Addressing the Opioid Epidemic: New Approaches to Safe and Effective Pain Management

Faculty

Mark S. Gold, MD
Adjunct Professor of Psychiatry, Washington University School of Medicine, St. Louis, MO
ASAM's Annual Lifetime Achievement John P. McGovern Award & Prize Winner
17th University of Florida Distinguished Alumni Professor, Gainesville, FL
Mark S. Gold, MD

Mark S. Gold, MD, is a teacher of the year, translational researcher, author, mentor, and inventor, best known for his work on the brain systems underlying the effects of opiate drugs, cocaine, and food. He has worked as an advisor to many White House Drug Czars, White House NIDA and NIMH directors over his career of 40+ years. He is an author and inventor who has published over 1,000 peer-reviewed scientific articles, texts, and practice guidelines. This pioneering work started with detoxification studies using clonidine and lofexidine as a non-opiate detox followed by oral naltrexone at Yale in the late 70s and continued at the University of Florida (UF). Dr. Gold translated opioid studies using mouse, rat, and non-human primate models before developing his opioid withdrawal hypothesis with his Yale colleagues. He then led the first studies to demonstrate non-opioid treatment efficacy for alpha-2 agonists. He also led rapid detoxification and clonidine to naltrexone studies in the late 70s and early 80s. Dr. Gold, trying to find patients who would take oral naltrexone, began his studies of Impaired Health Professionals and employees in health and safety occupations.

Dr. Gold has received a number of national awards for his research, including the Lifetime Achievement Award of the National Association of Addiction Treatment Professionals, Foundations Fund Prize (APA), PRIDE Lifetime Achievement Award, DEA 30 Years of Service Pin, the McGovern Award for Lifetime Achievement (ASAM-ABAM 2015), National Leadership Award (NAATP), DARE Lifetime Achievement Award, Public Relations Society’s Silver Anvil Award, and China Academy of Sciences and DARE awards for his career in research and prevention (2015). More recently, he received the PATH Foundations Lifetime Achievement Award (2016) as one of the “fathers” of addiction medicine, presented to him by President Obama’s White House Drug Czar Michael Botticelli. Dr. Gold was awarded Distinguished Alumni Awards at Yale University, University of Florida, and Washington University in St. Louis as well as the Wall of Fame at the UF College of Medicine.

Dr. Gold was a Professor, Eminent Scholar, Distinguished Professor, Distinguished Alumni Professor, Chairman, and Emeritus Eminent Scholar during his 25 years at the University of Florida. His work is widely cited by his peers. It includes citation classics in cocaine neurobiology, opioid addiction neurobiology and treatment, and food and process addictions. He proved that cocaine was misclassified as safe, or the champagne of drugs, leading to revision in the DSM 3 and diagnosis of addiction. He has been called a groundbreaking researcher, father of medication-assisted recovery, the first to translate rat experiments into theory and treatments for human addicts, and mentor of the next generation of addiction researchers and clinicians. Working closely with Bart Hoebel at Princeton University, Dr. Gold helped develop the food addiction theory he posited in the 80s. With Nicole Avena, he worked on sugar self-administration models for hedonic overeating and developed new treatments for overeating and obesity. Kelly Brownell and Dr. Gold’s Food and Addiction, published by Oxford University Press, has been widely recognized as groundbreaking. Although working on food and drug-like reinforcement systems has been an important part of his work for 30 years, he has also worked on dual disorders, anorexia and bulimia nervosa. Dr. Gold worked closely with Al Rhoton and Bill Luttge to establish the UF Brain Institute. He was an original member of the McKnight Brain Institute and Director working to develop programs in Psychiatry, Addiction, Neurology, and Neurosurgery.

