Scientific Meeting

APS Annual Scientific Meeting Registration Is Open

Join us for the APS 31st Annual Scientific Meeting in Honolulu, HI, May 16–19. Be sure to register by April 5 to save $100! To register, visit the conference home page.

Don't miss any of the cutting-edge plenary lectures planned for this year's annual meeting. Join us on Thursday, May 17, at 7:45 am for "Translating Her Opioids into His Opoids" with Jon Levine, MD PhD. On Friday, May 18, Lorimer Moseley, PhD, will present "The Body in Mind—Disruption and Treatment of Cortical Body Maps in People with Chronic Pain" at 7:30 am. Following Dr. Moseley's lecture, Robert Gereau, PhD, will present "Translational Pain Research: Targeting Central Sensitization" at 8 am.

In addition, the Kerr and Fordyce lectures will again have dedicated time during the meeting. Plan to join us on Saturday, May 19, from 8–9 am. Kathleen Sluka, PhD PT, 2012 recipient of the Frederick W.L. Kerr Basic Science Research Lecture, will discuss models of muscle pain. Immediately following Dr. Sluka's lecture, Jennifer Haythornthwaite, PhD, recipient of this year's Wilbert E. Fordyce Clinical Lecture, will present "When Pain Persists: Are We Doing All that We Can Do?" Following the award lectures, David Dodick, MD, will present the Global Year Against Pain Lecture, "Migraine: Pathophysiology and Emerging Therapies" at 9 am.

Last Chance to Register for Discounted Rate!

Register by April 5 to save $100 on your APS 31st Annual Scientific Meeting registration fees. If you're an APS member, you can save even more on your meeting registration! For more information or to register, visit APSScientificMeeting.org.

Treatment

APS Announces 2012 CCOE Award Recipients

The American Pain Society Clinical Centers of Excellence (CCOE) in Pain Management Awards Program helps advance the quality of pain management in the United States by recognizing and rewarding excellence in quality clinical care. APS is pleased to announce the following 2012 CCOE Award recipients.

University-Based Programs
Division of Pain Medicine
Stanford University
Palo Alto, CA

Fairview Pain Management Center
University of Minnesota Medical Center
Minneapolis, MN

Comprehensive Pain Center
James A. Haley Veterans' Hospital
Tampa, FL

Community-Based Programs
United Back Care
Redmond, WA
Everett, WA
Puyallup, WA

Chronic Pain Rehabilitation Program,
Neurological Center for Pain, Cleveland Clinic
Cleveland, OH

Click here to learn more about the CCOE Awards Program.

Research

APS 2011 Future Leaders in Pain Research Grants Program Recipients

The Future Leaders in Pain Research Grants Program has been established to fund research projects of doctorally prepared investigators who have not yet attained National Institutes of Health (NIH) RO1 level funding. The program's intent is to encourage research in pain that will add to the body of knowledge and allow investigators to develop pilot data that will aid them in securing additional grant funding. In 2011 APS was able to award three grants of $20,000 each.

APS is pleased to announce the 2011 grant recipients:

Claudia Campbell, PhD
Johns Hopkins University
Baltimore, MD
"Determining the Role of Stress Hormones, Inflammatory Markers and Sleep on Ethnic Disparities in Pain Perception"

Jennifer J. DeBerry, PhD
University of Pittsburgh
Pittsburgh, PA
"Mechanisms Underlying Long-Term Afferent Sensitization and Persistent Bladder Pain"

Timothy Doyle, PhD
Saint Louis University
St. Louis, MO
"Sphinogosine Receptor 1 and Morphine Antinociceptive Tolerance"

Research America: A $1.3 Billion Increase for NIH

Representatives Bilbray (R-CA) and Markey (D-MA) have coauthored a letter to push for $1.3 billion in new funding for NIH. Contact your representative and urge them to sign-on to the letter, which can be found at Research America. New investments in medical research are critical for maintaining our global competitiveness, saving lives, and creating new jobs across America.

IASP Call for Applications

The International Association of the Study of Pain (IASP) has a number of funding opportunities. For complete award information, eligibility requirements, and application instructions, visit the IASP website. Application materials are due March 15.

