Past Conference 2012

We are pleased to present the conference program
for this past 2012
International Conference on Opioids.

DAY ONE: Sunday, June 10, 2012

12:00 p.m. - 5:00 p.m.
Attendee Registration,  Exhibits & Posters Set-up

6:00 p.m. - 9:00 p.m.
Opening Keynote -
Opioid Therapy: Time to “Re-Balance”?

Keynote Speaker:

Daniel B. Carr, MD,
s University, Boston, MA

Monday, June 11, 2012

7:00 a.m. - 8:00 a.m.

Registration & Continental Breakfast

8:00 a.m. - 8:15 a.m.
Conference Chair’s Welcome
Paul A. Sloan, MD, Co-Chair
Carol A. Warfield, MD, Co-Chair

8:15 a.m. - 9:00 a.m.
Keynote - A Regulator’s Perspective on Opioid Drug Use and Misuse

The FDA has taken a prominent role in working with a variety of stakeholder
groups to address the ongoing crisis of abuse and misuse of opioid drugs
in the United States. Dr. Throckmorton will discuss various activities the FDA
is a part of, and where the FDA fits in the larger governmental effort
to address the opioid crisis.

Keynote Speaker:
Douglas Throckmorton, MD,
Deputy Director for Regulatory Programs
in the Center for Drug Evaluation and Research (CDER)
at the United States Food and Drug Administration (FDA)

9:00 a.m. - 10:15 a.m. & 10:45 a.m. - 12:00 p.m.
Neuro-Ethical Issues in Opioid Use: Implications for the Future of Pain Medicine

• From the neuroscience of pain to a neuroethics of pain care: Imperatives for policy and practice
• Right and prudent use of opioids: Importance to the future of pain medicine
• Pain, dependence, addiction and pharmacogenetics: Words, tools and traps
Evidence-based, evidence-biased or medicine-based evidence forms of practice?
• From facts and ethics to law: Juggling a two-sided blade

James Giordano, PhD, University of Oxford
Jane Ballantyne, MD, University of Washington
Daniel Hall-Flavin, MD, Mayo Clinic
Mark V. Boswell, MD, University of Louisville
Barry Eliot Cole, MD, MPA

10:15 a.m. - 10:45 a.m.
Refreshment Break: Exhibits & Posters Open

12:00 p.m. - 12:30 p.m.
Opioid Case Study I

Carol A. Warfield, MD, Harvard Medical School

12:30 p.m. - 1:30 p.m.
Lunch Presentation:
Medication Taking Behaviors of the Pain Patient Population

Amadeo J. Pesce, PhD, DABCC
Angela Huskey, PharmD, CPE

Sponsored by: Millennium Laboratories

1:30 p.m. - 2:30 p.m.
Practical Guidelines for Everyday Practice/
Complications of Chronic Opioid Therapy

Paul A. Sloan, MD, University of Kentucky
Carol A. Warfield, MD, Harvard Medical School

2:30 p.m. - 3:30 p.m.
Urine Drug Screening

Rationale for drug monitoring in chronic opioid analgesic therapy
• Urine drug monitoring
• Complementary and alternative testing matrices
• Ethical aspects of drug monitoring

 Gary M. Reisfield, MD, University of Florida College of Medicine

3:30 p.m. - 3:45 p.m.
Refreshment Break: Exhibits & Posters Open

3:45 p.m. - 5:00 p.m.
Medical-Legal and Regulatory Aspects of Prescribing Opioids:
Avoiding Problems with the Board of Registration in Medicine and the DEA

• Formulate risk management strategies to reduce your exposure to being audited by the BOM and DEA for improper prescribing of opioids
• Review the definitions of “the usual course of medical practice” and “for legitimate medical purposes”
• Develop strategies to prevent abuse, misuse & diversion of scheduled drugs
• Examine cases where the US government criminally prosecuted physicians for improprieties involving prescribing opioids

David M. Benjamin, PhD

5:00 p.m. - 6:00 p.m.
Erasure of a Spinal Memory Trace of Pain by a Brief, High-Dose Opioid Administration

Painful stimuli activate nociceptive C fibers and induce synaptic long-term potentiation (LTP) at their spinal terminals. LTP at C-fiber synapses represents a cellular model for pain amplification (hyperalgesia) and for a memory trace of pain. μ-Opioid receptor agonists exert a powerful but reversible depression at C-fiber synapses that renders the continuous application of low opioid doses the gold standard in pain therapy. We discovered that brief application of a high opioid dose reversed various forms of activity-dependent LTP at C-fiber synapses. Depotentiation involved Ca2+-dependent signaling and normalization of the phosphorylation state of a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors. This also reversed hyperalgesia in behaving animals. Opioids thus not only temporarily dampen pain but may also erase a spinal memory trace of pain.