Since his retirement as a Director of the McKnight Brain Institute, Chairman, Distinguished Professor, and a full-time academic in 2014, Dr. Gold has continued his teaching, mentoring, research, and writing. He finished his 5-year State Department grant on opium smokers and the effects of second- and third-hand opium on children in Afghanistan. He has worked on de novo clinical addiction programs at the Medical College of Georgia, Northwestern, UF, and Tulane Lakeview Health. Dr. Gold regularly lectures at national and international meetings, medical societies, grand rounds around the United States, and international and national scientific meetings on his career, bench-to-bedside science in eating disorders, obesity, and addictions. Recently, he gave a keynote speech at the National Opioid Summit and Florida Opioid Summit as well as for the DEA-DOJ. He speaks regularly at medical schools across the United States, recently at Yale University, Mayo Clinic, Tulane, Washington University in St. Louis, Stanford, University of Connecticut (UConn), UCSF, Emory, Harvard-McLean-Borden Cottage, and UNC. He has given recent keynote addresses at American College of Psychiatrists, CADCA, ASAM, NAATP, APA, and Biological Psychiatry as well as a many states, medical, and psychiatric associations, dealing with the opioid epidemic.

Dr. Gold is an Adjunct Professor in the Department of Psychiatry at Washington University and an active member of the Clinical Council at the Washington University School of Medicine’s Public Health Institute. He has Wash University mentees and works with them regularly. He is the Director of Research for the DEA Educational Association, working closely with DEA and moderating their quarterly educational events broadcast from DEA Headquarters around the world.

A. Omar Abubaker, DMD, PhD
Professor and S. Elmer Bear Chair, Department of Oral and Maxillofacial Surgery
Virginia Commonwealth University School of Dentistry, Richmond, VA
A. Omar Abubaker, DMD, PhD

Dr. A. Omar Abubaker earned a Bachelor of Dental Surgery degree (BDS) from University of Alexandria, Egypt in 1975. He also earned a Doctor of Dental Medicine (DMD) degree and a Ph.D. in Anatomical Sciences from School of Dental Medicine, University of Pittsburgh. He completed his residency in Oral and Maxillofacial Surgery at Presbyterian University Hospital in Pittsburgh. He also completed a one-year research fellowship in Oral and Maxillofacial Surgery sponsored by the American Association of Oral and Maxillofacial Surgery at University of Pittsburgh Medical Center.

Dr. Abubaker was appointed to the faculty of the Department of Oral and Maxillofacial Surgery in the School of Dentistry, and at the Department of Surgery, school of Medicine, Virginia Commonwealth University in July 1991 with the rank of assistant professor. In 1996 he was promoted to associate professor with tenure and in 2002 to full professor. In 2002, he was appointed to serve as the Chairman of the Department of Oral and Maxillofacial Surgery, Chief of Division of Oral and Maxillofacial Surgery in the Department of Surgery, VCU School of Medicine and Chairman of Department of Dentistry at VCU Health System. In 2014 he was appointed as the Elmer Bear Endowed Chair of the Department of Oral and Maxillofacial Surgery at VCU School of Dentistry.

Dr. Abubaker co-authored two textbooks in oral and maxillofacial Surgery, over 50 chapters and over 40 scientific articles in peer review journals. He presented before many local, national and international scientific meetings.

In 2016, Dr. Abubaker earned a Graduate Certificate in Addiction Studies from the International Program in Addiction Studies from a coalition between Virginia Commonwealth University, The University of Adelaide, Australia and Kings College London, England. Over the past four years he has developed an interest in education and research in the field of addiction. Over the past two years he presented on the topic of substance use disorder, opioid epidemic and pain management to more than 50 local, regional and national groups and organizations.

