2013 Clinical Track

Download a 29-page Preview Guide (pdf) to the 2013 National Rx Drug Abuse Summit.

Treating Pain
Tuesday, April 2, 2013, 12:30 pm – 1:45 pm
 Moderator Carla Saunders
Advance Practice Coordinator, Pediatrix Medical Group at East Tennessee Children’s Hospital
 Presenters Dr. Daniel Barnett, MD, JD
Medical Director, BlueCross BlueShield Tennessee
Dr. Randy Easterling, MD
The Street Clinic, and Medical Director, Marian Hill Chemical Dependency Unit
 Session Description The Centers for Disease Control and Prevention (CDC) has declared prescription drug abuse an epidemic and a public health crisis. The CDC also found that in 2009, almost half (475,000) of all patients who received prescription painkillers in Emergency Rooms were already abusing them. Currently, 49 states have operational prescription drug monitoring programs (PDMP), or enacted legislation to implement one, according to the Alliance of States with Prescription Monitoring Programs. The reality is that narcotics have changed the physician’s practice.

This session will discuss the cost of prescription drug abuse, both from a human and a financial perspective. Attendees will explore the dilemma that physicians find themselves in today in treating chronic pain. Participants will gain a better understanding of what regulatory boards look for in identifying inappropriate prescriptive patterns and the value of PDMPs. As we develop a better understanding of prescription drug abuse, we can better equip clinicians in defeating this epidemic, just like we have done for every epidemic in America’s history.

 Learning Objectives 1. Describe the evaluative criteria of regulatory boards in prescriptive patterns.
2. Examine the cost of prescription drug abuse economically and socially.
3. Identify non-safe versus safe prescribing protocols.
Successful Endeavors and Outcomes
Tuesday, April 2, 2013, 2:00 pm – 3:15 pm
 Moderator LCDR Christopher Jones
Prescription Drug Overdose Team, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention
 Presenters Dr. Robert DuPont
Clinical Professor, Psychiatry, Georgetown University School of Medicine
Dr. William M. Johnson
Chief Medical Officer, Pikeville Medical Center
 Session Description SAMHSA recently found that 1.2 million visits to emergency rooms in 2009 involved pharmaceutical drugs, compared with 627,000 in 2004. Primary care centers, hospital emergency rooms, trauma centers, and other community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.

In this session, attendees will hear how a chief medical officer of a regional hospital implemented effective processes for limiting costs associated with prescription drug abuse within his health system. A more in-depth examination of their approach will reveal strategies that the attendee can implement in their own practice or health system. We’ll also discuss how to use state Physician Health Programs for successful long-term recovery of prescription drug abuse.

 Learning Objectives 1. Analzye the latest data about the cost of prescription drug abuse to hospitals.
2. Explain the Physician Health Program model’s relevance to the treatment of prescription drug abuse.
3. Prepare strategies that you can implement in your own practice to reduce costs.
Prescribing Practices
Tuesday, April 2, 2013, 3:30 pm – 4:45 pm
 Moderator Dr. Kelly Clark, MD, MBA, FASAM, DFAPA
Chief Medical Officer, Behavioral Health Group
 Presenters Dr. Alex Cahana, MD, Dphil, DAAPM, FIPP
Advisor to the Vice Chancelor for Venture Academics, and Affiliate Professor Science, Technology, Education and Health Studies
Dr. Stuart Gitlow, MD, MPH, MBA
President, American Society of Addiction Medicine
 Session Description According to the Centers for Disease Control and Prevention (CDC), enough prescription painkillers were prescribed in 2010 to medicate every American around-the-clock for one month. Primary care management of long-term opioid therapy for chronic pain is burdened by inadequate coordination between primary care providers and pain specialists.

This session will discuss some pros and cons of attempting to change physician prescribing patterns and the dichotomy between over- and under-utilization of opioid prescribing which is dependent on the condition being treated. Attendees will hear how the University of Washington’s model of care delivery for chronic pain yielded a 44 percent reduction in prescription opioid dose accompanied by 50 percent improvement in mood and 21 percent of functioning in patients. Issues of iatrogenic opioid addiction, patient stigmatization, and the need to further educate physicians will be discussed.

