The ASAM Pain & Addiction: Common Threads XX 2019 (8 CME)

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OVERVIEW

The ASAM Pain & Addiction: Common Threads Course is one of ASAM's longest running and most popular courses. This course is designed to develop learners' clinical skills and improve treatment of patients who fall somewhere in the gray area around pain and addiction. Participants will learn clinical best practices and new research developments affecting treatment and how to integrate these techniques into their own practices. This year's course will examine complex and challenging patient cases and identify next steps to treatment.

LEARNING OBJECTIVES

Upon completion of this educational activity, participants should be able to:

  1. List 5 ways that trauma can impact a patient’s pain and/or addiction.
  2. Create a script for communicating with patients about challenging clinical issues such as buprenorphine cessation or opioid induced hyperalgesia.
  3. Evaluate current research on non-pharmacologic therapies for pain and identify which may be useful with their patients.
  4. Develop a peri-operative treatment plan for patients on agonist and antagonist medications that reflects the current research and coordinates care with other members of the team.
  5. Identify methods to address acute pain in a chronic pain patient and methods to transition back after an instance of acute pain.
  6. Explain indications, risks, and benefits for tapering or discontinuing buprenorphine.
  7. Analyze current research on cannabis use in patients with pain and communicate that information to patients.
  8. Describe the recent data, risks, benefits, and indications for using gabapentinoids while treating patients with pain.
  9. Explain the relationship between pain, sleep, and addiction. Identify effects that key drugs play on sleep and the risks that creates.
  • Evaluation and Certificate - Pain & Addiction Course 2019

    Contains 2 Component(s), Medical Credits Offered

    CME Evaluation for the ASAM Pain & Addiction Course 2019

    Complete the course evaluation first and then claim credits. Attendees should claim only the credit commensurate with the extent of their participation in the activity.

  • Neuroscience of Pain, Addiction & Trauma (1 CME)

    Product not yet rated Contains 4 Component(s), Medical Credits Offered Recorded On: 04/04/2019

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning how early life trauma modifies the brain, making the risk of chronic pain and/or addiction are more probable from this conference recording from The ASAM Pain & Addiction: Common Threads XX Course.

    (1 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course, you will learn about the overlap between pain, addiction, and trauma. Understanding the neuroscience of Pain, Addiction and Early Life Trauma is key to connecting people to the right treatment. In this session we will take a deep look at how early life trauma modifies the brain, making the risk of chronic pain and/or addiction are more probable. We will look at how the structures and neurotransmitters change based on different inputs, medications and behavioral health conditions. The deeper dive into the neuroscience should set a solid framework to explore the concepts of treatment in these complex patients.

    R. Corey Waller

    MD, MS, DFASAM

    R. Corey Waller, MD, MS, FACEP, DFASAM, is an addiction, pain and emergency medicine specialist. Dr. Waller earned his bachelor's degree in biology and his master's degree in neuromolecular biology at Southwest Texas State University in San Marcos, Texas. He earned his medical degree at University of Texas Medical School in San Antonio. Dr. Waller completed his emergency medicine residency at Thomas Jefferson University in Philadelphia. He is board certified and fellowship trained in addiction medicine.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Psychodynamic Aspects of Chronic Pain and Trauma (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about central sensitization and neuroplastic pain from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course:

    There is increasing recognition that central mechanisms play a critical role in chronic pain. The predictive coding model posits that the brain generates all of our internal sensations, and therefore all pain originates in the brain. We have learned that pain can exist in the presence or absence of peripheral nociceptive input. There is evidence that many pain syndromes occur in the absence of ongoing tissue injury. This lecture will compare and contrast two models of central pain: central sensitization and neuroplastic pain. The dynamic nature of neuroplastic pain will be emphasized and recent research studies that demonstrate this dynamic property of pain will be discussed. A video clip will be shown that describes a new method of treating chronic pain.

    Ross Halpern

    PhD, LP

    Ross Halpern, Ph.D., L.P. & Associates

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Balance, Grasshopper: Using both CAM and "Traditional" Techniques for Comprehensive and Effective Pain Management (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning how to use complementary and alternative medicine for pain from this conference recording from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course, you will learn about complementary and alternative medicine. Patients with chronic pain are often referred to various types of specialists and may be recommended to try non-surgical procedural interventions, in addition to use of medications. Many are also engaging in treatments and self-care practices that utilize complementary and alternative medicine (CAM). Due to lack of reliable evidence or knowledge thereof, physicians may not be offering input or recommendations regarding use of CAM, or having open communication with their patients about the use of these approaches. This presentation will educate the audience on the array of CAM therapies in practice, while also reviewing "traditional" and new, cutting-edge interventional techniques for pain management. Attendees should come away with more comfort in their ability to confidently discuss the relative merits of non-pharmacologic care options in both the traditional pain management and CAM categories. Most importantly, the presenters take you "outside of the box" and show how these treatment options can be integrated effectively and seamlessly to manage pain in a comprehensive and multi-modal fashion, while minimizing the risk for development or worsening of addictive disease.

