PAINWeek® - September 9-13, 2009 - Red Rock Casino, Resort, and Spa Las Vegas, NV - The national conference for frontline practitioner.

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PAINWeek^® 2010 Courses

PAINWeek offers a diverse curriculum and multidisciplinary faculty who will present courses in the following areas: addiction, complementary & alternative medicine, geriatrics, health coaching, hypnosis, medical/legal, narcoterrorism, neurology, pain & chemical dependency, palliative care, pediatrics, pharmacology, physical medicine & rehabilitation, primary care, regional pain syndromes, and rheumatology.

Along with the annual Pain Educators Forum (PEF), PAINWeek 2010 presents a riveting 6-hour Narcoterrorism track and a unique, full-day program presented by the National Association of Drug Diversion Investigators (NADDI). Based on feedback from 2009 attendees, PAINWeek has added several new course concentrations in pediatrics, geriatrics, and regional pain syndromes.

100+ hours of continuing medical education will be presented by experts from 12 medical and patient advocacy organizations. There is only one national pain conference for frontline clinicians—and it is PAINWeek!

Please note that the course schedule is subject to change, as additional courses and commercially supported activities will be added over time.

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Course Code: CAM-01	Prolotherapy for the Management of Musculoskeletal Pain Rick Marinelli, ND, M.Ac, OM Saturday, September 11, 2010, 8:10 AM – 9:10 AM Location: Veranda AB View Course Information This presentation will survey the historical and present clinical use of prolotherapy and injection of platelet-rich plasma for musculoskeletal pain and dysfunction. Current research on prolotherapy and platelet-rich plasma injection will be reviewed and critiqued.

Course Code: CAM-02	Natural Supplements for Joint Health Rick Marinelli, ND, M.Ac, OM Saturday, September 11, 2010, 9:20 AM – 10:20 AM Location: Veranda AB View Course Information This presentation will survey the research and clinical use of natural supplements for joint health. The concepts of disease modifying osteoarthritis drugs will be reviewed. The current research on natural supplements for joint health will be discussed and critiqued.

Course Code: CAM-03	Acupuncture and Biostimulation Robert Alan Bonakdar, MD Saturday, September 11, 2010, 10:40 AM – 11:40 AM Location: Veranda AB

Course Code: CAM-04	The Nature of Placebo Analgesia Richard Glickman-Simon, MD Saturday, September 11, 2010, 11:50 AM – 12:50 PM Location: Veranda AB View Course Information Learning Objectives Identify four explanations for the observed analgesic effect of a single therapeutic event in an individual patient Describe two psychological mechanisms most likely underlying the placebo response Name on feature that distinguishes research placebos from clinical placebos Explain how the open-hidden methodology can be used to document a placebo response Identify three characteristics of complementary and alternative medicine that would tend to enhance the placebo response This session is devoted to the role of the placebo response in the practice of pain medicine. After reviewing the defining characteristics, known psychophysiology and experimental evidence for placebo analgesia, we consider how clinicians knowingly and unknowingly manipulate the probability of a placebo response in the care of virtually all of their patients. We then examine the claim that non-allopathic practitioners are more likely to generate placebo responses than their allopathic colleagues. Finally, we debate the ethics of practicing placebo medicine.

Course Code: CAM-05	Nutrition in Pain and Headache Management Robert Alan Bonakdar, MD Saturday, September 11, 2010, 3:40 PM – 4:40 PM Location: Veranda AB View Course Information This session will provide an overview of how diet, dietary supplements, and exercise are utilized in the setting of pain. This will include review of their scientific basis and clinical efficacy. Additionally, the session will summarize the rationale and guidelines for incorporation of diet, dietary supplements, and exercise for optimal pain management.

Course Code: CAM-06	Translating CAM Research Into Clinical Practice Richard Glickman-Simon, MD Saturday, September 11, 2010, 3:40 PM – 4:40 PM Location: Summerlin F View Course Information This session is devoted to the practical application of research into the analgesic effects of complementary and alternative therapies. We begin by identifying the most popular and well-studied CAM therapies used for the treatment of chronic pain. We then consider the unusual challenges researchers face in this area of investigation and summarize the general state of the evidence given these limitations. Finally, we develop a strategy for safely using selected CAM therapies in the context of an allopathic pain medicine practice.

Course Code: GER-01	Common Pain Syndromes of Older Adults Paul J. Christo, MD, MBA Saturday, September 11, 2010, 10:40 AM – 11:40 AM Location: Veranda DE Presented by the Journal of Family Practice View Course Information By 2050, the number of older persons globally will exceed the number of younger people for the first time in history. Chronic conditions, especially pain will escalate in prevalence as the population ages. Chronic pain is not a normal part of aging, but persistent pain ranges from 25% to 50% in older adults and even increases with age. Osteoarthritis, low back pain, postherpetic neuralgia, and postoperative pain represent common pain conditions from which older adults suffer. Clinicians should consult recent guidelines and best practices for effective treatment strategies in each of these pain syndromes. This course will address four common pain syndromes in older adults and treatment options that provide optimal health outcomes.

Course Code: GER-02	Assessment Challenges of the Cognitively Impaired Patient Michael E. Schatman, PhD, CPE Saturday, September 11, 2010, 11:50 AM – 12:50 PM Location: Veranda DE View Course Information Greater cognitive impairment has been empirically related to poorer pain assessment by physicians among nursing home residents. Additionally, the literature tells us that pain exacerbates the behavioral manifestations of dementia to a greater degree among those with severe dementia than those with mild and moderate dementia. Thus, patients with cognitive deficits are more likely to receive delayed or incorrect diagnoses. This session examines appropriate assessment tools (visual analogue vs numerical rating), validity of pain behaviors in the cognitively impaired, and complex assessment strategies that are often required when dealing with this patient population.

Course Code: GER-03	Dilemmas Encountered When Treating Geriatric Pain: Case Studies Kathryn L. Hahn, PharmD, CPE, DAAPM Saturday, September 11, 2010, 2:30 PM – 3:30 PM Location: Veranda DE

Course Code: GER-04	Treatment Considerations in Relation to Concurrent Pharmacology Paul J. Christo, MD, MBA Saturday, September 11, 2010, 3:40 PM – 4:40 PM Location: Veranda C View Course Information Learning Objectives Describe physiological changes associated with older adulthood Identify pharmacokinetic changes in older adults Recognize pharmacodynamic alterations in older adults Recognize pharmacodynamic alterations in older adults Review the elements of the American Geriatrics Society (AGS) Panel’s pharmacological recommendations In older adults, disease can present earlier due to impaired physiological reserve and medications can cause adverse effects that would not occur in younger people. Both hepatic and renal function decline leading to slower drug metabolism and a decrease in creatinine clearance, respectively. Pharmacokinetic changes cause more substantial drug concentrations, and pharmacodynamic changes result in unpredictable medication effects. Consequently, older adults typically require lower drug doses with expanded intervals and practitioners should know which drugs are both recommended and contraindicated according to recent guidelines. Interventional procedures can offer pain control while limiting the risks associated with polypharmcy. This presentation addresses physiological changes and pharmacodynamic alterations associated with older adults, and will covertypical procedural interventions that may be useful for controlling pain in older adults.

Course Code: HCH-01	“Cure Me, or I Give Up!” The Role of Acceptance in Patient Self-Management Rebecca Curtis, ACC Friday, September 10, 2010, 8:10 AM – 9:10 AM Location: Veranda DE View Course Information The clinician’s dilemma is helping chronic pain patients move beyond a “cure me” mentality toward self management. Becky Curtis shares her own story and that of others she has coached, focusing on the role acceptance has in moving chronic pain patients from victim to pain manager. Included are tips on how using the coach approach can move a patient toward acceptance.

Course Code: HCH-02	Application of the Trantheoretical Model of Change in Coaching Chronic Pain Patients Rebecca Curtis, ACC Friday, September 10, 2010, 9:20 AM – 10:20 AM Location: Veranda DE View Course Information Lack of patient adherence to prescribed pain management modalities can result in an endless cycle of pain flares and hopelessness. Becky Curtis will discuss how coaches and chronic pain professionals can use the transtheoretical model to assess a patient\'s readiness to make the changes necessary to reduce his or her experience of pain.

