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Spring 2013, Issue 1

Founders Society
The Foundation is grateful for the foresight and generosity of our creators. Established in connection with the formation of the Foundation, the Founders Society recognizes benefactors who support patient safety, education and research for the Academy through the Foundation. This society has been established to allow us to distinguish individuals for their vision, their tremendous influence in launching the Foundation, and their commitment of time as well as financial support of at least $1,000 to the campaign prior to Dec. 31, 2013. It is through this recognition that a legacy for the Foundation is created, in hopes of inspiring future leadership and benefactors who are committed to patient safety, prescriber education, and credentialing and training.

Donor Appreciation
Thank you to Depomed and Purdue Pharma for their generous, early support of the campaign with gifts of $75,000 or more.

Current Founders . Society Members

Charles E. Argoff, MD James Barrett Gil Bashe Michelle Byers Perry Fine, MD Rollin Mac Gallagher, MD Elliot Krames, MD Phil Saigh Marsha Stanton, PhD, RN Kevin Weber Lynn Webster, MD We invite you to join with a gift of $1,000 or more before Dec. 31, 2013!

for more inform ation visit W W W.PAI NM E D.ORG /F OU NDATION/

4

Depomed is pleased to support the important initiatives of the American Academy of Pain Medicine Foundation. We believe that patient care can be enhanced through expanded education of all providers involved in treating pain and applaud the Foundations efforts in this area.

AAPMF Connection: Advancing Patient Safety is the official newsletter of the American Academy of Pain Medicine Foundation. The opinions expressed are not necessarily those of the AAPMF or its Board. The validity of opinions and accuracy of content are not guaranteed by AAPMF. Copyright, American Academy of Pain Medicine Foundation 2013. AAPMF Board: Charles E. Argoff, MD, President Marsha Stanton, PhD, RN Jeremy A. Adler, MS, PA-C Gil Bashe Michelle Byers B. Todd Sitzman, MD, MPH Patricia Bruckenthal, PhD, APRN-BC, ANP Lynn R. Webster, MD, AAPM Board Liaison Sean Mackey, MD, PhD, AAPM Board Liaison Campaign Executive Committee: Charles E. Argoff, MD Gil Bashe Michael J. Brennan, MD Michelle Byers Elliot Krames, MD Marsha Stanton, PhD, RN Kevin Weber Lynn R. Webster, MD Address all contributor correspondence and inquiries to: Susan Farrell, MPS Interim Executive Director American Academy of Pain Medicine Foundation 4700 W. Lake Avenue Glenview, IL 60025 sfarrell@aapmfoundation.org 847-375-6355 Managing Editor: Beth Dove of Dove Medical Communications, LLC, Salt Lake City, Utah, dove.beth@gmail.com Design by XO Marketing, Sandy, Utah, 801-272-8686

www.website.com visit for more information

Connection
A Foundation for Safety Founders Society
specialist for every 9,500 patients with chronic pain. It is essential, then, that pain education reach beyond the core specialist group to encompass front-line providers everywhere. In recognition of the need, the Foundation has launched a Campaign to Advance Patient Safety with the goal of raising $1.5 million. The Foundation seeks to provide funding support for a variety of goals, including: Promoting quality pain education and training for prescribers Conducting research into the causes and treatment of pain conditions and disease Supporting best practices to optimize patient outcomes Ensuring a comprehensive, integrated and coordinated system of care

AAPMF

AAPMF Foundation
Quarterly NewsletterEssential Tools to Expand Audience Reach FDA Panel Discussion

Advancing Patient Safety

topics at a Glance

A Foundation for Safety

The American Academy of Pain Medicine Foundation (Foundation) was formed in 2011 to support the core purpose of the American Academy of Pain Medicine (Academy). A separate non-profit entity, the Foundations role is to provide funding and infrastructure support to the Academys initiatives. In accordance with the Academys mission to eliminate pain as a public health problem, the Foundations overarching focus will be to advocate for patient safety. The goal is nothing less than to set the agenda for an international discussion on safety in the delivery of pain therapies. To understand why patient safety is a top priority, consider that some 100 million Americans suffer with chronic pain and another 25 million face acute pain, according to the Institute of Medicine. At the same time, prescription drug abuse is a fast-growing national problem, and the education for medical professionals is woefully inadequate when it comes to treating pain effectively and safely. The Journal of Pain reported that many U.S. medical schools have no pain courses, while others offer fewer than five hours of classes. Despite the extraordinary need, the United States has only one pain

These efforts will require the enthusiastic collaboration of other leading medical professional organizations as well as donor support from parties dedicated to achieving safe and effective access to multidisciplinary pain therapies for patients who suffer. Improvement in pain medicine outcomes will advance patient safety.