    Gregory Rudolf

    MD

    Dr. Rudolf is a physician board certified in addiction medicine, pain medicine, and medical acupuncture practicing at Swedish Pain Services in Seattle. The clinic integrates multidisciplinary pain care approaches in an effort to optimize patient functional outcomes and self-efficacy. He has also worked extensively in inpatient substance use disorder treatment settings and has published on the topic of withdrawal management. He is on the ASAM Pain and Addiction Course Planning Committee, the board of directors of the Washington Society of Addiction Medicine, and is a clinical assistant professor at University of Washington.

    Michael Sprintz

    DO, DFASAM

    Michael Sprintz, D.O. received his medical degree from Midwestern University-Chicago College of Osteopathic Medicine in 1997 and went on to a residency in Anesthesiology at Johns Hopkins Hospital. He left Hopkins to do post-doctoral research in biomedical nanotechnology before returning to complete his anesthesia training at University of South Florida. Dr. Sprintz completed a Pain Medicine Fellowship at MD Anderson Cancer Center in 2012 and is triple-board-certified in Anesthesiology, Addiction Medicine, and Pain Medicine. Dr. Sprintz is the Past-President of the Texas Society of Addiction Medicine, as well as the CEO of iLumHealth, a software company developing world-class products to prevent abuse and diversion of prescription drugs, educate providers, and employ rational solutions that save lives and create value. In addition, Dr. Sprintz is the Founder and Chief Medical Officer of the Sprintz Center for Pain and Dependency, an ultra-specialized outpatient center for the comprehensive treatment of chronic pain, dependency and addiction, located in The Woodlands, TX.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Peri-Operative Pain Management for Patients on Agonist and Antagonist Medications (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about clinical challenges of managing patients who are on buprenorphine-naloxone treatment and compare different pain management strategies, risks and benefits from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course: 

    This presentation will provide an overview of the relevant literature of perioperative pain management of patients with Opioid Use Disorders on medication (methadone, buprenorphine-naloxone, i.m. naltrexone) treatment, patients in remission without medications and those who are misusing opioids at the time of the surgery. Specifically , Dr. Ward will focus on the clinical challenges of managing patients who are on buprenorphine-naloxone treatment and compare different pain management strategies such as stopping bup-nx preoperatively vs not and discuss the associated risk and benefits.

    Nalan Ward

    MD

    Nalan Ward, MD is an associate psychiatrist in the Department of Psychiatry at the Massachusetts General Hospital (MGH) and an Assistant Professor in Psychiatry at Harvard Medical School (HMS). She completed psychiatry residency and addiction psychiatry fellowship at the Boston University Medical Center. She joined MGH Department of Psychiatry in 2005 as the Medical Director of the Outpatient Addiction Services. Dr.Ward is a co-chair of the MGH Substance Use Disorders Education Committee and a member at MGH Opioid Task Force Steering Committee and the Academy at HMS.  Dr. Ward is a medical consultant for the Massachusetts Department of Public Health, Bureau of Substance Addiction Services for Quality Assurance and Licensing. Dr. Ward is a Course Director for Buprenorphine Waiver Training (PCSS-MAT). She is the lead addiction psychiatry consultant for the Partners Healthcare, Center for Population Health Management Behavioral Health Consults. Previously, she worked as the Medical Director of the Methadone Maintenance Program for North Charles Institute for Addictions from 2002-2009. Dr. Ward has presented locally and nationally. She has authored and co-authored more than 19 articles and 4 book chapters. Her topic of interests is treatment of opioid use disorders, comorbid pain conditions, clinical innovations in increasing access to addictions care, clinical education of trainees and professional academic development in the field of addiction psychiatry. Dr. Ward is board certified in adult and addiction psychiatry.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Use of Buprenorphine in the Management of Acute and Chronic Pain (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about buprenorphine in the management of pain in both acute and chronic settings from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course: 

    This session will address the use of buprenorphine in the management of pain in both the acute and chronic settings. The different formulations of buprenorphine available specifically for these indications will be covered. Appropriate dose titration and escalation will be discussed. A variety of management strategies will be explored. Emphasis will be placed on focusing on the patient rather than the medication.