Course Code: HCH-03	Courage to Change: Tools for Helping Patients Embrace Self-Management and Identify Strengths for Change Rebecca Curtis, ACC Friday, September 10, 2010, 10:40 AM – 11:40 AM Location: Veranda C View Course Information Evidence suggests that coaching methods can help patients move from an unhealthy dependence on healthcare professionals to ownership of their own pain management strategy. Becky Curtis will discuss ways to empower the patient by using motivational interviewing (MI) to increase a patient\'s readiness to change, and appreciative inquiry (AI) to identifying the strengths they can use to succeed.

Course Code: HCH-04	Essential Ingredients of Self - Management Rebecca Curtis, ACC Friday, September 10, 2010, 2:30 PM – 3:30 PM Location: Veranda C View Course Information Certain key elements have been shown to help decrease the experience of pain and lead to a better overall quality of life for chronic pain patients. In this final segment Becky Curtis will identify some essential ingredients to an effective self-management strategy and suggest ways to motivate patients to implement these changes in their lives.

Course Code: HYP-01	Mind/Body Techniques for Relief of Chronic Pain Michael B. Ellner, CHt, MSH Wednesday, September 08, 2010, 8:10 AM – 9:10 AM Location: Veranda DE This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Mind/body approaches can be effective tools in addressing pain relief and healing. When you attend this program you will learn how to harness easy-to-use strategies and discover how to apply them in your practice. After participating in this activity participants will be able to discuss pain coping strategies with chronic pain patients and use basic mind/body pain relief techniques if desired.

Course Code: HYP-02	Effective Communication for Fear and Pain Reduction Michael B. Ellner, CHt, MSH Wednesday, September 08, 2010, 9:20 AM – 10:20 AM Location: Veranda DE This activity is not scheduled to be presented as a post-conference Webinar. View Course Information You may be surprised to realize how quickly your patients can experience recognizable levels of relief from painful conditions through simple shifts in language and perspective. Learn how to use dissociation to promote comfort, increase compliance and create greater success for your patients today.

Course Code: HYP-03	Reducing Presurgery Fears and Postsurgery Pain Michael B. Ellner, CHt, MSH Wednesday, September 08, 2010, 10:40 AM – 11:40 AM Location: Veranda DE This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Patients who feel better heal better. Help your patients regain a sense of control in the seeming chaos of pre-op situations and watch them relax away fears and anxiety. You may even notice quicker recovery and improved results when your patient feels greater comfort, confidence and ease with the whole surgical process. Join us and discover ways that work.

Course Code: HYP-04	Functional Pain Relief with Hypnosis and Self-Hypnosis Michael B. Ellner, CHt, MSH Wednesday, September 08, 2010, 4:50 PM – 5:50 PM Location: Veranda DE This activity is not scheduled to be presented as a post-conference Webinar. View Course Information The mind/body connection may be the single most effective influence in relieving the suffering associated with irritable bowel syndrome (IBS), fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS). After all, it helps create the symptomology. Discover ways to assist a change in your patient\'s relationship with their bodies that produces a feeling of relief.

Course Code: HYP-05	Patient Compliance: Conversational Techniques to Improve Participation Michael B. Ellner, CHt, MSH Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Veranda DE This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Medications and other treatments all share one aspect in order to be effective: the patient has to use them! Compliance has always been a challenge and this program demonstrates simple conversational approaches that will have surprising results in your practice. Returning for their fourth year at PAINWeek, Dan Cleary and Michael Ellner will reveal entrancing language patterns and shifting perspectives to create better rapport and greater compliance with your patients.

Course Code: HYP-06	Mind/Body Medicine: Expanding the Scope of Your Practice Michael B. Ellner, CHt, MSH Thursday, September 09, 2010, 4:50 PM – 5:50 PM Location: Veranda AB This activity is not scheduled as a post-conference Webinar. View Course Information The mind/body connection is simply a fact of life. More and more medical practitioners are recognizing and using the amazing power of this resource in their practice. These practitioners are seeing rapid healing, improved attitudes among patients and greater compliance with treatment protocols. Michael Ellner and Daniel Cleary share with you effective language and techniques to utilize the natural connections for amazing outcomes.

Course Code: KEY-01	Keynote Address Lisa Sanders, MD Wednesday, September 08, 2010, 6:00 PM – 7:00 PM Location: Charleston Ballroom

Course Code: MAS-01	Hands-On Evaluation of Orofacial Pain Peter Foreman, DDS, FICD, FAGD, FADSA, DipAAPM Wednesday, September 08, 2010, 8:10 AM – 10:20 AM Location: Trails View Course Information Orofacial and other head and neck pains are often seen by dental and medical practitioners, physical and massage therapists, chiropractors, and others. Treatment approaches have been varied and controversial. Muscles and their fascia as sources of pain have long been recognized by pioneers such as Travell and Simons, yet this is often overlooked. This Master Class will address these issues and treatment options.

Course Code: MAS-02	Clinical Examination of Neuropathic Pain: A Hands-On Approach Pam Squire, MD, CCFP, CPE Owen Williamson, MD Charles Argoff, MD Thursday, September 09, 2010, 10:40 AM – 12:50 PM Location: Sienna This activity is not scheduled to be presented as a post-conference Webinar. View Course Information This Master Cclass will begin with a didactic and interactive lecture reviewing the diagnosis of neuropathic pain. It will briefly describe the physiologic basis for Quantitative Sensory Pain Testing (QSPT), provide compelling reasons for adoption of this technique into daily practice as well as focus on actual examination techniques. The second hour will involve small group hands-on sessions to allow demonstration and practice of new skills.

Course Code: MAS-03	Malingering and Deception Blake H. Tearnan, PhD Blake Tearnan, PhD Thursday, September 09, 2010, 2:30 PM – 4:40 PM Location: Veranda AB View Course Information For the most part, patients are motivated to convey accurate information. But a host of factors can distort the true nature of a patient’s pain problem, leading to wrong and sometimes potentially harmful treatment decisions. Therefore, it is crucial for the clinician to understand what can affect an accurate patient self-report and be able to detect when symptom presentation veers from the truth. In reaching conclusions about the trustworthiness of a patient’s presenting complaints, it is also essential the clinician address the possibility of deception and malingering, since this problem is prevalent enough to warrant serious consideration. This presentation is devoted to discussing fundamental issues regarding deception and malingering, especially as they relate to assessing chronic pain. Methods of assessment will be discussed, including the use of various deception detection strategies germane to the domain of medical complaints/chronic pain. The use of objective testing in deception detection will be included.

Course Code: MAS-04	Neurogenic Thoracic Outlet Syndrome Allen J. Togut, MD Wednesday, September 08, 2010, 10:40 AM – 12:50 PM Location: Trails View Course Information Patients with this illness present predominantly with pain, paresthesias, and dysfunction of the upper extremity. Unfortunately, the diagnosis is either discounted or not considered because there usually is no muscle loss or atrophy and there is a limited neurological examination of the upper extremity. The traditionally done electromyographic/nerve conduction study (EMG/NCS) is usually negative and therefore, by assumption, does not implicate the brachial plexus. This master class will help you better understand this maligned diagnosis from how to think about it, make the diagnosis, and provide appropriate treatment options.

Course Code: MAS-05	Fall Prevention for Osteoporosis Patients Ellen Smulders, MSc Wednesday, September 08, 2010, 2:30 PM – 4:40 PM Location: Veranda C View Course Information Falling is a major health problem. Persons with osteoporosis are particularly at risk for fall-related fractures, because of decreased bone strength. Hence, fall prevention is very important in this target group. It has been shown that exercise programs can prevent falls and fall-related injuries in the elderly, but only little attention is given to persons with osteoporosis. Therefore, the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis has been developed. Unique in this program is that participants not only learn to prevent falls but also learn fall techniques, based on martial arts, to fall as safely as possible. The NFPP for persons with osteoporosis was evaluated for its efficacy in a randomized, controlled trial. The participants showed a significant decrease in fall incidence rate and an increase in balance confidence. In this presentation the development of the NFPP for persons with osteoporosis will be described, as well as the RCT to evaluate its efficacy. Furthermore, the training of fall techniques will be demonstrated in a workshop that follows the lecture.