IASP Research Symposium
This yearly program provides up to a maximum of $50,000 for research symposia on topics of interest to basic scientists and clinical researchers. Submit your application now to be considered for funding for a 2013 symposium.

IASP Collaborative Research Grants
These grants encourage and support collaborative, multidisciplinary research between two or more research groups in different countries. Up to three grants of $15,000 each may be awarded.

IASP Developing Countries Collaborative Research Grants
These grants encourage and support collaborative, multidisciplinary research between laboratories in developed and developing countries working on the same topic. Up to two grants of $15,000 each may be awarded.

IASP Research Grants Funded by the Scan|Design Foundation BY INGER & JENS BRUUN
These grants encourage and support collaborative, multidisciplinary research between two or more research groups located in the five Scandinavian countries (Denmark, Finland, Iceland, Norway, and Sweden) and the United States. Investigators must be based in a Scandinavian country and the United States. Two grants of up to $25,000 each are available for either clinical or basic research projects.

Advocacy

Mayday Pain and Society Fellowship Call for 2011 Applications

The Mayday Fund, a New York City foundation dedicated to alleviating the incidence, degree, and consequence of human physical pain, announced that it will begin accepting applications for the 2012 Mayday Pain and Society Fellowship: A Media and Policy Initiative. The program, is designed to equip physicians, nurses, pharmacists, social workers, scientists, policy experts, and legal scholars in pain management with the necessary skills to become effective advocates and spokespeople about pain issues in the United States and Canada.

Developing their communications skills through the fellowship, the six experts chosen will be poised to move the field forward with their willingness to educate and work with the media, policy makers, advocates, and health and business leaders. Six fellows are chosen each year, and the fellowship program runs through 2013.

Candidates must be accomplished experts, clinicians, or researchers in pain management and be able and willing to devote a significant amount of time to using the skills learned in the fellowship. They must show an interest in going beyond their professional pursuits to inspire change and make an impact on the pain field. Those interested can apply online at www.MaydayFellows.org.

Education

Call for Submissions

Psychosocial Research SIG Junior Investigator Poster Award

The Psychosocial Research SIG is pleased to announce a call for submissions for the third annual Junior Investigator Poster Award. The purpose of this award is to recognize and help develop junior investigators conducting psychosocial pain research.

The Poster Award winner will receive a certificate in recognition of the accomplishment and will provide a brief 10-minute presentation of their research at the APS Psychosocial Research SIG meeting, which will be held Wednesday, May 16, 2–4 pm in Honolulu, HI.

Eligible candidates for this award include undergraduates, graduate students, and postdoctoral fellows presenting first-authored posters at the APS annual meeting. Self-nominations as well as nominations by faculty members or research mentors are welcome. Candidates do not need to be a member of the SIG to be nominated. To be considered for the award, please e-mail poster abstract, abstract number, and contact information to Kevin Vowles by April 1. Posters will be evaluated by a subcommittee of the SIG. The winner will be notified by April 15.

Members

What is your area of specialty?
Pain assessment and pharmacological management in adults

What initially sparked your interest in working in your field? Briefly describe your career path.
When I graduated from nursing school one of my first clinical experiences was the care of adults with burn pain. These patients suffered terribly. Their pain was horribly undertreated. This seemed unnecessary and cruel.

What has been a highlight of your work?
I focused on developing instruments for more accurate and regular assessment of pain and the detection of undertreatment.

Is there a particular challenge that you've either overcome or hope to address soon?
One of the greatest challenges has been to hold clinicians accountable for accepting and treating a patient's report of pain. This has involved addressing many misconceptions, such as addiction.

Summaries

The Journal of Pain Highlights

The following highlights summarize selected articles from March 2012 (volume 13, number 3).

Adverse events associated with taking opioid pain medications increase among individuals who concurrently use sedatives and alcohol. A new study published in The Journal of Pain advises physicians to use caution in prescribing sedatives for patients taking opioids, even if there is no history of substance abuse.

Concurrent use of sedatives and alcohol with opioid analgesic medications can exacerbate respiratory depression and sedation. In most deaths associated with prescription opioids, other drugs are identified in the blood stream, such as sedatives, alcohol, and illicit drugs. In this study, the authors sought to assess the prevalence and predictors of concurrent use of opioids with sedatives and alcohol among patients receiving chronic opioid therapy for noncancer pain.

