J O U R N A L O F O Journal of OPIOID CERTIFICATION PROGRAM P I O I TM D Presented by M This 2-day program, led by a renowned group of specialists, is designed A N to inform and certify primary care physicians, pain specialists, and A Opioid Management other opioid prescribers in the uses, abuses, and legal ramifications G E of opioids. Upon completion of this program, the Society will issue M E A medical journal for proper and adequate use a framed certif icate verifying completion of the course. Attendance N required at all sessions to receive certificate. T Volume 1, Number 5 NOVEMBER/DECEMBER 2005 ISSN 1551-7489 DAY 1 O n Lega l–Take back your practice n Understanding opioids – M n How do opioids interact with n What do they do and how? CONTENTS OPIOID n other medications? n Addictions & doctor shoppin g– MANAGEMENT n How to handle cancer and why n How to spot a doctor shopper S n OPIOID NEWS AND EVENTS Monitoring outcomes during long-term opioid n Physician side of the legal issue n Pai n– How to deal with it SOCIETY n FBI, DEA, who, why, where, how n Nonopioid ways to deal with pain News briefs . 234 therapy for noncancer pain: Results with the Pain Assessment and Documentation Tool . 257 DAY 2 Calendar . 236 Steven D. Passik, PhD In association with n Tapering someone off opioids n Dosages and under prescribing Kenneth L. Kirsh, PhD n Hazards of long-term opioid use n Opioids for medical traumas n GUEST EDITORIAL Journal of Laurie Whitcomb, MA n Arthritis and Cox2 inhibitors n and diseases What can we learn from baseball’s TM Jeffrey R. Schein, PhD, MPH n out of the picture n Types of opioids and uses steroid scandal? . 237 Opioid Management Mitchell A. Kaplan, PhD n Rotation of opioids n Dosing levels by type of pain Gary M. Reisfield, MD n History and science of opioids n Opioids for neuropathic pain Sheri L. Dodd, MSc George R. Wilson, MD Leah Kleinman, PhD Nathaniel P. Katz, MD n CASE REPORT Russell K. Portenoy, MD DATE SPONSOR AND Dextropropoxyphene and the cardiovascular N April 22 –23, 2006 CERTIFICATE O system: About two cases of acute poisoning Electronically monitored single-use V PROVIDER E patient-controlled analgesia pumps M with cardiac conduction abnormalities . 240 B in postoperative pain control . 267 E Frédérik Staikowsky, MD, PhD Opioid Management Society R / Michael Zimmermann, MD TIME D Sébastien Candella, MD and Journal of Opioid Management E Karin Friedrich, MD C Maurice Raphael, MD Saturday, April 22 – 8 AM TO 4:30 PM 470 Boston Post Road E M Rolf Kirchner, MD Sunday, April 23 – 8 AM TO 3:30 PM B Weston, Massachusetts 02493 E R n PHARMACY PERSPECTIVE 781-899-2702 • fax 781-899-4900 2 0 n LITERATURE REVIEW 0 Methadone in end-of-life pain management . 244 5 Cholecystokinin antagonists: Can they LOCATION Diane L. Chau, MD M. Nathan Mason, MD augment opioid-derived analgesia? . 273 The Conference Center at Harvard Medical CONFERENCE Gary McCleane, MD LEADER 77 Avenue Louis Pasteur n ORIGINAL ARTICLES Boston, Massachusetts 02115-5899 Robert E. Enck, MD, Professor of Medicine, A comparison of oral and implant naltrexone Assistant Division Chief f or Clinical Activities, Division outcomes at 12 months . 249 of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania Ross Colquhoun, BPsych (Hons) Donald Y-K. Tan, MBBS Samantha Hull, BPsych (Hons) REGISTRATION INFORMATION Fee: $695 per person. Registration before November 30, 2005, fee: $645 per person. Fee for JOM subscribers: $595 per person. JOM subscriber registration before November 30, 2005, fee: $545 per person. V O L . 1 , TO REGISTER CONTACT: N O . 5 or : 1-800-743-7206 x103 x107 2 www.opioidmanagementsociety.org 2 5 - 2 8 0 OPIOID CERTIFICATION PROGRAM Presented by O OPIMOID MANAGEMENT STM SOCIETY In association with AD Journal of Opioid Management TM This 2-day program, held at The Conference Center at Harvard Medical in Boston and led by a renowned group of specialists, is designed to inform and certify primary care physicians, pain specialists, and other opioid prescribers in the uses, abuses, and legal ramifications of opioids. Upon completion of the entire program, the Society will issue a framed certificate verifying that you have completed the program. Please see our ad on the back cover for complete Conference details Jour nal of Opioid Management TM A medical journal for proper and adequate use 470 Boston Post Road, Weston, MA 02493 • 781-899-2702 • Fax: 781-899-4900 E-mail: [email protected] • Web site: www.opioidmanagement.com Call for manuscripts Editorial Policy the exception of forum articles, book advise contributors of the status of their sub - The mission of the Journal of Opioid reviews, or letters to the editor, manuscripts missions within 60 days. Management is to educate and promote, should include the following five sections: through scientifically rigorous research, the Abstract, Introduction, Methods, Results, References adequate and safe use of opioids in the and