Course Code: MAS-06	Optimizing Medical Adherence in Your Practice Geralyn Datz, PhD Friday, September 10, 2010, 10:40 AM – 12:50 PM Location: Veranda DE View Course Information All of us have endured the frustration of non-compliant patients. Be it over medicating, under medicating or simply erratic medication taking, medical non-adherence is a major public health problem in this country, that incurs billions of dollars of healthcare spending each year. The ways in which we choose to address, or not address, medical non-adherence also has major implications for healthcare reform. This master class will explore the scope, causes, and evidence-based techniques for addressing these problematic behaviors. Unique factors that arise from both patients and prescribers will be highlighted. Issues unique to pain patients, including medication misuse and the use of treatment agreements, will also be shared. This course is of vital importance to all professionals involved in the care of pain patients and will provide practical, meaningful, and empirical understanding of this challenging healthcare topic.

Course Code: MAS-07	Mastering the Biopsychosocial Approach to Chronic Pain Management Michael E. Schatman, PhD, CPE Saturday, September 11, 2010, 2:30 PM – 4:40 PM Location: Veranda C View Course Information The biopsychosocial approach to chronic pain management has been encouraged and practiced for almost 30 years. Despite the great clinical efficacy and cost-efficiency of interdisciplinary chronic pain management programs, such programs are currently available to very few chronic pain sufferers, due primarily to economic factors. In addition, there are very few board-certified pain “specialists” practicing, relative to the growing chronic pain population. As a result, chronic pain is treated primarily in primary care. This class will provide strategies for physicians and other healthcare professionals (especially in primary care) for provision of the most biopsychosocial treatment possible within the confines of our current medicoeconomic system. Recommendations will be made regarding utilization of physician extenders and brief counseling tools that will enhance the biopsychosocial quality of the treatment that is provided. Finally, future directions for more biopsychosocial models will be discussed.

Course Code: MAS-08	Pain As a Part of Trauma Spectrum Disorder in Military Populations Kathleen S. Brown, PhD Saturday, September 11, 2010, 10:40 AM – 12:50 PM Location: Veranda C Presented by Federal Practitioner View Course Information This master class addresses pain as part of trauma spectrum disorder among returning service members. Specifically, this material will examine how the warrior ethos impacts pain management. The National Defense Authorization Act of 2010 will be discussed in relation to the fragmentation of pain management care across the US. Also covered will be understanding military values (loyalty, duty respect, honor, etc), opioid abuse in the military, the relationship of prescription pain medication to suicide, and the linkage of well-being to neurobiology.

Course Code: MAS-09	Neurogenic Thoracic Outlet Syndrome Allen J. Togut, MD Friday, September 10, 2010, 2:30 PM – 4:40 PM Location: Trails

Course Code: MAS-10	The Art and Science of Diagnosis Lisa Sanders, MD Thursday, September 09, 2010, 8:10 AM – 10:20 AM Location: Veranda AB

Course Code: MDL-01	Legal/Regulatory Update: Taking Control of Your Prescribing Jennifer Bolen, JD Wednesday, September 08, 2010, 8:10 AM – 9:10 AM Location: Pavilion View Course Information In 2010, DEA published a key opinion in an administrative case that every pain practitioner should read. The administrative case focuses on the DEA registrant’s responsibilities: (1) to prescribe for a legitimate medical purpose, (2) while acting in the usual course of professional practice, and (3) while taking reasonable steps, as part of routine clinical practice, to prevent abuse and diversion. During this lecture, we will discuss in detail the facts of the Hassman and Iyer cases and focus on the underlying facts that reveal how practitioners can take control of their prescribing. Handouts will include the Hassman and Iyer cases, as well as a checklist that practitioners can use to facilitate a self-audit of their prescribing practices.

Course Code: MDL-02	Physician Dispensing: Can I? Should I? Jennifer Bolen, JD Thursday, September 09, 2010, 8:10 AM – 9:10 AM Location: Pavilion View Course Information When a healthcare practitioner receives his/her DEA Registration, federal law permits that practitioner to administer, dispense, and prescribe controlled medications. Federal law then defers to state law, allowing state law enforcement and professional licensing agencies to decide whether the practitioner needs to obtain additional registrations to fulfill state laws relating to the administration, dispensing, and prescribing of controlled medications. Some states permit physicians to “dispense” controlled medications from their medical office setting; others do not. For states that do allow physician dispensing, there are often several state laws that apply to the nature of the physician office dispensary and the actual steps in physician dispensing, including physician final review of the dispensed medication. With the continued reports of increasing prescription drug abuse and diversion, as well as the recent changes in state laws governing pain clinics, physicians should take care to learn about the applicable federal and state laws and regulations governing physician dispensing. During this session, attendees will be provided with a survey of state positions on physician dispensing and learn about common state requirements for practitioner dispensing. In addition, attendees will learn about the important distinctions between dispensing bulk and repackaged medications and about the documentation required to comply with common physician dispensing laws.

Course Code: MDL-03	Self-Audit Workshop Jennifer Bolen, JD Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Willows View Course Information The American Medical Association (AMA) makes clear that physicians often find themselves entangled in the legal system, whether it is licensing board, civil, or criminal cases, when they are (1) Dated, (2) Duped, (3) Dishonest, and (4) Disabled. The AMA also makes clear that a physician’s documentation is critical to demonstrating treatment in accordance with generally accepted standards of care and federal and state laws. Similarly, published legal opinions in administrative, civil, and criminal cases prove that poor documentation often contributes to the judgment against the practitioner for inappropriate prescribing. During this session, attendees will learn about the critical documentation requirements associated with the treatment of chronic pain and the prescribing of controlled medications. Attendees should bring copies of blank office forms that they use to document patient records and a redacted example of an initial patient evaluation and patient follow-up. The presenter will redact and use attendee examples to illustrate critical documentation areas. Using a hypothetical case file, attendees will learn how to assess and improve documentation and will receive a checklist to facilitate their self-audit sessions.

Course Code: MDL-04	Mock Medical Board Hearing: Licensing Board vs Dr. Pain Jennifer Bolen, JD Friday, September 10, 2010, 10:40 AM – 12:50 PM Location: SummerlinEB View Course Information Using snippets from cases these lawyers have been involved with, Ms. Bolen and Mr. Thexton will work with their faculty and present a mock medical board hearing involving allegations of inappropriate documentation and prescribing of controlled medications. At the end of the mock hearing, faculty will discuss critical learning points, including: (1) the role of the medical board in overseeing its licensees, (2) procedural aspects of medical board hearings, (3) the importance of involving legal counsel, (4) production of documentation, (5) strategy decisions, including the selection of medical and legal experts, and (6) a list of reading materials to facilitate understanding of the licensee\'s responsibilities when treating pain with controlled medications.

Course Code: MDL-05	Drug Testing Legal and Reimbursement Issues: Myths and Realties Jennifer Bolen, JD Friday, September 10, 2010, 2:30 PM – 3:30 PM Location: Summerlin AB View Course Information In 2010, it is clear that the pain practitioner is obligated to assess and monitor patient risk potential for the abuse and diversion of controlled medications, including both illicit and licit drugs. One method of assessing and monitoring risk is the use of a drug testing program that allows the practitioner to objectively assess new and established patients. During this session, attendees will learn about (1) the medico-legal reasons for drug testing, (2) drug testing platforms, and (3) critical legal and reimbursement issues associated with drug testing, laboratory structure, and relationships with outside laboratories. Attendees will receive copies of example Medicare carrier coverage determinations for qualitative drug screening. At the end of the session, attendees will be able to distinguish between the myths and realities of drug testing legal and reimbursement issues and plan for improved physician office laboratory structure and the selection of a proper laboratory testing partner. The overall goal of the session is to provide attendees with the tools they need to take control of their drug testing and to make it a proper tool to not only assess and monitor risk, but also to support their patients\' legitimate ongoing use of controlled medications.

Course Code: NAD-01	Drug Diversion vs Pain Management: Finding a Balance John J. Burke Thursday, September 09, 2010, 8:10 AM – 10:20 AM Location: Veranda DE View Course Information This presentation will explore prescription drug abuse and is designed to assist prescribers and their employees in recognizing and dealing with the prescription drug seeker. In addition to giving an overview of this issue in America today, common sense solutions are offered for prescribers to effectively deal with drug seekers and to protect their practice. The program is designed to make the vast majority of prescribers more comfortable in their prescribing to legitimate patients, with the ultimate hope of increasing quality care to those in pain. Several examples of egregious prescriber behavior are reviewed, with the insight that these examples represent prescribers who are significantly out of the scope of anyone’s idea of legitimate medical practice.

