc.com
Program Overview
Chronic pain is widespread and often poorly managed. As our
understanding of chronic pain neurobiology continues to expand
and novel neuromodulatory approaches emerge specifically
targeting the pathophysiological underpinnings of chronic pain,
clinicians who manage patients with chronic pain must be aware
of these advances in science and medicine in order to provide the
best possible care for their patients. Thus, this activity will begin
with an overview of the prevalence and morbidity associated with
chronic pain conditions and barriers that exist in effectively
treating patients suffering from pain. Next, the faculty will review
the current understanding and latest findings in the
pathophysiology of chronic pain and highlight potential
neuromodulatory targets for treatment. They will then go on to
discuss a paradigm shift in the chronic pain management
approach from an empirical methodology of trying-and-rejecting
and symptom control towards mechanism-specific intervention
and rational selection of analgesics in individual patients.
Furthermore, they will discuss recent clinical trial data
demonstrating efficacy and safety data of adjuvant analgesics in
managing chronic pain effectively. The activity will conclude with
an interactive question and answer session.
Learning Objectives
At the conclusion of this activity, participants should be better
able to:
1. Identify appropriate pain assessment tools as an integral
component of effective pain management
2. Describe the molecular and cellular mechanisms of chronic
pain as they relate to rational selection of adjuvant analgesics
3. Summarize the efficacy and safety data of adjuvant analgesics
in the management of chronic pain
Target Audience
This activity is designed for pain specialists, including
anesthesiologists, physiatrists, psychiatrists, neurologists, and
other healthcare professionals interested in the management of
patients with chronic pain conditions.
Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance
with the Essential Areas and policies of the Accreditation Council
for Continuing Medical Education through the joint sponsorship
of the Postgraduate Institute for Medicine and ACCELMED. The
Postgraduate Institute for Medicine is accredited by the ACCME
to provide continuing medical education for physicians.
Credit Designation
The Postgraduate Institute for Medicine designates this live
activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™.
Physicians should claim only the credit commensurate with the
extent of their participation in the activity.
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires instructors,
planners, managers and other individuals who are in a position
to control the content of this activity to disclose any real or
apparent conflict of interest they may have as related to the
content of this activity. All identified conflicts of interest are
thoroughly vetted by PIM for fair balance, scientific objectivity of
studies mentioned in the materials or used as the basis for
content, and appropriateness of patient care recommendations.
Americans with Disabilities Act
Event staff will be glad to assist you with any special
needs (ie, physical, dietary, etc). Please contact
ACCELMED prior to the live event at (877) 374-8323.
An official independent satellite symposium held in conjunction with the American Academy of Pain Medicine’s 27th Annual Meeting.
Jointly sponsored by the Postgraduate Institute of Medicine and ACCELMED
This activity is supported by an educational grant from Lilly USA, LLC.
Please Join Us for a
Product Theater Dinner Presentation
American Academy of Pain Medicine
NEW PERSPECTIVES ON ACUTE PAIN:
Focusing on Efficacy and Tolerability
Friday, March 25, 2011
7:00 pm – 8:15 pm
Dinner will be served
Gaylord National Hotel
& Convention Center
Meeting Room: Woodrow Wilson A
Washington, DC
Perry G. Fine, MD
Professor of Anesthesiology
Pain Research Center
University of Utah School of Medicine
Salt Lake City, Utah
Sunil J. Panchal, MD
President
National Institute of Pain
Lutz, Florida
This promotional educational activity is not accredited.
The program content is developed by PriCara Division
of Ortho-McNeil-Janssen Pharmaceuticals, Inc. Speakers
present on behalf of the company and are required
to present information in compliance with FDA
requirements for communications about its medicines.
If you are licensed in any State or other jurisdiction,
or an employee or contractor of any organization or
governmental entity, that limits or prohibits meals from
pharmaceutical companies, please identify yourself
so that you (and we) are able to comply with such
requirements. Your name, the value, and purpose of
any educational item, meal, or other items of value
you received may be reported as required by state or
federal law. Once reported, this information may be
made available for public review. Thank you for your
cooperation.
© Ortho-McNeil-Janssen Pharmaceuticals, Inc. 2011
An official independent satellite
symposium held in conjunction with the
American Academy of Pain Medicine’s
27th Annual Meeting.
Preregistration: There is no registration fee
for attending this symposium; however, seating
is limited. To preregister for this satellite
symposium, please register online at
www.symposiareg.org/aapm or contact
Cathy Rickert at 847-375-4881. Preregistration
does not guarantee seating. We do recommend
arriving at the symposium location early.
March 2011
Sponsored by
02TL11008E
AAAmerican
P M 2 0 11 Ann
u a l Mofe ePain
t i ngMedicine • 27th Annual Meeting
the
Academy
3
Contents
General Information
Welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
27th Annual Meeting Supporters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2010–2011 Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Program Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2011 AAPM Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Past Award Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Convention Center Floor Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Schedule of Events
Schedule at a Glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Preconference Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Plenary Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Concurrent Scientific Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
AAPM Faculty List and Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Satellite Symposia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Non-CME Corporate Symposia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Exhibits
Corporate Showcase Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Exhibit Hall Floor Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
List of Exhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Exhibit Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Exhibitors By Product Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Exhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Corporate Relations Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Index of Advertisers
Endo Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC
Eli Lilly & Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
PriCara®, A Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Medtronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Mallinckrodt Inc., A Covidien Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Purdue Pharma L.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64–68, BC
Exclusive MRI Labeling
Only Medtronic premium neurostimulators are
FDA conditionally approved for 1.5-Tesla MRI head scan*
Only Medtronic SynchroMed® infusion systems are
FDA conditionally approved for 3.0-Tesla MRI full body scan
Visit professional.medtronic.com/mri for more information.
Visit us at Booth #117.
*Except Itrel® 3
NeurostimulatioN systems for paiN therapy
Brief summary: product technical manuals and programming Guides must
be reviewed prior to use for detailed disclosure.
Be a Part of
the Premier
Association
for Pain
indication for use - Chronic, intractable pain of the trunk and/or limbs-including unilateral
or bilateral pain. Contraindications: Diathermy. Warnings: Defibrillation, diathermy,
electrocautery, MRI, RF ablation, & therapeutic ultrasound can result in unexpected
changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator
can result in severe burns. Electrical pulses from the neurostimulator may result in an
inappropriate response of the cardiac device. precautions: The safety and effectiveness
of this therapy has not been established for: pediatric use, pregnancy, unborn fetus,
or delivery. Follow programming guidelines & precautions in product manuals. Avoid
activities that stress the implanted neurostimulation system. EMI, postural changes, & other
activities may cause shocking/jolting. adverse events: Undesirable change in stimulation;
hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic
response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest
wall stimulation, & surgical risks.
For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult
Medtronic’s website at www.medtronic.com.
USA Rx Only Rev 0209
syNChromed® ii druG iNfusioN system Brief summary:
product technical manuals and the appropriate drug labeling must be reviewed prior to
use for detailed disclosure.
indications: US: Chronic intraspinal (epidural and intrathecal) infusion of preservativefree morphine sulfate sterile solution in the treatment of chronic intractable pain, chronic
intrathecal infusion of preservative-free ziconotide sterile solution for the management
of severe chronic pain, and chronic intrathecal infusion of Lioresal® Intrathecal (baclofen
injection) for the management of severe spasticity; chronic intravascular infusion of
floxuridine (FUDR) or methotrexate for the treatment of primary or metastatic cancer.
Outside of US: Chronic infusion of drugs or fluids tested as compatible and listed in the
product labeling. Contraindications: Infection; implant depth greater than 2.5 cm below skin;
insufficient body size; spinal anomalies; drugs with preservatives, drug contraindications,
drug formulations with pH ≤3, use of catheter access port (CAP) kit for refills or of refill kit for
catheter access, blood sampling through CAP in vascular applications, use of Personal Therapy
Manager to administer opioid to opioid-naïve patients or to administer ziconotide. Warnings:
Non-indicated formulations may contain neurotoxic preservatives, antimicrobials, or
antioxidants, or may be incompatible with and damage the system. failure to comply
with all product instructions, including use of drugs or fluids not indicated for use with
system, or of questionable sterility or quality, or use of non-medtronic components
or inappropriate kits, can result in improper use, technical errors, increased risks to
patient, tissue damage, damage to the system requiring revision or replacement, and/
or change in therapy, and may result in additional surgical procedures, a return of
underlying symptoms, and/or a clinically significant or fatal drug under- or overdose.
Refer to appropriate drug labeling for indications, contraindications, warnings, precautions,
dosage and administration information, screening procedures and underdose and overdose
symptoms and methods of management. Physicians must be familiar with the drug stability
information in the product technical manuals and must understand the dose relationship to
drug concentration and pump flow rate before prescribing pump infusion. Implantation and
ongoing system management must be performed by individuals trained in the operation
and handling of the infusion system. An inflammatory mass that can result in serious
neurological impairment, including paralysis, may occur at the tip of the implanted catheter.
Clinicians should monitor patients on intraspinal therapy carefully for any new neurological
signs or symptoms, change in underlying symptoms, or need for rapid dose escalation.
Inform patients of the signs and symptoms of drug under- or overdose, appropriate drug
warnings and precautions regarding drug interactions, potential side effects, and signs
and symptoms that require medical attention, including prodromal signs and symptoms of
inflammatory mass. Failure to recognize signs and symptoms and seek appropriate medical
intervention can result in serious injury or death. Instruct patients to notify their healthcare
professionals of the implanted pump before medical tests/procedures, to return for refills at
prescribed times, to carry their Medtronic device identification card, to avoid manipulating
the pump through the skin, to consult with their clinician if the pump alarms and before
traveling or engaging in activities that can stress the infusion system or involve pressure or
temperature changes. Strong sources of electromagnetic interference (EMI), such as short
wave (RF) diathermy and MRI, can negatively interact with the pump and cause heating
of the implanted pump, system damage, or changes in pump operation or flow rate, that
can result in patient injury from tissue heating, additional surgical procedures, a return of
underlying symptoms, and/or a clinically significant or fatal drug underdose or overdose.
Avoid using shortwave (RF) diathermy within 30 cm of the pump or catheter. Effects of
other types of diathermy (microwave, ultrasonic, etc.) on the pump are unknown. Drug
infusion is suspended during MRI; for patients who can not safely tolerate suspension, use
alternative drug delivery method during MRI. Patients receiving intrathecal baclofen therapy
are at higher risk for adverse events, as baclofen withdrawal can lead to a life threatening
condition if not treated promptly and effectively. Confirm pump status before and after MRI.
Reference product labeling for information on sources of EMI, effects on patient and system,
and steps to reduce risks from EMI. precautions: Monitor patients after device or catheter
replacement for signs of underdose/overdose. Infuse preservative-free (intraspinal) saline
or, for vascular applications, infuse heparinized solutions therapy at minimum flow rate if
therapy is discontinued for an extended period of time to avoid system damage. EMI may
interfere with programmer telemetry during pump programming sessions. EMI from the
SynchroMed programmer may interfere with other active implanted devices (e.g., pacemaker,
defibrillator, neurostimulator). adverse events: Include, but are not limited to, spinal/vascular
procedure risks; infection; bleeding; tissue damage, damage to the system or loss of, or
change in, therapy that may result in additional surgical procedures, a return of underlying
symptoms, and/or a clinically significant or fatal drug underdose or overdose, due to end of
device service life, failure of the catheter, pump or other system component, pump inversion,
technical/programming errors, or improper use, including use of non-indicated formulations
and/or not using drugs or system in accordance with labeling; pocket seroma, hematoma,
erosion, infection; post-lumbar puncture (spinal headache); CSF leak and rare central nervous
system pressure-related problems; hygroma; radiculitis; arachnoiditis; spinal cord bleeding/
damage; meningitis; neurological impairment (including paralysis) due to inflammatory mass;
potential serious adverse effects from catheter fragments in intrathecal space, including
potential to compromise antibiotic effectiveness for CSF infection; anesthesia complications;
body rejection phenomena; local and systemic drug toxicity and related side effects; potential
serious adverse effects from catheter placement in intravascular applications.
USA Rx Only Rev 1009
As a member of AAPM, you will have
access to the following benefits:
• Pain Medicine—AAPM’s journal (members
receive a complimentary subscription)
• AAPM e-News—biweekly e-newsletter that
provides the most current information on
pain medicine, advocacy related to pain as
a specialty, clinical trials, members in the
news, and AAPM updates
• Discounted registration rates for
AAPM’s Annual Meetings and
Online Education and CME
Portal, where you can receive
trusted, quality education by
top physicians and researchers
in the field
t h e
A M E R I C A N
A C A D E M Y
o f
PA I N
M E D I C I N E
PAIN MEDICINE
P h y s i c i a n s
D e d i c a t e d
t o
R e l i e v i n g
P a i n
Vol. 25, No. 1 • Summer/Fall 2010
Chester ‘Trip’ Buckenmaier:
On the Frontline of Pain Management
Jane Martinsons, Staff Writer
Pain Medicine Network recently had the opportunity to speak with Chester
‘Trip’ Buckenmaier III, MD COL MC, about his involvement with the U.S.
Army’s Pain Management Task Force, the Military Advanced Regional
Anesthesia and Analgesia Handbook he coauthored, and his new position
as editor-in-chief of U.S. Medicine magazine.
Dr. Buckenmaier is Chief of the Army Regional Anesthesia and Pain Management Initiative at the Walter Reed
Army Medical Center in Washington, DC, and Associate
Professor at the Uniformed Services University of the
Health Sciences in Bethesda, MD.
Dr. Buckenmaier at a medical facility in Camp Bastion,
Afghanistan
Q
The U.S. Army’s Pain Management Task
Force Final Report, which provides
recommendations for a substantial overhaul
of pain services in the military, has been
approved. Is there anything you would like
to say about the report?
Dr. Buckenmaier: In the report’s executive summary is an
excellent introduction that includes U.S. Army Surgeon
General [Eric B.] Schoomaker’s vision of the task force
(see www.painmed.org). While there [are] many centers
around the country where pain providers are doing very
good work in the military system, [Schoomaker] recognizes the system is fragmented and not necessarily consistent
throughout the entire continuum.
A major [responsibility] of the task force was to provide
a holistic, interdisciplinary, but, most importantly, integrated approach to pain throughout the continuum—from
point of injury back to the United States, so that a soldier
Continued on page 4
• AAPM’s website—
continuously updated, it
contains a growing library
of pain medicine resources,
an interactive Members’
Community, information on
upcoming meetings, and much
more.
Inside…
AAPM Leaders Speak Out on REMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Tamper-Resistant Dosage Forms Do Not
Translate to Abuse Deterrents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Time Is on Your Side: How to Use Time-Based
Coding for E/M Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Managing the Claim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
AAPM’s Website Redesign Offers a More
Engaging and Interactive Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
AAPM Announces New Strategic Plan . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Avoid Denial—Follow These Signature Guidelines
for a Medical Record Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
• Patient education materials
• Online career center
• Practice management
assistance
• Membership directory
For more information, visit www.PainMed.org.
Contact AAPM at
info@painmed.org or 847.375.4731
6
AAEL
W
PM
C O2011
M E Ann u a l M e e t i ng
Welcome!
As co-chairs of AAPM’s 27th Annual Meeting Planning Committee, we would like to extend a welcome to all
attendees and provide an overview of what this meeting has to offer. In concert with AAPM’s tradition of focusing
on emerging issues in pain medicine, this Annual Meeting features a multitude of expert faculty who will address
the latest science and most relevant topics facing physicians who treat pain. “The Governing Voices of Pain:
Medicine, Science, and Government” boasts an outstanding array of sessions, in both the science and practice of
pain medicine. Below are just a few of the meeting’s highlights.
Preconference Sessions
On the onset of AAPM’s Annual Meeting, 2 days of world-class preconference educational opportunities include
the renowned “Essential Tools for Treating the Patient in PainTM” course, the 2-day Cadaver Workshop, “Ultrasound
Guidance for the Pain Physician,” and a practice management preconference session.
Keynote Plenary Speaker, Regina E. Herzlinger, PhD
Named America’s leading advocate for market-driven, consumer-oriented health reform, Regina E. Herzlinger, PhD,
is one of the country’s most respected healthcare economists. She is widely recognized for the groundbreaking
role she played in pointing the way toward a bold, new healthcare plan. Herzlinger has been dubbed by Money
Magazine as the “godmother” of consumer-driven health care and has been listed by Modern Healthcare as one of
the nation’s 100 most powerful people since 2003.
All New Patient-Centered Scientific Sessions
New this year, AAPM offers a progressive and innovative patient-centered pain track that runs concurrent with a
fully developed track on practice management. The new patient-centered scientific sessions bridge together the
most advanced medical management therapies and protocols of specific pain disease states with the very latest
advancements on the interventional pain frontier.
Scientific Research
The Academy continues to advance the science of pain medicine through its presentation of cutting-edge
scientific-research abstracts. The 2011 Scientific Poster Review Committee has selected six of the highest ranking
poster submissions to be delivered in a plenary venue. In addition to attending this session, please visit the poster
presentations in the exhibit hall Thursday evening through Saturday morning (there will be two sets of poster
displays and presentations, so be sure to visit every day).
Networking With Colleagues
The meeting offers a tremendous opportunity to network with fellow pain medicine practitioners. Face-to-face
dialogue with world-class pain medicine experts and colleagues is a professional benefit for all. In addition, you also
will receive a first look at the latest and greatest new products on the pain medicine market and much, much more.
We are certain you will find this educational experience personally and professionally rewarding. We are delighted
to extend this welcome to AAPM’s 27th Annual Meeting.
Tim J. Lamer, MD
Associate Professor, Department Chair
Mayo Clinic
Rochester, MN
Sunil J. Panchal, MD
President
National Institute of Pain and the COPE Foundation
Lutz, FL
2 7 t h Ann u a l M e e t i ng S u pp o r t e r s
7
Annual meeting Supporters
Platinum Level
GOLD Level
Silver Level
SM
Bronze Level
Preconference Supporters
Cadaver Workshop
Boston Scientific
Cosman
Epimed International, Inc.
Essentials Course
Cephalon, Inc.
Eli Lilly and Company
Endo Pharmaceutical Inc.
GE Healthcare
Globus Medical
Ultrasound Course
Kimberly-Clark
Kyphon Inc.
Biosound Esaote Ultrasound
Esaote North America
Medtronic, Inc.
GE Healthcare
MinSurg Corp.
SonoSite, Inc.
NeuroTherm
Terason Ultrasound
St. Jude Medical
Stryker International Spine
Vertos Medical
8
2010–2011 leadership
2010-2011 Board of Directors
President
Eduardo M. Fraifeld, MD
Vice President for Scientific Affairs
Martin Grabois, MD
President-Elect
Perry G. Fine, MD
Immediate Past President
Rollin M. Gallagher, MD MPH
Treasurer
Lynn R. Webster, MD
Editor, Pain Medicine
Rollin M. Gallagher, MD MPH
Secretary
Zahid H. Bajwa, MD
Directors-at-Large
Donna Marie Bloodworth, MD
Timothy R. Deer, MD
Gilbert Fanciullo, MD, MS
Scott M. Fishman, MD
Sean Mackey, MD PhD
Bill McCarberg, MD
Jerome Schofferman, MD
ABPM Liaison Director
Michel Y. Dubois, MD
Representative of Past Presidents
Richard L. Stieg, MD
Executive Director
Philip A. Saigh, Jr.
2011 Program Committee
Conference Co-Chairs
Tim J. Lamer, MD
Associate Professor, Department
Chair
Mayo Clinic
Rochester, MN
Nothing to disclose
Sunil J. Panchal, MD
President
National Institute of Pain and the
COPE Foundation
Lutz, FL
King (consultant); Purdue (consultant);
Endo (speaker)
Essential Tools for Treating the Patient
in Pain™ Co-Chairs
Zahid H. Bajwa, MD
Director, Education and Clinical Pain Research
Beth Israel Deaconess Medical Center
Boston, MA
Allergan, Inc. (research grant—co-principal investigator);
EndoPharmaceuticals (research grant—co-principal
investigator); King Pharmaceuticals, Inc. (speaker’s
bureau—speaker’s training), Merck & Co., Inc. (research
grant—co-principal investigator), Pfizer, Inc. (consultant);
Xanodyne Pharmaceuticals, Inc. (consultant—speaker
training)
Salim M. Ghazi, MD
Chair, Department of Pain Medicine
Mayo Clinic
Jacksonville, FL
Nothing to disclose
Scientific Poster Session Chair
Jeffrey M. Tiede, MD
Columbia Interventional Pain Center
Columbia, MO
Committee Members
Michael A. Ashburn, MD MBA MPH
Director, Penn Pain Medicine
Philadelphia, PA
Philip S. Kim, MD
Director, Pinnacle Mid-Atlantic Pain Medicine,
PC
Newtown Square, PA
ZARS Pharma, Inc. (stockholder)
Elan Corporation plc (speaker); Medtronic, Inc. (speaker);
Stryker Instruments (speaker)
Edward T. Bope, MD ABFP (AAFP)
Primary Care Residency Program, Director
Chalmers P. Wylie Veteran’s Affairs Ambulatory
Care Center
Columbus, OH
Robert M. Levy, MD PhD
Professor, Neurosurgical Surgery
Northwestern University
Chicago, IL
Nothing to disclose
Chester C. Buckenmaier, III, MD COL MC
USA
Chief, Army Regional Anesthesia and Pain
Management Initiative
Walter Reed Army Medical Center
Washington, DC
Nothing to disclose
Timothy R. Deer, MD
Past Co-Chair
President and CEO
The Center for Pain Relief
Charleston, WV
Azur (consultant); Bioness, Inc. (consultant/research);
Medasys, Incorporated (consultant/research); Medtronic
(consultant); Spinal Modulation, Inc. (consultant);
Stryker Instruments (consultant); St. Jude Medical, Inc.
(consultant); Vertos Medical Inc. (consultant)
Martin Grabois, MD
Professor and Chairman, Department of
Physical Medicine and Rehabilitation
Baylor College of Medicine
Houston, TX
Endo Pharmaceuticals (speaker, advisory board); King
Pharmaceuticals, Inc. (speaker, advisory board); Purdue
Pharmaceuticals (advisory board)
Michael W. Hooten, MD
Assistant Professor, Mayo Clinic College of
Medicine
Rochester, MN
Nothing to disclose
Bioness, Inc. (speaker, education, consulting); Codman
Shurtleff, Inc. (speaker, education, consulting); Medtronic
Neurological (speaker, education, consulting); Spinal
Modulation (speaker, education, consulting); St. Jude
Medical, Inc. (speaker, education, consulting); Stryker
Instruments (speaker, education, consulting); Vertos
Medical, Inc. (speaker, education, consulting)
Sean Mackey, MD PhD
Director, Stanford University Medical Center
Palo Alto, CA
Nothing to disclose
John D. Markman, MD
Associate Professor, University of Rochester
Rochester, NY
Afferent Pharmaceuticals (consultant); Alkermes, Inc.
(consultant); Endo Pharmaceuticals (researcher); U.S.
Food and Drug Administration (special government
employee); Infinity Pharmaceuticals, Inc. (consultant,
speaker); NeurogesX® (consultant); Pfizer, Inc. (researcher)
Joseph J. Ruane, DO
Medical Director, McConnell Heart Health
Center
Cleveland, OH
Genzyme Biosurgery (honorarium, speaker/consultant);
Pfizer, Inc. (honorarium, speaker)
Ajay D. Wasan, MD MSc
Director, Brigham and Women’s Hospital
Chestnut Hill, MA
Eli Lilly and Company (consultant); Medtronic, Inc.
(consultant)
2010–2011 leadership
9
Lynn R. Webster, MD
Medical Director, Lifetree Clinical Research and Pain Clinic
Salt Lake City, UT
Adolor Corporation (research); Alkermes, Inc. (research); Alko (research); Ameritox
(advisory board); AstraZeneca (consultant); Bayer (research); Boston Scientific
(consultant, research); Cephalon, Inc. (consultant, research); Collegium Pharmaceutical
(research); Elan Corporation, plc (consultant); Endo Pharmaceuticals (research); Forest
Pharmaceuticals, Inc. (research); Hisamitsu Pharmaceutical Co., Inc. (research); HoffmanLaRoche LTP (research); King Pharmaceuticals, Inc. (research, advisory board); Medtronic,
Inc. (consultant, research, advisory board); Myriad Genetics, Inc. (research); Nektar
(advisory board); NeurAxon (research); NeurogesX® (advisory board); Neuromed (advisory
board); Nevro Corp. (consultant); Pfizer Inc. (research); Purdue Pharma LP (consultant,
advisory board); QRxPharma Limited (research); Reckitt Benckiser Group plc (research);
Recro Pharma, Inc. (research); Regeneron Pharmaceuticals, Inc. (research); Theravance
(research); Wyeth (research, advisory board)
Michael L. Whitworth, MD
President, Advanced Pain Management Surgery
Columbus, IN
Advisors
Perry G. Fine, MD
Professor, Department of Anesthesia
Pain Research Center University of Utah
Salt Lake City, UT
Ameritox (consultant, advisory board); Cephalon, Inc. (consultant, advisory board);
Covidien (consultant, advisory board); King Pharmaceuticals, Inc. (consultant, advisory
board); MEDA Pharmaceuticals, Inc. (consultant, advisory board); PriCara®, a Division
of Ortho-McNeil-Janssen Pharmaceuticals, Inc. (consultant, advisory board); Janssen/
Johnson & Johnson Services, Inc. (consultant, advisory board)
Scott M. Fishman, MD
Chief, Division of Pain Medicine
University of California–Davis School of Medicine
Sacramento, CA
American Pain Foundation (president, chairman of board)
Nothing to disclose
Council of Past Presidents
1985
Benjamin L. Crue, Jr., MD FACS
1998
J. David Haddox, DDS MD (Vice-Chair)
1986
Joel L. Seres, MD
1999
Norman J. Marcus, MD
1987
Robert G. Addison, MD
2000
Edward C. Covington, MD
1988
Philipp M. Lippe, MD
2001
Albert Ray, MD
1989
Jack J. Pinsky, MD
2002
Marc B. Hahn, DO
1990
Andrew G. Shetter, MD
2003
Melvin C. Gitlin, MD (Chair)
1991
Sridhar V. Vasudevan, MD
2004
Samuel J. Hassenbusch, MD PhD (Deceased)
1992
E. Richard Blonsky, MD (Deceased)
2005
Scott M. Fishman, MD
1993
Peter R. Wilson, PhD MBBS
2006
Frederick W. Burgess, MD PhD
1994
Richard L. Stieg, MD
2007
B. Todd Sitzman, MD MPH
1995
Hubert L. Rosomoff, MD DMedSc FAAPM (Deceased)
2008
Kenneth A. Follett, MD PhD
1996
Steven D. Feinberg, MD
2009
Rollin M. Gallagher, MD MPH
1997
Gerald M. Aronoff, MD
10
program information
Schedule of Events
Please note that the schedule of events included in this program book
was current at the time of publication and includes several program
changes that have occurred since the mailing of the meeting brochure.
Please check the day-at-a-glance schedule, available at the registration
desk, for room locations and any last-minute program changes.
Objectives
After attending this meeting, participants should be better able to
• assess, diagnose, and evaluate patients with a variety of acute and
chronic pain disorders
• develop appropriate treatment and rehabilitation plans for patients
with acute and chronic pain, and identify when to refer patients
• identify, treat, or appropriately refer patients with addiction
• implement new therapies, techniques, and diagnostic procedures
in pain management
• improve safety and decrease risks associated with established pain
medicine interventions
• improve the assessment, evaluation, and treatment of chronic pain
patients with psychological issues
• evaluate the legal, ethical, and regulatory issues surrounding the
practice of pain medicine
• implement strategies and processes for providing patient-centered
pain care in a changing healthcare environment
• maximize efficiencies and improve the business model of pain
medicine.