We invite you to learn more about the Foundations Campaign to Advance Patient Safety by talking to a member of the Campaign Executive Committee:

Specific and immediate initiatives to advance Charles E. Argoff, MD e patient safety include: Gil Bashe ine and look for the blu onl MD tion Brennan, Expanded continuing medical Michael contribution. Visit the Founda a tax-deductible education programs ke Michelle Byers ma to ton but e New web-based delivery andDonat Elliot Krames, MD knowledge management systems Marsha Stanton, PhD, RN Investments in the Early Career Kevin Weber Investigator Small Grants Program Lynn Webster, MD f, Pioneering patient-focused educational Dr. Charles Argof initiatives AAPMF president, rience is advised the that clinical expe rted it asse as er nt de -based He furth FDA panel s ponent of evidence AAPMF Presi considered opioid an integrated com ld not be ignored. to treat chronic, to FDA: bate medicine and shou

Courses patientintegrative and Interventional, a faculty include: are covered by centered care primary specialists and pain rt expe ess and Pelvic Pain of addr Abdominal omy, The goal is to s. ician phys h istent Pain: Anat muc care Acute and Pers needs of the y the educational iology and Patholog re providers, Phys thca heal of l Pain larger audience who work nced Interventiona ists Adva mac phar tech prescribers and e include Procedures New web-based ort AAPMF vision of Failed nts in pain. Thes Management of daily with patie ent De in family noncancer pain. Appropriate face delivery supp ty hy, practitioners Pain Managem Opioids vs. held Feb. safe doctors of osteopat assistants, ic hearing was Back Syndrome be advancing patient icine, physician y med mon nal The two-day publ Testi Should not inter and Treatment of Md. and more. Assessment in Bethesda, , and in ids ers nt 2013 ding tition pio Patie 7-8, inclu prac the nurse Non-O to opioid for Treating Headaches lus stakeholders, labeling limits thcare Essential Tools came from 50-p loved ones tion of Pain ted to Panel weighs average of 250 heal ting who have lost Assessment and treatment dura ery model was crea Pain reaches an al mee family members icians and and Palliative Care The blended deliv of pain dosage, indication year at the annu overdose, phys Cancer Pain cribers outside professionals a to opioid-related h as many pres of Pain Medicine onal Pain Syndrome are patients living reac for noncancer pain emy ings for s offer Acad limits cate Live rican Complex Regi of the Ame as possible. ers of professional advo with the labeling detailing the m icine tition and Myofascial Pain ider draw ulties culu med prac lgia ld prov diffic curri r mya its shou ists, er ed othe mac Furth Fibro highlight ent regimen boration with d to (Academy). Now with pain, phar One presentation rant Behaviors dental surgery, planned in colla will be A pain managem or may medicine is slate were proposed. Guide to Aber ialties and may amentals of pain addition, courses cy medicine and ers genetic variations In l al spec fund rgen tition idua eutic ions. iple eme prac Analgesic Use indiv mac of mult ff, nizat ery ing With phar orga from les Argo ed deliv ter numbers s from Associated research show a single a new web-bas id therapy, Char reach ever-grea ation. new faceand representative , casting doubt that of offered through not include opio ialties by blending Workers Compens nd video feeds, Low Back Pain rican Academy in opioid response nt need. spec ema and Ame iple patie on-d es the all mult of live, in pani ort t tment of Pain FDA com model, using MD, presiden access to ideration by the hanism-Based Trea ge cap could supp cates argued that an FDA panel ne delivery. ts, Mec cons told on-li dosa r men n, and com unde datio ce to-fa Proposals nt advo id therapy Pain Procedures urce existing recorded against Pain Medicine Foun long-term opio Physicians and patie not static Office-Based and an online reso d, the Bad evidence for and include limiting severe pain are study materials erate pain), for ss to learning ements: The Goo and ids selfmod as it weighed the g acce Agre opio d id erate on ludin s Opio base nded mod (exc s restriction of the The expa mg to severe pain ed against restriction y. Pain library. tightening labeling ort more with the mission ge limit of 100 and the Ugly states and warn . Those who supp g a daily dosa us opportunities fits of a malignanc entered Medical Medicine inuo settin not nt-C cont or Pain rial and Patie ng of ence ty noncancer pain the mate limiti emy ts, and on the pres Pain and argue that safe focused course American Acad advance morphine equivalen sed. rated The clinically restrictive labeling e, multindation) to noncancer pain. Home is pain, they stres not been demonst no a comprehensiv ation. Foundation (Fou use to 90 days for and the Law ssing, encompasses effectiveness have gh enhanced educ sed that care if Pain Medicine oach to asse NSAIDs Dr. Argoff stres patient safety throu emy and Foundation icians dont know or y of Opioids and disciplinary appr long term. But nts with president of Phys Acad relief for all oid receptors patie ptors the MD, ent Opi ing rece at Pharmacolog e dny, perc treat ers for thos Kolo 100 do Lead P), Andrew and diagnosing and therapy gives has cancer, nor on of the need ures Prescribing (PRO gniti id ing eone in as a nonLect reco Opio som s. near pent track le d is rome gaba expresse for Responsib