Full Schedule

Wednesday, May 13 | Thursday, May 14 | Friday, May 15 | Saturday, May 16

Saturday, May 16

8–9:45 am
General Session

Continuing Education Credit Available for Sessions 105-107: 1.5 Hours for Physicians, Psychologists, Nurses, and Pharmacists

8–8:30 am

(105) Frederick W. L. Kerr Basic Science Research Lecture: Making and Braking Pain
Clifford Woolf, MD PhD

The initiating point of most pain is activation of the nociceptor. It is now possible using a small set of transcription factors to transform mouse or human fibroblasts into nociceptors. This provides an opportunity to begin to study human pain in a dish, one that will permit the analysis of how genetic mutations produce inherited pain or congenital analgesia and screens for the activity of novel analgesics. Ultimately, we may be able to identify who is at risk of developing many categories of pain and why, as well as identify what treatment will work best.

8:30–9 am

(106) Wilbert E. Fordyce Clinical Lecture: Fibromyalgia: A Disease, Common Pathway, or Rubbish?
Daniel Clauw, MD

Fibromyalgia has struggled for credibility even though the pathophysiology is fairly well understood, and treatments based on a contemporary understanding of the neurobiology have generally been found to be successful in subsets of patients. Rather than thinking of fibromyalgia as being a discrete disease, it should be considered a final common pathway that occurs in subsets of most, if not all, chronic pain states. The subset of individuals with any chronic pain state who display the cardinal features of fibromyalgia (multifocal pain accompanied by fatigue, sleep, and memory and mood difficulties) likely have prominent central nervous system contributions to their symptomatology. Identifying these individuals is critical, because they seem to be less responsive to commonly used treatments for nociceptive pain, such as opioids, injections, and surgical procedures, and more responsive to centrally acting analgesics that work via modulation of central nervous system neurotransmitters.

9–9:45 am

(107) Global Year Against Pain Lecture: ‘Listening’ and ‘Talking’ to Neurons: Clinical Implications of Glial Dysregulation of Pain, Opioid Actions and Drugs of Abuse
Linda Watkins, PhD

Work over the past 20 years has challenged classical views of pain & opioid actions as being mediated solely by neurons. Recently, this challenge to classical views has extended to drug abuse. Glia (microglia & astrocytes) in the CNS are key players in chronic pain, compromising the efficacy of opioids for suppressing pain, contributing to opioid tolerance and dependence/withdrawal, and potently contributing to the rewarding effects of opioids, cocaine, methamphetamine, and alcohol. Further, glial reactivity can be “primed” so to create enduring, amplified neuroinflammation, thereby contributing to the transition of acute-to-chronic pain.

Intriguingly, the glial activation receptor that creates neuroinflammation under conditions of chronic pain is one and the same receptor that is activated by opioids and other abused drugs. Importantly, this glial activation receptor is not the neuronal opioid receptor that suppresses pain. Indeed, clinically-relevant therapeutics targeting this glial activation receptor in particular or glially-drive neuroinflammation more generally have shown remarkable efficacy as stand alone treatments for neuropathic pain, improving the clinical utility of opioids and suppressing drug abuse. As such compounds are rapidly moving toward clinical trials, translation of laboratory findings to humans is approaching.

9:45–10 am
Break

10–11:30 am
Symposia

Continuing Education Credit Available for Sessions 800-805: 1.5 Hours for Physicians, Psychologists, Nurses, and Pharmacists

(800) Social and Interpersonal Factors in Pain: New Models for Research and Practice
Jamie Rhudy, PhD (Moderator); John Burns, PhD; Annmarie Cano, PhD; Amanda Williams, PhD

Social processes are often neglected in studies of pain, leaving clinicians with few options for how to address social and interpersonal issues that impact pain. This symposium will address this issue by identifying the social and interpersonal factors that contribute to pain (above and beyond the reinforcement of pain behaviors), describing social issues that may contribute to judgments about pain in others, and identifying positive and negative social and interpersonal factors that could be addressed in the clinical context.