Data for the study was generated from individuals in health plans participating in the Consortium to Study Opioid Risks and Trends (CONSORT). Health plan enrollees were eligible for the study if they filled an opioid prescription within 30 days of the sample selection date. Phone interviews took place from June to November 2008.

Overall, 2,163 patients were interviewed, 31% had a history of substance use disorder, and concurrent sedative use was common—about 32%. Alcohol use was less common, as 12% of patients said they had two or more drinks within 2 hours of taking an opioid. Male subjects showed the highest rate of concurrent alcohol use.

Another key finding was that younger, depressed women taking opioid pain medications at higher doses for multiple pain problems have the highest risk for concurrent sedative use. The authors concluded that "the widespread practice of prescribing opioids and sedatives, particularly among patients receiving chronic opioid therapy at high opioid dosages, deserves increased scrutiny."

Multicomponent Cognitive-Behavioral Group Therapy with Hypnosis for the Treatment of Fibromyalgia: Long-Term Outcome
Antoni Castel, Rosalia Cascón, Anna Padrol, José Sala, and Maria Rull; Hospital Universitari de Tarragona Joan XXIII, Multidimentional Pain Research Group, and Universitat Rovira i Virgili

In several studies, cognitive behavioral therapy (CBT) has been shown effective for treatment of various pain disorders including fibromyalgia. There is also extensive evidence about the benefits of hypnosis in reducing acute and chronic pain, but there have been few studies examining the benefits of hypnosis in treatment of fibromyalgia.

For this study, the authors hypothesized that multicomponent cognitive behavioral treatments alone and with hypnosis would provide greater benefits for women with fibromyalgia than standard pharmaceutical care. They also sought to determine if adding hypnosis would increase the effectiveness of CBT.

Ninety-three patients with fibromyalgia participated in the study and were divided in three groups: standard care, CBT, and CBT with hypnosis.

The results showed that patients with fibromyalgia who received CBT alone or CBT plus hypnosis showed greater improvements in several outcomes (pain intensity, sleep quality, catastrophizing, functionality) than patients on standard pharmaceutical therapy. The authors also concluded that adding hypnosis increased the effectiveness of CBT's effects on psychological stress. Among patients who reported meaningful improvement in pain intensity from CBT, those treated with hypnosis had superior improvement compared with CBT alone.

Group cognitive behavioral intervention (CBI) has been found effective in reducing low back pain (LBP) and disability over a 12-month period in comparison with best practice advice given in primary care. These researchers studied the effects of this CBI beyond 12 months, undertaking an extended follow-up of their original randomized controlled trial of a group receiving CBI and best practice advice in primary care (in comparison with best-practice advice alone).

Most LBP is managed by primary care practitioners. Long-lasting effective treatments are difficult to identify, particularly for subacute and chronic pain. Exercise, acupuncture, manipulation, and postural approaches produce small to moderate short-term (4 or fewer months) benefits; longer-term (12 or more months) benefits typically are small or not statistically significant.

Researchers designed a CBI for primary care management of LBP, comprising a 1-hour individual assessment and six group therapy sessions (1.5 hours each). The majority of participants, both in the original trial and extended follow-up, had chronic symptoms. Physiotherapists, nurses, psychologists, and occupational therapists were trained to deliver the program via a 2-day course. Training included guided discovery, identifying and countering negative automatic thoughts (but not complex core beliefs), back pain education, pacing, graded activity, relaxation, and other strategies.

The authors conclude that the positive effects of group CBI on LBP disability, initially observed over a 12-month period, are sustained to at least 3 years (with an average of 34 months). CBI is more effective than best practice advice alone in reducing LBP-related disability.

A Randomized Controlled Evaluation of an Online Chronic Pain Self Management Program
Linda S. Ruehlman, Paul Karoly, and Craig Enders; Goalistics, LLC, and Arizona State University

Internet-based educational and therapeutic programs (e.g., e-health applications) are becoming increasingly popular ways to address a variety of psychological and physical disorders. Researchers tested the efficacy of an online chronic pain management program—a comprehensive, fully self-directed and self-paced system that integrates social networking features and self-management tools into an interactive learning environment.