Continuing Medical Education Credits
Accreditation Council for Continuing Medical Education
The American Academy of Pain Medicine (AAPM) is accredited by the
Accreditation Council for Continuing Medical Education (ACCME) to
sponsor continuing medical education (CME) for physicians.
AAPM designates all AAPM CME activities associated with the 27th
Annual Meeting for a maximum of 28.75 AMA PRA Category 1 Credits™.
Physicians should only claim credit commensurate with the extent of
their participation in the activity.
AAPM 27th Annual Meeting and Related Education Programs
27th Annual Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.75 credits
Essential Tools for Treating the Patient in Pain™ . . . . . . . . . . . . . . . 16 credits
Cadaver Workshop . . . . . . . . . . . . . . . . . . . . . . . . . . Not eligible for CME credits
Ultrasound Guidance for the Pain Physician . . . . . . . . . . . . . . . . . . . 4 credits
Taking Control of Your Interventional Pain
Practice: Accessing and Improving Practice
Management Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 credits
Note. Attendees cannot receive credit for simultaneous sessions, including preconference
sessions and concurrent workshops. The highest number of credits can be earned by
combining the 27th Annual Meeting and Essential Tools for Treating the Patient in Pain™,
which will provide a maximum of 28.75 CME credits.
American Academy of Family Physicians (AAFP)
The AAPM is approved by the American Academy of Family Physicians
(AAFP) to offer continuing medical education for the 27th Annual
Meeting. This activity has been reviewed and is acceptable for up to
12.75 prescribed credits by the AAFP.
American Academy of Physician Assistants (AAPA)
AAPA accepts Category 1 CME credit from the American Osteopathic
Association Council on Continuing Medical Education (AOACCME),
prescribed credit from AAFP, and AMA PRA Category 1 credit™ for the
PRA organizations accredited by ACCME.
How to Obtain CME Credit
An evaluation form of the 27th Annual Meeting will be available online
to each registrant. To receive CME credit for each session you attend,
you must evaluate that session in the appropriate section of the online
evaluation. You will be able to print your certificate once you complete
the evaluation.
Commercially Supported Satellite
Symposia
Satellite symposia will be offered during breakfast, lunch, and dinner
hours during the annual meeting. These independently managed
satellite symposia are supported by AAPM’s Corporate Relations
Council members. The programs have been reviewed by the AAPM
Program Committee and approved for presentation as part of the
Satellite Symposia program.
These sessions are offered free of charge to all meeting registrants;
however, those who have preregistered will be seated first. A limited
number of seats will also be available on a first-come, first-served basis.
Check for availability at the registration desk outside the session room
30 minutes before the scheduled start of the program.
Disclosure
It is the policy of AAPM to plan and implement educational activities
in accordance with ACCME’s Essential Areas and Elements to ensure
balance, independence, objectivity, and scientific rigor. As an ACCMEAccredited Provider, AAPM is eligible to receive commercial support
from commercial interests but cannot receive guidance, either
nuanced or direct, on the content of the activity or on who should
deliver the content.
All program faculty and planners are required to disclose all financial
relationships they may have or have had within the last 12 months
with commercial interests whose products or services are related to
the subject matter of the presentation. Any real or apparent conflicts
of interest must be resolved prior to the presentation. Planning
committee disclosures are listed in this brochure. All confirmed faculty
disclosure information will be made available to attendees on the
AAPM Annual Meeting website and in the program book. Faculty will
also be expected to disclose this information to the audience both
verbally and in print (slide presentation) at the beginning of each
presentation.
Faculty is also required to inform program participants if any unlabeled
uses of products regulated by the U.S. Food and Drug Administration
will be discussed.
evaluations
11
Attendees will be asked to submit evaluations online for the 2011 AAPM Annual Meeting. Please use the space provided to make any notes about
the sessions you attend to help you fill out the online evaluation form, which will be provided to all meeting attendees.
WEDNESDAY, MARCH 23
7:30 am–5 pm
Essential Tools for Treating the Patient in Pain™: What Every Primary Care and Pain Specialist Needs to Know: Day 1
Salahadin Abdi, MD PhD; Zahid H. Bajwa, MD; Edward T. Bope, MD; Paul J. Christo, MD MBA; Salim M. Ghazi, MD; Philip S. Kim, MD; John D. Markman, MD
THURSDAY, MARCH 24
7:30 am–5 pm
Essential Tools for Treating the Patient in Pain™: What Every Primary Care and Pain Specialist Needs to Know: Day 2
Paul J. Christo, MD MBA; Steven P. Cohen, MD; Oscar A. De Leon-Casasola, MD; Scott M. Fishman, MD; Rollin M. Gallagher, MD MPH; Salim M. Ghazi, MD; Aaron M. Gilson, MS MSSW
PhD; Bill H. McCarberg, MD; Ben A. Rich, JD PhD; Mark D. Sullivan, MD PhD; Ajay D. Wasan, MD MSc
7:30–11:30 am
Ultrasound Guidance for the Pain Physician (001)
Mark F. Hurdle, MD; Susan M. Moeschler, MD; Steven J. Wisniewski, MD
1–5 pm
Taking Control of Your Interventional Pain Practice: Accessing and Improving Practice Management Protocols (002)
Trish Bukauskas, CMM CPC CMSCS CMPA; Amy G. Mowles; Linda M. VanHorn, MBA
12
evaluations
FRIDAY, MARCH 25
8:45–9:30 am
Plenary Session
Consumer-Driven Health Care: Implications for the Pain Physician (102)
Regina E. Herzlinger, PhD
10:30–11 am
AMA President-Elect Address (103)
Peter W. Carmel, MD; Richard Deem, MD
11–11:45 am
Medical Specialties Converge: Future Perspectives of Interventional Pain Physicians and Spine Surgeons (104)
Timothy R. Deer, MD; Robert M. Levy, MD PhD
1:30–2:30 pm
CRPS: Innovative Management Strategies (201)
May L. Chin, MD; Mehul J. Desai, MD MPH; John C. Rowlingson, MD
1:30–2:30 pm
Improving Outcomes of Interventional Pain Procedures (202)
Charles N. Aprill, MD; Michael L. Whitworth, MD
1:30–2:30 pm
Guidelines for the Treatment of Low Back Pain (203)
Ray M. Baker, MD; Laxmaiah Manchikanti, MD; Richard W. Rosenquist, MD
1:30–2:30 pm
Legal and Ethical Aspects of Pain Care (204)
Lora L. Brown, MD; Alex Cahana, MD; Larry C. Driver, MD; Ben A. Rich, JD PhD
evaluations
FRIDAY, MARCH 25 (continued)
3–4 pm
Army Pain Management: From Injury to Home (205)
Chester C. Buckenmaier III, MD; Rollin M. Gallagher, MD MPH; Kevin T. Galloway, MHA BSN RN
3–4 pm
Physical Therapy for Non-Physiatrists (206)
Donna M. Bloodworth, MD; Gagan Mahajan, MD; Steven P. Stanos, DO
3–4 pm
Blurring the Line Between Surgeons and Pain Physicians (207)
Richard G. Bowman II, MD; Timothy R. Deer, MD; Leonardo Kapural, MD PhD
3–4 pm
Using Outcomes Data to Improve Patient Care (208)
Michael A. Ashburn, MD MBA MPH; Martin D. Cheatle, PhD; Fred N. Davis, MD; Gilbert J. Fanciullo, MD
4:30–5:30 pm
Pelvic Pain: A New Approach (209)
Leonardo Kapural, MD PhD; Tamer M. Yalcinkaya, MD
4:30–5:30 pm
Regenerative Therapies: Clinical Applications and Evidence-Based Review (210)
Ronald W. Hanson, MD; Joseph J. Ruane, DO
4:30–5:30 pm
Myofascial Pain: Bench to Bedside (211)
Mehul J. Desai, MD MPH; Jay P. Shah, MD
13
14
evaluations
FRIDAY, MARCH 25 (continued)
4:30–5:30 pm
Patient-Centered Pain Care: Who is Driving the Bus? (212)
Alex Cahana, MD; Bernice R. Hecker, MD MHA FACC; Mark D. Sullivan, MD PhD
SATURDAY, MARCH 26
8:30–9:30 am
Plenary Research Highlights (105)
Adnan Al-Kaisy, MB, ChB, FRCA; Edward J. Bilsky, PhD; Julie Cunningham, PharmD AAMP CPNP; Timothy R. Deer, MD; Rosemary C. Polomano, PhD RN; Hoameng Ung, BS
10:30–11:15 am
Plenary Session
Pain Care Reform (106)
Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General (Invited Faculty)
1:45–2:45 pm
When Acute Pain Becomes Chronic (301)
Ian R. Carroll, MD MS; Sean Mackey, MD PhD
1:45–2:45 pm
Evidence-Based Therapies in Cancer Pain Management (302)
Allen W. Burton, MD; Vitaly Gordin, MD
1:45–2:45 pm
The Value Proposition in Health Care: Do You Want to Get Paid for What You Do? (303)
David W. Polly, MD
evaluations
SATURDAY, MARCH 26 (continued)
3–4 pm
All About Opioids (304)
Martin S. Angst, MD; Annika Rhodin, MD PhD; Lynn R. Webster, MD
3–5:15 pm
Pain Treatment Debate: Mock Trial (305)
Richard G. Bowman, II, MD; Timothy R. Deer, MD; Leonardo Kapural, MD PhD; Robert M. Levy, MD PhD; Sunil J. Panchal, MD; William M. Tiano, Esq.
3–4 pm
Contracting with Payors (306)
Trish Bukauskas, CMM CPC CMSCS CMPA
4:15–5:15 pm
Opioid Misuse in Cancer Patients: A Growing Problem (307)
Dhanalakshmi Koyyalagunta, MD; Diane M. Novy, PhD; Steven D. Passik, PhD
4:15–5:15 pm
2011: Coding Update and Beyond (308)
Fred N. Davis, MD; Emily H. Hill, PA
15
16
evaluations
SUNDAY, MARCH 27
8:30–9:30 am
REMS Update—E-Prescribing (401)
Scott M. Fishman, MD; Aaron M. Gilson, PhD MS MSSW
8:30–9:30 am
Medical Marijuana for the Treatment of Chronic Pain (402)
Mike W. Hooten, MD; Joshua B. Murphy, JD; Terry D. Schneekloth, MD; Ajay D. Wasan, MD MSc
8:30–9:30 am
Spine Imaging: The Significance of Structure and Morphology (403)
Timothy P. Maus, MD
9:45–10:45 am
National Institutes of Health (NIH) Pain Research: Optimizing Funding Through Grant Writing (404)
Yu (Woody) Lin, MD PhD; Sean Mackey, MD PhD; Weijia Ni, PhD
9:45–10:45 am
Social Media Revolution: Marketing in the Decade Ahead (405)
Linda M. VanHorn, MBA
9:45–10:45 am
Chronic Daily Headache (406)
Zahid H. Bajwa, MD
evaluations
SUNDAY, MARCH 27 (continued)
11 am–Noon
Optimizing Clinical Research Opportunities and Publishing in Pain Medicine (407)
Rollin M. Gallagher, MD MPH; Ajay D. Wasan, MD MSc
11 am–Noon
Cost Effectiveness of Spinal Cord Stimulation and Intrathecal Polyanalgesia in the Management of Chronic
Non-Malignant Pain (408)
Sharon Bishop, MHlthSci BNurs; Krishna Kumar, MD MBBS MS FRCS
11 am–Noon
Psychological Therapies for Chronic Pain (409)
Mary Elena Collazo, PsyD; Albert L. Ray, MD
17
18
2 0 1 1 A A P M A wa r ds
Philipp M. Lippe, MD, Award
The Philipp M. Lippe, MD, Award is given to a physician for outstanding contributions to the social and political aspect of pain
medicine. Social and political accomplishments could be those that benefit the science, practice, or recognition of the specialty. This
.
award is supported by
Douglas Throckmorton, MD
Douglas Throckmorton, MD, is deputy center director of the U.S.
Food and Drug Administration (FDA) Center for Drug Evaluation
and Research (CDER). He also serves the FDA as division director
of cardiac and renal drug products. Dr. Throckmorton began his
career with the FDA in 1997 as medical officer of the division of
cardiac and renal drug products.
Before his career at the FDA, Dr. Throckmorton served as an
academic nephrologist at the Medical College of Georgia for
3 years. During that time, he simultaneously worked as staff
physician at the Veteran’s Administration Medical Center in
Augusta, GA.
Dr. Throckmorton received his doctor of medicine degree from
the University of Nebraska Medical School and completed
clinical and research fellowships in nephrology at Yale-New
Haven Hospital. He is board certified by the National Board of
Medical Examiners and the American Board of Internal Medicine
and subspecialty certified in nephrology through the American
Board of Internal Medicine.
Dr. Throckmorton holds membership on multiple FDA
working groups and committees, including the Medical
Policy Coordinating Committee, the Active Controls Working
Group, the Problem Labeling Working Group, the Arthritis and
Rheumatology Working Group, the Material Facts Assessment
Subcommittee, the Reviewer for USP monographs, and the
Office of Drug Safety Pediatrics Working Group. He also is chair
of the QT Working Group and co-chair of the Drug-Device
Working Group.
Dr. Throckmorton is the recipient of more than 30 prestigious
awards, including the Secretary’s Award for Distinguished
Service, the FDA Outstanding Service Award, the
Commissioner’s Special Citation, the Center Director’s Special
Citation, and the Leveraging/Collaboration Award.
20 1 1 A A P M A wa r ds
19
Founders Award
The Founders Award is given to an individual for outstanding contributions to the science or practice of pain medicine. This award
is given for continued contributions for the basic or clinical science of pain medicine or for demonstration of clinical excellence or
innovation in the practice of pain medicine.
Daniel B. Carr, MD
Daniel B. Carr, MD, serves as the Saltonstall Professor of Pain
Research in the department of anesthesia at Tufts Medical
Center in Boston. He is co-founder and director of the pain
research, education, and policy certificate and degree programs
at Tufts University School of Medicine.
Known internationally for his contributions to pain research
and education, evidence-based pain medicine, and social and
political aspects of pain relief, Dr. Carr co-chaired and drafted
major portions of the first U.S. Federal Clinical Practice Guidelines
on Acute and Cancer Pain Management and has served as an
advisor or board member for many subsequent governmental
and nongovernmental pain-related programs, initiatives, and
societies.
He led the formation of comprehensive multidisciplinary pain
treatment centers and their accredited fellowship programs at
the Massachusetts General Hospital, Tufts Medical Center, and
Caritas-St. Elizabeth’s Medical Center. Dr. Carr also co-developed
a novel outcomes instrument (“TOPS”) for patients with chronic
pain.
Dr. Carr has edited and otherwise contributed to numerous
books and peer-reviewed publications in the field. In addition
to serving as founding editor of the International Association for
the Study of Pain’s newsletter, Pain: Clinical Updates, Dr. Carr was
the lead editor for pain trials within the Cochrane collaborative
review group on Pain, Palliative, and Supportive Care, and serves
as a referee and on the editorial boards of several journals. He
has advised numerous firms, holds analgesics-related patents,
and served as chief medical officer of Javelin Pharmaceuticals
before it was acquired by Hospira in 2010.
Dr. Carr is the recipient of numerous awards, including the
Bernard Schoenberg Award of the American Institute of LifeThreatening Illness and Loss, the American Pain Society’s
Distinguished Service and Fordyce Awards, and AAPM’s Philipp
M. Lippe, MD, Award. He is an honorary fellow for the Faculty
of Pain Medicine of the Australia and New Zealand College of
Anaesthetists.
20
2 0 1 1 A A P M A wa r ds
Distinguished Service Award
The Distinguished Service Award is given to an individual for commitment and contributions to the American Academy of Pain
Medicine. This award is given to an individual for specific outstanding contributions.
Timothy R. Deer, MD
Timothy R. Deer, MD, is the president and chief executive officer
of The Center for Pain Relief in Charleston, WV. He is a clinical
professor of anesthesiology at the West Virginia University
School of Medicine and an Alpha Omega Alpha graduate of
West Virginia University School of Medicine. He completed his
training in anesthesiology and pain medicine at the University
of Virginia.
In addition to his involvement with a busy private practice, Dr.
Deer maintains a demanding research schedule. His publications
have involved extensive work regarding injection techniques,
minimally invasive disc procedures, intrathecal drug delivery,
spinal cord stimulation, and peripheral nerve stimulation. Dr.
Deer has lectured at many national and international symposia
and has been involved in the hands-on training of more than
1,000 interventional pain specialists.
His current work in organized medicine includes serving as
a member of the board of directors for the North American
Neuromodulation Society and the American Academy of
Pain Medicine, immediate past chair of the Committee on
Pain Medicine for the American Society of Anesthesiologists,
member of the Neuromodulation Editorial Board, president of
the West Virginia Society of Interventional Pain Physicians, and
member of several other boards and committees. Dr. Deer has
authored numerous journal articles, book chapters, and review
articles.
Dr. Deer has served as faculty at numerous prestigious meetings,
most recently the American Society of Anesthesiologists Annual
2010 Meeting, the 17th Annual Napa Pain Conference, and the
18th Annual International Spine Intervention Society Meeting.
20 1 1 A A P M A wa r ds
21
Patient Advocacy Award
The Patient Advocacy Award recognizes activity of an individual in advocating for appropriate evaluation and treatment of patients
suffering from pain. This award was created to honor those healthcare professionals whose deeds reflect their recognition of the
importance and impact of the specialty of pain medicine.
Will Rowe
Will Rowe began his career at the American Pain Foundation
(APF) in 2003 as executive director and was subsequently
appointed chief executive officer of the organization in 2008.
Under his leadership the APF has doubled in size and emerged
as one of the leading pain advocacy organizations in the
country. The APF has developed a nationwide grassroots pain
advocacy structure, the “Action Network,” which has been
effectively engaged in advancing positive state and national
pain policy. Mr. Rowe is also one of the founders of the Pain Care
Forum, which now has 62 member organizations addressing
national pain policy priorities. His work was instrumental in the
passage of the Military and Veterans Pain Acts and in ensuring
inclusion of the pain provisions in the Affordable Health Care
Act. He has also chaired multiorganizational committees
addressing risk evaluation and mitigation strategy (REMS) and
the FDA’s concerns regarding the safe use of acetaminophen.
Mr. Rowe is committed to creating a massive pain advocacy
movement involving all pain practitioners and the millions of
people who are affected by pain.
22
2 0 1 1 A A P M A wa r ds
Presidential Commendations
Colonel Chester C. Buckenmaier, MD
Colonel Chester C. Buckenmaier, MD,
serves as chief of the Army Regional
Anesthesia & Pain Management Initiative
at Walter Reed Army Medical Center.
He also serves as program director of
the National Capital Consortium’s Acute
Pain Medicine and Regional Anesthesia
Fellowship Program and as assistant
professor of anesthesiology at the
Uniformed Services University of the Health Services.
Over the course of his time in the army, Dr. Buckenmaier has
been the recipient of numerous awards, including the Military
Medicine “A” Designator, the Legion of Merit Meritorious Service
Medal, the Army Achievement Medal, and the National Defense
Service Medal.
Dr. Buckenmaier has been instrumental in developing pain
services in the military, including the Defense Veterans Pain
Management Initiative (DVPMI) and the Army Pain Management
Task Force. He successfully launched the Acute Pain Section
of Pain Medicine and serves as editor of Military Medicine. Dr.
Buckenmaier has contributed to numerous publications and
serves as consultant reviewer for Regional Anesthesia and
Pain Medicine, Anesthesia & Analgesia, and the British Journal of
Anaesthesia.
Colonel Kevin Galloway, AN
Colonel Kevin Galloway, AN, is a career
Army officer with more than 22 years
of service. He serves as the chief of staff
of the Army’s Pain Management Task
Force and as action officer for the Army’s
Comprehensive Pain Management
Campaign Plan. He is also the chief of the
Support Branch in the Rehabilitation and
Reintegration Division (R2D) at the United
States Army Office of The Surgeon General (OTSG). Col. Galloway
has a bachelors of science in nursing degree from the Catholic
University of America and a graduate degree in Health Care
Administration from the United States Army-Baylor University
Graduate Program.
Col. Galloway was commissioned as an Army Nurse Corps
officer in 1988. His career has included a variety of clinical and
administrative assignments in both fixed facility hospitals and
military field hospitals. He has served in staff and leadership
roles in several military emergency departments, ambulatory
care clinics, and troop medical clinics. Prior to his current
assignment at OTSG, Col. Galloway served as the strength
management, education, and training officer at Army Nurse
Corps Branch, U.S. Army Human Resources Command, the
Army’s personnel headquarters.
Col. Galloway’s military awards include the Bronze Star Medal,
Meritorious Service Medal (X4), Army Commendation Medal (X6),
Joint Service Achievement Medal, and the Army Achievement
Medal (X6). He is a recipient of the Order of Military Merit and
the Army Surgeon General’s “A” Proficiency designator, an award
given to recognize the accomplishments of senior medical
leaders who have made significant contributions to the Army
Medical Department.
20 1 1 A A P M A wa r ds
23
Presidential Commendations
Lieutenant General Eric B.
Schoomaker, MD PhD
Brigadier General Richard W.
Thomas, MD DDS FACS
Lieutenant General Eric B. Schoomaker,
MD PhD, was sworn in as the 42nd Army
Surgeon General and assumed command
of U.S. Army Medical Command in
2007. He had previously served as the
commanding general of Walter Reed
Army Medical Center and the North
Atlantic Regional Medical Command.
Brigadier General Richard W. Thomas,
MD DDS FACS, is an Army physician and
serves as the U.S. Army assistant surgeon
general (Force Projection) in the Office of
the Surgeon General in Washington, DC.
Ltg. Schoomaker completed his internship and residency in
internal medicine at Duke University Medical Center, followed by
a fellowship in hematology at Duke University Medical Center.
He also completed his PhD in human genetics. He is certified
by the American Board of Internal Medicine in both internal
medicine and hematology.
The Army Surgeon General appointed Ltg. Schoomaker to the
position of chief of the Army Medical Corps when he assumed
command of the Southeast Regional Medical Command/
Dwight David Eisenhower Army Medical Center from June 2002
to June 2005. Before commanding the North Atlantic Regional
Medical Command, he was the commanding general of the
U.S. Army Medical Research and Materiel Command and Fort
Detrick, MD.
His awards and decorations include the Distinguished Service
Medal with one oak leaf cluster, the Legion of Merit with four
oak leaf clusters, the Meritorious Service Medal with two oak
leaf clusters, the Joint Service Commendation Medal, the Army
Commendation Medal, the Army Achievement Medal, and
the Humanitarian Service Medal. He has been honored with
the Order of Military Medical Merit and the “A” Proficiency
Designator and holds the Expert Field Medical Badge.
Bg. Thomas earned a bachelors degree
from West Virginia University (WVU). A
distinguished military graduate, he was commissioned through
the Reserve Officer Training Corps. Upon graduation from
the WVU School of Dentistry, he began his career with the
Army Medical Department as a Dental Corps officer. Following
assignments in Panama and with the 82D Airborne Division,
Bg. Thomas returned to the WVU School of Medicine. After
receiving his medical degree, he completed an internship
at Brooke Army Medical Center, Fort Sam Houston, TX, and
residency in otolaryngology/head and neck Surgery at Madigan
Army Medical Center in Fort Lewis, WA. He is certified by the
American Board of Otolaryngology/Head & Neck Surgery and is
a fellow of the American College of Surgeons.
Bg. Thomas’s military education includes the Army War College,
the Army Command and General Staff College, the Army
Medical Department Officer Advanced and Basic Courses, the
Combat Casualty Care Course, the U.S. Army Airborne School,
the Air Assault School, and the U.S. Army Jumpmaster and Flight
Surgeon Courses.
Bg. Thomas’s many awards, decorations, and honors include the
Legion of Merit with two oak leaf clusters, the Bronze Star Medal
with one oak leaf cluster, the Meritorious Service Medal with
two oak leaf clusters, the Air Medal, the Army Commendation
Medal with two oak leaf clusters, the Army Achievement Medal
with three oak leaf clusters, the Armed Forces Expeditionary
Medal and various campaign medals. The Army Surgeon
General has bestowed upon him the “A” proficiency designator
for expertise in his medical specialty and he has been honored
with the Order of Military Medical Merit.
24
2 0 1 1 A A P M A wa r ds
Presidential Commendations
Lisa A. Robin
Jeffrey M. Tiede, MD
Lisa A. Robin is senior vice president,
advocacy and member services for
the Federation of State Medical Boards
(FSMB), a position she has held since
2007. She began her career with FSMB in
1994 as associate of Leadership Support
Services. Ms. Robin received both her
bachelor’s degree and her master’s of
liberal arts from Texas Christian University.
Jeffrey M. Tiede, MD, received his medical
degree from St. Louis University, where
he graduated summa cum laude and
Alpha Omega Alpha. He completed
his anesthesiology residency at Mayo
Graduate School of Medicine in
Rochester, NY, where he was named the
most outstanding resident in his class. Dr.
Tiede continued his training at Mayo with
a fellowship in pain medicine. In her role at FSMB, Ms. Robin manages public policy,
government relations, education, library services, and public
affairs for a national association of 70 state medical licensing and
disciplinary boards, developing public policy positions, reports,
and recommendations for the board of directors and general
membership consideration.
Ms. Robin served as principal investigator for the Office for
the Advancement of Telehealth, License Portability Grant
Program, and the Attorney General Prescriber and Consumer
Grant Program, Online Prescriber Education Network. She has
also served as project director for the initiatives: Responsible
Opioid Prescribing, a Physician’s Guide; Promoting Balance
and Consistency in the Regulatory Oversight of Pain Care; and
the Centers for Disease Control and Prevention’s Collection of
Physician Contact Information.
Dr. Tiede has served as managing partner of Columbia
Interventional Pain Center, LLC, since 2007, where he oversees
16 staff members and thousands of active patients. Previously,
he served as chair of the department of pain medicine at
Mayo Clinic in Jacksonville, FL, and as medical director for the
department of pain medicine at Mayo Clinic in Rochester.
He has also previously served as assistant professor of
anesthesiology at the Mayo Clinic.
Dr. Tiede has served as an invited lecturer for Pfizer, MinSurg, St.
Jude Medical, and Boston Scientific on topics such as Lyrica and
minimally invasive spine surgery. He has also served as faculty
for the numerous other pain conferences.
He is an American Board of Pain Medicine Diplomate and
is certified by the American Board of Anesthesiology in
Anesthesiology and Pain Management. Dr. Tiede serves as a
Program Committee member and Scientific Poster Committee
chair for AAPM.