measurements to us pain synd fit when someone d the FDA to best practices and des vario bene patients and cited gh clinical trials show only ione ting to inclu el petit mina ond the gned of mod that resp disse The nt and are desi Thou year urgency in ling the organization said Rebecca Kirch tice and to patie ebo case presentations of clinical experience, opioid example. in pain medicine e ng, said the labe the end of life, changes in prac effective than plac y which opioid prescribi new developments She said a full rang all levels itional education eting at ety. ting, limit Add mark Soci s. mee iders er in al sher man ome prov gabapentin is more rein is Canc annu refre outc ty the ed to American needed community improve for some and opathy, the reali round, not just at the field. would changes are need formulations are nt harm and providing basics in treating neur , he said. by specialists in manufacturers and enting of therapies and will reduce patie icine. rs. to experience pain is largely attended practices by drug differ. After pres nts. med information for othe patients continue d for legitimate patie because patients outcomes in pain ad under-controlle this years not block access anti-opioid practitioners emic co-chairs of ence of widespre id-safety strategies and ide evid acad prov pioid paign to the is e cam of pro-o t of ns ledg One who cated opio the Foundatio The primary inten This dichotomy serve the skills they bring expert know family members pain, Kirch advo safe use, Early support of Academy information and ff said. It does not course said the tools toughest, Several bereaved echoed ating patients on stry partners and with both practical is false, Dr. Argo or society to bear on the takethe patient who PROP petition that included educ by several indu ssionals, patients and experience enhancing drug to better manage medicine. supported the additional education osal; this use er pain proin disp ing s can canc healthcare profe are mak and or issue is e ge s. stora clinicians members thcare providers nic, end-of-lif most controversial Kolodnys assertion ; educating pain has acute, chro well. Ethical heal associate sions within back programs possible! g and pain an Mahajan, MD, e treatment deci Ahadian, healthier abuse screenin pain, said Gag health and mak Center in , said Farshad M. pain relief and on substance criptionand to Davis Medical That is powerful Patients want safe ompson, strengthening pres anesthesiology on on the program professor at UC that context. Ada Giudice-T co-chair of this assessment; and al professor of said For more informati and clinic ., s, Pain Calif MD, ome for after outc . Susan Farrell at Sacramento, tor of the Center designed so the claim by died in his sleep itoring programs is ite direc ael mon se ical desp donate, contact Mich cour , , med said son and whose undation.org. years course. The ersity of California Furthermore, he omorphone. She some of mfo Univ nt journal has hydr aap the d the eme of ewed at rell@ cribe impl out e -revi sfar can peer Medicine readily ingesting pres estions to com warnings of gesic that practitioners some that no ning to ing that power to issue clear Other safety sugg xone for supporting the anal ediately upon retur San Diego. Mak will be and to urged the FDA co-prescribing nalo these tools imm published evidence 90 days, e in the trenches on opioid labels htened hearing included therapy beyond accessible to thos addictive potential supporting prescribing acknowledging heig to 52 their practices. benefit of opioid high-risk patients, studies lasting up formative. tal disorders, that the data nsion trans re men exte l ensu orbid -labe by open required rate. risk with com e, dental nd the 90 days directives are accu r quantities for acut omes weeks (well beyo onstrate prescribing fewe outc blish efficacy) dem term. tion and skills pain, and tracking t limits they the FDA to esta fit long and post-surgical opposed treatmen practical informa gned to deter nts derive bene Other speakers formulations desi patients. Dennis or cancer ioners with both that some patie the FDA id by rable opio ired vulne for ered on requ cent are onic, end-of-life to provide practit say would harm is chr test consensus nt not Arachnoiditis te, grea Extension studies the inte ugh acu The of , Altho lf e. ary has arch ty. abus o beha r rese inued safe The prim ient wh al Center. ention, Capolongo, on funding for bette to establish cont tigators also of reness and Prev the need for more ter manage the pat at UC Davis Medic bet sor oint, some inves to National Institutes fes pain the Society for Awa use hic pro gh Dr. opat , can ate throu y a required endp neur ples oci the litating coordinated te partners. on efficacy. As exam described the debi Mahajan, MD, ass al disease r public and priva choose to report 30 percent, le with the spin Health and othe pain, said Gagan ies showing that suffered by peop to account Argoff cited stud patients P petition failed 46 percent of even and said the PRO 40 percent and fit after one a point he said s bene need e id rienc opio for their continued to expe rphone, . -release hydromo / Kolodny conceded year from extended ntadol, respectively. events/fda/130207 tape worldwide.com/ oxymorphone and at: http://www.tv tial Popular Essen ram to Tools Prog d Expand Beyon Audience -toPain-Specialist nology and face
Access webcast archives of the FDA hearing