Course Code: NAD-02	A Law Enforcement Perspective to Drug Abuse Lisa McElhaney Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Veranda DE View Course Information Law enforcement has a long history of fighting diversion and prescription drug abuse. The present drug regulations and federal laws focus on physician prescribing and fail to cover the many methods of pharmaceutical drug diversion. This presentation will provide an analysis of the influencing factors that have enabled the explosion of pharmaceutical diversion, and a summary of the “flags” that alert law enforcement to the activities of diversion and drug trafficking.

Course Code: NAD-03	Rx Fraud, Doctor Shoppers, and Pill Mills Lisa McElhaney Thursday, September 09, 2010, 2:30 PM – 4:40 PM Location: Veranda DE View Course Information Pharmaceutical diversion is a widespread epidemic across the nation. Any effort to combat the numerous facets of this problem must be able to clearly understand the basic elements of diversion and the cycle of fraudulent activities. This presentation will identify the elements of a basic Rx fraud case to a detailed “pill mill” operation and explain the variety of codependent relationships that exist in each area. This will provide the legitimate medical practitioner with the ability to recognize the many tricks and trends of diverters and to prevent their criminal activity from entering the medical office.

Course Code: NAD-04	Organized Diversion Rings Lisa McElhaney Thursday, September 09, 2010, 4:50 PM – 5:50 PM Location: Veranda DE View Course Information Organized Rx fraud rings are becoming commonplace in our society. This block of instruction will provide an overview of the structure of an organized fraud ring and the steps that law enforcement followed to dismantle the operation.

Course Code: NAR-01	Defining the Problem, Process, and Needs for Policy James J. Giordano, PhD, Mphil Saturday, September 11, 2010, 8:10 AM – 9:10 AM Location: Pavilion View Course Information This track brings together renowned experts from medicine, ethics, cultural intelligence, policy, law and the military to present a multi-disciplinary perspective of "narcoterrorism" as it affects the scope, tenor and integrity of pain care in the US, and the various professional, public, economic, and politico-legal domains that are both impacted by these activities and effects, and that could serve to mitigate such narcoterrorism, and the substrates it targets through prudent re-examination and revision of professional, legal and political approaches to national public health security and the problem of chronic pain. Chaired by neuroscientist and ethicist Professor James Giordano, PhD, with engaging lectures by cultural-legal scholar Kim Abramson, international terrorism scholar Profesor Yonah Alexander, PhD, physician and legal scholar John Hall, MD, JD, and strategic analyst BGen David Rest USMC (ret) former Assistant Deputy Commandant, Installations and Logistics Department, United States Marine Corps, the track provides broad and deep insight to the many facets of this somewhat subtle but ever more pervasive problem, and poses views on the ways that interdisciplinary cooperation could resolve current and future problems of narcoterrorism as affecting pain care.

Course Code: NAR-02	Caught in the Crossfire: Narcoterrorism’s Impact on Patient Care Kim Abramson Saturday, September 11, 2010, 9:20 AM – 10:20 AM Location: Pavilion View Course Information The threat of narcoterrorism on patient care in the US is significant, as its goals include funding terrorist activities and destabilizing governments and societies. It is within this last realm that narcoterrorism affects pain care, both by creating drug dependencies that divert national focus and resources, and by shifting the control, cost, availability, and quality of narcotics provided to physicians and patients, from legitimate agencies to illicit organizations. Recent legal prosecutions or “diversion investigations” of physicians deemed to be inappropriately prescribing lend to restricting access to pain medications for chronic pain patients and risk medical providers’ careers, freedom, and professional standing. It is imperative to understand the problem and potential solutions from the perspectives of the physician, patient, addict, law enforcement personnel, policy maker, military operator, and narcoterrorist. This presentation will address the medico-legal and economic impact of narcoterrorism on pain care, examine key focal issues, and posit potential approaches toward resolving questions and problems that arise in a two-front War on Pain and War on Drugs.

Course Code: NAR-03	Targets of Opportunity David G. Reist, (BGen, USMC, Retired) Saturday, September 11, 2010, 11:50 AM – 12:50 PM Location: Pavilion View Course Information Narcoterrorism is one of many threats to US national security. Insurgent groups do not possess the ability to challenge the US militarily but they are attempting to affect US national infrastructure (economics, public health, military and government, etc.) via indirect measures. The disruption and weakening of the US writ large is the end state of our enemies, and the wars being fought within our borders are potentially crippling. The medication (more accurately over-medication) of soldiers portends problems and the impact upon military readiness is slowly becoming more apparent.

Course Code: NAR-04	Balancing Patient Care and Government Regulation: The Influence of Narcoterrorism John Hall, MD, JD Saturday, September 11, 2010, 2:30 PM – 3:30 PM Location: Pavilion View Course Information Physicians incur protean responsibilities to myriad individuals, groups, and organizations and must carefully balance complex issues of patient care with tolerable levels of personal and professional risk when regulatory or statutory mandates subvert their ethical principles. This collision of ethics and law is currently exemplified by two specific therapies. The first is the increasing use of marijuana for medical purposes. The second is the use of narcotics, particularly schedule II narcotics, for the relief of pain. This presentation will address these issues in relation to increased scrutiny of prescribing practices by state and federal agencies and how these events relate to a narcoterrorism-based dilemma.

Course Code: NAR-05	Physician Roles and Responsibilities in Profession and Practice James J. Giordano, PhD, Mphil Saturday, September 11, 2010, 3:40 PM – 4:40 PM Location: Pavilion

Course Code: NAR-06	Profile of Narcoterrorism: Economic Considerations Chris Brown Saturday, September 11, 2010, 4:50 PM – 5:50 PM Location: Pavilion

Course Code: NRO-01	Migraine Headache: Differential Diagnosis and Prophylactic Treatment Charles E. Argoff, MD, CPE Friday, September 10, 2010, 8:10 AM – 10:20 AM Location: Charleston Ballroom Presented by Neurology Reviews

Course Code: NRO-02	Complex Regional Pain Syndrome Philip Getson, DO Friday, September 10, 2010, 10:40 AM – 12:50 PM Location: Veranda AB View Course Information Complex regional pain synrome (CRPS) is an old problem with a new name. In the past, type 1 was termed reflex sympathetic dystrophy (RSD) and type 2 was termed causalgia in older literature. This lecture will discuss the fundamentals of CRPS, its clinical manifestations and basic treatment. It will be followed by an hour of case studies and more in-depth discussion of treatment options.

Course Code: NRO-03	Posttraumatic Headache: Pathophysiology and Treatment Gary W. Jay, MD, DAAPM Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Hills View Course Information As posttraumatic headache is a difficult problem to deal with, this activity will address the pathophysiology of the most typical of posttraumatic headaches. Also discussed will be other issues that may accompany posttraumatic headaches: minor traumatic brain injury as well as postconcussive syndrome. The timing of treatment, the type of treatment, and the express need for interdisciplinary treatment will also be discussed.

Course Code: NRO-04	Autonomic Aspects of Soft-Tissue Pain Gary W. Jay, MD, DAAPM Thursday, September 09, 2010, 3:40 PM – 4:40 PM Location: SummerlinEB View Course Information The autonomic nervous system anatomy and physiology will be reviewed, along with the pertinent issues of myofascial pain syndrome. Sympathetically maintained pain will be discussed, and a case presentation will be discussed. Finally, we will discuss how selective tissue conductance can help the clinician in determining the presence or absence of these clinical issues.

Course Code: PAL-01	The Multifaceted Nature of Grief and Bereavement Alessandra Strada, PhD Thursday, September 09, 2010, 8:10 AM – 9:10 AM Location: Veranda C This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: PAL-02	Acceptance and Commitment Therapy Skills Alessandra Strada, PhD Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Veranda C This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: PAL-03	Progressive Muscle Relaxation Alessandra Strada, PhD Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Veranda C This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: PCD-01	The 5 Pillars of Pain Management Douglas L. Gourlay, MD, MSc Saturday, September 11, 2010, 8:10 AM – 9:10 AM Location: SummerlinEB

Course Code: PCD-02	Rules of the Game: Federal Regulations for Prescribing a Controlled Substance Howard A. Heit, MD, FACP, FASAM Saturday, September 11, 2010, 9:20 AM – 10:20 AM Location: SummerlinEB View Course Information Pain is among the most common complaints for which people seek medical care; yet pain is also among the most undertreated patient complaints. Reasons for this include reluctance by clinicians to prescribe and support the use of opioids, often due to a fear of the regulatory agencies in prescribing a controlled substance, especially an opioid. To address this issue, the prescriber must know the federal regulations for prescribing a controlled substance. This lecture will present the “Rules of the Game” so the prescriber will have a greater comfort level in prescribing rational pharmacotherapy to their patients.