Pas t A wa r d R e c i p i e n t s
Philipp M. Lippe, MD, Award
1995 Philipp M. Lippe, MD
1996 Joel Saper, MD
1997 Richard Stieg, MD
1998 Sridhar Vasudevan, MD
1999 Hubert Rosomoff, MD
2000 J. David Haddox, DDS MD
2001 Kathleen M. Foley, MD
2002 Michael Ashburn, MD MPH
2003 Daniel B. Carr, MD
2004 Robert G. Addison, MD
2005 Kenneth A. Follett, MD PhD
2006 Samuel J. Hassenbusch, MD PhD
2007 Scott M. Fishman, MD
2008 Benjamin L. Crue, Jr., MD FACS
2009 Albert L. Ray, MD
2010 Michel Y. Dubois, MD
Founders Award
1995 Benjamin Crue, MD
1996 Wilbert Fordyce, PhD
1997 Peter Wilson, MBBS PhD
1998 Tony Yaksh, PhD
1999 Steven Feinberg, MD
2000 Rollin M. Gallagher, MD MPH
2001 Gary J. Bennett, PhD
2002 Russell Portenoy, MD
2003 Donald D. Price, PhD
2004 James C. Eisenach, MD
2005 Edward C. Covington, MD
2006 Gerald F. Gebhart, PhD
2007 Richard B. North, MD
2008Michael J. Cousins, MBBS MD DSc FANZCA FRCA
FAChPM(RACP) FFPMANZCA
2009 Nikolai Bogduk, MD PhD DSc
2010 David Joranson, MSSW
25
Distinguished Service Award
1996 Patricia Owen
1997 Not Awarded
1998 Paul Gebhard, JD; Kristie Haley
1999 Peter Wilson, MBBS, PhD; Ruth Tiernan
2000 Not Awarded
2001 Joel R. Saper, MD FACP FAAN
2002 Elliot Krames, MD
2003 Samuel J. Hassenbusch, MD PhD; Jeffrey W. Engle
2004 Albert L. Ray, MD
2005 Rollin M. Gallagher, MD MPH
2006 Edward C. Covington, MD
2007 Eduardo M. Fraifeld, MD
2008 David A. Fishbain, MD DFAPA
2009 Colleen M. Healy
2010 Scott M. Fishman, MD
Patient Advocacy Award
2001 Warner Wood, MD
2002 Robert Biscup, MS DO
2003 Not Awarded
2004 Kenneth Moritsugu, MD MPH
2005 John (Jack) C. Lewin, MD
2006 Not Awarded
2007 Louis W. Sullivan, MD
2008 Robert D. Kerns, PhD
2009 Not Awarded
2010 Myra Christopher
26
AA P M 2011 Ann u a l M e e t i ng
Cyber Café
Program Evaluation Tool
Keep in touch with your home or office during the annual meeting.
Visit the Cyber Café located near the AAPM Registration Desk. Several
computers will be available with Internet access to check your e-mail.
The Cyber Café is sponsored by Purdue Pharma, LP.
AAPM offers its meeting evaluation in an online format. Meeting
registrants can access the evaluation by visiting the AAPM website,
www.painmed.org/dc, and clicking on the Evaluation link. The online
evaluation may be completed during the meeting or after attendees
have returned home. Participants will receive their continuing medical
education certificate immediately when they submit their evaluations
online. Certificates also can be sent from the system to participants’
e-mail addresses for printing later or saving electronically. All attendees
are encouraged to complete the meeting evaluation regardless of
whether they are seeking continuing
education credits. If you have any
questions, please call 847.375.4731.
Virtual Exhibit Hall
The final exhibitor list and floor plan can be found at www.
awebsource.com/expocad/shows/aapm2011/start.html. The AAPM
virtual floor plan allows you to search by company, product type, or
booth location. Links to the exhibitor websites are also available on
this page. The floor plan and exhibit list will be posted for 3 months
following the meeting.
Paperless Meeting
Registrants are able to view, download, and print faculty slides and
presentation information at www.painmed.org/dc 1 week prior to
the 27th AAPM Annual Meeting and after the meeting. A printed
schedule of sessions and events will be provided to each attendee at
registration.
Networking Opportunities
Thursday, March 24
Friday, March 25
Friday, March 25
Saturday, March 26
5–6:30 pm
8:30–8:45 am
5:30–7 pm
12:45–1:30 pm
Welcome Reception
Join friends and colleagues for
the Welcome Reception in Prince
George’s Exhibit Hall C. Exhibits
and poster sessions (Group 1) will
be available for visitation.
AAPM Welcome Address
10:30–11 am
AMA Address
Reception
Visit the exhibits and poster
sessions (Group 2) in Prince
George’s Exhibit Hall C.
AAPM Members’ Business
Meeting and AAPM Awards
Presentation
Convention Center Floor Plan
27
28
Schedule at a Glance
WEDNESDAY, MARCH 23, Preconference Sessions, Day 1
7:30–11:30 am
Essential Tools for Treating the Patient in Pain™:
What Every Primary Care and Pain Specialist
Needs to Know—Day 1 (PME)
11:45 am–1 pm
Satellite Luncheon Symposium
1.25 CME
Essential Tools for Treating the Patient in Pain™:
What Every Primary Care and Pain Specialist
Needs to Know—Day 1 (PME)
1–5 pm
Thursday, March 24, Preconference Sessions, Day 2
7:30–11:30 am
Essential Tools for Treating the Patient in
Pain™: What Every Primary Care and Pain
Specialist Needs to Know—Day 2 (PME)
11:45 am–1 pm
1–5 pm
Cadaver Workshop (CW11)
Ultrasound Guidance for the Pain Physician
(001)
Satellite Luncheon Symposium 1.25 CME
Essential Tools for Treating the Patient in
Pain™: What Every Primary Care and Pain
Specialist Needs to Know—Day 2 (PME)
Cadaver Workshop (CW11)
Taking Control of Your Interventional Pain
Practice: Accessing and Improving Practice
Management Protocols (002)
AAPM 27th Annual Meeting Welcome Reception
Exhibits and Poster Sessions (Group 1)
5–6:30 pm
6:30–7:45 pm
Satellite Dinner Symposium 1.25 CME
Friday, March 25, Meeting Day 1
7–8:15 am
Satellite Breakfast Symposium 1.25 CME
8:30–8:45 am
AAPM Welcome Address (101)
8:45–9:30 am
Plenary Session
Consumer-Driven Health Care: Implications for Pain Physicians (102)
Regina E. Herzlinger, PhD
9:30–10:30 am
Break
Exhibits and Poster Sessions (Group 1)
10:30–11 am
American Medical Association President-Elect Address (103)
11–11:45 am
Medical Specialties Converge: Future Perspectives of Interventional Pain Physicians and Spine Surgeons (104)
Noon–1:15 pm
Satellite Luncheon Symposium 1.25 CME
Practice Management
Sessions
Patient-Centered Care Sessions
1:30–2:30 pm
CRPS: Innovative Management
Strategies (201)
Improving Outcomes of
Interventional Pain Procedures
(202)
2:30–3 pm
3–4 pm
4–4:30 pm
Guidelines for the Treatment
of Low Back Pain (203)
Break
Army Pain Management:
From Injury to Home (205)
Patient-Centered Care Sessions
Practice Management
Sessions
Physical Therapy for
Non-Physiatrists (206)
Using Outcomes Data to Improve
Patient Care (208)
Blurring the Line Between
Surgeons and Pain Physicians (207)
Break
Practice Management
Sessions
Patient-Centered Care Sessions
4:30–5:30 pm
Legal and Ethical Aspects of Pain
Care (204)
Regenerative Therapies: Clinical
Pelvic Pain: A New Approach (209) Applications and Evidence-Based
Review (210)
Myofascial Pain:
Bench to Bedside (211)
5:30–7 pm
AAPM 27th Annual Meeting Reception
Exhibits and Poster Sessions (Group 2)
7–8:15 pm
Satellite Dinner Symposium Non-CME Event
Patient-Centered Pain Care: Who Is
Driving the Bus? (212)
Schedule at a Glance
29
Saturday, March 26, Meeting Day 2
7–8:15 am
Satellite Breakfast Symposium 1.25 CME
8:30–9:30 am
Plenary Research Highlights (105)
9:30–10:30 am
BREAK
Exhibits and Poster Sessions (Group 2)
10:30–11:15 am
Pain Care Reform (106)
Invited Faculty—Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General
11:30 am–12:45 pm
Satellite Luncheon Symposium 1.25 CME
AAPM Members’ Business Meeting
AAPM Awards Presentation
12:45–1:30 pm
Patient-Centered Care Sessions
1:45–2:45 pm
When Acute Pain Becomes Chronic (301)
2:45–3 pm
Evidence-Based Therapies in
Cancer Pain Management (302)
All About Opioids (304)
Practice Management Sessions
Pain Treatment Debate: Mock Trial, Part 1
(305)
4–4:15 pm
Contracting with Payors (306)
Break
Patient-Centered Care Sessions
4:15–5:15 pm
The Value Proposition in Health Care: Do You
Want to Get Paid for What You Do? (303)
Break
Patient-Centered Care sessions
3–4 pm
Practice Management Sessions
Opioid Misuse in Cancer Patients:
A Growing Problem (307)
Practice Management Sessions
Pain Treatment Debate: Mock Trial, Part 2
(305)
2011: Coding Update and Beyond (308)
Satellite Dinner Symposium non-cme event
5:30–6:45 pm
Sunday, March 27, Meeting Day 3
7–8:15 am
Satellite Breakfast Symposium (Event is not confirmed at time of printing; check on site for announcements.)
Patient-Centered Care Sessions
8:30–9:30 am
REMS Update—E-Prescribing (401)
Medical Marijuana for the Treatment
of Chronic Pain (402)
Patient-Centered Care Sessions
Practice Management Sessions
Patient-Centered Care Sessions
National Institutes of Health (NIH) Pain
Research: Optimizing Funding Through
Grant Writing (404)
Social Media Revolution: Marketing in the
Decade Ahead (405)
Chronic Daily Headache (406)
Break
9:30–9:45 am
9:45–10:45 am
10:45–11 am
Spine Imaging: The Significance of
Structure and Morphology (403)
Break
Patient-Centered Care sessions
11 am–Noon
Optimizing Clinical Research Opportunities and Cost Effectiveness of Spinal Cord Stimulation Psychological Therapies for Chronic Pain (409)
Publishing in Pain Medicine (407)
and Intrathecal Polyanalgesia in the
Management of Chronic Non-Malignant Pain
(408)
30
Schedule at a Glance
Registration and Cyber Central
Speaker Ready Room
Tuesday, March 22
Wednesday, March 23
Thursday, March 24
Friday, March 25
Saturday, March 26
Sunday, March 27
Tuesday, March 22
Wednesday, March 23
Thursday, March 24
Friday, March 25
Saturday, March 26
Sunday, March 27
5–7 pm
6:30 am–5 pm
6:30 am–6 pm
7:30 am–6 pm
8 am–5 pm
8 am–Noon
4–7 pm
6:30 am–6 pm
6:30 am–6 pm
7 am–6 pm
7:30 am–5:15 pm
7:30 am–Noon
Exhibits
Opening Reception with Exhibits and Posters (see poster schedule below)
Thursday, March 24, 5–6:30 pm
Exhibits Open
Friday, March 25, 9:30 am–Noon, 2:30–7 pm
(Reception and posters, 5:30–7 pm; see poster schedule below)
Exhibits Open
Saturday, March 26, 9:30–11:30 am
Posters
In an effort to be more ecologically friendly, AAPM will not be listing the poster abstracts in the printed program book. Instead, abstracts are posted on the
AAPM website at www.painmed.org and in Pain Medicine (volume 12, issue 3). Scientific posters will be on display in Prince George’s C.
The six highest ranking poster authors have been selected to present their posters at a plenary research highlights session.
This session will be held on Saturday, March 26, from 8:30–9:30 am.
Group 1. Posters will be on display Thursday, March 24, 5 pm, through
Friday, March 25, 11 am. The presentation group includes posters
categorized by the following clinical topics
• Epidemiology/Health Policy/Education
• Pharmacological
• Psychosocial/Rehabilitation
Author-Attended Sessions
Welcome Reception with Poster Session
Thursday, March 24, 5–6:30 pm
Exhibit and Poster Break
Friday, March 25, 9:30–10:30 am
Group 2. Posters will be on display Friday, March 25, 5:30 pm, through
Saturday, March 26, 10:30 am. This presentation group includes posters
categorized by the following clinical topics:
• Procedures (Interventional)
• Translational
Author-Attended Sessions
Reception with Poster Session
Friday, March 25, 5:30–7 pm
Exhibit and Poster Break
Saturday, March 26, 9:30–10:30 am
the American Academy of Pain Medicine
Letter from AAPM Membership Co-Chairs Keep Your M
embership
Active and
G
et Involved
in AAPM
Dear Colleag
ue,
The whole pr
actice of pain
medicine is ch
specialty all to
anging, cultu
itself, focused
rally and pol
on treating th
the clinical w
itically. It has
e pain patient
isdom and ex
become a med
with “consult
perience of a
ical
of social and
ant grade” ca
la
rge number of
intellectual co
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ab
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it
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d
In
iv
te
m
idual medical
grating
plexity. Gover
and society at
specialties ca
nmental agen
large are all sl
n be full
cies, insurance
owly discove
To accomplis
carriers, fello
ring the talent
h this succes
w physicians,
s and needs fo
sfully takes ad
certif ication)
r
th
e pain medic
vo
ca
cy and educat
, and commit
ine specialist
ion, quality as
ment to clinic
.
surance (by w
al excellence.
It is the goal
ay of board
of the Americ
an Academy
pain medicin
of Pain Medic
e specialist w
ine to foster
ith
the profession
al developmen
• educational
t of the
opportunitie
s,
such as AAPM
plenary, and
’s Annual Mee
concurrent se
ting, includin
ssions on the
g preconferen
latest pain th
ce workshop
er
apies and pro
• access to cu
s, cedures
rrent inform
ation, by mea
ns of a dynam
ic website
• social, pol
itical, and pro
fessional advo
Association,
cacy, such as
giving you a
formal represe
voice in thes
ntation with
sentation and
e
changing tim
the American
advocacy in W
es
;
th
e
Medical
P
ai
as
n
hington, DC
Care Coalition
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preaterials, such
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• a world-cla
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ns with shared
M’s new Mem
goals and con
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cerns, on loca
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We encourage
l, state,
you to take a
m
or
e active role in
organization
as we seek to
2011 in this
robust and vi
encourage th
patients in th
e highest leve
gorous profes
e world, in a
sional
ls
of
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in
dynamic inte
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membership
llectual, tech
for some of th
online at w w
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al
,
social, and cu
w.painmed.o
lt
ltural environ
rg or by callin
ment. Renew
g 847.375.473
your
1 and update
Thomas L . Y
your account
earwood, MD
.
PhD
Co-Chair, M
embership C
F
ommittee
rancis P. Lag
attuta, MD
Co-Chair, M
embership C
ommittee
Renew your membership online at www.painmed.org
or by calling 847.375.4731
32
Preconference Sessions
Wednesday, March 23–Thursday, March 24
Thursday, March 24
Essential Tools for Treating the Patient in Pain™
7:30–11:30 am, 1–5 pm Room: Annapolis
Cadaver Workshop (Non-CME Activity) (CW11)*
What Every Primary Care and Pain Specialist Needs to Know*
Essential Tools for Treating the Patient in Pain™ is designed for clinicians
interested in obtaining an overview of some of the fundamentals of
pain medicine in addition to practical approaches to the treatment of
common pain disorders. The course offers clinically focused lectures
and case presentations on the assessment, diagnosis, and treatment of
patients with various acute, cancer, and chronic pain syndromes.
Co-Chairs
Zahid H. Bajwa, MD
Salim M. Ghazi, MD
Day 1, Wednesday, March 23
7:30–11:30 am, 1–5 pm
Room: Woodrow Wilson CD
Topics
• Assessment of Pain
• Pain in Older Adults
• Office-Based Pain Practice
• Mechanism-Based Treatment of Pain
• Assessment and Treatment of Headache
• Pharmacology of Opioids and NSAIDs
• Low Back Pain
• Advanced Interventional Pain Procedures
• Abdominal and Pelvic Pain
Day 2, Thursday, March 24
7:30–11:30 am, 1–5 pm
Room: Woodrow Wilson CD
Topics
• Complex Regional Pain Syndrome
• Cancer Pain and Palliative Care (Medicine)
• Appropriate Management of Failed Back Syndrome
• Guide to Aberrant Behaviors Associated with Analgesic Use
• Opioid Agreements: The Good, the Bad, and the Ugly
• Pain and the Patient-Centered Medical Home
• Fibromyalgia and Myofascial Pain
• Pain Medicine and the Law
The goals of interventional pain medicine physicians are to relieve,
reduce, or manage pain and to improve a patient’s overall quality of
life through minimally invasive techniques specifically designed to
diagnose and treat painful conditions. AAPM presents an excellent
hands-on opportunity to learn and perform basic and advanced
interventional pain medicine procedures in a simulated setting.
Participation in this workshop is essential to improving patient safety
and patient outcomes in the interventional pain setting.
Co-Chairs
Lora L. Brown, MD
Salim M. Hayek, MD PhD
Faculty
Ramsin Benyamin, MD
David Caraway, MD
Ken Chapman, MD
Steven Cohen, MD
Oscar De Leon-Cassasola, MD
Michael Frey, MD
Salim Ghazi, MD
Michael Gofeld, MD
Leonardo Kapural, MD PhD
Philip Kim, MD
Patrick McIntyre, MD
Nilesh Patel, MD
Dave Petersen, MD
Joshua Prager, MD
Binit Shah, MD
Michael Stanton-Hicks, MD
This workshop will be a highlight of AAPM’s preconference educational
activities and will complement a robust curriculum of interventional,
scientific, and practice management sessions that are slated for AAPM’s
27th Annual Meeting. Cadaver Workshop attendees will be able to
select the type of procedures that are most relevant to their pain
practice by accessing the registration form on AAPM’s website at
www.painmed.org/cadaver.
This educational program is supported by Epimed, GE Healthcare, Kimberly Clark, Stryker
International Spine, Boston Scientific, Globus Medical, Medtronic, NeuroTherm,
St. Jude Medical, Vertos Medical, Cosman, Kyphon, and MinSurg, Corp.
7:30–11:30 am Room: Woodrow Wilson B
Ultrasound Guidance for the Pain Physician (001)*
*An additional fee is required to attend all preconference sessions.
Preregistration is required.
Responding to the accelerated advancement in the use of ultrasound
guided blocks in the treatment of pain medicine, this program will
provide an overview of the advantages and limitations of ultrasound
guidance in the practice of pain medicine. This program will also
provide hands-on application for the ultrasound novice to practice
real-time techniques for common ultrasound procedures and review
the available literature regarding feasibility, safety, and outcomes.
Participation in this preconference session will enable learners to
improve both cognitive and practical skills related to the use of
ultrasound technology for regional anesthesia and interventional pain
procedures. Dissemination of knowledge related to the difference
between ultrasound and fluoroscopy will be discussed in accordance
with the advantages and disadvantages of each of these interventional
techniques.
Preconference Sessions
Educational Objectives
1. Apply the interventional techniques of ultrasound technology.
2. Perform musculoskeletal ultrasound examinations of the major
joint areas, and apply real time ultrasound visualization to guide the
needle to the target joint safely and efficiently.
3. Maximize proficiency in adjusting machine settings to optimize
images, demonstrate basic ultrasound exams, and visualize needles
through the use of ultrasound technology.
This educational program is supported through in kind donations from Esaote North
America, GE Healthcare, SonoSite, and Terason.
Faculty
Michael J. Derr, DO
Mederic M. Hall, MD
Bryan C. Hoelzer, MD
Mark F. Hurdle, MD
Susan M. Moeschler, MD
Matthew J. Pingree, MD
James C. Watson, MD
Steven J. Wisniewski, MD
7:30–7:35 am
Introduction
Mark F. Hurdle, MD
7:35–7:55 am
Ultrasound Guided Musculoskeletal Injections
Steven J. Wisniewski, MD
7:55–8:15 am
Ultrasound Guided Peripheral Nerve Blocks
Susan M. Moeschler, MD
8:15–8:30 am
Ultrasound Guided Axial Injections
Mark F. Hurdle, MD
8:30–8:40 am
Break
8:40–11:30 am
Hands on Application Workshop
Michael J. Derr, DO
Mederic M. Hall, MD
Bryan C. Hoelzer, MD
Mark F. Hurdle, MD
Susan M. Moeschler, MD
Matthew J. Pingree, MD
James C. Watson, MD
Steven J. Wisniewski, MD
Due to the “hands-on” interactive format of the Ultrasound session, space will be limited
to 56 registrants. This session may be subject to change. Please refer to AAPM’s website for
the most current session information.
33
1–5 pm Room: Woodrow Wilson B
Taking Control of Your Interventional Pain Practice:
Accessing and Improving Practice Management
Protocols (002)*
This preconference session will provide interventional pain physicians
the opportunity to ask questions about billing, coding, compliance,
and other emerging practice management issues that affect the
practice of interventional pain medicine. Seasoned professionals with
proven track records in the pain management industry will provide
attendees with what they need to stay current, compliant, and
profitable in this ever-challenging healthcare arena. After completing
this activity, attendees will improve their ability to review and reduce
denials, identify OIG targets, pinpoint “problem areas” throughout the
continuum of their practice, and implement monitoring techniques to
increase profitability by decreasing loss in reimbursement.
Educational Objectives
1. Understand what constitutes medical necessity in patient selection
for utilizing ancillary services.
2. Strategically analyze the efficacy and profitability of an ancillary
prior to implementing it in their practice.
3. Correctly code and document according to industry and federal
guidelines for all ancillary services performed.
Moderator
Trish Bukauskas, CMM CPC CMSCS CMPA
Faculty
Trish Bukauskas, CMM CPC CMSCS CMPA
Amy G. Mowles
Linda M. VanHorn, MBA
1–1:05 pm
Introduction
Trish Bukauskas, CMM CPC CMSCS CMPA
1:05–2:05 pm
Ready to Open a Pain Management Facility? Developing an OfficeBased or Ambulatory Surgery Facility
Amy G. Mowles
2:05–3:05 pm
Hidden Sources of Revenue: How to Incorporate Non-Physician
Providers in Your Practice
Linda M. VanHorn, MBA
3:05–3:20 pm
Break
3:20–4:20 pm
Optimize Revenue and Compliance in the Interventional Pain
Practice by Accurately Coding and Documenting UDS and
Diagnostic Ancillaries
Trish Bukauskas, CMM CPC CMSCS CMPA
4:20–5 pm
Question and Answer Panel
*An additional fee is required to attend all preconference sessions.
Preregistration is required.
34
Plenary Sessions
Friday, March 25
Saturday, March 26
Room: Prince George’s D
8:30–8:45 am AAPM Welcome Address (101)
Room: Prince George’s D
8:30–9:30 am Plenary Research Highlights (105)
Perry G. Fine, MD
8:45–9:30 am Room: Prince George’s D
Consumer-Driven Health Care: Implications
for the Pain Physician (102)
Regina E. Herzlinger, PhD, Nancy R. McPherson Professor of Business
Administration, Harvard Business School, Boston, MA
Regina E. Herzlinger, PhD, will give this year’s Keynote
Address. Named America’s leading advocate for marketdriven, consumer-oriented health reform, Dr. Herzlinger is one the
country’s most respected healthcare analysts. She is widely recognized
for the groundbreaking role she played in pointing the way toward a
bold new healthcare plan. She has been dubbed by Money magazine
as the “godmother” of consumer-driven health care and has been
listed annually by Modern Healthcare as one of the nation’s 100 most
powerful people since 2003.
10:30–11 am Room: Prince George’s D
American Medical Association Address (103)
Amid the national initiative to reform the country’s healthcare delivery
system and in its continual effort to improve the framework in which
physicians deliver care to patients, American Medical Association (AMA)
President-Elect Peter W. Carmel, MD, and AMA Senior Vice President
of Advocacy Richard Deem, MD, will address the challenges brought
forth through the healthcare reform legislation and its short- and longterm effect on membership to both AMA and other related specialty
societies.
Healthcare Reform
Peter W. Carmel, MD (Pictured left)
Legislative Affairs
Richard Deem, MD
11–11:45 am Room: Prince George’s D
Medical Specialties Converge: Future Perspectives of
Interventional Pain Physicians and Spine Surgeons (104)
Various treatment options exist for treatment of complex spine
disease in both the interventional pain practice and the spine surgery
practices. This session examines the options, future perspectives, and
cost effectiveness of treating the complex spine patient through the
eyes of a prominent neurosurgeon and a prominent interventional
pain medicine physician.
Moderator
Timothy R. Deer, MD (Pictured left)
Correcting the Problem: The
Invasive Approach to Spine Disease
Robert M. Levy, MD PhD
Reducing the Risks: The Minimally
Invasive Approach to Spine Disease
Timothy R. Deer, MD
Increasing both the quality and quantity of scientific pain research
remains a primary goal of the 27th Annual Meeting Planning
Committee. The reputation of AAPM as a premier professional service
and scientific organization continues to result in a significant increase in
the quality of cutting-edge scientific-research abstracts. The Scientific
Poster Review Committee has selected six of the highest ranking
poster submissions for presentation in this plenary venue.
Moderator
Jeffrey M. Tiede, MD (Pictured)
The Regional Analgesia Military Battlefield Pain
Outcomes Study (RAMBPOS): A Preliminary Report
Rosemary C. Polomano, PhD RN
Role of the Rostral Ventromedial Medulla in a Rat
Model of Stress-Induced Hypersensitivity to Pain
Edward J. Bilsky, PhD
Associations Between Spousal or Significant Other Solicitous
Responses and Opioid Use in Patients with Chronic Pain
Julie L. Cunningham, PharmD, AAMP, CPNP
Analgesia of Axial Low Back Pain with Novel Spinal
Neuromodulation
Adnan Al-Kaisy, MB, ChB, FRCA
Detecting Chronic Low Back Pain Based on Brain Gray Matter
Hoameng Ung, BS
MiDAS I (mild® Decompression Alternative to Open Surgery)
Prospective, Open Label, Multi-Center Clinical Study:
Comprehensive 1-Year Follow-Up
Timothy R. Deer, MD
10:30–11:15 am Pain Care Reform (106)
Room: Prince George’s D
Invited Faculty
Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General
As AAPM continues to work with President Barack Obama’s
administration and other national medical organizations to develop
productive pain management solutions to vexing public health
challenges, the Academy has extended a formal invitation to Surgeon
General Regina Benjamin, MD MBA, to address the Academy and its
extended learners to a series of public health issues that continue
to threaten the safety of the American public. Dual problems of
undertreatment of pain and prescription drug abuse will be discussed
in a population-based forum.
Concurrent Sessions
35
Friday, March 25
1:30–2:30 pm Room: Annapolis 3-4
Guidelines for the Treatment of Low Back Pain (203)
Room: Woodrow Wilson CD
1:30–2:30 pm CRPS: Innovative Management Strategies (201)
Based on the Cochrane methodology for systemic reviews
and the United States Preventive Services Task Force (USPSTF)
recommendations for guideline production, this scientific session
will discern the various methodologies, criteria, and safeguards used in
the production of quality, unbiased, valid evidence-based guidelines. A
pro/con format will compare and contrast the APS and ASIPP guidelines
relative to the treatment of low back pain. Audience participation will
address additional questions and concerns related to the treatment of low
back pain.
Patients suffering from complex regional pain syndrome
(CRPS) often present with severe, intractable pain that is not
responsive to conventional treatment. Treatment of such
patients is often daunting and many patients become debilitated with
chronic pain. This scientific session addresses current concepts in the
effective treatment and management of CRPS, including therapeutic
and interventional modalities. This session discusses treatment
strategies based upon current understanding of the underlying
pathophysiological mechanisms in patients presenting with this
chronic pain syndrome.