Discus sion. Subheads should be insert - References are organized in AMA for - treatment of pain as well as the legal and ed at suitable levels. Style should conform mat; that is, they are to be cited numerically regulatory issues surrounding abuse, addic - to “Uniform Requirements for Manuscripts in the text and in consecutive order, includ - tion, and prescription practices (both over- Submitted to Biomedical Journals” (avail - ing the first three authors followed by et al., and under-prescribing). Original articles, able online at http://www.icmje.org). and listed at the end of the article in the fol - case studies, literature reviews, editorials, lowing format: and letters to the editor concerning all Figures & Tables Journal articles — aspects of opioid management will be con - The Journal welcomes illustrations, 1. Mudd P, Smith JG, Allen AZ, et al.: sidered for publication. All submissions, charts, and photographs to accompany arti - High ideals and hard cases: The evolution of excluding editorials and letters to the edi - cles. Figures should be titled and numbered opioid therapy for cancer pain. Hastings tor, are subject to peer review by the edito - consecutively according to the citation in Cent Rep . 1982; 12(2):11-14. rial board prior to acceptance. the text. Information presented in figures Books — and tables should be explained in the text. 1. Bayles SP (ed.): Nutritional Supple - Manuscript Submission If data have been published previously, an ments and Interactions with Analgesics . Electronic manuscript submission is pre - appropriate reference should be included. Boston: GK Hall & Co., 1978. ferred. Attach articles in MS Word, Short, descriptive legends should be Book chapters — WordPerfect, or rich text (.rtf) format to the provided on a separate page. Legends for 1. Martin RJ, Post SG: Introducing alterna - journal email address at [email protected]. If figures previously published should include tive prescribing strategies. In Smith J, Howard submitting via regular mail, please supply a complete reference to the original publi - RP, and Donaldson P (eds.): The Oncology your article on a 3-1/2 inch IBM-PC format cation, with the copyright designation. Management Handbook . Madison, WI: floppy disk or CD in MS Word 6.0 or greater, Copies of the publisher's and author's per - Clearwater Press, 1998, pp. 310-334. WordPerfect, or rich text format (.rtf). mission to use the figure must be provided. Web sites — Manuscripts and all correspondence should Photo graphs should include legends and Health Care Financing Administration: be addressed to the Managing Editor, Journal should be numbered consecutively accord - HCFA Statistics at a glance. Available at: of Opioid Management, 470 Boston Post ing to the citation in the text and labeled on www.hcfa/gov/stats/stahili.htm. Accessed Road, Weston, MA 02493. Submit one paper the back. Tables, photos, and figures must December 27, 2002. copy of the manuscript, typed and double- be submitted in the following formats: spaced, with the floppy disk or CD. As a gen - TIFF, JPEG, or EPS. Ethics eral guideline, text should be 1,500 to 2,500 Style should conform to “Uniform Require - words (seven to 12 pages for a research paper, Manuscript review ments for Manuscripts Submitted to Biomedi - three to five manuscript pages for editorials or Manuscripts are received with the under - cal Journals” prepared by the International book reviews). standing that they are submitted solely to Committee of Medical Journal Editors and Journal of Opioid Management and that, pub lished in Ann Intern Med 1997; 126: 36-47, Manuscript Format apart from abstracts, none of the material con - and available on the web at http:www.acpon - The cover page should indicate the arti cle’s tained in the manuscript has been published line.org/journals/annals/01jan97/unifreqr.htm. title, the full name, highest pertinent acade - previously or is under consideration for pub - The Journal expects authors to disclose mic degrees, institutional affiliations, and lication elsewhere. Authors should secure all any commercial or financial associations current address of each author, contact necessary clearances and approvals prior to that might pose a conflict of interest in con - information for the author handling all cor - submission. nection with the submitted article. All fund - respondence, telephone number, fax num - Journal of Opioid Management is a ref - ing sources supporting the work should be ber, and, if the manuscript was orally pre - ereed journal. All manuscripts are generally acknowledged on the title page. sented at a meeting, the name of the organi - subject to review by at least two members of Manuscripts and all correspondence re - zation, place, and date it was read. The first the editorial advisory board who are noted garding them should be addressed to the use of an un common abbreviation should experts in the appropriate subject area.