www.painmed.o

rg/foundation

s ut the Foundation For information abo please contact: ing, focus for fundrais , Interim Executive Director Susan Farrell, MPS ation.org und sfarrell@aapmfo 847-375-6355

be mai Donations may also AAPM Foundation nue 4700 W. Lake Ave 25 Glenview, IL 600

led to:

Case Study:

DEEP GROUNDWATER
T

Delineating Groundwater Contaminatio Plume Envir n Through a onment Multip

SONIC SAMPLING
Service: Location:

le-

Boart Longyear
Case-Studies

THE ALPHA STAGE3 DIAMOND CORING

T
Vital Stats: 80 % les s investigation derived waste Fast and reli (IDW) Improved able performance sample quality

Sonic Ground water Samp ling Massachuset ts Military Re servation, Cape Cod, Ma Client: ss., U.S.A. Department of Application : Deep Ground Defense Water Sonic Sampling

Case Study: Alpha Stage3 Diamond Coring Bit is Field Tested

ULTRAMATRIX

Overview: Subsurface Investigatio ns The Massachu setts Military Reservation has a unique (MMR) loc source aquifer ation, above a fast-flowin g, sole. Past militar fe y pra release of har ctic it Li es B resulted in the In mful che se mic ea als into the seriously imp% Incr dy: 75acting the groundwater environment, Stu the De partment of qua Case lity. In 1982, Defense init Restoration iated the Ins Program to tallation identify and contaminated evaluate pot sites. entially By 1989, the Environment al Protection added MMR Agency had to the Nation al Priorities Lis a Superfund t, site. An agg ressive ground making it was setto water goal work toward 100% contain numerous gro ment of the undwater plu me was used for subsurface inv s detected. Sonic drilling estigations to remediation efforts. aid in the