The Importance of Producing Quality Guidelines: An Overview
Ray M. Baker, MD
American Pain Society (APS) Low Back Pain Guidelines: A Pro/
Con Debate
Moderator
Richard W. Rosenquist, MD—In Defense of the APS Low Back Pain Guidelines
Laxmaiah Manchikanti, MD—The APS Low Back Pain Guidelines: An Alternate View
May L. Chin, MD
Current Treatment Concepts in CRPS
John C. Rowlingson, MD
Outpatient Ketamine Infusion for CRPS
May L. Chin, MD
Neuromodulation in CRPS: Indications and Efficacy
Mehul J. Desai, MD MPH
1:30–2:30 pm Room: Annapolis 1-2
Improving Outcomes of Interventional Pain Procedures (202)
The potential for some type of complications directly related to
interventional pain procedures remains inevitable. Although most
of the complications are of minimal clinical impact, some carry the
risk of being life threatening. Patient complications can be greatly reduced
through utilization of a scrupulous history and physical examination, best
practice techniques, and recognition of pre-procedure pathophysiology.
This scientific session demonstrates the importance and effectiveness
of adhering to interventional pain guidelines as a method of improving
patient and procedural outcomes, encouraging best practices while
maintaining enough latitude to alter these techniques when specialists
demonstrate it is in the best interest of the patient.
1:30–2:30 pm Room: Woodrow Wilson B
Legal and Ethical Aspects of Pain Care (204)
This scientific session provides critical information on the most
pressing legal and ethical issues impacting the practice of pain
medicine in America. Session faculty provide significant
perspectives surrounding the new “Pill Mill” law in Texas, along with an
overview of Washington State landmark legislative developments
regarding opioid prescribing, and the proposed threat to access quality
pain care in the State of Florida. This scientific session concludes with
an open dialogue surrounding each state’s individual perspectives.
Audience concerns and questions will be addressed.
Moderator
Michael L. Whitworth, MD
Avoidable Complications of Advanced Interventional Pain
Procedures
Moderator
Larry C. Driver, MD
Texas Legislation Impact on Pain Practice
Larry C. Driver, MD
Overview of Developments in Washington State Guidelines
Alex Cahana, MD FIPP
In Pursuit of the Goal: Proposed Threats to Access and Quality
Pain Care in the State of Florida
Lora L. Brown, MD (invited faculty)
Emerging Ethical Considerations in Responsible Opioid
Prescribing
Ben A. Rich, JD PhD
Michael L. Whitworth, MD
Avoidable Complications of Interventional Pain Injections and
Neuroablation
Charles N. Aprill, MD
Patient-Centered Care Sessions
The new patient-centered care sessions bridge together advanced medical
management therapies and protocols of pain disease states with the latest
advancements in interventional pain medicine.
Practice Management Sessions
Practice management sessions provide the latest information
needed to successfully manage your thriving pain practice.
Concurrent Sessions
36
3–4 pm Room: Woodrow Wilson B
Army Pain Management: From Injury to Home (205)
3–4 pm Room: Annapolis 1-2
Physical Therapy for Non-Physiatrists (206)
Historically, the military’s approach to pain has been centered
on the use of opioid medications. While the success of opioids
in pain management is well established, these medications
have a significant side effect profile that can be lethal in the austere
and chaotic military medical environment. Pain researchers continue
to support an evolving appreciation that poorly managed pain can
develop into a chronic disease of the nervous system.
Physicians and patients often misconstrue that going to
physical therapy will result in primary pain relief and in turn are
disappointed to hear a report about (from the physician) or
experience (as the patient) sore muscles and even increased pain. The
primary end goal of exercise application is not the relief of pain but the
improvement of flexibility, endurance, or strength. Sometimes when
strength, endurance, or flexibility is improved, patients experience less
pain due to improved mechanics, increased joint support, endorphin
release, or other processes. Like all modalities used to treat pain, such
as medication, injections, and stimulators, exercise does not help all
patients and does not completely and permanently relieve many
painful conditions.
From 2009–2010, the U.S. Army Pain Management Task Force (PTF)
performed a comprehensive review of pain medicine within the U.S.
Army Medical Command (MEDCOM) and the Department of Defense
(DoD). Its findings included 105 recommendations in regard to a pain
medicine strategy that was holistic and multidisciplinary, utilized the
most current pain care modalities and technologies, and focused
on optimizing the quality of life of the suffering pain patient. All of
the PTF recommendations were designed to support the task force’s
vision statement of “providing a standardized DoD and VHA vision
and approach to pain management to optimize the care for warriors
and their families.” This session provides an overview of the PTF’s Final
Report and the corresponding comprehensive pain medicine strategy.
Moderator
Chester C. Buckenmaier, III, MD COL MC USA
This educational session examines types of exercise and variations
in intensity and frequency that result in different physiologic effects,
along with multiple reviews regarding splinting for a variety of
musculoskeletal conditions. This session also discusses prescription of
physical therapy for specific conditions including complex regional
pain syndrome (CRPS), low back pain, and shoulder and neck ailment.
The focus is on writing the initial script, following up, and monitoring
progress with the patient. Pearls for identifying optimal private physical
therapy facilities will be offered.
Battlefield Pain Management: From Point of Injury to Home
Moderator
Chester C. Buckenmaier, III, MD COL MC USA
Donna M. Bloodworth, MD
After the DoD: The Pain Care Continuum
Types of Exercise and Splints
Rollin M. Gallagher, MD MPH
Donna M. Bloodworth, MD
The Army Pain Task Force
Exercise Prescription for CRPS
Kevin T. Galloway, MHA BSN RN
Gagan Mahajan, MD
Exercise for Low Back, Neck, and Shoulder Conditions
Steven P. Stanos, DO
3–4 pm Room: Woodrow Wilson CD
Blurring the Line Between Surgeons and Pain Physicians (207)
The line between what has traditionally been the role of
surgeon and that of the pain medicine physician is becoming
increasingly difficult to define. With new treatments options,
including cutting-edge, minimally invasive techniques, the pain
physician is now providing the patient with options that provide
safe, quality interventional pain care options at a decreased delivery
cost. This scientific session reviews these emerging interventional
techniques and discusses their costs and overall impact on the
healthcare delivery system.
Moderator
Timothy R. Deer, MD
Minimally Invasive Surgical Interventions for Spinal Stenosis
Timothy R. Deer, MD
Bi-Annuloplasty and Endoscopic Laser Disc Surgery
Leonardo Kapural, MD PhD
Percutaneous Fusion: The Future of Stability
Richard G. Bowman, II, MD
Patient-Centered Care Sessions
The new patient-centered care sessions bridge together advanced medical
management therapies and protocols of pain disease states with the latest
advancements in interventional pain medicine.
Practice Management Sessions
Practice management sessions provide the latest information
needed to successfully manage your thriving pain practice.
Concurrent Sessions
3–4 pm Room: Annapolis 3-4
Using Outcomes Data to Improve Patient Care (208)
The practice of pain medicine is under increasing demand to
provide evidence that care delivered to patients produces
improved patient outcomes. Without significant outcomes data,
pain physicians have limited information to guide patient care and face
increasing risk of non-payment from payors for services rendered. While
the gold standard for evidence is a well-controlled clinical trial, such trials
are often not possible in select patient populations or for select
interventions. Because of the difficulty, expense, and time needed to link
quality outcomes data to improved patient pain care, few programs have
successfully integrated outcomes data collection.
This educational session reviews the potential that valid outcomes data
offers pain physicians and demonstrates two ways that this data can
be collected as part of ongoing pain care. It clearly demonstrates how
outcomes data can be used to guide individual patient care, as well as
how the data may be used to guide efforts to improve the process of
patient care. Additional information about providing clinical outcomes
of interdisciplinary pain care and ways in which pain physicians can
make informed data-driven decisions regarding resource utilization will
also be discussed.
Moderator
Michael A. Ashburn, MD MPH MBA
Can Outcomes Data Improve Outcomes?
Michael A. Ashburn, MD MPH MBA
Outcomes Data Collection Within a Busy Pain Practice
Gilbert J. Fanciullo, MD MS
The Use of Outcomes Data to Improve Patient Care
Martin D. Cheatle, PhD
Using a Patient Management System to Guide Data-Driven
Decision Making
Fred N. Davis, MD
4:30–5:30 pm Room: Woodrow Wilson CD
Pelvic Pain: A New Approach (209)
Chronic pelvic pain syndrome is a chronic pain condition lasting
longer than 6 months that often results in impaired function,
signs of depression, and, more frequently, pain out of proportion
to pathology. Pelvic afferent sensitization is caused by chronic irritation of
visceral organs in the pelvis, their striated sphincters, muscular structures
of the pelvic floor, or pudendal or other causes of neuralgias.
This session will highlight the critical value of multidisciplinary team
members for proper assessment, diagnosis, and treatment of chronic
pelvic pain. Faculty will further discuss the significant roles of different
specialists, including but not limited to psychologists, gynecologists,
urologists, and pain medicine interventionalists, and examine
new diagnostic and interventional techniques (i.e., surgery and
neuromodulation) to be utilized in the treatment of chronic pelvic pain.
Moderator
Leonardo Kapural, MD PhD
A Gynecologist’s Approach: Novel Surgical Therapies for Chronic
Pelvic Pain
Tamer M. Yalcinkaya, MD
Proposed Pain Medicine Algorithm for Treatment of Chronic
Pelvic Pain
Leonardo Kapural, MD PhD
37
4:30–5:30 pm Room: Annapolis 3-4
Regenerative Therapies: Clinical Applications and
Evidence-Based Review (210)
There have been considerable advances in understanding
painful soft-tissue disorders, most notably chronic
tendinopathies. The histopathology supports degeneration
over an inflammatory model. It is unknown what interventions best
stimulate the healing mechanisms necessary to induce tissue repair.
This session delivers an understanding of the basic science of plateletrich plasma (PRP), which is rapidly gaining exposure and notoriety
in the treatment of painful tendinopathies and related soft-tissue
disorders, and is the foundation of the new frontier of what are being
called regenerative therapies. It compares PRP to other regenerative
therapies and their optimum clinical applications, and reviews the
evidence for safety and efficacy.
Moderator
Joseph J. Ruane, DO
PRP and Regenerative Therapies
Ronald W. Hanson, MD
PRP: State of the Evidence
Joseph J. Ruane, DO
4:30–5:30 pm Room: Annapolis 1-2
Myofascial Pain: Bench to Bedside (211)
Muscle pain in the context of myofascial pain syndrome (MPS)
is a common condition in contemporary pain practice. Recently
there have been tremendous breakthroughs in elucidating
the pathophysiology of myofascial pain, including the quantification
of biochemicals involved in this process. Furthermore, the role of
sensitization in the development in MPS has increasingly been
examined. This scientific session details the development of novel
diagnostic techniques including microdialysis, magnetic resonance
elastography, and ultrasound in the treatment of myo-fascial pain.
Moderator
Mehul J. Desai, MD MPH
Neurobiology of Muscle Pain and Clinical Evaluation of
Myofascial Pain
Jay P. Shah, MD
Treatment Options for Myofascial Pain
Mehul J. Desai, MD MPH
Concurrent Sessions
38
4:30–5:30 pm Room: Woodrow Wilson B
Patient-Centered Pain Care:
Who Is Driving the Bus? (212)
Pain medicine has struggled to establish pain as far more than
a mere symptom of disease and as itself a legitimate focus of
health care. This effort has succeeded in establishing pain
assessment and management as a focus of regulatory attention (i.e.,
The Joint Commission) and quality improvement efforts (e.g., VA pain
management initiatives). However, despite such efforts, reducing pain
intensity among outpatients has generally not improved the quality of
the pain patients’ lives.
Cost expenditures on back pain care have greatly increased in the
past decade without improvement in patient outcomes. The goals
of outpatient pain care are usually disease centered or pain centered
rather than patient centered. This can achieve symptom reduction over
the short term but rarely achieves the long-term global improvement
in patients’ ability to live their lives and achieve their personal goals.
In the case of chronic opioid therapy, this pain-centered focus has led
to an increase in opioid abuse and overdose but little improvement in
chronic pain patients’ overall function. A narrow focus on eliminating
pain may be no more patient centered than the focus on eliminating
the pain-causing disease that it sought to replace. Incentives present
within fee-for-service pain care have promoted use of disease-focused
procedures but have not increased patient-centered outcomes. We
postulate that the only sustainable path available to patient-centered
pain care is the implementation of a case-managed measurement
and value-based model that focuses on patient-centered pain care
outcomes rather than pain reduction.
Given that hydrocodone and acetaminophen are currently prescribed
more than any other medication—125 million times per year—there
is a great need to understand the necessary factors controlling the
duration of prescription opioid use and pain surrounding surgery.
This scientific session reviews the medical and societal problem of acute
pain transitioning to chronic pain and the mechanisms and factors
responsible for this transition—using surgery and low back injury as
models for study. Additional treatments used to reduce the development
of chronic pain and persistent opioid use will also be presented.
Moderator
Sean Mackey, MD PhD
What Do We Know and How Can We Prevent It?
Sean Mackey, MD PhD
Why Do Some Patients Have Persistent Opioid Use Following
Surgery?
Ian R. Carroll, MD MS
1:45–2:45 pm Room: Annapolis 1-3
Evidence-Based Therapies in Cancer Pain
Management (302)
With the advances in the treatment of cancer, a greater number
of patients suffer from acute and chronic pain related to the
disease itself or secondary to the cancer-related treatments.
This scientific session provides an overview of effective medical pain
therapies as well as innovative interventional pain techniques that
improve cancer pain outcomes and are readily available in tertiary pain
research centers.
Moderator
Vitaly Gordin, MD
Medical Management of Cancer-Related Pain
This scientific education session examines recent and upcoming
changes in patient-centered pain care that will affect all pain
practitioners.
Vitaly Gordin, MD
Current Trends in Cancer Pain Management
Allen W. Burton, MD
Moderator
Interventional Therapies in Cancer Pain
Mark D. Sullivan, MD PhD
Patient-Centered Pain Care: It’s Not About the Pain
Mark D. Sullivan, MD PhD
Aligning Clinical Outcomes, Public Policy, and Payer Incentives
to Create Sustainable Pain Care
Alex Cahana, MD
Bernice R. Hecker, MD MHA FACC
Saturday, March 26
1:45–2:45 pm Room: Woodrow Wilson CD
When Acute Pain Becomes Chronic (301)
Chronic pain remains an enormous challenge for the American
population. With 10% of Americans developing chronic pain
postsurgery, the development of postsurgical chronic pain is
often thought to be secondary to sensitization of injured peripheral
neurons. However, these mechanisms fail to explain: (a) why surgery
does not lead to chronic pain in 90% of patients even though almost
every surgery damages superficial and deep nerves and (b) why fear,
anxiety, and depression (supraspinal pathology) best predict who
will develop post-injury chronic pain. In addition to the problem of
persistent pain after surgery, there is the societal problem of patients
who continue to use opioids after surgery.
Patient-Centered Care Sessions
Allen W. Burton, MD
1:45–2:45 pm Room: Woodrow Wilson B
The Value Proposition in Health Care: Do You
Want to Get Paid for What You Do? (303)
One of the defining goals of medicine is to add “years to life”
and “life to years.” The economics of medicine indicate that
there is a defined healthcare “resource pie” that must be
divided among all contemporary medical treatments. A logical, rational
approach to this problem is to optimize the healthcare benefit per
dollar expended.
This scientific session examines and demonstrates how the
methodology of the quality-adjusted life year (QALY) can be utilized by
individual pain practitioners to calculate the value of any pain medical
treatment or interventional pain procedures by simply determining the
change in QALYs of the intervention.
The new patient-centered care sessions bridge together advanced medical
management therapies and protocols of pain disease states with the latest
advancements in interventional pain medicine.
Moderator and Faculty
David W. Polly, MD
Practice Management Sessions
Practice management sessions provide the latest information
needed to successfully manage your thriving pain practice.
Concurrent Sessions
3–4 pm All About Opioids (304)
Room: Woodrow Wilson CD
Opioids are an important part of the multimodal painmanagement treatment plan and are often the drugs of
choice in treating severe acute and chronic pain. Long-term
opioid therapy provides much needed pain relief for many chronic
pain conditions but carries the risks of several adverse outcomes,
including but not limited to opioid-related hyperalgesia, an opioidinduced pain sensitivity. This scientific session will bring to the forefront
the emerging science behind opioid-related hyperalgesia and the
cumulative effect opioids have on the endocrine system. In addition,
new opioid formulations and innovative opioid delivery systems will
also be discussed.
Moderator
Lynn R. Webster, MD
New Opioid Formulations and Delivery Systems
Lynn R. Webster, MD
Opioid-Induced Hyperalgesia
Martin S. Angst, MD
Opioid Endocrinopathy
Annika Rhodin, MD PhD
3–5:15 pm Room: Annapolis 1-3
Pain Treatment Debate: Mock Trial (305)
Using a mock-trial format, this scientific session examines common
modalities of pain treatments and their efficacies, as well as the pros
and cons of established pain treatments. This scientific session also
explains the unresolved conflicts in treatment algorithms for the spine
patient, and the proper patient evaluation and selection for whom
spinal cord stimulation (SCS) may produce favorable outcomes.
Several pain therapies and interventional treatments will be discussed,
including whether or not spine surgery is advantageous to the chronic
pain patient, whether oral opioids work effectively for noncancer pain,
whether SCS and peripheral devices are effective, and whether minimally
invasive surgeries are optimal alternatives to a larger, open surgery.
Moderator
Timothy R. Deer, MD
39
3–4 pm Room: Woodrow Wilson B
Contracting with Payors (306)
This scientific session provides an in-depth discussion of payor
groups as well as the benefits of being “in network” with PPO/
HMO insurance companies versus “out of network” with
insurance companies. This session will provide specific tools for
interpreting payor contracts and working with carriers to make
contracts more “specific” to the needs of pain medicine specialists.
Scientific session attendees will learn how to successfully negotiate
with the payors in order to achieve maximum reimbursement as well
as explore what tools and data are necessary to develop successful
contract negotiation with payors.
Moderator and Faculty
Trish Bukauskas, CMM CPC CMSCS CMPA
4:15–5:15 pm Room: Woodrow Wilson B
Opioid Misuse in Cancer Patients:
A Growing Problem (307)
There is growing awareness about the misuse and abuse of
prescription opioids. Additionally, the risk of addiction remains
a valid concern when initiating long-term opioid therapy. The
growing awareness of opioid misuse in the chronic pain population,
along with increasing survivorship in cancer, has heightened awareness
that the same risks, misuse, abuse, and addiction that exist in the
chronic pain population may also effect the cancer pain population.
This scientific session explores safe prescribing principles adapted from
chronic pain literature, as well as effective avenues that mitigate the
inherent risks and still allow clinicians to continue to treat pain successfully.
Experts in the field of cancer pain will utilize a case discussion approach
in their presentation of an algorithm of multidisciplinary care for the
treatment of cancer pain in the at-risk population.
Moderator
Larry C. Driver, MD
Overview of the Potential Scope of the Problem
Diane M. Novy, PhD
Challenging Patients—Issues and Opportunities
Spine Surgery for Back Pain
Dhanalakshmi Koyyalagunta, MD
Plaintiff: Robert M. Levy, MD PhD
Defendant: Sunil J. Panchal, MD
Steven D. Passik, PhD
Oral Opioids for Noncancer Pain
Plaintiff: Timothy R. Deer, MD
Defendant: Sunil J. Panchal, MD
Spinal Cord Stimulation and Peripheral Nerve Stimulation
Devices for Pain
Plaintiff: Robert M. Levy, MD PhD
Defendant: Timothy R. Deer, MD
Minimally Invasive Surgery Versus Larger Spine Surgery
Plaintiff: Leonardo Kapural, MD PhD
Defendant: Richard G. Bowman, II, MD
Judge and Attorney for all trials William M. Tiano, Esq.
Multimodal Care Strategies for Multifaceted Problems
4:15–5:15 pm Room: Woodrow Wilson CD
2011: Coding Update and Beyond (308)
2011 has brought some changes to CPT® pain coding coupled
with changes in relative value units (RVUs) for these and other
codes. This session provides attendees with the latest coding
changes along with an opportunity to discuss any challenging coding
and reimbursement problems they may be facing in their practice.
This session also addresses ICD-9-CM changes as well as relevant Medicare
policy and reimbursement issues impacting pain medicine practices.
Participants will have the opportunity to practice their coding skills using
clinical case studies. Case studies will highlight common coding scenarios
and include a discussion of modifier usage, multiple-procedure reporting,
and the importance of ICD-9 coding on reimbursement.
Moderator
Fred N. Davis, MD
Coding Update: 2011
Fred N. Davis, MD
Coding Update and Beyond
Emily H. Hill, PA
Concurrent Sessions
40
Sunday, March 27
8:30–9:30 am Room: Annapolis 1-3
REMS Update—E-Prescribing (401)
The Academy recognizes that prescription drug abuse,
misuse, and diversion are a serious public health crisis that
requires mindful solutions to ensure maximum safety for the
American public. AAPM national leadership is shaping populationbased solutions to help the growing number of Americans whose
quality of life and productivity is adversely affected by chronic pain
conditions and diseases, while at the same time addressing concerns
about the prescription drug abuse public health crisis. This plenary
session provides a unique opportunity to discuss standards for
disease management of chronic pain conditions and diseases, while
assuring its pivotal role in developing professional and educational
opportunities for all other physicians.
Moderator
8:30–9:30 am Room: Woodrow Wilson CD
Spine Imaging: The Significance of Structure and
Morphology (403)
All spine imaging has a “specificity challenge” because of a
large background of asymptomatic degenerative disease,
which increases with age. With radicular pain syndromes,
concordance is essential. There is also a major sensitivity fault in typical
spine imaging because pain syndromes may be dynamic (i.e., only
seen with weight-bearing or specific postures). In axial pain syndromes,
there is extensive evidence that only physiologic imaging parameters
correlate with joint pain.
This scientific session provides an extensive summary of published
literature examining the relationship between structural imaging
abnormalities and pain syndromes. Faculty will further examine the
case-based evidence to provide a valuable prediction of discogenic
pain from imaging findings.
Scott M. Fishman, MD
Moderator and Faculty
REMS Update
Timothy P. Maus, MD
Scott M. Fishman, MD
E-Prescribing Policy
Aaron Gilson, PhD MS MSSW
8:30–9:30 am Room: Woodrow Wilson B
Medical Marijuana for the Treatment of
Chronic Pain (402)
Controversy exists regarding the use of marijuana in the
treatment of both acute and chronic pain. This controversy is
further amplified by the current legal environment in which
the use of marijuana for medical purposes, including the treatment of
pain, is legal in some but not all states.
Despite the legalization of marijuana for the treatment of pain in
some regions of the United States, clinical efficacy has not been firmly
established. This is of particular significance as the abuse potential of
marijuana is recognized worldwide. Furthermore, the medical-legal
liabilities and risks posed by medical marijuana have not been well
defined for the specialty of pain medicine. This scientific session will
further explore the following question: Should patients be placed at
risk of developing iatrogenic medical conditions when the efficacy of
the prescribed pharmacologic agent has not been firmly established?
This scientific session also provides information about the pharmacology
and efficacy of marijuana use for the treatment of acute and chronic
pain. Additionally, clinical implications of marijuana abuse and
dependence, as well as medical-legal risks and liabilities that medical
marijuana poses for the pain medicine physicians will be further defined.
Moderator
Mike W. Hooten, MD
Evidence-Based Outcomes of Smoked Marijuana for Chronic
Pain
Mike W. Hooten, MD
Pharmacology of Smoked Marijuana
Ajay D. Wasan, MD MSc
Smoked Marijuana for Chronic Pain: A Medical-Legal Perspective
Joshua B. Murphy, JD
9:45–10:45 am Room: Woodrow Wilson B
National Institutes of Health (NIH) Pain Research:
Optimizing Funding Through Grant Writing (404)
A successful application for research funding requires careful
planning, along with a keen understanding of grant writing
within the appropriate funding system. This scientific session
outlines the grant writing, peer review, and funding processes of
grant application at the National Institutes of Health (NIH). Faculty
will provide critical information on NIH funding opportunities in
pain research as well as defined funding mechanisms, peer review
processes, and referral processes with the NIH.
This scientific session provides an excellent opportunity to investigate
NIH grant writing from a principal investigator’s perspective.
Moderator
Yu (Woody) Lin, MD PhD
Funding Opportunities and Mechanisms at NIH
Yu (Woody) Lin, MD PhD
NIH Grant Writing from a Principal Investigator’s Perspective
Sean Mackey, MD PhD
NIH Peer Review and Referral Processes
Weijia Ni, PhD
9:45–10:45 am Room: Annapolis 1-3
Social Media Revolution: Marketing in the
Decade Ahead (405)
Twitter, Facebook, YouTube, LinkedIn—social media is
fundamentally changing the way the world communicates.
More than 50% of the world’s population is younger than 30
years old and 96% of them belong to a social media site. Current
research reports that the fastest growing segment on Facebook is
55–65-year-old females.
This practice management session addresses how you can harness the
power of social media to differentiate your pain practice from your peers,
improve patient satisfaction, and continue to improve market share.
Smoked Marijuana and Addiction
Terry D. Schneekloth, MD
Patient-Centered Care Sessions
The new patient-centered care sessions bridge together advanced medical
management therapies and protocols of pain disease states with the latest
advancements in interventional pain medicine.
Moderator and Faculty
Linda M. VanHorn, MBA
Practice Management Sessions
Practice management sessions provide the latest information
needed to successfully manage your thriving pain practice.
Concurrent Sessions
41
9:45–10:45 am Room: Woodrow Wilson CD
Chronic Daily Headache (406)
11 am–Noon Room: Woodrow Wilson CD
Psychological Therapies for Chronic Pain (409)
Intractable migraine and cervicogenic headaches are
among the most challenging conditions in headache and
pain medicine, and understanding their pathophysiology is
crucial to the application of appropriate diagnostic and therapeutic
modalities.
In the course of treating chronic pain patients, several
psychological modalities may be used to modify a variety of
unhelpful neurological patterns, associations, or behaviors.
These psychological modalities include eye movement desensitization
and reprocessing (EMDR) and hypnosis. EMDR encompasses a
comprehensive, integrative psychotherapy approach. EMDR is
an information-processing therapy using structured protocols of
psychodynamic, cognitive behavioral, interpersonal, experiential, and
body-centered therapies. Hypnosis uses a wakeful state of focused
attention and heightened suggestibility, with diminished peripheral
awareness. It is a mental state (state theory) or set of attitudes and
beliefs (non-state theory) usually induced by a procedure known as a
hypnotic induction, which is commonly composed of a long series of
preliminary instructions and suggestions.
This symposium emphasizes the importance of the multidisciplinary
approach to treating headache disorders. It will review the
pathophysiology, comorbidity, and advances in pharmacological
therapies. Topics covered in this session include the emerging role of
various interventional diagnostic and therapeutic techniques, the role
of radiofrequency ablation, and neuromodulation.
Moderator and Faculty
Zahid H. Bajwa, MD
Diagnosis and Treatment of Chronic Daily Headache
Zahid H. Bajwa, MD
11 am–Noon Room: Woodrow Wilson B
Optimizing Clinical Research Opportunities and
Publishing in Pain Medicine (407)
Several pain physicians have great interest in conducting
clinical research but need tips as to the “how to” in getting
started in the arena of beginning clinical investigation. This
scientific session promises to be of great interest to both the pain
medicine specialists in academia as well as the pain practitioner in
private practice. Renowned research faculty will deliver hands-on
clinician-scientist information regarding the process of beginning
clinical research. In addition, the editor of Pain Medicine will discuss
hands-on deliverables on how to get published in pain medicine. This
session will allow ample time for a panel discussion in which attendees
are able to bring up specific issues and questions to the expert faculty.
