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Landmark
Legislation Passed in
Albany, NY
The
New York State Legislature recently and unanimously passed the Palliative
Care Education and Training Act [AB11162, S07458A] to improve palliative
care and pain management. Initiated by Compassion and Choices, a
nonprofit organization working to improve care and expand choice
at the end of life, the legislation addresses the urgent public
healthcare crisis of the undertreatment of pain. The legislation
will
- establish
a statewide advisory council on palliative care and pain management
-
create undergraduate and graduate palliative care training programs
-
establish Department-of-Health-designated Centers for Palliative
Care Excellence
-
authorize the Department of Health to certify one or more palliative
care resource centers to assist physicians in the treatment of
patients in pain.
Up
to $4.5 million is authorized annually for the training programs.
Supporters
of the bill included numerous medical and healthcare organizations,
institutions, and advocacy groups. The bill was crafted with significant
assistance from Dr. Joseph Fins, Chief Division of Medical Ethics,
Weill Medical College of Cornell University, and Dr. Russell Portenoy,
Chair of Pain Medicine and Palliative Care at Beth Israel Medical
Center, New York City.
To
read more about Compassion and Choices, visit www.compassionandchoices.org.
Mayday
Fund Announces 2006–2007 Recipients of the Mayday Pain and
Society Fellowship
The
Mayday Fund announced the selection of six experts in pain management
to be fellows under The Mayday Pain and Society Fellowship. The
new fellows hail from across the United States and specialize in
a wide range of healthcare disciplines including anesthesiology,
palliative care, pediatrics, nursing, and social work. APS extends
special congratulations to the three new fellows—Paul Arnstein,
Steven Passik, and Steven Weisman—who are APS members.
Established
in 2003, the fellowship provides leaders in the pain management
field with tools and skills to advocate on behalf of better treatment
for pain. Fellows learn how to better communicate with media and
policy makers and raise visibility for their issues. To date, the
program has supported 12 fellows. The Mayday Fund will fund the
fellowship through 2009, allowing for two more generations of fellows.
2006–2007
Fellows
Terry A. Altilio, LCSW, Coordinator of Social Work,
the Department of Pain Medicine and Palliative Care, Beth Israel
Medical Center, NYC
Paul M. Arnstein, PhD RN, Department Chair, Community
Health and Psychiatric/Mental Health Nursing, and Associate Professor
at the William F. Connell School of Nursing, Boston College
James Patrick Murphy, MD, Medical Director, Murphy
Pain Center, and Assistant Clinical Professor, Department of Anesthesiology,
the University of Louisville School of Medicine, Louisville
Shirley Otis-Green, MSW LCSW, Senior Research Specialist,
Department of Nursing Research and Education, City of Hope National
Medical Center, Duarte, CA
Steven D. Passik, PhD, Associate Attending Psychologist,
Department of Psychiatry and Behavioral Sciences, Memorial Sloan
Kettering Cancer Center
Steven J. Weisman, MD, Jane B. Pettit Chair in
Pain Management, Children's Hospital of Wisconsin, and Professor
of Anesthesiology and Pediatrics, the Medical College of Wisconsin.
As
part of their training, the new fellows will attend an intensive
4-day workshop in Washington, DC, in October 2006, and work closely
with Burness Communications, a public relations firm, which works
solely with nonprofit organizations. Fellows will learn how to connect
with local and national media, write opinion editorials, develop
relationships with university public affairs and government relations
leaders, and talk with state legislators and members of Congress.
By improving their communications skills, the candidates will be
poised to move the field forward by educating and working with the
media, policymakers, advocates, and health and business leaders.
The
Fellows will develop skills to advocate and communicate on many
of the pain issues they deal with everyday including the undertreatment
of pain, pediatric pain, chronic pain, palliative care, the treatment
of pain with prescription pain medications, and disparities in pain
treatment.
Applications
will be accepted for the fourth year (2007–2008) of the Mayday
Fellowship in early 2007. Six more applicants will be chosen. For
more information, click
here.
2006
Update on Prescription Monitoring Programs
According
to a recent review performed by the Pain and Policy Studies Group
(PPSG), 26 states (Alabama, California, Colorado, Hawaii, Idaho,
Illinois, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan,
Nevada, New Mexico, New York, North Carolina, Ohio, Oklahoma, Rhode
Island, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia,
and Wyoming) have adopted laws establishing prescription monitoring
programs (PMPs). PMPs monitor the prescribing of certain controlled
substances in order to detect illicit prescribing and dispensing
and to identify patients who are obtaining prescriptions from multiple
sources. All 26 PMPs rely on electronic transmission of data among
pharmacies, although New York and Texas still require practitioners
to obtain and use state issued, serialized prescription forms in
addition to the electronic component. Evidence indicates a continuing
increase in the number of states that have adopted PMPs or are considering
PMP legislation.
The
PPSG encourages research to evaluate the impact of PMPs on both
access to medications for patients needing controlled substances
for legitimate medical purposes and the incidence of drug abuse
and diversion. Through these efforts, an accurate assessment of
the success of PMPs in achieving a balanced approach can be made.
A trend
graph, a list of states with PMPs, and other resources (including
federal government documents encouraging states to use Medicaid
data to identify prescription drug diversion) can be found by clicking
here.
