Further information coming soon:
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Opioid Prescribing – Getting the Balance Right
Chair: Dr Tim Semple – Pain Medicine Specialist
Dr Mark Hardy – Addiction Medicine Specialist
Dr Malcolm Hogg – Pain Medicine Specialist
A/Prof Peter Gonski – Geriatrician
The use of opioids in the treatment of chronic non-cancer pain is a topic of much debate. When not optimally managed, prescribing opioids can result in escalating doses, poor patient outcomes and unsanctioned use. Nonetheless, many patients in Australia are safely prescribed opioids for their chronic non-cancer pain, significantly improving both their physical functioning and quality of life.
In this symposium chaired by Dr Tim Semple, three experts in their fields, Dr Marky Hardy, A/Professor Malcolm Hogg and A/Professor Peter Gonski will outline how they use opioids in carefully selected patients, minimising the potential risks and ultimately improving patient outcomes. The presentations will be followed by a panel discussion with the audience.
Chair: Professor Stephen Schug, (MD, FANZCA, FFPMANZCA), Director of Pain Medicine, Royal Perth Hospital
Dr Michael Vagg is a consultant in rehabilitation and pain medicine. He graduated from Monash University in 1994 and spent several years as a uniformed Medical Officer in the RAAF before undertaking vocational training. Dr Vagg completed a Fellowship of the Australasian Faculty of Rehabilitation Medicine (AFRM) in 2004. He subsequently gained Fellowship of the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists in 2006. Dr. Vagg is also a Director of Pain Matrix.
His areas of clinical interest include soft tissue pain, post-amputation pain and interventional pain treatments.
It is estimated that between 2 and 5% of people in developed countries have fibromyalgia, a chronic centralized pain condition characterised by widespread pain, poor unrefreshing sleep and fatigue. Research in recent years has found treatment options and strategies that have proven to help manage fibromyalgia symptoms.
Dr Michael Vagg will be presenting on the management of fibromyalgia in his clinical practice. He will be focusing on the practical side of managing fibromyalgia patients, what strategies are employed in his practice, Pain Matrix, and how he is using a combination of strategies to improve patients’ quality of life. There will be time for questions at the end of the talk.
Monday 9 April, Afternoon Session - 5.15 - 6.15 pm (canapes and drinks to follow)
Transitional Pain Medicine: Improving Peri-Hospital Care as a model for long-term change in pain management and opioid prescribing
Chair: Professor Stephen Schug, (MD, FANZCA, FFPMANZCA), Director of Pain Medicine, Royal Perth Hospital and Dr Hester Wilson, Staff specialist in Addiction at the Langton Centre, South East Sydney Local Health District.
Dr Hance Clarke is the Director of Pain Services and the Medical Director of the Pain Research Unit at the Toronto General Hospital, Canada. After his medical doctor (MD) and anesthesia subspecialty training in Toronto he received his PhD from the Institute of Medical Sciences at the University of Toronto and is a member of the Royal College Clinician Scientist Program. He is the Research Chair For the University of Toronto Centre For the Study of Pain.
With the current concern about opioid prescribing and opioid dependence, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and pre-surgical opioid use. Dr. Clarke will discuss the development and implementation of a Transitional Pain Program that enables close monitoring of pain, opioid medications and mental health vulnerabilities that place certain patients at a higher risk of developing chronic postsurgical pain and progressing to dependence. Beyond in-hospital interventions, he is working to scale the Transitional Pain Program post-discharge, involving community partners to tackle the current public health crises of pain and opioid addiction. Selected cases in which opioid prescribing no longer serves the patients’ pain needs and instead a rotation to buprenorphine/naloxone to manage dependence resulted in pain reduction and improved functioning and quality of life after years of chronic pain, will be presented for discussion.
Ketamine and buprenorphine – old analgesics in a novel sublingual formulation
Dr Janakan Krishnarajah is the Chief Medical Officer at iX Biopharma Ltd. He is a Consultant Physician with specialist interests in Clinical Pharmacology and Internal Medicine and a Fellow of the Royal Australasian College of Physicians.
Ketamine is being used extensively in pain management, however, its optimal use remains to be determined. The clinical scenarios in which ketamine can be given are constrained by the only licensed formulations being an injection. Sublingual administration if ketamine by lozenges or rapidly dissolving sublingual wafers (Wafermine™) can provide rapid onset and effective pain reduction.
Despite proven clinical utility, buprenorphine has not been used widely for the treatment of acute and chronic pain. Mounting evidence from clinical studies strongly support superior safety and efficacy profile of buprenorphine versus other marketed opioids. Bnox™ is a novel sublingual buprenorphine wafer currently in clinical development.
In this talk, Dr Janakan Krishnarajah will discuss clinical use cases for sublingual ketamine and sublingual buprenorphine. He will also provide an update on the clinical development and latest clinical trial data for Wafermine™ and Bnox™ sublingual wafers.
Tuesday 10 April, Morning Session - 7.30 - 8.30 am (includes breakfast)
ActiPatch: wearable, paraesthesia-free, neuromodulation for chronic pain relief
Dr Sree N. Koneru (Ph. D – VP of Product Development) obtained his Ph.D. in Biomedical Engineering from Binghamton University, NY. His dissertation work involved researching and documenting the physiological responses of human subjects, when stimulated using pulsed radiofrequency fields. This led to the development of advanced electroceutical devices that are capable of providing deep-tissue heat and non-invasively modulating afferent nerve activity. He leads new product development at BioElectronics, with an emphasis on prototype development and validation of efficacy through pilot clinical studies. Dr. Koneru’s primary interest lies in tapping into the potential of non-invasive electroceutical technologies to treat/prevent the onset chronic degenerative diseases.
Chronic musculoskeletal pain is prevalent in Australia/New Zealand, and presents significant socio-economic challenges. Chronic pain can be complex to manage, since the level of pain is often unrelated to the level of underlying tissue damage. Existing therapies like drugs/topicals/TENS have limited effectiveness, since they do not target the underlying issue: Central Sensitization, a.k.a. nerve hypersensitivity.
ActiPatch is a wearable, paraesthesia-free neuromodulation device that provides chronic pain relief. Learn how this device uses high-frequency electromagnetic waves to regulate afferent nerve activity and mitigate nerve hypersensitivity. The ActiPatch has distinct advantages over TENS, since it can be used 24/7 and works even over clothing/bandaging.
Does ‘Strong Analgesic’ Equal ‘Strong Opioid’? : Tapentadol and the Concept of ‘µ Load’
Professor Ralf Baron is Head of the Division of Neurological Pain Research and Therapy, Department of Neurology, Christian-Albrechts-Universitaet Kiel, in Germany.
This session will deliver a comprehensive explanation of the difference between analgesic and opioid equivalence in pain management and will discuss the role of ‘µ load’ in strong analgesics and the effects of MOR activity on efficacy and tolerability. Prof Ralf Baron will also discuss the atypical opioid Tapentadol, the molecule’s mode of action and describe how Tapentadol immediate release and sustained release fits into his practice by sharing his clinical experience.