  Jürgen Sandkühler, MD, PhD
Center for Brain Research, Medical University of Vienna, Vienna, Austria

DAY THREE: Tuesday, June 12, 2012

7:00 a.m. - 8:00 a.m
Continental Breakfast

8:00 a.m. - 8:45 a.m.
Keynote - What is a SAMHSA and why should you care?

Keynote Speaker:
Robert Lubran, Director,
Division of Pharmacologic Therapies
Center for Substance Abuse Treatment (CSAT)
Substance Abuse and Mental Health Services Administration (SAMHSA)

8:45 a.m. - 10:15 a.m.
Taking Back Your Turf:
Understanding Legal/Regulatory Changes
Impacting Pain Management and Controlled Substance Prescribing

A program dedicated to covering not only the “what” of recent legal/regulatory changes, but also the “how to respond” strategies.
This program will serve as a platform for understanding the need to continually evaluate clinical approaches to patient risk assessment,
patient selection, and overall patient monitoring for safety and appropriate utilization of controlled medication.

Jennifer Bolen, JD, J Bolen Group, LLC
Eric Vinsant, JD, Physicians Pharmaceutical Corp.
Ted Jones, PhD, Behavioral Medicine Institute, P.C.
Chris Vinsant, MD, Tennova Health Care Group

10:15 a.m. - 10:30 a.m.
Refreshment Break: Exhibits & Posters Open

10:30 a.m. - 12:00 p.m.
Neurobiological Mechanism and Clinical Implication of Opioid-Induced Hyperalgesia

This symposium will present the up-to-date information on the neurobiological mechanism
and clinical implication of opioid-induced hyperalgesia as well as risk assessment for opioid therapy.

Lucy Chen, MD, Harvard Medical School
Robert N. Jamison, PhD, Harvard Medical School
Jianren Mao, MD, PhD, Harvard Medical School

12:00 p.m. - 12:45 p.m.
Evidence from Basic Research for Opioid Combinations

Opioid receptor pharmacology is reviewed including receptor genetics and downstream signaling. Receptor functional selectivity and ligand biased responses will be discussed in relationship to opioid pharmacodynamics, signal modulation and synergy. The accumulated bench research over the past decade, in particular, provides a rationale for considering clinical trials of opioid combinations. These combinations include both selective agonist-agonist or agonist-antagonist pairs which will be reviewed.

Mellar P. Davis, MD, FCCP, FAAHPM, Cleveland Clinic Lerner School of Medicine


12:45 p.m. - 1:45 p.m.
Lunch: Exhibits & Posters Open

1:45 p.m. - 2:45 p.m.
Latest Evidence and Research Findings from Studies Describing Opioid Error;
New Approaches to Monitoring PCA-Opioid Efficacy and QI Initiatives
to Improve Opioid Safety

Conor McDonnell, MD,  University of Toronto, Canada
Lisa A. Isaac, MD,  University of Toronto, Canada

2:45 p.m. - 3:45 p.m.
Managing the Risks Associated with an Opioid Trial:
Time-Efficient Strategies for Identifying, Monitoring, and Treating High-Risk Patients

Review of the clinical and regulatory climate that sets the stage for current pain medicine practice.
Discuss the 4 A’s of pain medicine and how they can be applied in a time-efficient manor to monitor patients on opioids.
Outline the elements of an adequate approach to risk stratification prior to prescribing opioids.
Define the range of aberrant medication behaviors, and outline steps to intervene that are tailored to the particular behavior.
 Outline tailoring an opioid program for high-risk individuals including individuals with addiction, cognitive impairment,
and past aberrant behaviors.
Clarify the role of buprenorphine/naloxone and methadone as alternatives in the setting of ongoing pain and medication abuse.
Use case examples to apply these clinical skills.

David M. Marks, MD, Duke University Medical Center
James Finch, MD, UNC College of Medicine, NC

3:45 p.m. - 4:00 p.m.
Refreshment Break: Exhibits & Posters Open

4:00 p.m. - 5:30 p.m.
A presentation of the newest findings on the use of opioids in cancer pain
on behalf of the European Palliative Care Research Collaborative (EPCRC)
and the European Association for Palliative Care (EAPC)

The EPCRC and EAPC have been engaged in a three-year project to update the EAPC recommendations on the use of opioids in cancer pain. The International Conference on Opioids is the forum for the first public presentation of these significant cutting-edge recommendations.

Professor Geoffrey Hanks, MD, DSc(Med), FRCP, FRCPE, University of Bristol, Bristol, UK
Professor Augusto Caraceni, MD
Professor Stein Kaasa, MD

Professor Augusto Caraceni was Project Leader of the EPCRC Project to Revise the EAPC Recommendations and Professor Stein Kaasa was overall Coordinator of the EPCRC, the first major EU-funded cancer palliative care research collaborative and he is also Chairman of the EAPC Research Network.

5:30 p.m.
Conference Wrap up - Close

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Please note that this schedule is subject to change without notice.