Moderator
Ajay D. Wasan, MD MSc
How to Collaborate Across Institutional Boundaries
Ajay D. Wasan, MD MSc
How to Publish in Pain Medicine
Rollin M. Gallagher, MD MPH
11 am–Noon Room: Annapolis 1-3
Cost Effectiveness of Spinal Cord Stimulation and
Intrathecal Polyanalgesia in the Management of
Chronic Non-Malignant Pain (408)
This scientific session provides a clear analysis of the cost impact
in regards to spinal cord stimulation and intrathecal drug
therapy in the management of chronic non-malignant pain.
Expert faculty will provide evidence of the cost savings and superior
pain control associated with these modalities when compared to other
conventional medical management treatment options. This session
also provides an update on the use of polyanalgesia, its appropriate
indications, and its important role in the restoration of lost pain control.
Moderator
Krishna Kumar, MD MBBA
Cost Effectiveness of SCS
Krishna Kumar, MD MBBA
Cost Impact and Clinical Benefits of Intrathecal Polyanalgesia in
the Management of Chronic Non-Malignant Pain
Sharon Bishop, MHlthSci BNurs
Targeted for the non-psychiatric pain practitioner, this scientific session
will explore each application in relationship to patient selection and
patient exclusion through multiple case scenarios.
Moderator
Albert L. Ray, MD
Hypnosis and Behavioral Cognitive Therapy in the Treatment of Pain
Albert L. Ray, MD
Eye Movement Desensitization and Reprocessing
Mary Elena Collazo, PsyD
42
AA P M F a c u l t y L i s t a n d D i s c l o s u r e s
Adnan Al-Kaisy, MB ChB FRCA
Consultant, Pain Medicine and Anaesthesia
Guy’s and St. Thomas’ Hospital
London, United Kingdom
Nothing to disclose
Martin S. Angst, MD
Associate Professor
Stanford University
Stanford, CA
Nothing to disclose
Charles N. Aprill, MD
Interventional Spine Specialists
Kenner, LA
Disclosure info
Michael A. Ashburn, MD MBA MPH
Director, Pain Medicine and Palliative Care
Penn Pain Medicine Center University of
Pennsylvania
Philadelphia, PA
ZARS Pharma, Inc. (stockholder)
Zahid H. Bajwa, MD
Director, Education and Clinical Pain Research
Beth Israel Deaconess Medical Center
Boston, MA
Allergan (research grant—co-principal investigator);
Endo (research grant—co-principal investigator); King
(speaker’s bureau—speaker’s training), Merck (research
grant—co-principal investigator), Pfizer (consultant);
Xanodyne (consultant—speaker training)
Ray M. Baker, MD
Director, Spine Program
Swedish Medical Center
Seattle, WA
Nothing to disclose
Edward J. Bilsky, PhD
Director, Center for Excellence in the
Neurosciences
University of New England College of
Osteopathic Medicine
Biddeford, ME
Aiko Pharmaceuticals (Ownership Stake—Co-Founder);
Biousian Biosystems, Inc. (Ownership Stake—Co-Founder;
Epix Pharmaceuticals (Payment, Consultant)
Sharon Bishop, MHlthSci BNurs
Clinical Research Coordinator
Regina General Hospital
Regina, SK, Canada
Nothing to disclose
Donna M. Bloodworth, MD
Outpatient Medical Director
Harris County Hospital District
Houston, TX
Nothing to disclose
Richard G. Bowman, II, MD
Pain Rehabilitation Director
The Center For Pain Relief, Inc.
Charleston, WV
Nothing to disclose
Lora L. Brown, MD
Coastal Pain Management and Rehabilitation
Bradenton, FL
Vertos Medical (honorarium—consultant); St. Jude
(honorarium—speaker)
Chester C. Buckenmaier, III, MD COL MC USA
Associate Professor, Uniformed Science
University of the Health Sciences
Defense and Veterans Pain Management
Initiative
Annapolis, MD
Nothing to disclose
Trish Bukauskas, CMM CMPA CMSCS CPC
Chief Executive Officer
Total Business Consulting
Clearwater, FL
AVEE Laboratories, Inc. (salary, marketing consultant)
Allen W. Burton, MD
Professor and Chair
University of Texas MD Anderson Cancer
Center
Houston, TX
Al Mann Foundation for Biomedical Research (consulting
fees—consultant); Azur, Inc. (honorarium—speaker);
Boston Scientific, Inc. (consulting fees—consultant);
Medtronic, Inc. (research grant to department—
investigator); Neurogesx, Inc. (honorarium—speaker)
Alex Cahana, MD FIPP
Chief, Pain Medicine
University of Washington Medical Center
Seattle, WA
Nothing to disclose
Peter W. Carmel, MD
President-Elect
American Medical Association
Chicago, IL
Nothing to disclose
Ian R. Carroll, MD MS
Assistant Professor
Stanford University
Palo Alto, CA
Nothing to disclose
Martin D. Cheatle, PhD
Director, Pain and Chemical Dependency
Research Center for Studies of Addiction
University of Pennsylvania
Philadelphia, PA
Ameritox, Inc (honorarium—advisory board)
May L. Chin, MD
Co-Director, Anesthesiology and Critical Care
Medicine
Pain Center at George Washington University
Washington, DC
Nothing to disclose
Mary Elena Collazo, PsyD
The Lite Center
Miami, FL
Nothing to disclose
Julie L. Cunningham, PharmD AAMP
CPNP
Pharmacotherapy Coordinator
Mayo Clinic
Rochester, MN
Nothing to disclose
Fred N. Davis, MD
Co-Founder
Michigan Pain Consultants, PC
Grand Rapids, MI
ProCare Research, LLC (no payment—speaker)
Richard Deem
Senior Vice President, Advocacy
American Medical Association
Washington, DC
Nothing to disclose
Timothy R. Deer, MD
President and CEO
The Center for Pain Relief, Inc.
Charleston, WV
Bioness, Inc. (consultant/research); Inset Technologies
(consultant); Medasys, Incorporated (consultant/
research); Spinal Modulation, Inc. (consultant);
Stryker Instruments (consultant); St. Jude Medical, Inc.
(consultant); Vertos Medical Inc. (consultant)
Michael J. Derr, DO
Associate Consultant—Clinical
Mayo Clinic
Rochester, MN
Nothing to disclose
Mehul J. Desai, MD MPH
Director, Pain Medicine Services
George Washington University Hospital
Washington, DC
Kimberly-Clark (Honorarium—Speaker/Faculty);
Medtronic Inc. (Honorarium—Speaker/Faculty)
Larry C. Driver, MD
Professor and Vice-Chair
University of Texas M.D. Anderson Cancer
Center
Houston, TX
Nothing to disclose
Gilbert J. Fanciullo, MD MS
Director, Section of Pain Medicine
Dartmouth Hitchcock Medical Center
Lebanon, NH
PriCara (honorarium—speaker, advisory committee)
Scott M. Fishman, MD
Chief, Pain Medicine
University of California–Davis School of
Medicine
Lawrence J. Ellison Ambulatory Care Center
Sacramento, CA
American Pain Foundation (President/Chairman of Board)
AA P M F a c u l t y L i s t a n d D i s c l o s u r e s
Rollin M. Gallagher, MD MPH
Clinical Professor, Psychiatry and
Anesthesiology
Director, Pain Policy Research and Primary
Care
Penn Pain Medicine
Deputy National Program Director for Pain
Management
Veteran’s Affairs Health System
Philadelphia VA Medical Center
Philadelphia, PA
Nothing to disclose
Kevin T. Galloway, MHA BSN RN
Office of the Army Surgeon General
Alexandria, VA
Nothing to disclose
Aaron M. Gilson, PhD MS MSSW
Director, U.S. Program at the Pain and Policy
Studies Group
University of Wisconsin School of Medicine
and Public Health
Paul P. Carbone Comprehensive Cancer Center
Madison, WI
Regina E. Herzlinger, PhD (Invited
Faculty)
Nancy R. McPherson Professor of Business
Administration
Harvard Business School
Boston, MA
Novartis (faculty)
Emily H. Hill, PA
President
Hill & Associates
Wilmington, NC
Nothing to disclose
Bryan C. Hoelzer, MD
Assistant Professor and Physician
Mayo Clinic
Rochester, MN
Nothing to disclose
Mike W. Hooten, MD
Assistant Professor
Mayo Clinic
Rochester, MN
Nothing to disclose
Covidien (honorarium—advisory board member, speaker
training), King Pharmaceuticals (research grant—
researcher), Meda Pharmaceuticals (honorarium—
advisory board member), Purdue Pharma (unrestricted
educational grant—Board of Regents of the University of
Wisconsin was the grantee)
Mark F. Hurdle, MD
Assistant Professor
Mayo Clinic
Rochester, MN
Vitaly Gordin, MD
Director, Pain Division
Penn State University College of Medicine
Hershey, PA
Leonardo Kapural, MD PhD
Medical Director, Chronic Pain Center
Wake Forest University Health Sciences
Winston-Salem, NC
Nothing to disclose
Boston Scientific (honorarium—workshop faculty);
Elan Pharma (honorarium—speaker); Kimberley Clark
(honorarium—speaker/workshop); Pfiedler Enterprises
(honorarium—workshop faculty); St. Jude Medical
(honorarium—workshop faculty)
Mederic M. Hall, MD
Sports Medicine Fellow
Mayo Clinic
Rochester, MN
Nothing to disclose
Ronald W. Hanson, MD
Physician
Centeno-Schultz Clinic
Broomfield, CO
American Medical Society for Sports Medicine
(honorarium—speaker); Sonosite (honorarium—speaker)
Salim M. Hayek, MD PhD
Chief, Division of Pain Medicine
University Hospitals Case Medical Center
Cleveland, OH
Boston Scientific (consultant), Endo Pharmaceuticals
(consultant), Johnson & Johnson (consultant), Pfizer
(consultant)
Bernice R. Hecker, MD MHA FACC
Contractor Medical Director
Medicare
Noridian Administrative Services
Mountlake Terrace, WA
Nothing to disclose
Nothing to disclose
Dhanalakshmi Koyyalagunta, MD
Associate Professor
University of Texas MD Anderson Cancer
Center
Houston, TX
Nothing to disclose
Krishna Kumar, MD MBBS MS FRCS
Clinical Professor
Regina General Hospital
Regina, SK, Canada
Nothing to disclose
Robert M. Levy, MD PhD
Professor
Northwestern University Feinberg School of
Medicine
Chicago, IL
Bioness, Inc. (speaker, education, consulting); Codman
Shurtleff, Inc. (speaker, education, consulting); Medtronic
Neurological (speaker, education, consulting); Spinal
Modulation (speaker, education, consulting); St. Jude
Medical, Inc. (speaker, education, consulting); Stryker
Instruments (speaker, education, consulting); Vertos
Medical, Inc. (speaker, education, consulting)
43
Yu (Woody) Lin, MD PhD
Program Director
National Institutes of Health
Bethesda, MD
Nothing to disclose
Sean Mackey, MD PhD
Chief, Division of Pain Management
Stanford University
Stanford, CA
Nothing to disclose
Gagan Mahajan, MD
Associate Professor
University of California–Davis
Sacramento, CA
Nothing to disclose
Laxmaiah Manchikanti, MD
Medical Director
Pain Management Center of Paducah
Paducah, KY
Nothing to disclose
Timothy P. Maus, MD
Assistant Professor of Radiology
Mayo Clinic
Rochester, MN
Nothing to disclose
Bill H. McCarberg, MD DABPM
Kaiser Permanente
Escondido, CA
Abbott (honorarium—speaker), Cephalon
(honorarium—speaker), Endo (honorarium—speaker),
Forest (honorarium—speaker), King (honorarium—
speaker), Ligand (honorarium—speaker), Lilly
(honorarium—speaker), Merck (honorarium—
speaker), Mylan (honorarium—speaker), Neurogesx
(honorarium—speaker), Pfizer (honorarium—speaker),
Pricara (honorarium—speaker), Purdue (honorarium—
speaker)
Susan M. Moeschler, MD
Anesthesiologist
Mayo Clinic
Rochester, MN
Nothing to disclose
Amy G. Mowles
President and CEO
Mowles Medical Practice Management, LLC
Edgewater, MD
Nothing to disclose
Joshua B. Murphy, JD
Associate Chief Legal Officer and Chair of
Litigation and Risk Management
Mayo Clinic
Rochester, MN
Nothing to disclose
Weijia Ni, PhD
Scientific Review Officer/Referral Officer
National Institutes of Health
Bethesda, MD
Nothing to disclose
44
AA P M F a c u l t y L i s t a n d D i s c l o s u r e s
Diane M. Novy, PhD
University of Texas—MD Anderson Cancer
Center
Houston, TX
John C. Rowlingson, MD
Cosmo A. DiFazio Professor of Anesthesiology
University of Virginia School of Medicine
Charlottesville, VA
James C. Watson, MD
Consultant
Mayo Clinic
Rochester, MN
Nothing to disclose
Nothing to disclose
Nothing to disclose
Sunil J. Panchal, MD
President
National Institute of Pain/COPE Foundation
Lutz, FL
Joseph J. Ruane, DO
Medical Director
McConnell Spine, Sport & Joint Center
Columbus, OH
Lynn R. Webster, MD
Medical Director
Lifetree Clinical Research and Pain Clinic
Salt Lake City, UT
King Pharmaceuticals (consultant); Purdue Pharma, LP
(consultant); Endo Pharmaceuticals (speaker)
Genzyme Biosurgery (honorarium—speaker, consultant);
Pfizer, Inc. (honorarium—speaker)
Steven Passik, PhD
Clinical Psychologist
Memorial Sloan-Kettering Cancer Center
New York, NY
Terry D. Schneekloth, MD
Psychiatrist
Mayo Clinic
Rochester, MN
Cephalon (honorarium—consultant and speaker);
King (honorarium—consultant and speaker); Pricara
(honorarium—consultant and speaker); Purdue
(honorarium—consultant and speaker)
Nothing to disclose
Adolor Corporation (research); Alkermes, Inc. (research);
Alko (research); Ameritox (advisory board); AstraZeneca
(consultant); Bayer (research); Boston Scientific
(consultant, research); Cephalon, Inc. (consultant,
research); Collegium Pharmaceutical (research); Elan
Corporation, plc (consultant); Endo Pharmaceuticals
(research); Forest Pharmaceuticals, Inc. (research);
Hisamitsu Pharmaceutical Co., Inc. (research); HoffmanLaRoche LTP (research); King Pharmaceuticals, Inc.
(research, advisory board); Medtronic Inc. (consultant,
research, advisory board); Myriad Genetics, Inc. (research);
Nektar (advisory board); NeurAxon (research); NeurogesX®
(advisory board); Neuromed (advisory board); Nevro
Corp. (consultant); Pfizer Inc. (research); Purdue Pharma
LP (consultant, advisory board); QRxPharma Limited
(research); Reckitt Benckiser Group plc (research); Recro
Pharma, Inc. (research); Regeneron Pharmaceuticals,
Inc. (research); Theravance (research); Wyeth (research,
advisory board)
Matthew J. Pingree, MD
Mayo Clinic
Rochester, MN
Nothing to disclose
David W. Polly, MD
Professor
University of Minnesota
Minneapolis, MN
Medtronic (consultant)
Rosemary C. Polomano, PhD RN
Associate Professor of Pain Medicine
University of Pennsylvania School of Nursing
Philadelphia, PA
Nothing to disclose
Albert L. Ray, MD
Medical Director
The Lite Center
Miami, FL
Eli Lilly and Co. (honorarium—speaker, medical advisory
board); King Pharmaceuticals (honorarium—speaker);
Xanodyne (honorarium—speaker, medical advisory
board)
Annika Rhodin, MD PhD
Department of Surgical Sciences,
Anaesthesiology, and Intensive Care
Uppsala University
Uppsala, Sweden
Grunenthal Sweden AB (salary, medical advisor)
Ben A. Rich, JD PhD
Professor and Chair, Bioethics
University of California–Davis School of
Medicine
Sacramento, CA
Nothing to disclose
Richard W. Rosenquist, MD
Director, Center for Pain Medicine and
Regional Anesthesia
University of Iowa
Iowa City, IA
Nothing to disclose
Jay P. Shah, MD
Senior Staff Physician
National Institutes of Health
Bethesda, MD
Nothing to disclose
Steven P. Stanos, DO
Medical Director, Center for Pain Management
Rehabilitation Institute of Chicago
Chicago, IL
Nothing to disclose
Mark D. Sullivan, MD PhD
Professor
University of Washington
Seattle, WA
ABT Biopharma (research consultation stipend—research
consultation)
William M. Tiano, Esq
Principal
Berthold, Tiano, and O’Dell
Charleston, WV
Nothing to disclose
Hoameng Ung, BS
Research Assistant
Stanford Systems Neuroscience and Pain Lab
Stanford, CA
Michael L. Whitworth, MD
Interventional Pain Physician
Advanced Pain Management
Columbus, IN
Nothing to disclose
Steven J. Wisniewski, MD
Assistant Professor
Mayo Clinic
Rochester, MN
Nothing to disclose
Tamer M. Yalcinkaya, MD
Section Head, Reproductive Endocrinology
Wake Forest School of Medicine
Winston-Salem, NC
Nothing to disclose
Nothing to disclose
Linda M. VanHorn, MBA
President/CEO
21st Century Edge, Inc.
Kansas City, MO
21st Century Edge, Inc. (owner), Boston Scientific
(consultant), St. Jude Medical (consultant)
Ajay D. Wasan, MD MSc
Director, Clinical Pain Research
Brigham and Women’s Hospital
Chestnut Hill, MA
Eli Lilly and Company (consultant); Medtronic, Inc.
(consultant)
All confirmed AAPM faculty disclosures are available at
www.painmed.org/disclosures.
S a t e l l i t e S y mp o s i a
45
Satellite symposia will be held in conjunction with the annual meeting. These independently sponsored, commercially supported symposia
are open to meeting registrants. The AAPM Program Planning Committee has reviewed and approved the symposia after determining the
topics are relevant to the audience and complementary to the official AAPM program. There is no additional fee to attend these symposia, but
preregistration is required. Seating will be available on a first-come, first-served basis. Program details and speakers are subject to change. All
satellite symposia will be designated for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with
the extent of their participation in the activity.
Please preregister at www.symposiareg.org/aapm or with Cathy Rickert at 847.375.4798 or crickert@connect2amc.com.
*A complete list of satellite symposia is available at the Annual Meeting section of the AAPM website at www.painmed.org or at www.symposia.org/aapm.
Wednesday, March 23
Thursday, March 24
11:45 am–1 pm
Satellite Luncheon Symposium
11:45 am–1 pm
Satellite Luncheon Symposium
Rational Selection of Adjuvant Analgesics in Chronic Pain
Management: Moving from Symptom Control Toward a
Mechanism-Based Approach
Chronic pain is widespread and often poorly managed. As our
understanding of chronic pain neurobiology continues to expand
and novel neuromodulatory approaches emerge specifically targeting
the pathophysiological underpinnings of chronic pain, clinicians who
manage patients with chronic pain must be aware of these advances
in science and medicine in order to provide the best possible care for
their patients. Thus, this activity will begin with an overview of the
prevalence and morbidity associated with chronic pain conditions
and barriers that exist in effectively treating patients suffering from
pain. Next, the faculty will review the current understanding and latest
findings in the pathophysiology of chronic pain and highlight potential
neuromodulatory targets for treatment. They will then go on to discuss
a paradigm shift in the chronic pain management approach from an
empirical methodology of trying-and-rejecting and symptom control
towards mechanism-specific intervention and rational selection of
analgesics in individual patients. Furthermore, they will discuss recent
clinical trial data demonstrating efficacy and safety data of adjuvant
analgesics in managing chronic pain effectively. The activity will
conclude with an interactive question and answer session.
Chairperson
Scott M. Fishman, MD
Faculty
Ajay D. Wasan, MD MSc
This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
(ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and
ACCELMED. PIM is accredited by the ACCME to provide continuing medical education for
physicians.
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and
other individuals who are in a position to control the content of this activity to disclose
any real or apparent conflict of interest they may have as related to the content of this
activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance,
scientific objectivity of studies mentioned in the materials or used as the basis for content,
and appropriateness of patient care recommendations.
PIM designates this educational activity for a maximum of 1.25 AMA PRA Category 1
Credit(s)™. Physicians should only claim credit commensurate with the extent of their
participation in the activity. For accreditation information, contact Jennifer Engelhardt at
720.895.5333 or jengelhardt@pimed.com.
This activity is supported by an educational grant from Lilly USA, LLC.
Risk Reduction in Breakthrough Pain Treatment: Applications
for Pain Management in Cancer
In this program, the pathophysiology and characteristics of
breakthrough pain will be reviewed as well as ways to assess and identify
breakthrough pain when present. The prevalence of breakthrough pain
and the negative impact in cancer patients will be explored. In addition,
the pharmacokinetics of opioids, benefits, and limitations of approved
treatments for breakthrough pain and investigational agents will be
examined. The concepts of opioid misuse, abuse, and addiction; ways to
minimize risk in patients taking opioids; and strategies to address issues,
including the implementation of Risk Evaluation and Mitigation Strategy
(REMS) programs, will be discussed. Finally, case studies will be examined
to apply breakthrough pain management strategies.
Course Director
Perry G. Fine, MD
Faculty
Steven D. Passik, PhD
Thomas Strouse, MD
This symposium is jointly sponsored by USF Health and MedXcel, LLC. This session will
offer continuing education for physicians, psychologists, nurses, and pharmacists.
Participants with any questions regarding continuing education earned through
participation in this independent satellite symposium should contact John Robinson at
jrobinson@medxcel.org or call 813.830.9311, ext. 120.
USF Health CME designates this educational activity for a maximum 1.25 AMA PRA
Category 1 Credits™. Physicians should only claim credit commensurate with the extent
of their participation in the activity. For accreditation information contact Kandi Smith,
CME Coordinator II, 813.974.6237 or ksmith3@health.usf.edu.
This symposium is supported by an educational grant from MEDA Pharmaceuticals, Inc.
6:30–7:45 pm
Satellite Dinner Symposium
The Nuances and Complexities of Opioid Rotation: A PointCounterpoint Debate
The goal when utilizing opioid therapy is to provide adequate pain
relief balanced with tolerable adverse events (AEs). Individual patients’
responses to different opioids can vary significantly. If gradual dose
titration yields treatment-limiting AEs or poor analgesia, there is a
change in the patient’s clinical status, drug-drug interactions suggest the
need for an opioid with different pharmacokinetic properties, or there is
a preference or need for a different administration route or formulation,
opioid rotation—switching from one opioid to another—can be a
therapeutic option. There are now many opioids and formulations to
choose from when utilizing opioid rotation. Physicians can reduce the
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S a t e l l i t e S y mp o s i a
risk of overdosing or underdosing as one opioid is discontinued and
another is administered by selecting a safe and reasonably effective
starting dose for the new opioid, followed by dose adjustment. This
requires knowledge of an “equianalgesic dose table,” which provides
broad estimates of the potency relationships between opioids and
guidelines for dose adjustments to individualize therapy for each patient.
The purpose of this educational activity is to provide physicians with
rationale, strategies, and best practices when considering opioid rotation
to improve clinical outcomes for patients with chronic pain.
Faculty Moderator
Gavril W. Pasternak, MD PhD
Faculty Speaker
Ricardo A. Cruciani, MD PhD
The University of Nebraska Medical Center, Center for Continuing Education (UNMC/CCE)
is accredited by the Accreditation Council for Continuing Medical Education (ACCME)
to provide continuing medical education for physicians. The UNMC/CCE designates this
educational activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)TM. Physicians
should only claim credit commensurate with the extent of their participation in the activity.
This activity has been planned and implemented in accordance with the Essential
Areas and Policies of the ACCME through the joint sponsorship of the UNMC/CCE and
PharmaCom Group, Inc. Participants with any questions regarding continuing education
earned through participating in this independent satellite symposium should contact
Diane Frost at dfrost@unmc.edu or call (402) 559-5145.
This activity is funded through an educational grant from Mallinckrodt Inc., a Covidien
company.
Friday, March 25
7–8:15 am
Satellite Breakfast Symposium
Practitioner’s Edge—Strategies to Ensure the Safe Use of
Opioid Therapy for Patients with Chronic Pain
The purpose of this educational program will be to discuss effective
strategies for the management of chronic pain that reduce the risk for
opioid misuse, abuse, and diversion. Attendees will be provided with
the latest published data regarding risk management strategies and
benefits of abuse-deterrent opioid formulations for chronic pain, the
consequences of inadequate pain relief, potential barriers to provision
of adequate pain relief, and strategies to overcome these barriers.
One key barrier to be addressed is the fear of opioid abuse, misuse,
diversion, and addiction.
In this program, video vignette case studies will be utilized to illustrate
clinically relevant examples of patients with varying levels of risk for
opioid misuse, abuse, diversion, and addiction. Faculty panel members
will work with audience members to identify optimal treatment
strategies while discussing the latest scientific information with regard
to pain management. A multimedia presentation will be interspersed
with audience response questions to further engage the audience and
provide data for rigorous panel discussion.
Practitioner’s Edge is an innovative symposium format that provides
attendees with cutting-edge medical education in a peer-to-peer
discussion setting. The goal is to provide practical tools and education
that may be utilized immediately in daily practice.
Faculty
Bill H. McCarberg, MD
Lynn R. Webster, MD
This independent commercially supported symposium is cosponsored by Postgraduate
Institute for Medicine (PIM) and Integrity Continuing Education, Inc. CME credits will
be awarded by PIM. PIM is accredited by the ACCME to provide CME for physicians. For
accreditation information, please visit www.pimed.com or contact Allison Hughes at
720.895.5315.
PIM designates this educational activity for a maximum 1.25 AMA PRA Category 1
Credits™. Physicians should only claim credit commensurate with the extent of their
participation in the activity. For accreditation information contact:Allison Hughes,
720.895.5315 or ahughes@pimed.com.
This activity is funded by an educational grant from King Pharmaceuticals, Inc.
Noon–1:15 pm
Satellite Luncheon Symposium
Osteoarthritis: From Biomarkers to New Strategies for Pain
Management
Osteoarthritis (OA), a chronic and painful degenerative joint disorder,
affects nearly 27 million U.S. adults. It is currently the leading source
of physical disability with severely impaired quality of life due to
pain and loss of joint function. Scientific advances in the field of OA
include increased understanding of the complex etiology of the
disease, as well as the concerted efforts to establish and validate
systemic (serum or urine) biomarkers to measure and predict the
full spectrum of disease progression. This symposium will include
an update on the most recent advances in the establishment of
systemic biomarkers for OA.
The management of OA pain is addressed by several recent guidelines,
but there is considerable variation in some of the recommendations,
particularly regarding the appropriate use of opioids. In this symposium
the most recent evidence, as well as the various recommendations for the
use of different drug classes, including topical agents, will be discussed.
Faculty
Introduction and Overview
F. Michael Gloth, II, MD FACP AGSF, Chair
Biomarkers in Osteoarthritis: Needs and Outcomes
Virginia Byers Kraus, MD PhD
The Use of Non-Opioid Analgesics in Osteoarthritis Pain
Marc C. Hochberg, MD MPH
The Use of Opioids in Osteoarthritis Pain
F. Michael Goth, II, MD FACP AGSF
This activity has been planned and implemented in accordance with the Essential Areas
and policies of the Accreditation Council for Continuing Medical Education (ACCME)
through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Miller
Medical Communications, LLC. CME credits will be awarded by PIM. PIM is accredited by
the ACCME to provide continuing medical education for physicians.