Course Code: PCD-03	A Simple Approach to Pain and Chemical Dependency: The Dual Role of Methadone in Pain and Addiction Douglas L. Gourlay, MD, MSc Saturday, September 11, 2010, 2:30 PM – 3:30 PM Location: SummerlinEB

Course Code: PCD-04	Buprenorphine: New Tricks with an Old Molecule for Pain Management Howard A. Heit, MD, FACP, FASAM Saturday, September 11, 2010, 3:40 PM – 4:40 PM Location: SummerlinEB View Course Information S/L buphrenorphine is a unique opioid medication based on its pharmacokinetics and pharmacodynamic properties. It may be used “on label” as an alternative choice to methadone for the treatment of opioid addiction or “off label” for the treatment of both acute and chronic pain. Because of high µ receptor affinity and resultant blockade, it has been suggested that this might interfere with the management of moderate to severe pain in patients on opioid agonist treatment (OAT). The following article will offer strategies and approaches to address some of these real and perceived challenges.

Course Code: PED-01	Assessment and Diagnosis of Pediatric Pain Michelle A. Fortier, PhD Wednesday, September 08, 2010, 9:20 AM – 10:20 AM Location: Veranda AB View Course Information Pain is one of the most common adverse events experienced by children. Despite the prevalence of pediatric pain and the availability of guidelines for pediatric pain management, treatment of children’s pain remains suboptimal. Part of the reason stems from difficulties translating guidelines to practice. For example, it takes an average of 5 years for published guidelines to be incorporated into routine clinical practice. Moreover, even accepted guidelines are not always followed. The purpose of the presentation, therefore, is to review prevalence and theories of pediatric pain and cover evidence-based assessment of both acute and chronic pain in children.

Course Code: PED-02	Consequences of Not Treating Pain in Children Michelle A. Fortier, PhD Wednesday, September 08, 2010, 11:50 AM – 12:50 PM Location: Veranda AB View Course Information Learning Objectives Cite current literature on prevalence of children’s pain Review the short- and long-term physiological effects of untreated pain on children Describe the short- and long-term behavioral and psychological consequences of untreated pain Describe acute pain management interventions for children Explain future research directions and clinical implications Children are routinely subjected to painful experiences, from daily bumps and bruises to vaccinations, blood draws, and surgeries. Infants receiving intensive care are subjected to multiple, repeated painful procedures on a daily basis. Focus on pediatric pain management has increased as a result of the documentation of undertreatment of children’s pain. Although there has been significant improvement of children’s pain management in many hospital settings, pediatric pain continues to be undertreated in a variety of situations.The purpose of this presentation is to review current evidence of children’s pain management and impact of untreated pain on children’s physiological and psychosocial functioning.

Course Code: PED-03	Management of Chronic Daily Headache in Children Daniel J. Lacey, MD, PhD Wednesday, September 08, 2010, 2:30 PM – 3:30 PM Location: Veranda AB View Course Information Chronic daily headache (CDH) is defined as headaches that occur on at least 15 days per month. This condition is now being seen in more children and adolescents. In these patients, chronic pain is often present in other body regions. Significant comorbidities of anxiety, depression, sleep disorders and poor school performance and attendance are often disruptive of their activities of daily living. Medication overuse and mild head trauma can also exacerbate headache frequency, severity and intractability, at times necessitating inpatient treatment. In order for children and teens with CDH to restore and preserve normal functionality, combined medication and nondrug modalities are usually required. These regimens will be discussed in more detail in the course.

Course Code: PED-04	Idiopathic Chronic Pain Syndromes in Children Daniel J. Lacey, MD, PhD Wednesday, September 08, 2010, 3:40 PM – 4:40 PM Location: Veranda AB View Course Information An idiopathic chronic pain syndrome is defined as long-lasting pain of unidentifiable etiology that is associated with a reliable constellation of other clinical signs and/or symptoms. These syndromes are common in children as well as adults, and include headaches, abdominal pain, musculoskeletal pain and others. We will discuss each of these in detail, focusing on diagnosis, treatment and the comorbid conditions that frequently accompany chronic pain in children. It will be emphasized that aggressive recognition and treatment are essential to prevent pain-related disability and disruption of activities of daily living. Differences between adults and children with chronic pain disorders will be noted where applicable.

Course Code: PEF-01	Pain Mechanisms David M. Glick, DC Wednesday, September 08, 2010, 8:10 AM – 9:10 AM Location: Summerlin F View Course Information Management of pain begins with an understanding of the underlying mechanism responsible for its generation. Treatment not linked to mechanism of pain is not likely to succeed. With better knowledge about the reasons for pain, treatment can be rendered.

Course Code: PEF-02	Pain Assessment Michael R. Clark, MD, MPH Wednesday, September 08, 2010, 9:20 AM – 10:20 AM Location: Summerlin F View Course Information Effective clinical interviewing and pain assessment are critical to the appropriate diagnosis and management of pain. In this presentation, the clinician will learn how to apply principles of effective communication skills and evaluate available assessment tools.

Course Code: PEF-03	Pain Diagnostic Methods David M. Glick, DC Wednesday, September 08, 2010, 10:40 AM – 11:40 AM Location: Summerlin F View Course Information Diagnostic testing is an integral component for differential diagnosis. In routine clinical practice there has been a tendency for clinical examinations to become more cursory, largely influenced by increasing demands of time and patient expectations of technological advances. The end result may arguably lead to an over- reliance upon technology for basic clinical diagnosis. The purpose of this session is twofold. It is meant to provide a review, and for some, an introduction to basic structural and functional studies used for the diagnosis of pain-related problems. Attention will also be given to the limitations of such studies and the importance of establishing clinical relevance, including enhancing best practices when utilizing such studies, which may otherwise adversely affect clinical management, potentially resulting in failed treatment.

Course Code: PEF-04	Pain Syndromes Chris J. Kottenstete, PA-C, CPE Wednesday, September 08, 2010, 11:50 AM – 12:50 PM Location: Summerlin F View Course Information This presentation will provide the clinician with an overview of common chronic pain syndromes seen in the primary care setting. Discussion will include prevalence, underlying mechanisms, evaluation, mangagement, and patient education.

Course Code: PEF-05	Therapeutics: Pharmacologic Mary Lynn McPherson, PharmD, BCPS, CPE Wednesday, September 08, 2010, 2:30 PM – 3:30 PM Location: Summerlin F View Course Information This course will review the pharmacology of pain management, highlighting the treatment options of simple analgesics, opioid analgesics, and adjuvant therapies, with a focus on balancing use of appropriate therapy to the appropriate patient.

Course Code: PEF-06	Interventional Pain Management Chris J. Kottenstete, PA-C, CPE Wednesday, September 08, 2010, 3:40 PM – 4:40 PM Location: Summerlin F

Course Code: PEF-07	Instructional Design Marcia J. Jackson, PhD, FACME Thursday, September 09, 2010, 8:10 AM – 10:20 AM Location: Summerlin F View Course Information Are you sometimes “stumped” on how to plan an educational session or meeting? Following the steps in a systematic design process will help you get over this hurdle. In this session you will learn about a standard instructional design model—ADDIE. This acronym references each stage in the model: Analyze, Design, Develop, Implement, and Evaluate.The session will include case examples to illustrate practical situations that you encounter as a pain educator.

Course Code: PEF-08	Using Games as Educational Tools Mary Lynn McPherson, PharmD, BCPS, CPE Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Summerlin F

Course Code: PEF-09	Principles of Adult Learning Marcia J. Jackson, PhD, FACME Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Summerlin F

Course Code: PEF-10	Pain Educators: Agents of Behavioral Change Mary Lynn McPherson, PharmD, BCPS, CPE Thursday, September 09, 2010, 2:30 PM – 3:30 PM Location: Summerlin F View Course Information Learning Objectives Describe the difference between teaching and learning List the ten educational points that should be included when teaching patients about their pain medications List five important self-management behaviors for patients with chronic pain Describe the impact pain education has on clinical outcomes List the eligibility criteria for the Certified Pain Educator exam Pain educators are a relatively new group of practitioners who have embraced pain education as an important mission. Pain Educators can actually catalyze changes in behavior for both patients and health care providers. This session answers the who, what, where, when, why, and how of pain educators. Participants will also learn about the Certified Pain Educator (CPE) examination including eligibility criteria and how to maintain the credential.