William F. Alden
Chairman, DEA Educational Foundation, Washington, DC
William F. Alden

Bill Alden has spent his entire distinguished career of nearly 50 years in the field of drug enforcement and abuse prevention, first as a DEA agent on the front lines, where he was the youngest agent ever promoted to front line supervisor, then, as the Chief of DEA’s Office of Congressional and Public Affairs. While heading the Office of Congressional and Public Affairs, he was instrumental in raising public awareness of drug related issues through developing Drug Wars: The Camarena Story, and by appearing in the print and TV media to promote awareness of DEA’s mission. His diverse experience led him to become the Deputy Director of DARE America and later to operate his own consulting firm, The Alden Group, providing law enforcement and drug prevention services to organizations including DARE America, Noblis, Verint Technology Inc., and Lafayette Group.

In 2001, Mr. Alden proposed the concept of a DEA Educational Foundation which came to fruition through his efforts and of which he was first the president and is now the Chairman of the Board. He currently lends his talent and expertise to the Foundation in support of the DEA Museum soliciting sponsors and partnerships to allow the museum to develop state-of-the-art displays and traveling exhibits. One such traveling exhibit, Drugs: Cost & Consequences has been seen by more than 22 million teachers, students and parents in 14 cities across the country. Another exhibit was created to educate Afghans on the dangers of opium use. Thousands of students in Afghanistan have viewed the exhibits as they traveled the countryside.

The Foundation also supports the DEA Youth Dance Program which provides an afterschool dance program to children across the country giving them an alternative to drugs while teaching them to make healthy and smart choices. The DEA YDP is currently in 47 cities across the U.S. The DEA EF developed an Opioid Awareness strategy which focuses its efforts on educating the public on the dangers of Opioid misuse.

As these examples illustrate, Mr. Alden’s dedication to drug awareness and his wide range of experience and skills continues to be an invaluable asset to the Foundation.

Mr. Alden received his B.A. degree from Indiana University in 1966.

Catherine Judd, MS, PA-C, CAQ-Psy, DFAAPA
Clinical Assistant Professor, Department of Physician Assistant Studies, UT Southwestern Medical Center School of Health Professions
Physician Assistant, Mental Health and Behavioral Medicine, Parkland Health and Hospital System, Dallas, TX
Hassan R. Mir, MD, MBA
Director of Orthopaedic Residency Program, University of South Florida
Director of Orthopaedic Trauma Research, Florida Orthopaedic Institute
Professor, University of South Florida, Tampa
Siegfried O. F. Schmidt, MD, PhD, FAAFP
Professor, Department of Community Health and Family Medicine, Director, Chronic Pain Management Program at Main, UF Health Family Medicine – Springhill, University of Florida, Gainesville, FL
Steven P. Stanos, DO
Executive Medical Director, Rehabilitation and Performance Medicine
Swedish Pain Services, Swedish Health System, Seattle, WA
Steven P. Stanos, DO

Steven P. Stanos, DO currently serves as Executive Medical Director of Rehabilitation and Performance Medicine, Swedish Pain Services at the Swedish Health System in Seattle, Washington. Aside from directing pain management services for the hospital system, he also leads Swedish’s pain rehabilitation center, Functional Restoration, an integral part of the pain medicine continuum of care. In addition to his work with Swedish Health System, he is active with committees work at Providence St. Joseph Health related to the system integration of pain management including primary and specialty care. Prior to joining Swedish and Providence, he served as medical director of the Center for Pain Management at the Rehabilitation Institute of Chicago (RIC) Northwestern University Medical School from 2002-2014, and served as an Assistant Professor at Northwestern University Feinberg School of Medicine and program-co chair of the multidisciplinary pain fellowship.

Dr. Stanos is board certified in physical medicine and rehabilitation and pain medicine by the American Board of Pain Medicine and by the American Board of Anesthesia.

Dr. Stanos is a Past President of the American Academy of Pain Medicine and serves on the Board of Directors of the American Board of Pain Medicine. He served as a panel member on the Service Delivery and Reimbursement work group for the National Pain Strategy, an invited consultant to the CDC for the CDC Opioid Guideline for Prescribing Opioids for Chronic Pain, and as a work group member for Healthy People 2020 and Healthy People 2030. He is active with the American Academy of Physical Medicine and Rehabilitation and has served as the co- chair of education for the Pain and Neuromuscular Council.