PIM designates this educational activity for a maximum of 1.25 AMA PRA Category
1 Credits™. Physicians should only claim credit commensurate with the extent of their
participation in the activity. For accreditation information contact Jennifer Engelhardt at
jengelhardt@pimed.com.
This activity is supported by an educational grant from Endo Pharmaceuticals Inc.
Saturday, March 26
7–8:15 am
Satellite Breakfast Symposium
Comprehensive Chronic Pain Management: Improving Physical
and Psychological Function
Using a unique, highly interactive, video patient case teaching format,
this symposium is intended to provide clinicians who manage patients
with chronic pain with new insights and expand their understanding
to achieve the goals of effective pain management—reduction of pain,
improvement in function, and restoration of psychological health—
utilizing a multidisciplinary (pharmacological and nonpharmacological)
approach. Attendees will have multiple “interactive” opportunities to
S a t e l l i t e S y mp o s i a
reinforce their own best practices or recognize potential gaps in their
clinical practice and will receive information to help them accurately
assess the severity of pain, evaluate biopsychosocial factors that impact
treatment, and develop strategies to meet the goals of therapy and
improve patient outcomes.
Faculty
Course Director
Ricardo A. Cruciani, MD PhD
Introduction—The Ongoing Unmet Need for Functional
Improvement in Chronic Pain Patients
Steven Stanos, DO
Chronic Pain Mechanisms: How Can Understanding the
Pathophysiology Improve Outcomes?
David A. Williams, PhD
Applying the Evidence: Patient Assessment, Selection, and
Monitoring of Pain Therapy
Bill H. McCarberg, MD
Multidisciplinary Care for Functional Improvement: Turning
Theory Into Practice
Steven Stanos, DO
This activity has been planned and implemented in accordance with the Essential Areas
and Policies of the Accreditation Council for Continuing Medical Education (ACCME)
through the joint sponsorship of Beth Israel Medical Center & St. Luke’s and Roosevelt
47
Hospitals and Health Education Alliance, Inc. Beth Israel Medical Center & St. Luke’s
and Roosevelt Hospitals are accredited by the ACCME to provide continuing medical
education for physicians.
Participants with any questions regarding continuing education earned through
participation in this independent satellite symposium should contact Lissa Charles at
lcharles@healtheducationalliance.com.
Beth Israel Medical Center designates this live educational activity for a maximum of 1.25
AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with
the extent of their participation in the activity. For accreditation information contact: Lois
Grossman, 212.420.2341 or lgrossman@chpnet.org.
This activity is supported by an educational grant from PriCara, Division of Ortho-McNeilJanssen Pharmaceuticals, Inc., administered by Ortho-McNeil-Janssen Scientific Affairs, LLC.
11:30 am–12:45 pm
Satellite Luncheon Symposium
An Interactive Exploration of Integrated Opioid Therapy in
Chronic Pain (Consultation with Experts)
Effective pain control in individuals with acute or chronic pain provides
a number of benefits, including an increased ability to work and
improved function, ability to perform activities of daily living, and
quality of life. The overall goal of therapy with analgesics is to find the
minimum dose that adequately manages pain and enhances patient
function while minimizing any unwanted adverse effects. Considerable
evidence indicates that opioids have a major role in the treatment
of chronic noncancer pain. Further, the American Academy of Pain
Non-CME Corporate SYMPOSIA
AAPM has opened its door to the following not-for-credit sessions.
The focus of these sessions is uniquely different from others at the
meeting. Those presenting at this session either represent or will be
discussing the views of a commercial interest. The session does not
meet continuing education requirements and offers no continuing
medical education credit.
The material discussed at the session does not represent the views
or opinions of AAPM. This satellite event is not considered an official
educational offering of the AAPM Annual Meeting. There is no fee
to attend; however, preregistration is encouraged. Seating will be
available on a first-come, first-served basis.
Friday, March 25
7–8:15 pm
Non-CME Corporate Dinner Symposium
New Perspectives on Acute Pain: Focusing on Efficacy and
Tolerability
Greater awareness of the role of ascending and descending
pathways in pain signaling, coupled with pharmacologic
innovations, has reshaped the approach used to manage acute pain.
Based on findings that support the management of pain through
multiple mechanisms of action and the importance of targeting
ascending and descending pathways, the speakers will discuss how
acute pain can be effectively managed with multimodal analgesia,
while maintaining tolerability.
Faculty
Perry G. Fine, MD
Sunil J. Panchal, MD
This non-CME corporate activity is funded through a grant from PriCara®, a
Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Saturday, March 26
5:30–6:45 pm
Non-CME Corporate Dinner Symposium
The Evolving Landscape of Chronic Opioid Therapy and Risk
Management
This corporate dinner session is designed to update the audience
on significant recent changes in the treatment landscape of
chronic opioid therapy. Presentations and discussion will focus on
recent major changes in regulations regarding prescribing opioids,
reimbursement for office-based drug testing, and strategies to
evaluate adherence to chronic opioid therapy. New data on how
adherence to chronic opioid therapy relates to reduced healthcare
costs will also be presented.
Moderator
Steve Passik, PhD
Updates on Regulations and Treatment Guidelines Related
to Chronic Opioid Therapy
Changing Compensation for Office-Based Urine Drug Testing
Heide Bajnrauh
Patton Boggs LLP, Public Policy Advisor
Optimizing Patient Outcomes While Minimizing Risk
Michael Larson, PhD
Healthcare Costs Among Chronic Opioid Users: Impact of
Adherence
Elizabeth Davis
Ami Sklar, MPH
This non-CME corporate session is funded through a grant from Ameritox.
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C ORPOR A TE S HO W C A S E S C HE D ULE
Medicine (AAPM) and American Pain Society (APS) systematic review
of the evidence on chronic opioid therapy for chronic noncancer
pain not only advocates the benefit of chronic opioid therapy but
also recommends the application of risk-minimization techniques as
preventive measures against potential exploitation, misappropriation,
or abuse of these legally prescribed analgesics.
This interactive and innovative symposium will utilize a blended
educational approach, including challenging case presentations, thought
leader consultations, and audience participation through discussion
and ARS. The goal will be to enable learners to develop strategies for
individualized management of chronic pain in their patients. Participants
will receive a tool kit containing valuable and relevant clinical tools.
Faculty
Perry Fine, MD, Chair
Case Study Presentation on Patient Selection
Lynn Webster, MD
Case Study Presentation on Opioid Optimization
Perry Fine, MD
Case Study Presentation on Risk Stratification
Kenneth Kirsh, PhD
MediCom Worldwide, Inc., is the accredited provider for this activity and is approved to
sponsor continuing education for physicians, psychologists, nurses, and pharmacists.
Join AAPM in thanking the following companies for supporting a satellite symposium:
Ameritox Ltd.
Endo Pharmaceuticals Inc.
King Pharmaceuticals, Inc.
Lilly USA, LLC
Mallinckrodt Inc., A Covidien
Company
MEDA Pharmaceuticals, Inc.
PriCara®, a Division of
Ortho-McNeil-Janssen
Pharmaceuticals, Inc.
Purdue Pharma L.P.
MediCom Worldwide, Inc. designates this educational activity for a maximum 1.25
AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate
with the extent of their participation in the activity. Participants with any questions
regarding continuing education earned through participation in this independent
satellite symposium should contact Joan Meyer at 215.337.9991 ext. 129 or
jmeyer@medicaled.com.
This symposium is supported by an educational grant from Purdue Pharma LP.
Corporate Showcase Schedule—Non-CME Events
We invite you to attend one of the Corporate Showcases that are being offered this year. These are industry-supported events. Come and learn
about the new products, services, and programs that are being offered. Showcase descriptions and times are listed below; please refer to the onsite
listing for the most current schedule. The events will be taking place in the Prince George Exhibit Hall C on the lower level the convention center.
Thursday, March 24
5–5:30 pm
Mild Clinical Research Compendium
A comprehensive review of mild clinical study patient outcomes
from the MIDAS Study Series. Session will cover clinical and statistical
relevance of mild procedure safety and efficacy.
Supported by Vertos Medical
5:30–6:30 pm
SCS Finally Comes Around: Clinical Results in Axial Low
Back Pain Treatment
To date, conventional SCS systems have not reliably demonstrated a
significant effect on low back pain. Please join us as Dr. Lora Brown
shares early data regarding the Nevro System’s (currently awaiting
pivotal trial) sustained and significant effect on axial low back and leg
pain in FBSS patients. The Nevro System is also designed to not induce
or require paresthesia to exert its effect.
Supported by Nevro Corp.
5:45–6:15 pm
Custom-Compounded Prescription Drugs
Masterpharm is a state-of-the-art compounding facility. We provide
superior customer service plus quality custom-compounded
prescription drugs at competitive pricing. MasterPharm has an
international reputation as an authority in pain management. We invite
you to call our healthcare professionals for assistance with placing an
order or to answer any questions.
Supported by MasterPharm Compounding Pharmacy
Friday, March 25
9:30–10:30 am
Announcing the First Buprenorphine Analgesic
Transdermal System
Joseph V. Pergolizzi, Jr, MD
Join your colleagues for this informative corporate showcase sponsored
by Purdue Pharma L.P. You’ll gain valuable product insight about the
first buprenorphine transdermal system. This is a promotional event.
CME will not be available. Full prescribing information, included boxed
warning, will be distributed and discussed at this event.
Supported by Purdue Pharma L.P.
5:45–6:15 pm
Mild Procedure Overview and Safety
Session will provide an introduction to the mild procedure, which will
include patient selection, treatment techniques, and overall safety profile.
Supported by Vertos Medical
6–6:45 pm
Advances in the Management of Postherpetic Neuralgia
(PHN): Understanding Localized Treatment and Its Role
in Clinical Practice
Dr. Standiford Helm, MD, medical director of Pacific Coast Pain
Management Center in Laguna Hills, CA, will outline advances in the
treatment of PHN, review the most recent clinical data for prescriptionstrength localized treatment, and discuss the practical management of
patients with PHN.
Supported by NeurogesX, Inc.
Saturday, March 26
9:30–10 am
Millennium Laboratories Corporate Showcase
Meet Robert Saenz—expert in answering the tough questions on
safeguarding your pain practice. Learn how to combat drug diversion
and recognize drug diverters.
Supported by Millennium Laboratories
9:30–10:30 am
Pain Pathophysiology III
This session will provide educational content on Pathophysiology of
Pain III.
Supported by Lilly USA, LLC
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List of Exhibitors
The AAPM exhibit program features more than 120 booths from companies showcasing their products and services specifically designed
for leaders in the study and treatment of pain. By visiting these vendors, you will learn more about advancements that can keep you and
your organizations at the forefront of your field. AAPM exhibitors feature products and information in pharmaceuticals, medical supplies and
equipment, medical publications, and alternate delivery systems, among others.
Exhibitors by Company Booth
Company
Booth
Advanced Device Access Management, LLC . . . . . . . . . . . . . . . . . . . . . . . . . 124
Advanced Infusion Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
Advanced Toxicology Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Aegis Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
AFTS Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 436
AllMeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
American Academy of Pain Medicine . . . . . . . . . . . . . . . . . Near Registration
American Chronic Pain Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Ameritox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Anazao Health Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Automated HealthCare Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
Bay Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
Biosound Esaote Ultrasound, Esaote North America . . . . . . . . . . . . . . . . 423
Boston Scientific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Calloway Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Caron Treatment Centers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Cephalon, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Competitive Technologies, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Cosman Medical, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Covidien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428
CPAIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Custom Compounding Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Company
Booth
Masterpharm Compounding Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
MD Logic EMR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Medical Positioning, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Medtox Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Medtronic, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Millennium Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
NeurogesX, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
NeuroTherm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Nevro Corp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
North American Neuromodulation Society . . . . . . . . . . . . . . . . . . . . . . . . . . 149
North American Spine Society . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
PainEDU.org/Inflexxion, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425
PainFromCancer.org . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Pain Medicine News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Pearson, Clinical Assessment Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421
Phamatech Laboratories and Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Physicians Business Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
Physician Partner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
PPM Information Solutions, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Practical Pain Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
Practice Partners in Healthcare, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Prescribe Responsibly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Dominion Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
PriCara®, Div. of Ortho-McNeil-Janssen
Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Elsevier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
ProStrakan, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Emerging Solutions in Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Purdue Pharma L.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Endo Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322
Redwood Laboratory Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Epimed International, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433
RJ Laser USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
GE Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Roxane Laboratories, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
Global Analyticals Development, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446
Select Laboratory Partners, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
gloStream . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
SonoSite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Harvest Technologies Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
St. Jude Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Journal of Opioid Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
StreamlineMD, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Kimberly Clark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Stryker Interventional Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405
King Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321, 343
Terason . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342
LabCorp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346
Theralase, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Lilly USA, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Valley Forge Medical Center & Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Linear Medical Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
Vertos Medical, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334
LiteCure, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Wiley-Blackwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
Mallinckrodt (A Covidien Company) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437
Xanodyne Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
as of February 15, 2011
Exhibitors by Product Category
Exhibit Schedule
Opening Reception with Exhibits and Posters*
Thursday, March 24, 5–6:30 pm
Exhibits Open
Friday, March 25, 9:30 am–Noon; 2:30–7 pm
(Reception with exhibits and posters*, 5:30–7 pm)
Exhibits Open
Saturday, March 26, 9:30–11:30 am
*See page 30 for more details.
ASC Developer/Manager
Practice Partners in Healthcare, Inc.
Assessments
Pearson, Clinical Assessment Group
Billing Services
PPM Information Solutions, Inc.
Chronic Pain & Addiction Treatment
Valley Forge Medical Center & Hospital
Clinical Trial Management
CPAIN
Drug Testing
MEDTOX Laboratories
Drug Addiction Testing
Caron Treatment Centers
Education
American Chronic Pain Assoc.
Emerging Solutions in Pain
Mallinckrodt (A Covidien Company)
North American Neuromodulation Society
North American Spine Society
PainEDU.org/Inflexxion, Inc.
PainFromCancer.org
Electronic Health Records
Allmeds
gloStream
MD Logic EMR
Imaging Equipment
GE Healthcare
Implantable Medical Devices
St. Jude Medical
In-Office Dispensing
Physician Partner
Laboratory Testing
Advanced Toxicology Network
Aegis Labs
AFTS Labs
Ameritox
Calloway Labs
Dominion Diagnostics
51
LabCorp
Millenium Laboratories
Phamatech Laboratories and Diagnostics
Redwood Laboratory Management
Laboratory Equipment & Testing
Select Laboratory Partners, Inc.
Global Analytical Development, LLC
Medical Devices
Millennium Laboratories
Medical Equipment/Supplies
Advanced Device Access Management, LLC
Biosound Esaote Ultrasound, Esaote North America
Boston Scientific
Competitive Technologies, Inc.
Cosman Medical, Inc.
Global Analytical Development, LLC
Harvest Technologies Corporation
Kimberly-Clark
Medical Positioning Inc.
Medtronic, Inc.
NeuroTherm
Nevro Corp
RJ Laser USA
Select Laboratory Partners, Inc.
SonoSite, Inc.
Stryker Interventional Spine
Terason
Theralase Inc.
Pain Management
Bay Recovery
Vertos Medical, Inc.
Pharmaceuticals
Anazao Health Corporation
Epimed International, Inc.
Cephalon, Inc.
Covidien
Custom Compounding Centers
Endo Pharmaceuticals, Inc.
King Pharmaceuticals, Inc.
MasterPharm Compounding Pharmacy
NeurogesX
PriCara®, A Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
ProStrakan, Inc.
Purdue Pharma L.P.
Roxane Laboratories, Inc.
Xanodyne Pharmaceuticals
Publishing
Elsevier, Inc.
Journal of Opioid Management
Pain Medicine News
Practical Pain Management
Wiley-Blackwell
Therapeutic Lasers
LiteCure, LLC
52
Exhibitors
BOOTH 124
BOOTH 147
Advanced Device Access Management, LLC
1630 Genesse Street
Utica, NY 13502
315.507.3838 fax 315.507.3294
www.adamimplants.com
American Chronic Pain Association
PO Box 850
Rocklin, CA 95677
916.632.0922 fax 916.632.3208
www.theacpa.org
BOOTH 242
BOOTH 211
Advanced Infusion Solutions
132 Fairmont Street, Suite B
Clinton, MS 39056
601.988.1700 fax 601.988.1701
www.advancedinfusionsolutions.com
AIS is the fastest growing pharmacy in the U.S. specializing in
intrathecal pump medications. Our program is unique. Physician
practices are never billed for intrathecal medications. We bill patient’s
insurance/Medicare. AIS is Joint Commission accredited, provides
complimentary concentration calculations, dosage conversions, and
optional online ordering for convenience.
Ameritox
300 E. Lombard Street, Suite 1610
Baltimore, MD 21202
443.220.0115 fax 443.220.0122
www.ameritox.com
BOOTH 417
Advanced Toxicology Network
3560 Air Center CV, #101
Memphis, TN 38118
901.794.5770 x241 fax 901.363.7979
www.atnlabs.com
BOOTH 135
Aegis Labs
515 Great Circle Road
Nashville, TN 37228
850.322.1129 fax 850.561.1129
www.aegislabs.com
For over 20+ years, Aegis® has remained one of the most trusted
drug testing laboratories for pain management, forensics and sports
organizations throughout the U.S. With Aegis you have access to
testing in oral fluid, urine and/or blood; consultation with 9 PhD/2
PharmD experts; and the highest quality client service in the industry.
BOOTH 436
AFTS Labs
586 New York Avenue, Unit 2
Huntington, NY 11743
631.923.0166 fax 631.923.0171
www.aftslabs.com
BOOTH 247
AllMeds
151 Lafayette Drive, Suite 401
Oak Ridge, TN 37830
865.482.1999 fax 865.481.0921
www.allmeds.com
BOOTH—In the Registration Area
American Academy of Pain Medicine
4700 West Lake Avenue
Glenview, IL 60025
847.375.4731 fax 877.734.8750
www.painmed.org
Corporate Relations Council
Silver Level
Support
BOOTH 138
Anazao Health Corporation
5710 Hoover Boulevard
Tampa, FL 33634
800.995.4363 fax 800.985.4363
www.anazaohealth.com
At Anazao Health, compounding high-risk sterile preparations is our
specialty. We offer a wide variety of patient-specific preparations
(local anesthetics, intrathecal pump refills, specialized injectables,
and epidural preparations) utilized by pain management physicians,
physiatrists, neurologists, and anesthesiologists. We are PCAB
Accredited and meet or exceed USP Chapter 797 requirements. Our
online ordering increases order accuracy, reduces order entry, and
provides report capabilities.
BOOTH 409
Automated HealthCare Solutions
2901 SW. 149th Avenue, Suite 400
Miramar, FL 33027
954.789.7853 fax 786.594.4659
www.ahcs.com
Automated HealthCare Solutions offers an automated Workers
Compensation Medication dispensing program utilizing state-of-theart technology. AHCS also offers on site drug testing. We assist you in
establishing and maintaining a CLIA waived laboratory. AHCS provides
programs and services to assist practices in improving patient care
while creating an ancillary revenue stream.
BOOTH 341
Bay Recovery
4241 Jutland Drive, Suite 103
San Diego, CA 92117
619.804.5324 fax 858.490.3424
www.bayrecovey.com
BOOTH 423
Biosound Esaote Ultrasound
ULTRASOUND COURSE SUPPORTER
Esaote North America
8000 Castleway Drive
Indianapolis, IN 46250
317.813.6000 fax 317.813.6600
www.biosound.com
Biosound Esaote is a leading manufacturer and distributor of medical
ultrasound and MRI equipment in the United States. The MyLab
ultrasound line offers unique MSK features which provide premium
performance for diagnostic ultrasound studies and high-level
Exhibitors
53
functionality at an excellent value. Biosound Esaote’s highly recognized
MyLab series provides an easy transition to becoming a Diagnostic and
Interventional MSK Specialist.
BOOTH 307
Corporate Relations Council
Boston Scientific 25155 Rye Canyon Loop
CADAVER COURSE SUPPORTER
Valencia, CA 91355
661.949.4339 fax 661.949.4359
www.controlyourpain.com
Boston Scientific’s Precision Plus™ SCS System powered by
SmoothWave™ Technology blends sophistication and simplicity to
deliver life-changing therapy for chronic pain patients. Investing in
innovative products, clinical initiatives, and world-class service, Boston
Scientific is committed to Making life smoother™ for physicians,
patients, and the neuromodulation community.
BOOTH 401
Calloway Labs
34 Commerce Way
Woburn, MA 01801
781.224.9899 fax 781.224.2423
www.callowaylabs.com
BOOTH 419
CADAVER COURSE SUPPORTER
Cosman Medical, Inc.
76 Cambridge Street
Burlington, MA 01803
781.272.6561 fax 781.272.6563
www.cosmanmedical.com
Cosman Medical is a leading manufacturer of radiofrequency
generators and electrodes for pain management and neurosurgery.
The new Cosman G4 generator Version 2 is fully automatic,
programmable with touch-screen controls, and has 4 RF outputs.
The G4’s features include physician settings presets, procedure data
storage, hand-held wireless remote control, and automatic staggered
lesion start feature. Also important, the Cosman Medical products are
economically priced!
BOOTH 428
BOOTH 239
Caron Treatment Centers
PO Box 150
Wernersville, PA 19565
610.743.6402 fax 610.670.0962
www.caron.com
Caron Treatment Centers is a nationally recognized nonprofit provider
of alcohol and drug addiction treatment. Caron has more clinical
programs to meet specific needs of each patient, regardless of their
age, gender or severity of their addiction than any other treatment
center in the U.S. With extensive experience in the treatment of
co-occurring psychological/psychiatric disorders, Caron offers the most
comprehensive treatment programs for adolescents, young adults,
adults and their families.
BOOTH 200
conducted in Rome, based on “Scrambler Therapy” using Information
Theory and Complex Systems. Calmare is a patented technology that
creates a series of complex artificial neuronal messages of “non-pain”
that are transmitted to the brain via the body’s dermatome pathway.
Corporate Relations Council
Cephalon, Inc.
ESSENTIALS COURSE SUPPORTER
41 Moores Road
Frazer, PA 19355
bronze Level
610.883.5878 fax 610.738.6311
Support
www.cephalon.com
Cephalon is a global biopharmaceutical company dedicated to
developing and bringing to market medications to improve the quality
of life of individuals around the world. Cephalon has first-in-class and
best-in-class medicines in several therapeutic areas and currently offers
more than 150 products in nearly 100 countries. For more information
about Cephalon, visit www.cephalon.com.
BOOTH 137
Competitive Technologies, Inc.
1375 Kings Highway East, Suite 400
Fairfield, CT 06824
203.368.6044 fax 203.368.5399
www.calmarett.com
Competitive Technologies, Inc., is introducing a new noninvasive
treatment for drug resistant chronic neuropathic and cancer related pain.
Our Calmare Pain Therapy treatment is the result of 22 years of research
Covidien
Corporate Relations Council
675 McDonnell Boulevard
Hazelwood, MO 63042
314.654.3348 fax 314.654.7129
www.covidien.com
Covidien is committed to providing quality medication along with
professional and consumer education in the therapeutic area of pain
management. Covidien intends to display EXALGO® (hydromorphone
HCI) Extended-Release Tablets and PENNSAID® (diclofenac sodium
topical solution) 1.5% w/w.
BOOTH 204
CPAIN
2343 Alexandria Drive, Suite 400
Lexington, KY 40504
859.223.4334 fax 859.514.4350
www.cpain.org
The Chronic Pain Impact Network (CPAIN) provides comprehensive
patient assessments in the form of Patient Profile reports that guide
pain management and monitor treatment effectiveness. CPAIN
captures data on pain treatments, associated patient-reported
outcomes and clinician assessments. CPAIN also provides data for
comparative effectiveness research (CER), enhanced post marketing
safety surveillance, cost-effective research, and assessment of risk
evaluation and mitigation strategies.
BOOTH 114
Custom Compounding Centers
3911 5th Avenue, Suite 202
San Diego, CA 92103
858.481.7060 fax 858.481.7063
BOOTH 110
Corporate Relations Council
Dominion Diagnostics
211 Circuit Drive
North Kingstown, RI 02852
877.734.9600 fax 401.667.0330
www.dominiondiagnostics.com
Dominion Diagnostics is a fully certified national medical laboratory
specializing in clinical quantitative urine drug testing, scientifically
54
Exhibitors
accurate medication monitoring, and fully integrated clinical support
services. Dominion provides information regarding patient prescription
adherence, illicit drug usage, addiction, and substance misuse for a
diversity of medical specialties, including pain and addiction medicine.
BOOTH 118
Elsevier
8701 Ivyberry Way
Gaithersburg, MD 20886
240.277.3001 fax 301.527.9248
BOOTH 146
Emerging Solutions in Pain
101 Washington Street
Morrisville, PA 19067
215.337.9991 fax 215.337.0956
www.emergingsolutionsinpain.com
BOOTH 238
gloStream
1050 Wilshire Drive, Suite 200
Troy, MI 48084
877.456.3671 fax 248.659.1577
www.glostream.com
gloStream provides physicians and healthcare facilities with certified
electronic medical records and practice management solutions
delivered through a nationwide network of local technology partners.
gloStream products are secure, easy-to-use applications and the only
integrated EMR/PM solutions on the market embedded with Microsoft
Office. For more information, visit www.glostream.com.
BOOTH 347
BOOTH 322
Corporate Relations Council
Endo Pharmaceuticals, Inc.
100 Endo Boulevard
Chadds Ford, PA 19317
610.459.7273
www.Endo.com
process including chemistry, hematology and toxicology specialities.
ESSENTIALS COURSE SUPPORTER
BOOTH 433
CADAVER COURSE SUPPORTER
Epimed International, Inc. 141 Sal Landrio Drive
Johnstown, NY 12095
518.725.0209 fax 518.725.0207
www.epimedpain.com
Epimed International, Inc. will be featuring products designed for
chronic and acute pain management techniques. We will display the
Expanded Line of Racz® Spring Guide Epidural Catheters; RX™, R.K.™,
and FIC Epidural Introducer Needles; R-F™ Line of Radiofrequency
Products; Coude™ & Straight Blunt Nerve Block Needles; and Mini
Trays. Also being shown are radiation safety products, TENS units, and
anatomical models.
BOOTH 108
CADAVER COURSE SUPPORTER
GE Healthcare
384 Wright Brothers Drive
ULTRASOUND COURSE SUPPORTER
Salt Lake City, UT 84116
801.201.6164 fax 435.884.6733
www.gehealthcare.com
GE is making a new commitment to health. Healthymagination
will change the way we approach healthcare, with more than
100 innovations all focused on addressing three critical needs:
lowering costs, touching more lives, and improving quality. For more
inforamtion, visit www.gehealthcare.com.
BOOTH 446
Global Analytical Development LLC
5990 142nd Avenue North
Clearwater, FL 33760
727.530.9996 fax 727.530.9991
Global Analytical provides clinical analyzers and technical consulting
services for practices intersted in performing routine lab and urine
drug screening for moderate and high complex testing. Emphasis
is placed on training and regulatory compliance for the lab set-up
Harvest Technologies Corporation
40 Grissom Road, Suite 100
Plymouth, MA 02360
508.732.7500 fax 508.732.0400
www.harvesttch.com
BOOTH 243
Journal of Opioid Management
470 Boston Post Road, Suite 301
Weston, MA 02493
781.899.2702 fax 781.899.4900
www.opioidmanagement.com
BOOTH 116
Kimberly-Clark
1400 Holcomb Bridge Road
Roswell, GA 30076
770.587.8274 fax 920.721.1961
www.kchealthcare.com
BOOTH 321, 343
King Pharmaceuticals, Inc.