: SSUMX DIAMOND BITS

Product: Alpha Stage3 Diamond Coring Bit Location: A Nickel Mine in Manitoba, Canada Application: Field Testing of the Alpha Stage3 Diamond Coring Bit Compared with the Alpha Extended

Inc. & Sons, height) Hughes m crown er: LJ Bit (12m Custom SSUMX rn PA, USA t: te Produc ation Southwes g Explor n: Locatio n: Surface Corin io Applicat

Vital Stats: The average bit life of the Alpha Stage3 was 120 meters Industry first in advanced drilling products Extended bit life

The data ga thered using Boart Long years sonic drills has enabled en vironmenta l scientists understand to the complex ity of this aquifer and design effect ive remediation strategies to restore the water be Boart Longyear Drilling Services has employed the neath Cape fe The Challeng Cod. d Bit Li e Boart Longyear Alpha Extended Crown for more than To Use the Increase Advancing three years at a nickel mine in Manitoba, Canada. The SSUMX Sonic Casin Temporary g to Well Serve as a ground conditions are demanding due to the variability bits Other Remediation efforts on MM bits in the formations, not only from one part of the mine to R kicked into 1996. Sonic high gear in drilling was the other, but even within a single hole. Formations in 0ced selected ove du rotary metho Re d r an mu auger ds due to ty Manitoba are typically hard abrasive quartz mixed with and rsatili d Ve depth inform lity to rview: its abi ed pro vide accurate Ove hanc atio medium hard and coarse ground. n to En del fe,ine nd ate containme and define the er Li ble grou Long rias nt plu va aquifer strat me , even highly igra rk were not cap nd s phy a wo st . T g en he aug Co in able of rea ng brok Until recently, the 08 ABREC configuration of the Alpha er le t, dril al et of ls s ch s chi d ce ng in fa dep w an . Sur and, due sloth, Drilling e 500 to rs drille time an traditional Extended Crown had proven to be the best bit in use at ns can b ed core th nc ive ie conditio er ns e expe ost exp ugh the the mine with an average bit life of 37.5 meters. for the m ts, although mor in cutting thro ns bi ive conditio diamond d bits, are effect n ground te d up whe nge bits in impregna , but do not hol ha ny c pa nd The bit-remains sharp and requires nd illing com ip rods a soft grou 1000 eed to tr tly to both the dr very little stripping. When stripping n he . T change ns is cos - it is done without the is needed, conditio variable rew. need to reduce water r c line of and thei tile matrix sa volume. tra er Ul t v e from th ar s mos Manitoba Drill Team X bit, rt Longye ee 1500 The SSUM ts, is one of Boa diamonds and fr tional bi e tradi diamond d bits. The larg rm both ce Challenge: te ut-perfo pensive surfaThe impregna rix allows it to o ex oft. Extending Bit Life in Hard,-Abraisive Ground at s, more ard to s h m fro cutting m d bits, as well a nging Conditions ra te ns na itio eg impr cond Bit Life: With the proven performance of the Alpha Extended ground 2000 set bits in Crown, the drilling teams were unsure about trying RIG 1 nal. exceptio bits are e UMX gned, w The SS was desi bits in t bi is th 2500 Before egnated drillers ed impr x never us nd. We had si with an ou ar softer gr bits over a ye d e se es ea Th cr 34 . In that ran e of 2,903 feet Bit Life lif lts for e su ag re er av od d bits. , very go 3000 are very t or impregnate se Bit Life: surface es gh Mick Hu

Overview: Drill Teams Experience a 300% Increase in Bit-Life At a nickel mine in Manitoba, Canada, Boart Longyear Drilling Services field tested the new Alpha Stage3 diamond coring bit in a multi-site deployment. Drill ts ce set bi teams experienced bit-life gains of up to 300% over s: over surfa sts Vital Stat crease in bit life tal operating co their previous standard, the Boart Longyear Alpha in to in % n uctio 75 Extended Crown. ificant red Sign

126

Alpha EC

122 126

Stage 3

104

INCREASE

eet) Depth (f

300% BIT-LIFE

41

42

28
RIG 3

40

Drilling

1,600 FT

RIG 2

RIG 4

75%

2,900 FT.

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