The American Academy of Pain Medicine      Annual Meeting Home Page     
24th Annual Meeting February 13-18, 2008 Orlando, FL
Annual Meeting Highlights
Supported by an educational grant from Merck & Co., Inc.



© 2006 American Academy of Pain Medicine
Saturday, February 16, 2008: 1:30 PM-3:30 PM
(403) A Rational Approach to Managing Risk in the Chronic Pain Practice
Pain and addiction can exist as comorbid conditions, such as alcohol dependence with peripheral neuropathic pain. However, pain and addiction may also exist in some cases as a continuum. In these cases, the problematic use of a prescription opioid may develop over time in response to the treatment of a chronic painful condition. When and how this transition occurs poses some interesting diagnostic challenges to the prescriber, who is looking to maximize relief while minimizing risk that is often inherent in the prescription of the opioid class of drugs. When the drug of choice is as much the problem as it is the solution, then tools such as the DSM-IV become ineffective in diagnosing substance dependence (addiction) and abuse. Failure to treat both conditions (when present) will undoubtedly lead to frustration and poor outcomes in both domains. This session will focus on how to approach the pain patient with or without a clear history of addiction by setting clear and effective boundaries with each patient from the outset. The real question before us is not “Is there a risk?” but rather “What is the risk, and is it manageable?” Fortunately, the answer to the second question invariably is “yes.” The challenge is in determining who is best to manage these risks.
1:30 PM Introduction
Douglas L. Gourlay, MD, MSc
1:35 PM Assessment of Composite Risk in the Management of Chronic Pain
Howard A. Heit, MD FACP
2:15 PM The “Golden Moment” in Addiction Medicine: What Is It and How Can I Use It in my Pain Practice?
Douglas L. Gourlay, MD, MSc
2:55 PM Question & Answer

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