400 Crossing Boulevard
Bridgewater, NJ 08807
908.429.6000 fax 908.927.8423
www.kingpharm.com
CADAVER COURSE SUPPORTER
Corporate Relations Council
PLATINUM Level
Support
BOOTH 346
LabCorp
500 Perimeter Park Drive, #C
Morrisville, NC 27560
919.481.5276 fax 919.481.5404
www.labcorp.com
LabCorp offers pain management drug testing profiles that provide
physicians with information relevant to the treatment of patients who
are prescribed pain medications. LabCorp pain management drug
tests can assist in monitoring patients and help detect prescription
drug diversion. To implement pain management drug testing in your
practice, contact LabCorp at 888.883.5017 or painmanagement@
labcorp.com.
Exhibitors
BOOTH 315
55
Corporate Relations Council
Lilly USA, LLC
Lilly Corporate Center
ESSENTIALS COURSE SUPPORTER
Indianapolis, IN 46285
317.277.1986
www.lilly.com
Lilly, a leading innovation-driven corporation, is developing a growing
portfolio of first-in-class and best-in-class pharmaceutical products
by applying the latest research from its own worldwide laboratories
and from collaborations with eminent scientific organizations.
Headquartered in Indianapolis, Ind., Lilly provides answers—through
medicines and information—for some of the world’s most urgent
medical needs.
BOOTH 431
Linear Medical Solutions
3333 Hendricks Avenue
Jacksonville, FL 32207
904.739.1309 fax 904.739.1310
www.linearsolutions.com
Linear Medical Solutions is a multifunctional medical services company
offering a diverse, niche based group of business services and products
targeted at physician practices throughout the United States. The
goal of Linear Medical Solutions is to provide business solutions that
product increased revenue, assist with cost containment and total
patient satisfaction thereby producing a tangible, quantifiable increase
in net profit for our clients. Our future depends on the success of your
practice.
BOOTH 142
LiteCure, LLC
250 Corporate Boulevard, Suite B
Newark, DE 19702
302.709.0408 fax 302.709.0409
www.lifecure.com
BOOTH 437
Mallinckrodt (A Covidien Company)
675 McDonnell Boulevard
Hazelwood, MO 63042
314.654.3348 fax 314.654.7129
www.covidien.com
C.A.R.E.S. Alliance, Collaborating and Acting Responsibly to Ensure
Safety, is committed to providing education and enabling tools to
healthcare professionals and patients, focusing on the safe prescribing,
dispensing, storage, use, and disposal of opioid analgesics. C.A.R.E.S.
Alliance focuses on collaboration, education and innovation to improve
outcomes for patients with pain.
BOOTH 339
Masterpharm Compounding Pharmacy
115-06 Liberty Avenue
Richmond Hill, NY 11419
866.630.5600 fax 866.630.5700
www.masterpharm.com
Masterpharm is a state-of-the-art ccompounding facility. We provide
superior customer service plus quality custom-compounded
prescription drugs at competitive pricing. MasterPharm has an
international reputation as an authority in pain management. We invite
you to call our healthcare professionals for assistance with placing an
order or to answer any questions.
BOOTH 107
MD Logic EMR
2170 Satellite Boulevard, Suite 435
Duluth, GA 30097
770.497.1560 fax 770.497.1469
www.mdlogic.com
BOOTH 441
Medical Positioning Inc.
1717 Washington
Kansas City, MO 64108
816.474.1555 fax 816.474.7755
www.medicalpositioning.com
BOOTH 122
Medtox Laboratories
402 W. County Road D
St. Paul, MN 55112
651.628.6175
www.medtox.com
The MEDTOX Prescription Management Sales Department sells our
laboratory testing services to pain and prescription management
clinics, offices, and departments throughout the United States.
BOOTH 117
Premier Executive
Medtronic, Inc.
710 Medtronic Parkway
Gold Level
Minneapolis, MN 55432
Support
800.328.2518 fax 763.505.0450
CADAVER COURSE SUPPORTER
www.medtronic.com At Medtronic, we’re committed to Innovating for Life by pushing the
boundaries of medical technology and actually changing the way the
world treats chronic disease. Medtronic Neuromodulation provides
innovative implantable neurostimulation and drug delivery devices to
therapeutically treat intractable pain as well as other chronic diseases
and neurological disorders.
56
Exhibitors
BOOTH 335
BOOTH 429
Millennium Laboratories
16981 Via Tazon
San Diego, CA 92127
877.451.3534
www.becausepainmatters.com
Millennium is the urine drug testing resource of choice for clinicians
focused on the treatment of chronic pain. Millennium’s turn-key
medication monitoring services include qualitative presumptive urine
testing at the point of care, quantitative confirmations and 12-hour/
day results interpretation assistance, and the fastest reliable urine drug
testing confirmation in the nation.
North American Spine Society
7075 Veterans Boulevard
Burr Ridge, IL 60527
630.230.3649 fax 630.230.3749
www.spine.org
BOOTH 217
Corporate Relations Council
NeurogesX, Inc.
2215 Bridgepointe Parkway, Suite 200
San Mateo, CA 94404
650.393.7419 fax 650.649.1798
www.neurogesx.com
BOOTH 126
BOOTH 425
PainEDU.org/Inflexxion, Inc.
320 Needham Street, Suite 100
Newton, MA 02464
617.332.6028 fax 617.332.1820
www.painedu.org
PainEDU.org and painACTION.com offer a synergistic and collaborative
approach to safe and effective chronic pain management through
clinician education and patient pain management. PainEDU.org
offers clinicians a better understanding of pain management through
interviews, articles, educational courses, and case studies. Registered
users have access to opioid risk management screening tools and
teaching resources.
CADAVER COURSE SUPPORTER
NeuroTherm
30 Upton Drive, Suite 2
Wilmington, MA 01887
978.406.4320
www.neurotherm.com
NeuroTherm is a leading manufacturer of products used in the field
of interventional pain, including RF generators, intradiscal therapies,
epidural catheters, discography, and a wide range of consumable
products used in the treatment of chronic pain. We are focused on
developing safe, effective and innovative products while offering a
remarkable level of service to ensure physicians are able to perform
procedures more safely, quickly, and effectively.
BOOTH 136
BOOTH 427
BOOTH 130
Nevro Corp
4040 Campbell Avenue, Suite 210
Menlo Park, CA 94025
650.283.4254 fax 650.251.9415
www.nevrocorp.com
The Nevro Neuromodulation System is designed to reliably treat axial
low back pain associated with FBSS and to overcome some of the
shortcomings of conventional SCS systems. Nevro’s neuromodulation
system is intended to provide significant relief of axial back and leg
pain without requiring paresthesia or inducing movement-related
shocking. Learn more about our clinical data and planned pivotal
trial at our corporate showcase March 24 at 6 pm, or at the plenary
session March 26 at 8:30 am.
Pain Medicine News
545 W. 45th Street
New York, NY 10036
212.957.5300 fax 212.957.7230
www.painmedicinenews.com
Pain Medicine News (PMN), an independent monthly newspaper, is the
best-read pain publication in the United States. Boasting an editorial
board of renowned clinicians and researchers across 12 specialties, PMN
provides comprehensive meeting coverage; clinical, legal and policy
issues; practice management information; educational review articles;
continuing medical education credit; and educational materials such as
special reports, wall charts, and pocket guides.
BOOTH 149
North American Neuromodulation Society
4700 W. Lake Avenue
Glenview, IL 60025
847.375.4398
www.neuromodulation.org
The North American Neuromodulation Society (NANS) is dedicated
to being the premier organization representing neuromodulation.
NANS promotes multidisciplinary collaboration among clinicians,
scientists, engineers, and others to advance neuromodulation through
education, research, innovation, and advocacy. Through these efforts
NANS seeks to promote and advance the highest quality patient care.
PainFromCancer.org
6 Erie Street
Montclair, NJ 07042
973.233.5572 fax 973.453.8245
www.painfromcancer.org
PainfromCancer.org has been created to provide your patients
with tools and information to educate themselves about the
types, causes, and available treatment options for cancer pain.
From communicating their pain to understanding its causes,
PainfromCancer.org is a valuable educational resource for your cancer
patients, their families, and practitioners.
BOOTH 421
Pearson, Clinical Assessment Group
19500 Bulverde Road
San Antonio, TX 78259
800.627.7271 fax 800.232.1223
http://psychcorp.com
BOOTH 235
Phamatech Laboratories and Diagnostics
10157 Barnes Canyon Road
San Diego, CA 92121
888.635.5840 fax 858.635.5843
www.phamatech.com
Exhibitors
BOOTH 413
Physicians Business Network
10950 Grandview, Suite 200
Overland Park, KS 66210
800.288.4901 fax 913.381.3454
www.pbnmed.com
BOOTH 134
Physician Partner
3607 Old Conejo Road
Thousand Oaks, CA 91320
800.333.9800 fax 800.333.9916
www.physicianpartner.com
BOOTH 128
PPM Information Solutions, Inc.
9000 W. 67th Street
Mission, KS 66202
913.262.2332 fax 913.262.3633
www.ppmconnect.com
PPM Information Solutions, Inc. offers today’s anesthesia and pain
practice everything it needs to control its revenue cycle. Our products
and services take the everyday complications out of medical billing
by providing accelerated claims processing, streamlined collections
management, and unparalleled reporting capabilities.
BOOTH 443
Practical Pain Management
7 North Willow Street
Montclair, NJ 07042
973.783.7009
www.ppmjournal.com
Pain is complex and can be challenging to treat safely and effectively.
Practical Pain Management and Practical Pain Management.com help
patients and clinicians navigate the latest research in pain to improve
patient care and ultimately the quality of life of pain sufferers.
Practical Pain Management is operated by Vertical Health, a leading
company focused on pain management, musculoskeletal disease,
and endocrine disease.
BOOTH 112
Practice Partners in Healthcare, Inc.
1 Chase Corporate Drive, Suite 200
Birmingham, AL 35244
205.824.6250 fax 205.824.6251
www.practicepartners.org
Practice Partners in Healthcare is a developer, manager, and minority
equity partner of single and multi-specialty ASCs. We deliver successproven expertise to new and existing surgery centers, in physician
owned or physician/hospital joint ventures in both CON and non-CON
states. For more information visit us at www.practicepartners.org.
BOOTH 106
Prescribe Responsibly
2000 L. Street NW, Suite 300
Washington, DC 20036
202.835.8876 fax 202.835.9438
www.PrescribeResponsibly.com
Prescribe Responsibly is an online resource for healthcare professionals
about the appropriate and responsible prescribing of opioid analgesics
for patients with acute and chronic pain. PrescribeResponsibly.com
57
brings together five leaders with expertise in pain management,
psychology and addiction medicine to address concerns physicians
might have when prescribing opioid analgesics. Prescribe Responsibly
is sponsored by PriCara®, a Division of Ortho-McNeil-Janssen
Pharmaceuticals, Inc.
BOOTH 109
PriCara®, Division of
Corporate Relations Council
Ortho-McNeil-Janssen Pharmaceuticals, Inc.
1000 Route 202
Raritan, NJ 08869
908.218.6000
www.pricara.com
PriCara®, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. is
dedicated to serving primary care physicians. We currently market
products to treat pain, acid reflux disease and infectious diseases.
BOOTH 123
ProStrakan, Inc.
1430 US Highway 206
Bedminster, NJ 07921
908.234.1096 fax 908.234.2835
www.abstral.com
BOOTH 301
Corporate Relations Council
Purdue Pharma L.P.
One Stamford Forum
Stamford, CT 06901
203.588.7311 fax 203.588.6262
www.Purduepharma.com
Silver Level
Support
BOOTH 240
Redwood Laboratory Management
15 Vernal Spring
Irvine, CA 92603
714.496.6164 fax 858.461.6851
BOOTH 237
RJ Laser USA
4140 Jade Street, Suite 102
Capitola, CA 95010
855.995.2737 fax 831.464.7744
www.rjlaserusa.com
RJ Laser USA provides the most versatile and powerful therapeutic
lasers in the US. The innovative RJ laser system is based on more than
28 years of experience in development and production of laser devices.
BOOTH 438
Roxane Laboratories, Inc.
PO Box 16532
Columbus, OH 43216
800.848.0120 fax 614.308.3576
www.roxane.com
58
Exhibitors
BOOTH 445
The Terason t3200™ Ultrasound System–MSK Series with Flexible Imaging
Technology (FIT) simplifies musculoskeletal ultrasound, with enhanced
image quality, custom exam presets, and state-of-the-art transducers.
The versatile, cost-effective Terason System is easy to use, and its image
quality is trusted by thousands of clinicians throughout the world.
Select Laboratory Partners, Inc.
1100 Revolution Mill Drive
Greensboro, NC 27405
336.510.1120
BOOTH 329
ULTRASOUND COURSE SUPPORTER
BOOTH 129
CADAVER COURSE SUPPORTER
St. Jude Medical
6901 Preston Road
Plano, TX 75024
972.309.8000 fax 972.309.8150
www.sjmneuro.com
St. Jude Medical Neuromodulation Division develops technologies
that put more control into the hands of those who treat chronic pain
patients worldwide. Our products include the innovative Penta™ lead,
the first five-column paddle lead for lateral coverage and precise field
control; the radiopaque, mechanical locking Swift-Lock™ anchor; and
MultiSteering technology for real-time assessment and coverage of
multifocal pain. To learn more, visit sjmneuro.com.
BOOTH 223
bronze Level
Support
StreamlineMD, LLC
3333 S. Arlington Road
Akron, OH 44312
330.564.2664 fax 330.706.6346
www.streamlinemd.com
StreamlineMD is a certified provider of Electronic Health Record
(EHR), Practice Management (PM), and outsourced billing solutions.
The company offers its services principally to independent physician
practices focused on Pain Management and related specialties.
The Streamline EHR contains fully developed clinical content for
interventional pain management including more than 40 procedures.
BOOTH 405
CADAVER COURSE SUPPORTER
Stryker Interventional Spine
4100 E. Milham Avenue
Kalamazoo, MI 49001
800.253.3210
www.stryker.com/ivs
Relieving pain. Improving lives. Stryker Interventional Spine services this
motto by focusing on minimally invasive spinal procedures that quickly
return patients to their active lifestyles. We deliver your “single source
solution” for treating vertebral compression fractures (Vertebroplasty &
Kyphoplasty), radiofrequency ablation and providing effective methods
for disc decompression and discography. Visit www.strykerivs.com or
by downloading our “app” at the App Store under Stryker IVS.
BOOTH 342
Terason
77 Terrace Hall Avenue
Burlington, MA 01803
781.270.4143 fax 781.270.4145
www.terason.com
BOOTH 234
Theralase, Inc.
29 Gervais Drive
Toronto, ON, Canada M3C 1Y9
866.843.5273 fax 416.447.3020
www.theralase.com
SonoSite
21919 30th Drive SE
Bothell, WA 98021
425.951.1200 fax 425.951.1201
www.sonosite.com
ULTRASOUND COURSE SUPPORTER
BOOTH 435
Valley Forge Medial Center & Hospital
1033 W. Germantown Pike
Norristown, PA 19403
610.539.8500 Ext. 292 fax 610.539.6065
www.vfmc.net
Since 1973, Valley Forge Medical Center and Hospital has provided
comprehensive treatment to adults with substance abuse. We
specialize in chronic pain and are the only recognized Center of
Excellence for Addiction-Free Pain Management® in the country. Our
professional staff provides high-quality treatment services and support
to individuals and their families seeking freedom from addiction and
relief of suffering with chronic pain. VFMC is a licensed hospital in PA
and is accredited by JCAHO.
BOOTH 334
Vertos Medical
11 Columbia, Suite B
Aliso Viejo, CA 92656
949.349.0008 fax 949.349.0218
www.vertosmed.com Elite Associate
PLATINUM Level
Support
CADAVER COURSE SUPPORTER
BOOTH 434
Wiley-Blackwell
350 Main Street
Malden, MA 02148
781.388.8200
www.wiley.com
Wiley-Blackwell is the international scientific, technical, medical, and
scholarly publishing business of John Wiley & Sons, with strengths in
every major academic and professional field and partnerships with
many of the world’s leading societies. Wiley-Blackwell publishes more
than 1,400 peer-reviewed journals and more than 1,500 new books
annually in print and online, as well as databases, major reference
works, and laboratory protocols. For more information, please visit
www.wileyblackwell.com or http://onlinelibrary.wiley.com/.
BOOTH 229
Corporate Relations Council
Xanodyne Pharmaceuticals
One Riverfront Place
Newport, KY 41071
859.371.6383 fax 859.371.6391
www.xanodyne.com
Xanodyne Pharmaceuticals, Inc., is an integrated specialty
pharmaceutical company with both development and commercial
capabilities focused on pain management. Xanodyne promotes
Zipsor® (diclofenac potassium) liquid-filled Capsules, an analgesic for
relief of mild to moderate acute pain in adults.
AAPM Gratefully Acknowledges members of Its
Corporate relations council
PREMIER EXECUTIVE
ELITE ASSOCIATE
ASSOCIATE
SM
59
60
Notes
Thank You
We appreciate your generous contribution
to the success of this annual meeting.
the American Academy of Pain Medicine
Thank
You
We appreciate your
generous contribution
to the success of this
annual meeting.
the American Academy of Pain Medicine
You’re invited to come learn about...
P V U
P B #
301
A F
B A
T S
Purdue Pharma L.P. Corporate Showcase
A A P M 27 A M
F, M 25, 2011
9:30 – 10:30 P G’ E H C
G N H & C C
W, DC
WARNING: IMPORTANCE OF PROPER PATIENT
SELECTION, POTENTIAL FOR ABUSE, AND
LIMITATIONS OF USE
Proper Patient Selection
Butrans is a transdermal formulation of buprenorphine
indicated for the management of moderate to severe
chronic pain in patients requiring a continuous,
around-the-clock opioid analgesic for an extended
period of time. (1)
Potential for Abuse
Butrans contains buprenorphine which is a mu opioid
partial agonist and a Schedule III controlled substance.
Butrans can be abused in a manner similar to other
opioid agonists, legal or illicit. Consider the abuse
potential when prescribing or dispensing Butrans
in situations where the physician or pharmacist is
concerned about an increased risk of misuse, abuse,
or diversion. (9)
Joseph V. Pergolizzi Jr, MD
Adjunct Faculty
Department of Anesthesiology
Georgetown University School of Medicine
Washington, DC
Persons at increased risk for opioid abuse include those
with a personal or family history of substance abuse
(including drug or alcohol abuse or addiction) or mental
illness (eg, major depression). Assess patients for
their clinical risks for opioid abuse or addiction prior
to being prescribed opioids. Routinely monitor all
patients receiving opioids for signs of misuse, abuse
and addiction. (2.2)
Limitations of Use
Do not exceed a dose of one 20 mcg/hour Butrans
system due to the risk of QTc interval prolongation. (2.3)
Avoid exposing the Butrans application site and
surrounding area to direct external heat sources.
Temperature-dependent increases in buprenorphine
release from the system may result in overdose and
death. (5.11)
Parentheses refer to sections in the Full Prescribing Information.
Please read Brief Summary
of Full Prescribing Information
on the following pages.
This is a promotional event.
CME will not be available for
this session.
©2011 Purdue Pharma L.P., Stamford, CT 06901-3431
B7895-PA 3/11
for transdermal administration
BRIEF SUMMARY OF PRESCRIBING INFORMATION
(For complete details please see the full prescribing information and Medication Guide.)
WARNING: IMPORTANCE OF PROPER PATIENT
SELECTION, POTENTIAL FOR ABUSE, AND
LIMITATIONS OF USE
Proper Patient Selection
Butrans is a transdermal formulation of buprenorphine indicated for the management of moderate
to severe chronic pain in patients requiring a
continuous, around-the-clock opioid analgesic
for an extended period of time. (1)
Potential for Abuse
Butrans contains buprenorphine which is a
mu opioid partial agonist and a Schedule III
controlled substance. Butrans can be abused in
a manner similar to other opioid agonists, legal
or illicit. Consider the abuse potential when
prescribing or dispensing Butrans in situations
where the physician or pharmacist is concerned
about an increased risk of misuse, abuse, or
diversion. (9)
Persons at increased risk for opioid abuse
include those with a personal or family history
of substance abuse (including drug or alcohol
abuse or addiction) or mental illness (e.g., major
depression). Assess patients for their clinical
risks for opioid abuse or addiction prior to being
prescribed opioids. Routinely monitor all patients
receiving opioids for signs of misuse, abuse and
addiction. (2.2)
Limitations of Use
Do not exceed a dose of one 20 mcg/hour
Butrans system due to the risk of QTc interval
prolongation. (2.3)
Avoid exposing the Butrans application site
and surrounding area to direct external heat
sources. Temperature-dependent increases in
buprenorphine release from the system may
result in overdose and death. (5.11)
1 INDICATIONS AND USAGE
Butrans is indicated for the management of moderate to
severe chronic pain in patients requiring a continuous,
around-the-clock opioid analgesic for an extended period
of time.
4 CONTRAINDICATIONS
Butrans is contraindicated in:
• patients who have significant respiratory depression
• patients who have severe bronchial asthma
• patients who have or are suspected of having paralytic ileus
• patients who have known hypersensitivity to any of its
components or the active ingredient, buprenorphine
• the management of acute pain or in patients who require
opioid analgesia for a short period of time
• the management of post-operative pain, including use
after out-patient or day surgeries
• the management of mild pain
• the management of intermittent pain (e.g., use on an as
needed basis [prn])
5 WARNINGS AND PRECAUTIONS
5.1 Respiratory Depression
Respiratory depression is the chief hazard of Butrans.
Respiratory depression occurs more frequently in elderly or
debilitated patients as well as those suffering from conditions
accompanied by hypoxia or hypercapnia when even moderate
therapeutic doses may dangerously decrease pulmonary
ventilation, and when opioids, including Butrans, are given
in conjunction with other agents that depress respiration.
Profound sedation, unresponsiveness, infrequent deep
(“sighing”) breaths or atypical snoring frequently accompany
opioid-induced respiratory depression.
Use Butrans with extreme caution in patients with any of
the following:
• significant chronic obstructive pulmonary disease or cor
pulmonale
• other risk of substantially decreased respiratory reserve
such as asthma, severe obesity, sleep apnea, myxedema,
clinically significant kyphoscoliosis, and central nervous
system (CNS) depression
• hypoxia
• hypercapnia
• pre-existing respiratory depression
5.2 CNS Depression
Butrans may cause somnolence, dizziness, alterations
in judgment and alterations in levels of consciousness,
including coma.
5.3 Interactions with Alcohol, Central Nervous System
Depressants, and Illicit Drugs
Hypotension, profound sedation, coma or respiratory
depression may result if Butrans is added to a regimen that
includes other CNS depressants (e.g., sedatives, anxiolytics,
hypnotics, neuroleptics, muscle relaxants, other opioids).
Therefore, use caution when deciding to initiate therapy with
Butrans in patients who are taking other CNS depressants.
Take into account the types of other medications being taken,
the duration of therapy with them, and the patient’s response
to those medicines, including the degree of tolerance that
has developed to CNS depression. Consider the patient’s
use, if any, of alcohol and/or illicit drugs that cause CNS
depression. If the decision to begin Butrans is made, start
with a lower Butrans dose than usual.
Consider using a lower initial dose of a CNS depressant
when given to a patient currently taking Butrans due to the
potential of additive CNS depressant effects.
5.4 QTc Prolongation
A positive-controlled study of the effects of Butrans on the
QTc interval in healthy subjects demonstrated no clinically
meaningful effect at a Butrans dose of 10 mcg/hour; however,
a Butrans dose of 40 mcg/hour (given as two Butrans 20
mcg/hour Transdermal Systems) was observed to prolong
the QTc interval [see Clinical Pharmacology (12.2)].
Consider these observations in clinical decisions when
prescribing Butrans to patients with hypokalemia or clinically unstable cardiac disease, including: unstable atrial
fibrillation, symptomatic bradycardia, unstable congestive
heart failure, or active myocardial ischemia. Avoid the use
of Butrans in patients with a history of Long QT Syndrome
or an immediate family member with this condition, or those
taking Class IA antiarrhythmic medications (e.g., quinidine,
procainamide, disopyramide) or Class III antiarrhythmic
medications (e.g., sotalol, amiodarone, dofetilide).
5.5 Head Injury
The respiratory depressant effects of opioids, including
Butrans, include carbon dioxide retention, which can lead to
an elevation of cerebrospinal fluid pressure. This effect may
be exaggerated in the presence of head injury, intracranial
lesions, or other sources of pre-existing increased intracranial
pressure. Butrans may produce miosis that is independent
of ambient light, and altered consciousness, either of which
may obscure neurologic signs associated with increased
intracranial pressure in persons with head injuries.
5.6 Hypotensive Effects
Butrans may cause severe hypotension. There is an added
risk to individuals whose ability to maintain blood pressure has been compromised by a depleted blood volume,
or after concurrent administration with drugs such as
phenothiazines or other agents which compromise vasomotor
tone. Buprenorphine may produce orthostatic hypotension
in ambulatory patients. Administer Butrans with caution to
patients in circulatory shock, since vasodilation produced
by the drug may further reduce cardiac output and blood
pressure.
5.7 Misuse, Abuse, and Diversion of Opioids
Butrans contains buprenorphine, a partial agonist at the mu
opioid receptor and a Schedule III controlled substance.
Opioid agonists have potential for being abused, are sought
by drug abusers and people with addiction disorders, and
are subject to criminal diversion.
Butrans can be abused in a manner similar to other opioid
agonists, legal or illicit. Consider this potential for abuse
when prescribing or dispensing Butrans in situations where
the prescriber or pharmacist is concerned about an increased
risk of misuse, abuse, or diversion. Monitor all patients
receiving opioids for signs of abuse, misuse, and addiction.
Furthermore, assess patients for their potential for opioid
abuse prior to being prescribed opioid therapy. Persons at
increased risk for opioid abuse include those with a personal
or family history of substance abuse (including drug or
alcohol abuse) or mental illness (e.g., depression). Opioids
may still be appropriate for use in these patients; however,
they will require intensive monitoring for signs of abuse.
Notwithstanding concerns about abuse, addiction, and
diversion, provide proper management of pain. However,
all patients treated with opioid agonists require careful
monitoring for signs of abuse and addiction, since use of
opioid agonist analgesic products carries the risk of addiction even under appropriate medical use [see Drug Abuse
and Dependence (9.2)]. Data are not available to establish
the true incidence of addiction in patients with chronic pain
treated with opioids.
Abuse of Butrans poses a significant risk to the abuser that
could potentially result in overdose or death [see Drug Abuse
and Dependence (9)].
Contact your state professional licensing board or state
controlled substances authority for information on how to
prevent and detect abuse or diversion of this product.
5.8 Hepatotoxicity
Although not observed in Butrans chronic pain clinical trials, cases of cytolytic hepatitis and hepatitis with jaundice
have been observed in individuals receiving sublingual
buprenorphine for the treatment of opioid dependence, both
in clinical trials and through post-marketing adverse event
reports. The spectrum of abnormalities ranges from transient
asymptomatic elevations in hepatic transaminases to case
reports of hepatic failure, hepatic necrosis, hepatorenal
syndrome, and hepatic encephalopathy. In many cases, the
presence of pre-existing liver enzyme abnormalities, infection
with hepatitis B or hepatitis C virus, concomitant usage of
other potentially hepatotoxic drugs, and ongoing injection
drug abuse may have played a causative or contributory role.