Course Code: PEF-11	Managing Difficult Patients Chris J. Kottenstete, PA-C, CPE Thursday, September 09, 2010, 3:40 PM – 4:40 PM Location: Summerlin F Presented by Clinician Reviews View Course Information Adults learn differently than children. The art and science of helping adults learn is called “andragogy.” Adults bring their own prior experience into the education setting, and these experiences can serve as a powerful resource for learning. Adults are independent and typically interested in learning that relates to problem-centered issues that they encounter in their daily lives. This session will highlight what we know about adult learners, present information about instructional strategies that are best suited to meet the learning needs of adults, and will also ask participants to reflect on their own learning as adults.

Course Code: PEF-12	Pharmacists and Pain Teams Thomas B. Gregory, PharmD, BCPS, CGP, CPE Thursday, September 09, 2010, 4:50 PM – 5:50 PM Location: Summerlin F View Course Information Pharmacists are the gatekeepers of the medications, compounds, salves, and drugs. That role has held true for hundreds of years. With the ever-changing and expanding roles of other healthcare providers, pharmacists are also stepping into a role away from the traditional dispensing and compounding functions and into a more clinically based approach to patient care. The utility of a pharmacist to a provider managing the health of the pain patient relates back to the pharmacist\'s function as the drug expert. Being able to bridge the knowledge gap has been a role that pharmacists have filled since the profession\'s inception. Having knowledge regarding drug interactions, optimal routes of administration, appropriateness of drug therapy, and the laws that surround prescribing medications are but some of the benefits to working with a pharmacist. Pharmacists can also provide analgesic dosage conversions, monitor patients for refill habits and inconsistencies, and relay all that to providers. Pharmacists and pain teams will provide learners with more information regarding the utility of pharmacists in optimizing patient care.

Course Code: PHM-01	Methadone Mary Lynn McPherson, PharmD, BCPS, CPE Friday, September 10, 2010, 8:10 AM – 9:10 AM Location: SummerlinEB View Course Information Magic, mystical, mysterious methadone--an excellent opioid that requires special handling. Participants in this program will learn about the unique pharmacokinetic and pharmacodynamic properties of methadone, how to initiate methadone therapy in an opioid-naïve patient, and how to switch patients from other opioids to methadone. Participants will also learn about how to monitor a patient converted to methadone and appropriate titration strategies.

Course Code: PHM-02	NSAIDs and COX-2 Toxicities Wayne T. Nicholson, MD, PharmD Friday, September 10, 2010, 9:20 AM – 10:20 AM Location: SummerlinEB This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Adverse drug events (ADRs) are one of the leading causes of mortality in the United States. Nonsteroidal antiinflammatory drugs (NSAIDs) are associated with several toxicities that include renal, GI and cardiovascular effects. Risks and pharmacologic mechanisms will be considered, to identify issues with the use of these agents.

Course Code: PHM-03	Opioid Conversions Mary Lynn McPherson, PharmD, BCPS, CPE Friday, September 10, 2010, 2:30 PM – 3:30 PM Location: SummerlinEB View Course Information Learning Objectives Describe reasons why clinicians must rotate patients from one opioid to another Explain the development of the Equianalgesic Opioid Dosing chart, and limitations with the data Perform opioid dose conversions from one oral dosage formulation to another of the same opioid Perform conversions between opioids, and between routes of administration Perform conversions to and from fentanyl dosage formulations Many patients receiving opioids wil lneed to switch from one opioid to another during therapy, or at least from one dosage formulation or route of administration to another. During this session, practitioners will learn to recognize clinical situations where opioid switching would be appropriate, and will work on a problem set designed to sharpen skills in opioid conversion calculation.

Course Code: PHM-04	Understanding Pharmacologic Metabolism and Using CYP450 Charts Wayne T. Nicholson, MD, PharmD Friday, September 10, 2010, 3:40 PM – 4:40 PM Location: SummerlinEB This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Pharmacokinetic problems related to drug metabolism are commonplace in clinical practice. Many drug-drug interactions and the cytochrome P450 (CYP450) are well described in the literature. More recently, genetic polymorphisms resulting in altered metabolism via CYP450 have gained interest within the practice of medicine. Pharmacokinetic and pharmacogenomic considerations will be identified to better predict metabolic issues.

Course Code: PHY-01	The Role of Modalities for Pain Control: Overview Larry Kopelman, PhD, DPT, ND Saturday, September 11, 2010, 8:10 AM – 10:20 AM Location: Summerlin F View Course Information Learning Objectives Differentiate acute, chronic, referred pain Describe peripheral and central mechanism of nociceptor and pain transmission Review appropriate methods and tools to quantify and qualify pain Explain medical methods and physical modalities interventions to control pain Cite 3 non-pharmacological treatment options for pain management Studies have shown that physical therapy is an effective intervention for patients with pain. Many patients have difficulty with pharmaceuticals for the management of pain, and physical therapy is an effective intervention as well as a cost-effective one. The first hour of this activity will identify various pain syndromes and effective physical therapy interventions. The second hour will cover physical agents (modalities) in clinical use for the management of pain that are more prevalent than ever. The American Physical Therapy Association’s Guide to Physical Therapy Practice, 2nd edition (the Guide) is widely recognized and used by physical therapists to categorize patients according to preferred practice patterns. These findings include typical findings and descriptive norms of types of ranges of interventions currently available and evidence-based.

Course Code: PHY-02	Muscle Pain Syndromes: Pathophysiology, Evaluation, and Treatment Sridhar V. Vasudevan, MD, CPE Saturday, September 11, 2010, 11:50 AM – 12:50 PM Location: Summerlin F Presented by SpineUniverse

Course Code: PHY-03	Prognostic Factors (FLAGS) in Rehabilitation of Patients with Lower Back Pain Sridhar V. Vasudevan, MD, CPE Saturday, September 11, 2010, 2:30 PM – 3:30 PM Location: Summerlin F Presented by SpineUniverse

Course Code: POS-01	Poster Session and Reception Joseph V. Pergolizzi, Jr., MD Thursday, September 09, 2010, 6:00 PM – 7:30 PM Location: Veranda

Course Code: POS-02	Oral/Podium Presentations Joseph V. Pergolizzi, Jr., MD Friday, September 10, 2010, 7:00 AM – 8:00 AM Location: Veranda C

Course Code: PUR-01	Harmony in Motion: The Science of Tai Chi (Premiere) Arthur Rosenfeld Thursday, September 09, 2010, 2:30 PM – 3:30 PM Location: Regal Cinema, Auditorium #5 Supported by Purdue Pharma L.P.

Course Code: PUR-02	Tai Chi Class Arthur Rosenfeld Friday, September 10, 2010, 7:00 AM – 8:00 AM Location: Ampitheatre Supported by Purdue Pharma L.P.

Course Code: PUR-03	Harmony in Motion: The Science of Tai Chi (Encore) Arthur Rosenfeld Friday, September 10, 2010, 3:40 PM – 4:40 PM Location: Charleston Ballroom Supported by Purdue Pharma L.P.

Course Code: PUR-04	Meditation Class Arthur Rosenfeld Friday, September 10, 2010, 6:00 PM – 7:00 PM Location: Ampitheatre Supported by Purdue Pharma L.P.

Course Code: PUR-05	Tai Chi Class Arthur Rosenfeld Saturday, September 11, 2010, 7:00 AM – 8:00 AM Location: Ampitheatre Supported by Purdue Pharma L.P.

Course Code: REG-01	Regional Pain Syndromes: Neck and Upper Extremities David M. Glick, DC Thursday, September 09, 2010, 9:20 AM – 10:20 AM Location: Pavilion View Course Information There are many potential underlying causes for neck and upper-extremity pain. All too often, only the most common working clinical diagnoses are provided. While this may lead to suscessful treatments and resolution of the pain pathology, it would be clinically prudent to alter the working clinical diagnosis. The purpose of this program is to review other common and not-so-common pain syndroms that can affect the neck and upper extremities. Attention will be given to clinical pearls and case presentations that may prove helpful when differentially diagnsosing and treating various neck and upper-extremity pain syndromes.

