by Mordecai Potash, MD
Barely a week goes by without me seeing at least one, and often multiple, mainstream news articles about the practice of pain management. Just the other day, there were a number of stories about a huge federal multi-state crackdown on what was called “rogue prescribing” of opiate pain medications by 76 doctors which led to them being arrested and charged with fraud and a long list of other charges [1]. Earlier in the month, I read an article about a dramatic increase in raids of offices of doctors who prescribe buprenorphine to treat opiate dependence [2]. Those targeted by that set of raids included a past-president of the American Society of Addiction Medicine and other nationally prominent specialists in opiate dependence.
In the past I would reassure myself that I would not be “raided” or even audited because I did right by my patients – taking my time to interact with them and create a treatment plan that was updated at each visit. Now, I am far less sure that doing this good care and good documentation will protect me from being raided by the DEA or other federal agencies that have been involved in this on-going national crackdown on prescribers of opiate medications [3].
If there is one thing these articles have confirmed to me, it is that the planning committee of the Southern Pain Society (SPS) has assembled an incredibly relevant program for our annual meeting. David M. Vaughn, Esq., CPC, is going to speak about Recent Government Audit Areas for Pain Management which should give us some insight into what federal regulators are considering before they generate an audit in these turbulent times in pain management.
A few of the doctors interviewed in these articles point to the CDC Opioid Guidelines as a benchmark goal they are trying to get their patients to achieve. For example, they are trying to get all their patients off opioid and benzodiazepam combinations and get all their patients on opioid doses of 90 milligram morphine equivalents or less. The SPS conference will feature Sanford M. Silverman, MD, addressing CDC Guidelines: Be Careful What You Wish For. Dr. Silverman will undoubtably give an expert critique of how the guidelines have been applied to direct patient care since they were released one and a half years ago.
I am very happy that we are going to feature a talk on medical / therapeutic marijuana by James Taylor, MD, titled Hemp, Hemp Hurray! Could Medical Hemp be a solution to the Opioid Crisis? I am even happier that we have this relevant talk considering that some other prominent national pain organizations have recently been compelled to cancel their own talks on medical marijuana [4].
We will also feature other speakers who will examine the turbulent environment in pain management presently. We will feature Kate M. Nicholson, JD, talking about Treatment Under Pressure: A Patient and Policy Perspective. Also featured will be Daniel F. Lonergan, MD, who will address Managing Chronic Pain in an Opioid Epidemic Environment. I am truly looking forward to both these talks because hardly a day goes by that I do not think about the changes in pain policies that are afoot in state and national levels and how do I manage pain compassionately in an environment that increasingly sees all opioid prescribing as contributing to a national epidemic.
If these topics aren’t enough to convince you to register now for SPS 2018, let me also point out that we have not one but two talks from David Hanscom, M.D., of the Swedish Neuroscience Institute. Dr. Hanscom was our star at last years’ successful conference and is going to discuss two topics at this year’s meeting: The Myth of Back Pain Surgery: What We Know vs. What We Are Doing and Solving Chronic Pain with a Self-directed Structured Approach.
If for some crazy reason that is still not enough reason to make your reservations for our SPS 2018 conference, right now, let me remind you that the national media is well documenting efforts to bring new, non-opioid, pain management treatments to market [5]. We are going to highlight the role of neuromodulation to bring attention to new treatments available to fight pain when B Todd Sitzman, MD, MPH, talks on Advance Techniques in Neuromodulation.
So, I hope my column has convinced you to join us in the great city of Atlanta for SPS 2018 because we have assembled an incredibly relevant conference. Never have the pressures in pain management felt so compelling and urgent and therefore, there has never been a greater reason to educate yourself on how to apply best policies to your own practice. We have put together a conference that will do exactly that. The only thing missing is for you to send in your reservation confirming that you will join us, as we explore the shifting paradigm of safe and effective pain management for all!
See you in Atlanta!
– Mordi
[2] https://tonic.vice.com/en_us/article/8xevwb/dea-raids-addiction-doctors