 Learning Objectives 1. Explain that prescribing patterns have shown over-utilization of opioids for pain and underutilization for opioid addiction.
2. Examine how a program for care coordination and prescribing guidelines for opioid therapy for pain improves quality and decreases total opioid use.
3. Outline how policy and regulatory developments have sought to decrease opioid prescribing for chronic pain and have sought to decrease treatment of opioid addiction.
The Innocent Victims: Neonatal Abstinence Syndrome (NAS)
Wednesday, April 3, 2013, 1:30 pm – 2:45 pm
 Moderator John L. Eadie
Director, Prescription Monitoring Program Center of Excellence, Brandeis University
 Presenters Dr. Michael Hokenson
Assistant Professor of Pediatrics, Ohio State Wexner Medical Center
Carla Saunders
Advance Practice Coordinator, Pediatrix Medical Group at East Tennessee Children’s Hospital
 Session Description According to the American Academy of Pediatrics (AAP), 55-94 percent of infants exposed to opioids in utero experience withdrawal or NAS. These babies’ first experience in this world will be one of significant suffering with their first days, weeks and months wrought with uncontrollable tremors, inconsolable crying, stomach cramps, vomiting, diarrhea, blistered and bleeding bottoms, fevers, sweating, rapid breathing, uncoordinated and ineffective sucking, poor feeding, and tight muscles. The very act of comforting these newborns can cause over-stimulation which can further aggravate their symptoms.

Infants with NAS have higher rates of neonatal complications, prolonged lengths of stay, and consume substantial NICU and hospital resources. Further, they impose a growing burden on already strained healthcare resources because state Medicaid expenditures are disproportionately impacted. This session is designed to educate clinicians and prescribers on the affects of NAS and offer solutions on how to effectively treat these patients while raising awareness for prevention.

 Learning Objectives 1. Identify the scope of babies affected by NAS with statistics and research.
2. Evaluate treatment programs around the country that work to care for babies with NAS.
3. Build solutions for clinicians to treat babies with NAS.
Risk Reduction: SBIRT, Abuse Deterrent Formulations and Hepatitis C
Wednesday, April 3, 2013, 3:00 pm – 4:15 pm
 Moderator Dr. Gayathri Dowling, PhD
Branch Chief, Science Policy, Office of Science Policy and Communications, National Institute on Drug Abuse
 Presenters Dr. Melinda Campopiano, MD
Medial Officer, Substance Abuse and Mental Health Services Administration (SAMHSA)
Dr. Jag Khalsa
Chief, Medical Consequences Branch, DPMC, National Institute on Drug Abuse
Dr. Douglas Throckmorton, MD
Deputy Director for Regulatory Programs in the Center for Drug Evaluation and Research, FDA
 Session Description According to the Centers for Disease Control and Prevention (CDC), 3.9 million Americans suffer from chronic Hepatits C (HCV). Recent reports indicate that there may be a re-emerging epidemic of HCV in 15- to 30-year-olds who have abused prescription opioid analgesics for non-medical purposes then transitioned to injecting illicit drugs. Although abuse deterrent opioid analgesics are intended to minimize abuse and diversion while providing effective pain control for appropriate patients, measuring and balancing these considerations are important challenges for the U.S. Food and Drug Administration (FDA).

In this session, attendees will hear of several comprehensive risk reduction measures that are being integrated to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. We will also summarize and share existing information about the epidemiology of HCV among this group, the scope of the problem, and formative research suggesting intervention strategies.

 Learning Objectives 1. Describe SBIRT and define its use to clinicians.
2. Investigate the use of abuse deterrent formulations.
3. State evidence of the emerging epidemic of Hepatitis C infection in youth transitioning from prescription drug abuse to injection drug use.
4. Outline solutions to reduce risk of Hepatitis by prescribers.