Course Code: REG-02	Regional Pain Syndromes: Chest John F. Peppin, DO Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Pavilion

Course Code: REG-03	Regional Pain Syndromes: Abdominal and Pelvic Pain Frank J. Nemec, MD Thursday, September 09, 2010, 2:30 PM – 3:30 PM Location: Pavilion View Course Information Chronic abdominal and pelvic pain is a common problem for both primary care physicians and pain specialists. The spectrum of diseases is broad, and therapies varied. Many of these patients have pain that is functional in nature, presenting considerable therapeutic challenges. This presentation will focus on the differential diagnosis of chronic abdominal and pelvic pain and the diagnostic workup, and offer therapeutic options for these patients.

Course Code: REG-04	Regional Pain Syndromes: Hip and Lower Extremity Pain Owen D. Williamson, MD Pam Squire, MD Thursday, September 09, 2010, 3:40 PM – 4:40 PM Location: Sienna View Course Information Hip and lower-limb regional pain syndromes can arise locally, be referred from the lower back, or be due to nerve compression in the back, buttock, or lower limb. This interactive workshop will involve a brief discussion of valid and reliable symptoms, signs, and investigations for differentiating the causes of hip and lower-limb regional pain syndromes and hands-on exercises practicing and interpreting a time-efficient examination sequence. Participants should dress to be examined by others during the workshop!

Course Code: RHM-01	Crystal-Induced Arthritis (Gout and Pseudogout) Ronald J. Rapoport, MD, FACR Wednesday, September 08, 2010, 9:20 AM – 10:20 AM Location: Pavilion View Course Information The two most common types of crystal-induced arthropathies are gout and pseudogout. Pain and joint inflammation are caused by the formation of crystals within the joint space, making it an incapacitating illness. Gout is inflammation caused by monosodium urate monohydrate (MSU) crystals. Pseudogout is inflammation caused by calcium pyrophosphate (CPP) crystals and is sometimes referred to as calcium pyrophosphate disease (CPPD). This presentation will review the pathophysiology, explain the risk factors and comorbidities of crystal-induced arthritis, and treatment options for acute and chronic flare-ups.

Course Code: RHM-02	Osteoarthritis Ronald J. Rapoport, MD, FACR Wednesday, September 08, 2010, 10:40 AM – 11:40 AM Location: Pavilion View Course Information Osteoarthritis (OA) is recognized to be more than a simple deterioration of joint surfaces through time. OA alters activities of daily living, interferes with ability for pleasure, and impacts quality of relationships with others. This presentation will describe OA as more than just a degenerative condition, putting it into context as a process radically changing quality of life for sufferers.

Course Code: RHM-03	Fibromyalgia Ronald J. Rapoport, MD, FACR Wednesday, September 08, 2010, 2:30 PM – 3:30 PM Location: Pavilion View Course Information With the availability of prescription medications for the management of fibromyalgia (FMS) and fMRI data suggesting that there is loss of cortical grey matter associated with it, many clinicians are better able to understand the presumed pathophysiology of the condition. The absence of abnormality in commonly used laboratory and imaging methods has created confusion about the condition. This presentation will focus on the known changes seen with fibromyalgia and describe current best practices for management.

Course Code: RHM-04	Rheumatoid Arthritis Ronald J. Rapoport, MD, FACR Wednesday, September 08, 2010, 3:40 PM – 4:40 PM Location: Pavilion View Course Information Rheumatoid arthritis (RA) is the most common of the inflammatory arthritides. Our current approach toward treatment is far more aggressive than treatments of the past. Practitioners need to be aware of the clinical presentation and options available in caring for these challenging patients.

Course Code: SIS-01	Coaching Your Patient to Manage Their Medical Conditions Elizabeth F. Jackson, RN, BSN, CRRN, CCM, CPUR, CPM Wednesday, September 08, 2010, 8:10 AM – 9:10 AM Location: Veranda C This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Have you ever prescribed a comprehensive treatment plan for your patient only to have that patient return in the same or a similar state? When you ask why they failed to follow through with all the recommendations you made they have all kinds of reasons and excuses for not following through. This session is designed to teach practical coaching skills that can be applied when faced with patient resistance and excuses. You will be surprised how a few simple reflective statements and the right questions can quickly turn negative talk into change talk. You will learn coaching techniques that can motivate and empower your patient to connect with their deepest motivators, explore ambivalence, and overcome obstacles.

Course Code: SIS-02	Pain Clinical Trials Joseph V. Pergolizzi, Jr., MD Wednesday, September 08, 2010, 2:30 PM – 4:40 PM Location: Veranda DE This activity has not been certified for CE/CME credit. View Course Information PAINWeek’s Scientific Poster and Abstracts Committee chairman, Joseph V. Pergolizzi, MD will be joined by Joseph Stauffer, DO, Robert Raffa, PhD, Douglas Y. Shapiro, MD, PhD, Sue-Ellen Kline, PhD, and Errol Gould PhD for a two-hour plenary session on pain clinical trials. The expert panel will speak to FDA regulations and testing for pain products, analgesic preclinical testing, designing components of analgesic clinical trials, HOPE studies in analgesic drug development, and investigator initiated trials along with a concluding panel discussion.

Course Code: SIS-03	Pain and Sickle Cell Disease Thomas B. Gregory, PharmD, BCPS, CGP, CPE Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Trails This activity is not scheduled to be presented as a post-conference Webinar. View Course Information Sickle cell disease affects 72,000 Americans and 30,000,000 worldwide. It’s the most commonly inherited blood disorder, causing excruciating pain in the arms, legs and back. Management of sickle cell disease involves not only medications (opioids, nonsteroidal antiinflammatory agents, etc.) but also psychosocial interventions in order to address the acute or chronic pain presentation. Medication management along with psychosocial intervention is necessary to address this multifactorial pain presentation. Opioid use is common within this patient population along with the risk of tolerance, pseudoaddiction, and drug aberrant behaviors. This program will provide the learner with an appreciation for sickle cell disease and its management.

Course Code: SIS-04	Unconscious Processes and the Undertreatment of Pain: Illustrations from Clinical Narratives and Poetry Nance K. Cunningham, PhD Howard Stein, PhD Friday, September 10, 2010, 9:20 AM – 10:20 AM Location: Trails This activity is not scheduled to be presented as a post-conference Webinar. View Course Information The presenters discuss some of the recent research on empathy as a possible physician or nurse barrier to good pain assessment and management. They make use of this attention to empathy by explaining how medical culture and psychodynamic processes can influence professionals’ responses to the distress of witnessing patients in pain. Examples from clinical narratives and poetry are used as illustrations.

Course Code: SIS-05	How Simple Pain Pathophysiology Can Transform Patient Care Pam Squire, MD, CCFP, CPE Owen Williamson, MD Friday, September 10, 2010, 11:50 AM – 12:50 PM Location: Sienna This activity is not scheduled to be presented as a post-conference Webinar. View Course Information In the last 20 years new concepts to explain chronic pain have changed our therapeutic focus from simply diagnosing and treating "pain, the symptom" to defining and managing the more complex phenomena associated with chronic pain, sometimes encapsulated as “pain, the disease.” This changing paradigm has engendered many new insights that now direct all aspects of modern pain practice. Emerging research indicates that knowledge can provide significant mitigation against the many fears our patients experience as a result of their relationship with chronic pain. This interactive session will share tools and techniques for implementing knowledge translation into practice.

Course Code: SIS-06	The Complexity Model of Chronic Pain Management John F. Peppin, DO Thursday, September 09, 2010, 11:50 AM – 12:50 PM Location: Pavilion

Course Code: SIS-07	Person-to-Person Penney Cowan Thursday, September 09, 2010, 10:40 AM – 11:40 AM Location: Trails

Course Code: SIS-08	Postoperative Pain Management Lynn Cintron, MD, MS Wednesday, September 08, 2010, 10:40 AM – 11:40 AM Location: Veranda C View Course Information Chronic pain after surgery is a significant problem that reduces patients’ quality of life. It is important to identify patients at risk of developing this syndrome. Iatrogenic neuropathic pain is a common cause of persistent postoperative pain (PPP). Treatment should be targeted at the progression of mechanisms leading to neurodegeneration. Improving the management of acute postop pain and good surgical technique are some helpful strategies. Furthermore, we need to educate patients wanting surgery for reasons other than illness or disability about the risk of persistent pain.