    Yoann Millet

    MD

    Dr. Yoann Millet is a dual board-certified physician in anesthesiology and pain management. He completed his undergraduate education at Cornell University and he obtained his medical training at Weill Cornell Medical College. He went on to complete a general surgery internship at NewYork-Presbyterian Hospital-Weill Cornell Medical College and his residency in anesthesiology at Baylor College of Medicine in Houston. He received subspecialty training in pain management in the Duke University pain fellowship program. In an effort to improve care, he has participated extensively in research and has published numerous abstracts, manuscripts, and book chapters. He was most recently involved in a project to improve spinal cord stimulator implant compliance with Surgical Care Improvement Project guidelines. He has presented his work across the country and has received multiple awards for his research and presentations. He trained with some of the most renowned pain physicians in the country and has gained experience with multimodal pain management including medication regimens, traditional fluoroscopic injections, ultrasound-guided procedures, spinal cord/peripheral nerve stimulators, intrathecal pumps, vertebral augmentation, and regenerative medicine. He is currently working at the Sprintz Center for Pain and Recovery where he is incorporating these sills in the management of both chronic pain and addiction patients.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Pain, Addiction and Sleep (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about the relationship between pain, addiction, and sleep from this conference recording from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course, you will learn about the relationship between pain, addiction and sleep. The neurophysiology of sleep will be reviewed as will the ways in which common medications used to treat pain and addiction can affect sleep and increase the risk of overdose or suicides. There will be a brief review of the treatment options for sleep disorders who have an opioid use disorder and pain.

    Learning Objectives:

    • Explore the bidirectional relationship of pain and sleep
    • Describe the relationship of pain, sleep, and addiction
    • Know the pharmacologic effects of key drugs on sleep
    • Understand how pain and sleep deprivation contribute to suicide

    Lynn Webster

    MD, FACPM, FASAM

    Dr. Lynn Webster has dedicated more than three decades to becoming an expert in the field of pain management. He is the vice president of Scientific Affairs of PRA Health Sciences and past president of the American Academy of Pain Medicine. A leading voice in trying to help physicians safely treat pain patients, Dr. Webster actively works within the industry to develop safer and more effective therapies for chronic pain and addiction. He is board certified in anesthesiology and pain medicine, as well as addiction medicine. Dr. Webster lectures extensively on the subject of preventing opioid abuse and criminal diversion in chronic pain patients and has authored more than 300 scientific abstracts, manuscripts, journal articles and a book entitled Avoiding Opioid Abuse While Managing Pain: A Guide for Practitioners, many of which are the basis for training physicians who are studying pain.

    Dr. Webster has played an instrumental role in his industry as a strong advocate for safe and effective pain resolution methods. The Opioid Risk Tool (ORT), which he developed, is currently used and is the standard in multiple countries and thousands of clinics worldwide. He currently spends his time developing safer and more effective therapies for chronic pain and campaigning for safer use of medications.

    He received his doctorate of medicine from the University of Nebraska and later completed his residency at the University of Utah Medical Center's Department of Anesthesiology. Dr. Webster has been quoted by multiple media sources, including in the Los Angeles Times and The Wall Street Journal, and has given over 250 presentations across the United States and internationally. He is the author of The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (Webster Media LLC) and producer of a documentary of the same name.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of .75 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of .75 AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn .75 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Cannabis Use: Evidence and Patient Communication (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about cannabis epidemiology, neurobiology, clinical management and policy issues relevant for providers from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course: 


    A case-based update on cannabis epidemiology, neurobiology, clinical management, and research/policy issues relevant for providers seeing patients using cannabis in any setting.


    Tauheed Zaman

    MD

    Dr. Zaman is an addiction psychiatrist at the San Francisco VA Health Care System, where he serves as Medical Director of the Addiction Consult and Opioid Safety Team. He is also an Assistant Clinical Professor at the UCSF Department of Psychiatry, and serves as Associate Director of the university's addiction psychiatry fellowship. Dr. Zaman also holds several positions within the California Society of Addiction Medicine (CSAM), including Chair of the 2019 Conference Planning Committee. He completed his addiction training at UCSF, and his psychiatry residency at Harvard Medical School.  

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Gabapentinoids: A Wolf in Sheep's Clothing (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about the epidemiology of the gabapentanoid epidemic from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course: Gabapentanoids(Gabapentin and Pregabalin) prescribing has increased dramatically over the last 5 years. The majority of the prescribing has been for off label indications. Accompanying the increased prescribing there is increasing misuse, addiction and overdoses. This presentation will review the epidemiology of the gabapentanoid epidemic, and describe the untoward effects of gabapentanoid misuse. Misuse is most common among patients on Opioid Agonist Therapy. Health care providers must understand the adverse effect profile of gabapentanoids, the need to dose reduce when renal failure is present, and the need to carefully monitor and follow patients on gabapentanoids. As a general rule, the combination of prescription opioids and gabapentanoids should generally be avoided.

    Edwin A. Salsitz

    MD, DFASAM

    Dr. Edwin A. Salsitz has been an attending physician in the Mount Sinai Beth Israel , Division of Chemical Dependency, New York City, since 1983, and is an Assistant Professor of Psychiatry at the Mount Sinai School of Medicine. He is the principal investigator of the Methadone Medical Maintenance (office-based methadone maintenance) research project. 

