American Pain Society's 27th Annual Scientific Meeting (May 8 – 10, 2008): Promoting Safe and Effective Chronic Opioid Therapy: An Integration of Scientific Evidence and Practice Considerations

The development of policies and guidance for the safe and effective use of opioids for the management of persistent pain is a high priority for healthcare systems. Bob Kerns will moderate the workshop and will describe the need to achieve balance between the promotion of access to opioid therapy for persons with moderate to severe pain with the responsibility to protect patients from adverse outcomes and to promote public safety. Bridget Martell will review evidence regarding the efficacy of chronic opioid therapy for non-cancer pain and the prevalence of aberrant behaviors and frank addiction associated with this therapy. Bruce Naliboff will discuss data from a recent prospective clinical trial that examined two different prescribing guidelines and identified predictors of adverse outcomes associated with opioid therapy. Jodie Trafton will describe development of a decision-support system designed to promote safe and effective use of opioids by providing individualized patient recommendations based upon clinical practice guidelines. Areas for future research to develop easily implementable, evidence-based guidelines for opioid prescribing will be articulated. Paul Kreis will offer recommendations for a balanced approach that addresses concerns associated with addiction and diversion while offering therapeutic options for prescribing opioids aimed at minimizing these risks.. Ken Berkowitz will discuss related ethical concerns. Scott Fishman will provide an integrative perspective on the practice of chronic opioid therapy with specific attention to contemporary legal issues. These three brief presentations will be followed by panel discussion of two complex cases that highlight important practice, policy, ethical, and legal issues. These cases will consider important management issues that are accentuated when delivering services to vulnerable populations such as persons with histories of substance abuse or serious mental illness, and the elderly. The session will provide ample time for responding to questions and to promote discussion among attendees.