Course Code: SIS-09	Postoperative Pain Management (Encore) Lynn Cintron, MD, MS Wednesday, September 08, 2010, 4:50 PM – 6:00 PM Location: Summerlin A

Course Code: SIS-10	Pain and Depression Michael R. Clark, MD, MPH Wednesday, September 08, 2010, 11:50 AM – 12:50 PM Location: Pavilion Presented by Current Psychiatry

Course Code: SIS-11	Leveraging Your Pain Management Expertise to Grow Your Practice: A Review of Innovative Marketing Models Bill Paquin Wednesday, September 08, 2010, 4:50 PM – 5:50 PM Location: Veranda AB View Course Information Bill Paquin, CEO of Vertical Health, investigates the benefits and flaws of standard models in practice marketing, including Yellow Pages, referring physician networks, your facility, and practice Web site. He will also demonstrate how leading practices are evolving their marketing techniques, not just to attract new patients, but the RIGHT patients. Learn innovative strategies on how to both improve the patient experience and patient referral marketing.

Course Code: SIS-13	Fibromyalgia and Sleep I. Jon Russell, MD, PhD Victor Rosenfeld, MD Thursday, September 09, 2010, 8:10 AM – 10:20 AM Location: Charleston Ballroom This activity is jointly sponsored by Global Education Group and the National Fibromyalgia Association.

Course Code: SIS-14	Fibromyalgia and Sleep I. Jon Russell, MD, PhD Victor Rosenfeld, MD Thursday, September 09, 2010, 3:40 PM – 5:50 PM Location: Charleston Ballroom This activity is jointly sponsored by Global Education Group and the National Fibromyalgia Association.

Course Code: SIS-15	Pain Care Advocacy: Be Part of the Solution Will Rowe Thursday, September 09, 2010, 9:20 AM – 10:20 AM Location: Sienna View Course Information This will be a presentation and discussion of the pain policy issues that immediately affect the practice of pain management. Most important will be concrete advice and motivation to get involved and take action to improve pain policy at the state and federal levels. Participants will gain an understanding of critical policy issues and will leave the room with simple advice about taking concrete advocacy actions. BE PART OF THE SOLUTION!

Course Code: SYM-01	Interactive ShowCASE: Persistent and Breakthrough Pain: Continual, Semi-Structured Assessment for Improved Opioid-Based Therapy Michael J. Brennan, MD Patricia Bruckenthal, PhD B. Todd Sitzman, MD Wednesday, September 08, 2010, 2:30 PM – 4:30 PM Location: Summerlin A Supported by an educational grant from Cephalon Inc. This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: SYM-02	Interactive ShowCASE: Persistent and Breakthrough Pain: Continual, Semi-Structured Assessment for Improved Opioid-Based Therapy (encore) Michael J. Brennan, MD Patricia Bruckenthal, PhD B. Todd Sitzman, MD Thursday, September 09, 2010, 10:30 AM – 12:30 PM Location: Summerlin A Supported by an educational grant from Cephalon Inc.This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: SYM-03	Interactive ShowCASE: Persistent and Breakthrough Pain: Continual, Semi-Structured Assessment for Improved Opioid-Based Therapy (encore) Michael J. Brennan, MD Patricia Bruckenthal, PhD B. Todd Sitzman, MD Thursday, September 09, 2010, 2:30 PM – 4:30 PM Location: Summerlin A Supported by an educational grant from Cephalon Inc. This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: SYM-04	Chronic Opioid Therapy: Understanding Risk While Maximizing Analgesia (Not Certified for Credit) Keela A Herr, PhD, RN Bill McCarberg, MD Thursday, September 09, 2010, 6:30 PM – 8:30 PM Location: Charleston Ballroom Supported by Endo Pharmaceuticals and the American Pain Foundation. This activity is not scheduled to be presented as a post-conference Webinar.

Course Code: SYM-08	Community Rx Crisis: Balance and Perspective on Prescription Drug Abuse (Not Certified for Credit) John J. Burke Lynn Webster, MD Michelle Lipinski, Principal Of Northshore Recovery HighSchool Thursday, September 09, 2010, 12:50 PM – 2:20 PM Location: Charleston Ballroom Sponsored by King Pharmaceuticals. This activity is not scheduled to be presented as a post-conference Webinar. View Course Information This session begins with an overview of the extent of prescription opioid abuse and diversion in the United States, followed by a description of a high school recovery program by Principal Michelle Lipinski with students\' discussion of how and why they began abusing prescription drugs, their access to the medications, how their drugs of choice evolved over time, and their trajectory of drug/alcohol use to addiction. Commander Burke and Ms. Lipinski conclude the presentation by reviewing best practices healthcare professionals can use to minimize prescription opioid abuse and diversion while maintaining therapeutic access to these medications. Attendees have the opportunity to ask questions at the end of the presentation.

PAINWeek® - September 9-13, 2009 - Red Rock Casino, Resort, and Spa Las Vegas, NV - The national conference for frontline practitioner.

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PAINWeek® 2008 Highlights

PAINWeek® 2010 Courses

Prolotherapy for the Management of Musculoskeletal Pain

Natural Supplements for Joint Health

Acupuncture and Biostimulation

The Nature of Placebo Analgesia

Nutrition in Pain and Headache Management

Translating CAM Research Into Clinical Practice

Common Pain Syndromes of Older Adults

Assessment Challenges of the Cognitively Impaired Patient

Dilemmas Encountered When Treating Geriatric Pain: Case Studies

Treatment Considerations in Relation to Concurrent Pharmacology

“Cure Me, or I Give Up!” The Role of Acceptance in Patient Self-Management

Application of the Trantheoretical Model of Change in Coaching Chronic Pain Patients

Courage to Change: Tools for Helping Patients Embrace Self-Management and Identify Strengths for Change

Essential Ingredients of Self - Management

Mind/Body Techniques for Relief of Chronic Pain

Effective Communication for Fear and Pain Reduction

Reducing Presurgery Fears and Postsurgery Pain

Functional Pain Relief with Hypnosis and Self-Hypnosis

Patient Compliance: Conversational Techniques to Improve Participation

Mind/Body Medicine: Expanding the Scope of Your Practice

Keynote Address

Hands-On Evaluation of Orofacial Pain

Clinical Examination of Neuropathic Pain: A Hands-On Approach

Malingering and Deception

Neurogenic Thoracic Outlet Syndrome

Fall Prevention for Osteoporosis Patients

Optimizing Medical Adherence in Your Practice

Mastering the Biopsychosocial Approach to Chronic Pain Management

Pain As a Part of Trauma Spectrum Disorder in Military Populations

Neurogenic Thoracic Outlet Syndrome

The Art and Science of Diagnosis

Legal/Regulatory Update: Taking Control of Your Prescribing

Physician Dispensing: Can I? Should I?

Self-Audit Workshop

Mock Medical Board Hearing: Licensing Board vs Dr. Pain

Drug Testing Legal and Reimbursement Issues: Myths and Realties

Drug Diversion vs Pain Management: Finding a Balance

A Law Enforcement Perspective to Drug Abuse

Rx Fraud, Doctor Shoppers, and Pill Mills

Organized Diversion Rings

Defining the Problem, Process, and Needs for Policy

Caught in the Crossfire: Narcoterrorism’s Impact on Patient Care

Targets of Opportunity

Balancing Patient Care and Government Regulation: The Influence of Narcoterrorism

Physician Roles and Responsibilities in Profession and Practice

Profile of Narcoterrorism: Economic Considerations

Migraine Headache: Differential Diagnosis and Prophylactic Treatment

Complex Regional Pain Syndrome

Posttraumatic Headache: Pathophysiology and Treatment

Autonomic Aspects of Soft-Tissue Pain

The Multifaceted Nature of Grief and Bereavement

Acceptance and Commitment Therapy Skills

Progressive Muscle Relaxation

The 5 Pillars of Pain Management

Rules of the Game: Federal Regulations for Prescribing a Controlled Substance

A Simple Approach to Pain and Chemical Dependency: The Dual Role of Methadone in Pain and Addiction

Buprenorphine: New Tricks with an Old Molecule for Pain Management

Assessment and Diagnosis of Pediatric Pain

Consequences of Not Treating Pain in Children

Management of Chronic Daily Headache in Children

Idiopathic Chronic Pain Syndromes in Children

Pain Mechanisms

Pain Assessment

Pain Diagnostic Methods

Pain Syndromes

Therapeutics: Pharmacologic

Interventional Pain Management

Instructional Design

Using Games as Educational Tools

Principles of Adult Learning

Pain Educators: Agents of Behavioral Change

Managing Difficult Patients

Pharmacists and Pain Teams

Methadone

NSAIDs and COX-2 Toxicities

PAINWeek^® 2008 Highlights

PAINWeek^® 2010 Courses