    Dr. Salsitz is certified by the American Board of Addiction Medicine (ABAM), as well as by the Board of Internal Medicine and Pulmonary Disease. He has published and lectures frequently on addiction medicine topics.Dr. Salsitz is a course director for ASAM sponsored buprenorphine trainings,and is a mentor in the PCSS-MAT mentoring program. He has co-chaired the ASAM Review Course, the ASAM Common Threads Course, the ASAM State of the Art course and is a reviewer for the Journal of Addiction Medicine and Drug and Alcohol Dependence. He is the chair of the ASAM REMS course on safe and effective prescribing of opioids. 

    Dr. Salsitz was the Co-chair of the ASAM CME committee and Chair of the New York Society of Addiction Medicine CME and Education committee. Dr. Salsitz is a member of the medical advisory panel, for the New York State Office of Alcohol and Substance Abuse Services.  Dr. Salsitz is the recipient of the 2014 ASAM Annual Award, and the 2018 ASAM Annual Educator of the Year Award.

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Buprenorphine Cessation (.75 CME)

    Product not yet rated Contains 3 Component(s), Medical Credits Offered

    Earn .75 AMA PRA Category 1 Credit(s)™ while learning about literature surrounding the discontinuation of buprenorphine from The ASAM Pain & Addiction: Common Threads XX Course.

    (.75 CME) In this conference recording from the 2019 Pain & Addiction: Common Threads Course:

    This session reviews current literature surrounding the discontinuation of buprenorphine. Limitations and areas for future studies are also examined.

    William S. Jacobs

    MD

    William S. Jacobs, M.D, Associate Professor, Medical College of Georgia. is a national clinical expert, triple board certified in Anesthesiology, Pain Medicine, and Addiction Medicine physician. A Magna Cum Laude University of Georgia undergraduate and graduate of the Medical College of Georgia, Dr. Jacobs did his Anesthesiology Residency at the University of Alabama-Birmingham. He had a 13 year career as a private practitioner in anesthesiology and pain management before matriculating to UF for his Addiction Medicine Fellowship. Dr. Jacobs has been a national expert, testifying on Capitol Hill on MDMA and prescription misuse and abuse.  He was a medical and scientific Consultant to the US Senate  as well as the Department of Labor. Dr Jacobs has also testified and consulted for the DEA on safe prescribing of narcotic drugs and the model of ideal treatment programs. Dr. Jacobs  has been the Medical Director of non-profit, profit, and academic chemical dependency and dual diagnosis programs.  After his promotion to Associate Professor, he left academia and started NexStep Integrated Pain Care Inc., a model outpatient program for the treatment of patients with both chronic pain and addiction disorders. He returned to the University of Florida full time as Associate Professor in Psychiatry and Addiction Medicine: Co-Chief of Pain Medicine in 2012. Dr. Jacobs  is the author of peer reviewed scientific papers, abstracts, textbook chapters including the ASAM and APA definitive substance use volumes, and practice guidelines including highly cited studies on mitigating opioid abuse in chronic pain treatment, physician recovery, naltrexone, urine drug testing, and body mass index and alcohol use. Dr Jacobs has returned home to Georgia to become the first Chief of Addiction Medicine at The Medical College of Georgia He is also Medical Director of The Bluff Plantation as well as Chief Medical Officer for Georgia Detox & Recovery. 

    ACCME Accredited with Commendation

    ACCME Accreditation Statement

    The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

    The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ABPM Maintenance of Certification (MOC)

    The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (tMOC)

    This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

This course is intended for those in the addiction medicine field who already have some experience with pain and addiction. Other healthcare providers and members of the care team interested in treating this patient population are also encouraged to attend.

Upon completion of this educational activity, participants should be able to:

  1. List 5 ways that trauma can impact a patient’s pain and/or addiction.
  2. Create a script for communicating with patients about challenging clinical issues such as buprenorphine cessation or opioid induced hyperalgesia.
  3. Evaluate current research on non-pharmacologic therapies for pain and identify which may be useful with their patients.
  4. Develop a peri-operative treatment plan for patients on agonist and antagonist medications that reflects the current research and coordinates care with other members of the team.
  5. Identify methods to address acute pain in a chronic pain patient and methods to transition back after an instance of acute pain.
  6. Explain indications, risks, and benefits for tapering or discontinuing buprenorphine.
  7. Analyze current research on cannabis use in patients with pain and communicate that information to patients.
  8. Describe the recent data, risks, benefits, and indications for using gabapentinoids while treating patients with pain.
  9. Explain the relationship between pain, sleep, and addiction. Identify effects that key drugs play on sleep and the risks that creates.

ACCME Accredited with Commendation

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 8 AMA PRA Category 1 Credit(s).  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 8 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of AMA PRA Category 1 Credit(s)™ for completing this course.