In other cases, insufficient data were available to determine
the etiology of the abnormality. The possibility exists that
buprenorphine had a causative or contributory role in the
development of the hepatic abnormality in some cases. For
patients at increased risk of hepatotoxicity (e.g., patients with
a history of excessive alcohol intake, intravenous drug abuse
or liver disease), baseline and periodic monitoring of liver
function during treatment with Butrans is recommended. A
biological and etiological evaluation is recommended when
a hepatic event is suspected.
5.9 Application Site Skin Reactions
In rare cases, severe application site skin reactions with signs
of marked inflammation including “burn,” “discharge,” and
“vesicles” have occurred. Time of onset varies, ranging from
days to months following the initiation of Butrans treatment.
Instruct patients to promptly report the development of severe
application site reactions and discontinue therapy.
5.10 Anaphylactic/Allergic Reactions
Cases of acute and chronic hypersensitivity to buprenorphine have been reported both in clinical trials and in the
post-marketing experience. The most common signs and
symptoms include rashes, hives, and pruritus. Cases of
bronchospasm, angioneurotic edema, and anaphylactic
shock have been reported. A history of hypersensitivity to
buprenorphine is a contraindication to the use of Butrans.
5.11 Application of External Heat
Advise patients and their caregivers to avoid exposing the
Butrans application site and surrounding area to direct
external heat sources, such as heating pads or electric
blankets, heat or tanning lamps, saunas, hot tubs, and
heated water beds, etc., while wearing the system because
an increase in absorption of buprenorphine may occur [see
Clinical Pharmacology (12.3)]. Advise patients against
exposure of the Butrans application site and surrounding
area to hot water or prolonged exposure to direct sunlight.
There is a potential for temperature-dependent increases in
buprenorphine released from the system resulting in possible
overdose and death.
5.12 Patients with Fever
Patients wearing Butrans systems who develop fever or
increased core body temperature due to strenuous exertion
should be monitored for opioid side effects and the Butrans
dose should be adjusted if necessary [see Dosage and
Administration (2.4)].
5.13 Driving and Operating Machinery
Butrans may impair the mental and physical abilities needed
to perform potentially hazardous activities such as driving
a car or operating machinery. Caution patients accordingly.
5.14 Seizures
Butrans, as with other opioids, may aggravate seizure disorders, may lower seizure threshold, and therefore, may induce
seizures in some clinical settings. Use Butrans with caution
in patients with a history of seizure disorders.
5.15 Special Risk Groups
Use Butrans with caution in the following conditions, due
to increased risk of adverse reactions: alcoholism; delirium
tremens; adrenocortical insufficiency; CNS depression;
debilitation; kyphoscoliosis associated with respiratory compromise; myxedema or hypothyroidism; prostatic hypertrophy
or urethral stricture; severe impairment of hepatic, pulmonary
or renal function; and toxic psychosis.
5.16 Use in Pancreatic/Biliary Tract Disease and Other
Gastrointestinal Conditions
Butrans may cause spasm of the sphincter of Oddi. Use with
caution in patients with biliary tract disease, including acute
pancreatitis. Opioids, including Butrans, may cause increased
serum amylase.
The administration of Butrans may obscure the diagnosis
or clinical course in patients with acute abdominal conditions. Use Butrans with caution in patients who are at risk
of developing ileus.
5.17 Use in Addiction Treatment
Butrans has not been studied and is not approved for use in
the management of addictive disorders.
5.18 MAO Inhibitors
Butrans is not recommended for use in patients who have
received MAO inhibitors within 14 days, because severe
and unpredictable potentiation by MAO inhibitors has been
reported with opioid analgesics.
6 ADVERSE REACTIONS
The following adverse reactions described elsewhere in the
labeling include:
• Respiratory Depression [see Warnings and Precautions
(5.1)]
• CNS Depression [see Warnings and Precautions (5.2)]
• QTc Prolongation [see Warnings and Precautions (5.4)]
• Hypotensive Effects [see Warnings and Precautions (5.6)]
• Application Site Skin Reactions [see Warnings and
Precautions (5.9)]
• Anaphylactic/Allergic Reactions [see Warnings and
Precautions (5.10)]
• Seizures [see Warnings and Precautions (5.14)]
6.1 Clinical Trial Experience
Because clinical trials are conducted under widely varying
conditions, adverse reaction rates observed in the clinical
trials of a drug cannot be directly compared to rates in the
clinical trials of another drug and may not reflect the rates
observed in practice.
A total of 5415 patients were treated with Butrans in controlled
and open-label chronic pain clinical trials. Nine hundred
twenty-four subjects were treated for approximately six months
and 183 subjects were treated for approximately one year. The
clinical trial population consisted of patients with persistent
moderate to severe pain.
The most common adverse reactions (≥5%) reported by
patients in clinical trials comparing Butrans 10 or 20 mcg/hour
to placebo are shown in Tables 2, and comparing Butrans 20
mcg/hour to Butrans 5 mcg/hour are shown in Table 3 below:
Table 2: Adverse Events Reported in ≥ 5% of Patients
during the Open-Label Titration Period and DoubleBlind Treatment Period: Opioid-Naïve Patients
Open-Label
Double-Blind
Titration Period Treatment Period
Butrans
Butrans Placebo
MedDRA
(N = 1024) (N = 256) (N = 283)
Preferred Term
Nausea
23%
13%
11%
Table 3: Adverse Events Reported in ≥ 5% of Patients
during the Open-Label Titration Period and DoubleBlind Treatment Period: Opioid-Experienced Patients
Open-Label
Titration Period
Butrans
Double-Blind
Treatment Period
Butrans 20
Butrans 5
MedDRA
(N = 1160) (N = 219)
Preferred Term
(N = 221)
Nausea
15%
12%
8%
Headache
11%
11%
5%
Application site
pruritus
9%
13%
5%
Somnolence
6%
5%
2%
Vomiting
5%
5%
2%
Dizziness
5%
5%
2%
Constipation
4%
6%
3%
Application site
erythema
3%
10%
5%
Application
site rash
3%
9%
6%
Application
site irritation
2%
5%
3%
The following table lists adverse events that were reported
in at least 2.0% of patients in four placebo/active-controlled
titration-to-effect trials.
Table 4: Adverse Events Reported in Titration-toEffect Placebo/Active-Controlled Clinical Trials with
Incidence ≥2%
MedDRA Preferred
Term
Butrans
(N = 392)
Placebo
(N = 261)
Nausea
23%
8%
Dizziness
16%
8%
Headache
16%
11%
Application site pruritus
15%
12%
Constipation
14%
5%
Somnolence
14%
5%
Vomiting
11%
2%
Peripheral edema
7%
3%
Dry mouth
7%
2%
Application site erythema
7%
2%
Application site rash
6%
6%
Fatigue
5%
1%
Hyperhidrosis
4%
1%
Pruritus
4%
1%
Fall
4%
2%
Diarrhea
3%
2%
Pain in extremity
3%
2%
Insomnia
3%
2%
Dyspnea
3%
1%
Dyspepsia
3%
3%
Urinary tract infection
3%
2%
Back pain
3%
2%
Joint swelling
3%
1%
Hypoesthesia
2%
1%
Dizziness
10%
4%
1%
Arthralgia
2%
2%
Headache
10%
5%
5%
Stomach discomfort
2%
1%
Application site
pruritus
8%
4%
7%
Somnolence
8%
2%
2%
Paraesthesia
2%
1%
Vomiting
8%
4%
2%
Tremor
2%
<1%
Constipation
7%
4%
1%
Confusional State
2%
3%
Rash
2%
1%
Anorexia
2%
1%
The adverse events seen in controlled and open-label studies
are presented below in the following manner: most common
(≥5%), common (≥1% - <5%), and less common (<1%).
The most common adverse events (≥5%) reported by
patients treated with Butrans in the clinical trials were nausea,
headache, application site pruritus, dizziness, constipation,
somnolence, vomiting, application site erythema, dry mouth,
and application site rash.
The common (≥1% to <5%) adverse events reported by
patients treated with Butrans in the clinical trials organized
by MedDRA (Medical Dictionary for Regulatory Activities)
System Organ Class were:
Gastrointestinal disorders: diarrhea, dyspepsia, and upper
abdominal pain
General disorders and administration site conditions: fatigue,
peripheral edema, application site irritation, pain, pyrexia,
chest pain, and asthenia
Infections and infestations: urinary tract infection, upper
respiratory tract infection, nasopharyngitis, influenza,
sinusitis, and bronchitis
Injury, poisoning and procedural complications: fall
Metabolism and nutrition disorders: anorexia
Musculoskeletal and connective tissue disorders: back pain,
arthralgia, pain in extremity, muscle spasms, musculoskeletal
pain, joint swelling, neck pain, and myalgia
Nervous system disorders: hypoesthesia, tremor, migraine,
and paresthesia
Psychiatric disorders: insomnia, anxiety, and depression
Respiratory, thoracic and mediastinal disorders: dyspnea,
pharyngolaryngeal pain, and cough
Skin and subcutaneous tissue disorders: pruritus, hyperhidrosis, rash, and generalized pruritus
Vascular disorders: hypertension
Other less common adverse events, including those known
to occur with opioid treatment, that were seen in <1% of
the patients in the Butrans trials include the following in
alphabetical order:
Abdominal distention, abdominal pain, accidental injury,
affect lability, agitation, alanine aminotransferase increased,
angina pectoris, angioedema, apathy, application site
dermatitis, asthma aggravated, bradycardia, chills, confusional state, contact dermatitis, coordination abnormal,
dehydration, depressed level of consciousness, depressed
mood, depersonalization, disorientation, disturbance in
attention, diverticulitis, drug hypersensitivity, drug withdrawal syndrome, dry eye, dry skin, dysarthria, dysgeusia,
dysmenorrhea, dysphagia, euphoric mood, face edema,
flatulence, flushing, gait disturbance, hallucination, hiccups,
hot flush, hyperventilation, hypotension, hypoventilation,
ileus, insomnia, libido decreased, loss of consciousness,
malaise, memory impairment, mental impairment, mental
status changes, miosis, muscle weakness, nervousness,
nightmare, orthostatic hypotension, palpitations, psychotic
disorder, respiration abnormal, respiratory depression,
respiratory distress, respiratory failure, restlessness, rhinitis,
sedation, sexual dysfunction, syncope, tachycardia, tinnitus,
urinary hesitation, urinary incontinence, urinary retention,
urticaria, vasodilatation, vertigo, vision blurred, visual
disturbance, weight decreased, and wheezing.
7 DRUG INTERACTIONS
7.1 Metabolic Drug Interactions
CYP3A4 Inhibitors
Co-administration of ketoconazole, a strong CYP3A4 inhibitor, with Butrans, did not have any effect on Cmax and AUC of
buprenorphine. Based on this observation, pharmacokinetics
of Butrans is not expected to be affected by co-administration
of CYP3A4 inhibitors.
However, certain protease inhibitors (PIs) with CYP3A4
inhibitory activity such as atazanavir and atazanavir/ritonavir
resulted in elevated levels of buprenorphine and norbuprenorphine following sublingual administration of
buprenorphine and naloxone. Patients in this study reported
increased sedation, and symptoms of opiate excess have
been found in post-marketing reports of patients receiving
sublingual buprenorphine and atazanavir with and without
ritonavir concomitantly. It should be noted that atazanavir is
both a CYP3A4 and UGT1A1 inhibitor. As such, the drug-drug
interaction potential for buprenorphine with CYP3A4 inhibitors is likely to be dependent on the route of administration
as well as the specificity of enzyme inhibition [see Clinical
Pharmacology (12.3)].
CYP3A4 Inducers
The interaction between buprenorphine and CYP3A4 enzyme
inducers has not been studied; therefore it is recommended
that patients receiving Butrans be closely monitored for
reduced efficacy if inducers of CYP3A4 (e.g. phenobarbital,
carbamazepine, phenytoin, rifampin) are co-administered
[see Clinical Pharmacology (12.3)].
7.2 Non-Metabolic Drug Interactions
Benzodiazepines
There have been a number of reports regarding coma and
death associated with the misuse and abuse of the combination of buprenorphine and benzodiazepines. In many,
but not all of these cases, buprenorphine was misused by
self-injection of crushed buprenorphine tablets. Preclinical
studies have shown that the combination of benzodiazepines
and buprenorphine altered the usual ceiling effect on
buprenorphine-induced respiratory depression, making the
respiratory effects of buprenorphine appear similar to those
of full opioid agonists. Prescribe Butrans with caution to
patients taking benzodiazepines or other drugs that act on
the central nervous system regardless of whether these drugs
are taken on the advice of a physician or are being abused/
misused. Warn patients that it is extremely dangerous to
self-administer benzodiazepines while taking Butrans, and
caution patients to use benzodiazepines concurrently with
Butrans only as directed by their physician.
Skeletal Muscle Relaxants
Butrans, like other opioids, may interact with skeletal muscle
relaxants to enhance neuromuscular blocking action and
increase respiratory depression.
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
Pregnancy Category C
There are no adequate and well-controlled studies with
Butrans in pregnant women. Butrans should be used during
pregnancy only if the potential benefit justifies the potential
risk to the mother and the fetus. In animal studies, buprenorphine caused an increase in the number of stillborn offspring,
reduced litter size, and reduced offspring growth in rats at
maternal exposure levels that were approximately 10 times
that of human subjects who received one Butrans 20 mcg/
hour, the maximum recommended human dose (MRHD).
Teratogenic Effects
Studies in rats and rabbits demonstrated no evidence of
teratogenicity following Butrans or subcutaneous (SC)
administration of buprenorphine during the period of major
organogenesis. Rats were administered up to one Butrans
20 mcg/hour every 3 days (gestation days 6, 9, 12, & 15)
or received daily SC buprenorphine up to 5 mg/kg (gestation
days 6-17). Rabbits were administered four Butrans 20 mcg/
hour every 3 days (gestation days 6, 9, 12, 15, 18, & 19) or
received daily SC buprenorphine up to 5 mg/kg (gestation
days 6-19). No teratogenicity was observed at any dose. Area
under the curve (AUC) values for buprenorphine with Butrans
application and SC injection were approximately 140 and
110 times that of human subjects who received the MRHD
of one Butrans 20 mcg/hour.
Non-Teratogenic Effects
In a peri- and post-natal study conducted in pregnant and
lactating rats, administration of buprenorphine either as
Butrans or SC buprenorphine was associated with toxicity
to offspring. Buprenorphine was present in maternal milk.
Pregnant rats were administered 1/4 of one Butrans 5 mcg/
hour every 3 days or received daily SC buprenorphine at
doses of 0.05, 0.5, or 5 mg/kg from gestation day 6 to
lactation day 21 (weaning). Administration of Butrans or SC
buprenorphine at 0.5 or 5 mg/kg caused maternal toxicity and
an increase in the number of stillborns, reduced litter size,
and reduced offspring growth at maternal exposure levels
that were approximately 10 times that of human subjects who
received the MRHD of one Butrans 20 mcg/hour. Maternal
toxicity was also observed at the no observed adverse effect
level (NOAEL) for offspring.
8.2 Labor and Delivery
The safety of Butrans given during labor and delivery has
not been established.
Opioids cross the placenta and may produce respiratory
depression and psychophysiologic effects in neonates.
Butrans is not recommended for use in women immediately
prior to and during labor, when use of shorter-acting analgesics or other analgesic techniques are more appropriate.
Occasionally, opioid analgesics may prolong labor through
actions which temporarily reduce the strength, duration and
frequency of uterine contractions. However this effect is not
consistent and may be offset by an increased rate of cervical
dilatation, which tends to shorten labor.
Closely observe neonates whose mothers received opioid
analgesics during labor for signs of respiratory depression.
Have a specific opioid antagonist, such as naloxone or
nalmefene, available for reversal of opioid-induced respiratory depression in the neonate.
Neonates whose mothers have been taking opioids chronically may also exhibit withdrawal signs, either at birth and/
or in the nursery, because they have developed physical
dependence. This is not, however, synonymous with addiction. Neonatal opioid withdrawal syndrome, unlike opioid
withdrawal syndrome in adults, may be life-threatening
and should be treated according to protocols developed by
neonatology experts.
8.3 Nursing Mothers
Buprenorphine has been detected in low concentrations
in human milk. Breast-feeding is not advised in mothers
treated with Butrans.
8.4 Pediatric Use
The safety and efficacy of Butrans in patients under 18 years
of age has not been established. Butrans is not recommended
for use in pediatric patients.
8.5 Geriatric Use
Of the total number of subjects in the clinical trials (5,415),
Butrans was administered to 1,377 patients aged 65 years
and older. Of those, 457 patients were 75 years of age and
older. In the clinical program, the incidences of selected
Butrans-related AEs were higher in older subjects. The
incidences of application site AEs were slightly higher among
subjects <65 years of age than those ≥ 65 years of age for
both Butrans and placebo treatment groups.
In a single-dose study of healthy elderly and healthy
young subjects treated with Butrans 10 mcg/hour, the
pharmacokinetics and safety outcomes were similar. In a
separate dose-escalation safety study, the pharmacokinetics
in the healthy elderly and hypertensive elderly subjects taking
thiazide diuretics were similar to those in the healthy young
adults. In the elderly groups evaluated, adverse event rates
were similar to or lower than rates in healthy young adult
subjects, except for constipation and urinary retention, which
were more common in the elderly. Although specific dose
adjustments on the basis of advanced age are not required
for pharmacokinetic reasons, use caution in the elderly
population to ensure safe use [see Dosage and Administration
(2.4) and Clinical Pharmacology (12.3)].
8.6 Hepatic Impairment
In a study utilizing intravenous buprenorphine, peak plasma
levels (Cmax) and exposure (AUC) of buprenorphine in
patients with mild and moderate hepatic impairment did not
increase as compared to those observed in subjects with
normal hepatic function. Butrans has not been evaluated
in patients with severe hepatic impairment and should be
administered with caution [see Dosage and Administration
(2.4), and Clinical Pharmacology (12.3]).
8.7 Renal Impairment
The pharmacokinetics of buprenorphine is not altered during the course of renal failure [see Clinical Pharmacology
(12.3]).
8.8 Gender Differences
There was no significant gender effect observed for Butrans
with respect to either the incidence of adverse events or
pharmacokinetics [see Clinical Pharmacology (12.3)].
9 DRUG ABUSE AND DEPENDENCE
9.1 Controlled Substance
Butrans contains buprenorphine, a mu opioid partial
agonist and Schedule III controlled substance. Butrans can
be abused and is subject to misuse, abuse, addiction and
criminal diversion.
9.2 Abuse
Abuse of Butrans poses a hazard of overdose and death. This
risk is increased with compromise of the Butrans Transdermal
System and with concurrent abuse of alcohol or other
substances. Butrans has been diverted for non-medical use.
All patients treated with opioids, including Butrans, require
careful monitoring for signs of abuse and addiction, because
use of opioid analgesic products carries the risk of addiction
even under appropriate medical use.
Addiction is a primary, chronic, neurobiologic disease, with
genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized
by behaviors that include one or more of the following:
impaired control over drug use, compulsive use, continued
use despite harm, and craving. Opioid drugs are sought by
people with substance use disorders (abuse or addiction,
the latter of which is also called “substance dependence”)
and criminals who supply them by diverting medicines out
of legitimate distribution channels. Butrans is a target for
theft and diversion.
“Drug-seeking” behavior is very common in persons with
substance use disorders. Drug-seeking tactics include, but
are not limited to, emergency calls or visits near the end of
office hours, refusal to undergo appropriate examination,
testing or referral, repeated “loss” of prescriptions, altering
or forging of prescriptions and reluctance to provide prior
medical records or contact information for other treating
physician(s). “Doctor shopping” to obtain additional prescriptions is common among people with untreated substance use
disorders, and criminals who divert controlled substances.
Abuse and addiction are separate and distinct from physical
dependence and tolerance. Physicians should be aware that
addiction may not be accompanied by concurrent tolerance
and symptoms of physical dependence in all addicts. In
addition, abuse of opioids can occur in the absence of true
addiction and is characterized by misuse for nonmedical
purposes, often in combination with other psychoactive substances. Since Butrans may be diverted for non-medical use,
careful record-keeping of prescribing information, including
quantity, frequency, and renewal requests is strongly advised.
The risks of misuse and abuse should be considered when
prescribing or dispensing Butrans. Concerns about abuse
and addiction, should not prevent the proper management
of pain, however. Treatment of pain should be individualized,
balancing the potential benefits and risks for each patient.
Butrans is intended for transdermal use only. Compromising
the transdermal delivery system will result in the uncontrolled
delivery of buprenorphine and pose a significant risk to the
abuser that could result in overdose and death [see Warnings
and Precautions (5.1)]. The risk of fatal overdose is further
increased when buprenorphine is abused concurrently with
alcohol or other CNS depressants, including other opioids
and benzodiazepines [see Warnings and Precautions (5.3)].
Abuse may occur by applying the transdermal system in the
absence of legitimate purpose, or by swallowing, snorting
or injecting buprenorphine extracted from the transdermal
system.
Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, proper dispensing
and correct storage and handling are appropriate measures
that help to limit misuse and abuse of opioid drugs. Careful
record-keeping of prescribing information, including quantity,
frequency, and renewal requests is strongly advised.
Healthcare professionals should contact their State
Professional Licensing Board or State Controlled Substances
Authority for information on how to prevent and detect abuse
or diversion of this product.
9.3 Physical Dependence and Tolerance
Tolerance is a state of adaptation in which exposure to a
drug induces changes that result in a diminution of one or
more of the drug’s effects over time. Tolerance could occur
to both the desired and undesired effects of drugs, and may
develop at different rates for different effects.
Physical dependence to an opioid is manifested by characteristic withdrawal signs and symptoms after abrupt
discontinuation of a drug, significant dose reduction, or
upon administration of an antagonist. Physical dependence
and tolerance are not unusual during chronic opioid analgesic therapy.
The opioid abstinence or withdrawal syndrome in adults
is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills,
piloerection, myalgia, mydriasis, irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia,
nausea, anorexia, vomiting, diarrhea, or increased blood
pressure, respiratory rate, or heart rate [see Use In Specific
Populations (8.2)]
Infants born to mothers physically dependent on opioids will
also be physically dependent and may exhibit respiratory
difficulties and withdrawal symptoms.
In general, opioids should not be abruptly discontinued [see
Dosage and Administration (2.5)].
10 OVERDOSAGE
10.1 Symptoms
Acute overdosage with Butrans can be manifested by respiratory depression, somnolence progressing to stupor or coma,
skeletal muscle flaccidity, cold and clammy skin, constricted
pupils, bradycardia, hypotension, partial or complete airway
obstruction, atypical snoring and death.
Deaths due to overdose have been reported with abuse
and misuse of buprenorphine. Review of case reports has
indicated that the risk of fatal overdose is further increased
when Butrans is abused concurrently with alcohol or other
CNS depressants, including other opioids.
10.2 Treatment
In cases of overdose, remove Butrans immediately. It is
important to take the pharmacokinetic profile of Butrans
into account when treating overdose. Even in the face of
improvement, continued medical monitoring is required
because of the possibility of extended effects as opioid
continues to be absorbed from the skin. After removal of
Butrans, the mean buprenorphine concentrations decrease
approximately 50% in 12 hours (range 10-24 hours) with an
apparent terminal half-life of approximately 26 hours. Due
to this long apparent terminal half-life, patients may require
monitoring and treatment for at least 24 hours.
In the treatment of Butrans overdosage, primary attention
should be given to the maintenance of a patent airway, and
of effective ventilation (clearance of CO2) and oxygenation,
whether by spontaneous, assisted or controlled respiration.
Supportive measures (including oxygen and vasopressors)
should be employed in the management of circulatory shock
and pulmonary edema accompanying overdose as indicated.
Cardiac arrest or arrhythmias may require cardiac massage
or defibrillation.
Naloxone may not be effective in reversing any respiratory
depression produced by buprenorphine. High doses of
naloxone, 10-35 mg/70 kg, may be of limited value in
the management of buprenorphine overdose. The onset of
naloxone effect may be delayed by 30 minutes or more.
Doxapram hydrochloride (a respiratory stimulant) has
also been used. Since the duration of action of Butrans
may exceed that of the antagonist, keep the patient under
continued surveillance and administer repeated doses of the
antagonist according to the antagonist labeling as needed
to maintain adequate respiration. Maintenance of adequate
ventilation is essential when managing Butrans overdose
and more important than specific antidote treatment with
an opioid antagonist such as naloxone.
Do not administer opioid antagonists in the absence of
clinically significant respiratory or circulatory depression
secondary to buprenorphine overdose. In patients who
are physically dependent on any opioid agonist including
Butrans, an abrupt partial or complete reversal of opioid
effects may precipitate an acute abstinence or withdrawal
syndrome. The severity of the withdrawal syndrome produced
will depend on the degree of physical dependence and the
dose of the antagonist administered. See the prescribing
information for the specific opioid antagonist for details
of its proper use.
17 PATIENT COUNSELING INFORMATION
See MEDICATION GUIDE (including Instructions for
Use) as appended at the end of the full prescribing
information.
17.1 Information for Patients and Caregivers
Provide the following information to patients receiving
Butrans or their caregivers:
1. Advise patients to carefully follow instructions for the
application, removal, and disposal of Butrans. Each week,
apply Butrans to a different site based on the 8 described
skin sites, with a minimum of 3 weeks between applications to a previously used site.
2. Advise patients to apply Butrans to a hairless or nearly
hairless skin site. If none are available, instruct patients to
clip the hair at the site and not to shave the area. Instruct
patients not to apply to irritated skin. If the application site
must be cleaned, use clear water only. Soaps, alcohol,
oils, lotions, or abrasive devices should not be used.
Allow the skin to dry before applying Butrans.
3. Advise the patient to wear Butrans continuously for 7 days.
4. Advise patients to talk to their doctor if they have any pain
or bothersome side effects while they are using Butrans.
The dose may have to be changed.
5. Advise patients not to increase or decrease the Butrans
dose they are using without first speaking to their doctor.
6. Advise patients that Butrans may impair mental and/or
physical ability required for the performance of potentially
hazardous tasks (e.g., driving, operating heavy machinery).
7. Advise patients who are taking Butrans not to drink alcohol.
They should also avoid taking sleep aids and CNS depressants, unless a doctor prescribes them.
8. Advise patients that while wearing Butrans, they should
avoid exposing the Butrans site to external heat sources,
such as heating pads, electric blankets, heat lamps,
saunas, hot tubs, heated water beds, etc, because an
increase in absorption of buprenorphine may occur that
could lead to an overdose or death.
9. Advise women who become pregnant, or who plan to
become pregnant, to ask their doctor about the effects
that Butrans may have on themselves and their pregnancy.
10. Advise patients that buprenorphine is a drug that some
people may abuse. They should use Butrans only as
directed, and not give it to anyone other than the individual for whom it was prescribed. Protect it from theft.
Be especially careful to keep this medication away from
children and pets.
11. Advise patients to tell their doctor if they have a history
of serious skin reactions to adhesives, as they may not
be able to use Butrans.
12. Advise patients who must stop using Butrans that they
should speak with their doctor to manage the transition
to other pain medications.
Healthcare professionals can telephone Purdue Pharma’s
Medical Services Department (1-888-726-7535) for
information on this product.
CAUTION
DEA Order Form Required.
Distributed by:
Purdue Pharma L.P.
Stamford, CT 06901-3431
Manufactured by:
LTS Lohmann Therapie-Systeme AG
Andernach, Germany
U.S. Patent Numbers: 5,681,413; 5,804,215; 6,264,980;
6,315,854; 6,344,211; RE41408; RE41489; RE41571.
Issued: August 2010
©2010, Purdue Pharma L.P.
302578-0A
the American Academy of Pain Medicine
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Pain Research Center School of Medicine
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