Results indicated that program use was associated with significant decreases in pain severity, pain-related interference and emotional burden, perceived disability, catastrophizing, and pain-induced fear. Further, program use led to significant declines in depression, anxiety, and stress. Finally, as compared with the wait-listed control group, the experimental group displayed a significant increase in knowledge about the principles of chronic pain and its management.

This study's authors caution that the lure of technical advancements in patient monitoring and online program delivery should not overshadow the need to ensure program quality and minimize risk. Future advocates of electronic programs for chronic pain will need to provide evidence of their effectiveness relative to credible alternatives (not just wait-listed control subjects), ensure that social networking options do not lead to violations of ethics and privacy, address differences in user sophistication and attrition potential, maximize the safety of data storage, and better educate practitioners and the public about the benefits and challenges of computer technology relative to its costs and practical limitations.

Pain Medicine Highlights

Minorities and low-income patients in the United States live predominantly in geographic areas that constrain access to needed health care, regardless of insurance status. Regional surveys of pharmacies in the United States have found stark differences in opioid availability by socioeconomic status and racial configurations of neighborhoods.

A crucial element of any pain initiative must focus on eliminating the pain care disparities that are pervasive throughout U.S. healthcare settings. This article focuses on macro-level factors related to these disparities that may be amenable to policy interventions.

Many direct and indirect provisions within the Affordable Care Act (ACA) and other national initiatives that leverage the ACA offer opportunities to achieve equity in pain care. These provisions address changes in insurance; public, provider, and legislative education; primary care and pain specialist training; workforce diversity; uniformity in race/ethnicity data collection; patient-centered outcomes research; and an increased focus on pain care disparities within the comparative effectiveness research paradigm.

Contemporary thinking about pain disparities requires a new organized etiological model that drives opportunities for change. The authors contend that by partitioning pain disparities into the domains of structural system, policy and advocacy, workforce, healthcare provider, and research, it is possible to grasp the magnitude of disparities and their impact on the health of those experiencing pain.

Animal-Assisted Therapy at an Outpatient Pain Management Clinic
Dawn A. Marcus, Cheryl D. Bernstein, Janet M. Constantin, Frank A. Kunkel, Paula Breuer, and Raymond B. Hanlon; University of Pittsburgh and University of Pittsburgh School of Medicine

A number of studies have evaluated the physiological impact of therapy dog interactions, documenting significantly reduced blood pressure and heart rates in both healthy volunteers and medical patients. This study evaluated the effects of brief therapy dog visits in an outpatient pain management facility, compared with time spent in a waiting room. Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in an outpatient waiting area. Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the dog visit or waiting room time.

When participants entered the room, they were introduced to the dog and provided with a chair. The dog was trained to stand or sit next to the chair for the duration of the participant's visit and accept handling. More than one participant could interact with the dog at the same time. Conversations between participants and the dog's handler focused on the dog (e.g., breed, age, training) and dog-related topics. Discussion of health issues with the handler was discouraged.

Significant improvements were reported for pain, mood, and other measures of distress among patients after therapy dog visits, with clinically meaningful pain relief for 23% of subjects after the therapy dog visit. Significant improvements also were seen after therapy dog visits for family, friends, and staff.

These data show that including complementary treatment such as therapy dog visits in a chronic pain waiting room can at least temporarily reduce symptoms of distress and pain in some patients.

In the Media

Survey finds integrative medicine most useful for pain (Baltimore Sun)

Is massage better than OTC pain relievers? (Fox News)

Collegium collects $22.5M to deter pain-pill abusers (The Wall Street Journal)

The world's hottest pepper: Brings pleasure and pain relief (ABC News)

Illinois doctor gets 4 life terms in drug case (TIME)

A lifesaving overdose antidote should be made more widely available (TIME)

Crackdown on painkiller epidemic hurts legitimate patients (USA Today)

Call for Submissions

Do you have a topic that is relevant to APS members? Is there a member who is doing work that APS should spotlight? Is there a funding opportunity APS members need to know about? Please submit stories, events, and more to enews@ampainsoc.org for consideration.