(801) Pain Public Policy Debate
Renee Manworren, PhD APRN-BC FAAN (Moderator); Robert Twillman, PhD; Aaron Gilson, PhD

We will move this debate from Congress and news media outlets to APS by presenting what evidence we can find for both sides of the most significant issues. Audience participation is required for effective debate and thorough presentation of the evidence. Examples of topics for 2015 include mandatory continuing education in pain management and/or substance abuse, medical marijuana, prior authorization reform, advanced practice nurse pain medication prescriptive authority, and others. Which side of the issues are you on?

(802) Urogenital Pain Syndromes: Using Rodent Models to Understand Comorbidity, Novel Targets, and Treatments
Erin Young, PhD (Moderator); Julie Christianson, PhD; Jennifer DeBerry, PhD; Erica Schwartz, PhD

This symposium will include three presentations that will discuss urogenital sensitivity and dysfunction resulting from neonatal maternal separation, targetable mechanisms underlying persistent bladder hypersensitivity, and characterization of an animal model of prostatitis.

(803) Enhanced Classification and Assessment of Chronic Pain: Moving Beyond Dichotomy
Kimberly Sibille, PhD (Moderator); Roger Fillingim, PhD; David Williams, PhD

Current clinical and research efforts are hindered by insufficient criteria to distinguish and characterize differences among individuals with chronic pain. This symposium will provide information regarding current limitations, new initiatives, and novel strategies to improve scientific investigations, with the overall goal of optimizing assessment, diagnosis, and treatment of chronic pain.

(804) Expanding the Toolbox: Theranostic Nanomedicine and Systems Biology Applied to Pain Research and Treatment
Jelena Janjic, PhD (Moderator); Jerry Gebhart, PhD; John Pollock, PhD; Yoram Vodovotz, PhD

This symposium will engage clinicians and researchers in a discussion aimed at recognizing the potential of nanotechnology and systems biology approaches applied to pain research and treatment. The presentations will provide brief theoretical discussions on nanomedicine and systems biology followed by examples of their use in pain animal models. Basic researchers will benefit from identifying new imaging and drug delivery approaches applied to pain in preclinical models. Clinicians will find that nanomedicine strategies, which have been clinically approved in other therapies, may be applicable for the treatment of pain.

(805) Voluntary Opioid Tapering in Nonaddicted Individuals: Research, Clinical Practice, and Ethical Issues for the Clinician
Ronald Kulich, PhD (Moderator); Jianren Mao, MD PhD; Mark Sullivan, MD PhD; Michael Schatman, PhD CPE

Risks associated with chronic opioid therapy are now well established, and clinicians are often required to implement voluntary tapering programs for nonaddicted patients with moderate- or high-dose opioids. This symposium will outline the current state of opioid tapering research and addresses practical clinical strategies for addressing complex or difficult-to-manage opioid regimens. Most current evidence-based tapering protocols are based on addiction medicine models, but many patients with chronic pain do not have access to traditional detoxification services. These services also may be inappropriate in the absence of an addiction diagnosis. Symposium speakers will address issues of pharmacotherapy and dosing with opioid therapy, integrated behavioral and management strategies, and ethical and medicolegal issues associated with a decision to taper and the structure of an opioid reduction program. Practical clinical applications will be reviewed, and attendees are encouraged to offer complex case examples for the panel discussion.

11:45 am–1 pm

(900) The National Pain Strategy–Where Do We Go From Here?

A core recommendation of the 2011 IOM Report: Relieving Pain in America (Recommendation 2-2) states: “The Secretary of the Department of Health and Human Services should develop a comprehensive, population health-level strategy for pain prevention, treatment, management, education, reimbursement, and research that includes specific goals, actions, time frames, and resources.”

This session will include discussion of a National Pain Strategy. The panel of speakers, who were involved in the strategy’s development, will offer insight into its current status and next steps.