Dr. Stanos’s work also includes ongoing educational initiatives for primary care, pain medicine, and physical medicine specialists around the United States and abroad. Dr. Stanos has published numerous scientific articles and book chapters related to pain management. He has been involved in the development and publication of treatment guidelines related to rehabilitation approaches for chronic pain and low back pain conditions. He also serves on the editorial board for the journal Pain Medicine and as a reviewer for other pain and rehabilitation journals.

A Mayday Foundation Advocacy fellow in 2013, Dr. Stanos’s advocacy has continued to focus on increasing awareness and access for inter-disciplinary biopsychosocially-based pain care for patients suffering with chronic pain. In 2014, the University of Washington Department of Pain Medicine awarded Dr. Stanos with the John J. Bonica, MD lecture. He has appeared on CNN, National Public Radio, Fox News, regional print, and television news covering various topics related to pain medicine and pain rehabilitation.

Statement of Need

The opioid epidemic underscores the importance of healthcare providers integrating a multimodal approach to safe and effective pain management. Doing so requires not only comprehensive assessment of patients, but the consideration of non-opioid medications, selected based on the severity of pain and injury. The Orthopedic Trauma Association recently released their Clinical Practice Guidelines including recommendations for pain medication strategies, cognitive strategies, physical modalities, and system tools, all of which are imperative when addressing pain management.

In part 2 of this 3-part series, expert faculty focus on the four-step approach that follows the SOAP (Subjective-Objective-Assessment-Plan) approach to pain management, as well as principles of communication with patients experiencing pain in order to help clinicians appropriately prescribe the best therapy for pain management in each patient.

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Upon evaluation of your current clinical workflow for opioid prescribing, incorporate two best practice strategies to optimize safe and competent prescribing and minimize potential for abuse and diversion.
  • Educate patients about their pain to optimize safe and effective, multimodal treatment plans.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Describe two best practice strategies to optimize safe and competent prescribing and minimize potential for abuse and diversion.
  • Educate patients about their pain to optimize safe and effective, multimodal treatment plans.

Financial Support

Supported by an educational grant from Johnson & Johnson.

Target Audience

Physicians, dentists, physician assistants, nurse practitioners, and pharmacists.

Credit Information

Physicians (ACCME) 1.0

CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ADA CERP: 0.75

ADA CERP: CME Outfitters, LLC is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP. CME Outfitters, LLC designates this activity for 0.75 continuing education credits. Concerns or complaints about a CE provider may be directed to the provider, or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.

Pharmacists/Pharmacy Tech (ACPE) 1.0

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit.
Activity UAN: 0376-0000-19-024-H01-P

ABIM MOC 1.0

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.


Dr. Gold has no disclosures to report.


Dr. Abubaker has no disclosures to report.


Mr. Alden has no disclosures to report.


Ms. Judd reports that she is on the speakers bureau for Alkermes; Neurocrine Biosciences, Inc.; Otsuka America Pharmaceutical, Inc.; Sunovion Pharmaceuticals Inc. She is on the advisory board for ACADIA Pharmaceuticals Inc.; Neurocrine Biosciences, Inc.


Dr. Mir reports that he is a consultant for OrthoGrid Systems, Inc.; Smith & Nephew; StabilizOrtho; Trice Medical; Zimmer Biomet.


Dr. Schmidt has no disclosures to report.


Dr. Stanos reports that he receives research support from Grunenthal and is a consultant for SCILEX Pharmaceuticals, Inc.


Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

  • Mae Ochoa, RPh (peer reviewer)
  • Jan Perez (planning committee)
  • Sharon Tordoff (planning committee)
  • Evan Luberger (planning committee)

CME Outfitters, LLC and the faculty do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

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Addressing the Opioid Epidemic: New Approaches to Safe and Effective Pain Management
Event Date: 06/04/2020