Volunteer
Spotlight: Steve Sanders
 Psychologist
Steve Sanders, PhD, joined APS in the middle of Jimmy Carter's
presidency. He wanted to pursue his growing professional interest
in pain. "Pain was a new area for psychologists at the time,
and the field presented an opportunity to extend my work in experimental
physiology," he said. "I also was influenced by William
Fordyce's book, which introduced me to the application of
behavioral science to pain management, and I became very interested
in how psychology can be used in the treatment of physical health
problems."
Since
1978, Sanders has compiled an impressive record with APS, serving
on numerous committees, guideline panels and task forces. Now he
has accepted a new role as editor of the APS Bulletin.
"I had been working on the Pain Clinic Perspectives department
for several years and Peter Vicente asked me to succeed him as editor
of the Bulletin. It has been a privilege working with him,"
said Sanders. "The Bulletin, in my opinion, is one
of the finest medical society newsletters in the nation. It has
become an excellent forum for APS members to share and debate their
ideas."
What's
in store for Bulletin readers with Sanders at the editorial
helm? When asked by E-News, he deferred—like a true
editor—to his upcoming column, not wanting to scoop his own
story. "Let's just say there will be no radical changes,"
Sanders hinted.
When
he isn't busy with the Bulletin, Sanders is the full-time
director of the pain rehabilitation center at Siskin Hospital for
Physical Rehabilitation in Knoxville, TN. He also is a clinical
professor of rehabilitative medicine at the University of Tennessee.
Through
the years, Sanders has seen APS grow and "become more sophisticated"
with regard to advocacy and communications on various pain care
issues. "We are still the go-to organization for anyone involved
in pain research," he said. "APS plays a unique role
in fostering information sharing, research, and collegiality."
News
Highlights from The Journal of Pain
 The
following highlights summarize selected articles from the July 2006
issue (volume 7, number 7).
Coping,
Pain Severity, Interference, and Disability: The Potential Mediating
and Moderating Roles of Race and Education
Annmarie
Cano, Ainoa Mayo, and Matthew Ventimiglia
Wayne State University, Detroit
This
study examined the roles of race and education as pain-coping variables.
Coping strategies are based on the individual's judgments of pain
as a threat, as well as perceived ability to deal with pain. Pain
and coping can affect long-term functional disability, and changes
in coping are related to improved psychological and physical functioning.
Some studies have shown racial differences in pain-coping strategies.
African Americans report using prayer and hoping to cope with pain
more than Caucasians. To date, the role of education in this relationship
has been uncertain.
The
authors recruited a sample comprising 105 diverse individuals with
chronic pain and their spouses in order to examine the role of education
in pain coping. Participants completed the Coping Strategies Questionnaire,
Multidimensional Pain Inventory, and the Sickness Impact Profile.
Results showed that the African Americans in the sample reported
significantly more pain severity, interference, and disability.
They also reported using attention diversion, prayer, and hoping
strategies more frequently than Caucasian participants. However,
only the differences in prayer and hoping remained when controlling
for education, and there were significant differences in reported
physical and psychosocial disability.
The
authors concluded that race and education should be considered together
when evaluating a person's ability to cope with pain.
Intensity Dependence of Auditory-Evoked
Cortical Potential in Fibromyalgia Patients: A Test of the Generalized
Hypervigilance Hypothesis
M.
T. Carrillo-de-le-Pena, M. Vallet, M. I. Perez, and C. Gomez-Perretta
University of Santiago Compostella, Spain
Clinical
studies have shown that fibromyalgia patients have impaired noise
tolerance and prefer lower levels of external stimulation than control
subjects. Recent studies have shown mixed results ranging from generalized
increased sensitivity to stimuli to hypersensitivity restricted
to tender points. A concern is the lack of accepted, robust measures
of hypervigilance, which most often have been characterized on the
basis of subjective ratings of aversion to nonpainful stimulation.
There is evidence showing migraine patients are hypersensitive to
auditory evoked potentials (AEPs) elicited by tones of increasing
intensity, but no studies have applied this methodology to fibromyalgia
patients.
The
authors hypothesized that fibromyalgia patients may be hypervigilant
to sensory stimuli, especially when loud tones are used. Further,
a generalized hypervigilance to painful and nonpainful sensations
may be at the root of this disorder. For this study, the researchers
examined 27 fibromyalgia patients and 25 control subjects.
Results
showed the difference in sensitivity to the increasing tones among
fibromyalgia patients was concentrated almost entirely at the highest
sound levels. The authors concluded that because stronger tone sensitivity
has been related to weak serotonergic transmission, the response
of fibromyalgia patients to intense auditory stimuli may be due
to a serotonergic deficit. These findings may be useful in guiding
pharmacological treatment of fibromyalgia.
Comparison of Clincial and Evoked Pain
Measures in Fibromyalgia
Richard
E. Harris, Richard H. Gracely, Samuel A. McLean, David A. Williams,
Thorsten Giesecke, Frank Petzke, Ananda Sen, and Daniel J. Clauw
University of Michigan
Fibromyalgia
affects up to 4% of the U.S. population and is characterized by
chronic diffuse pain. According to diagnostic criteria developed
years ago, patients must report widespread spontaneous pain and
have 11–18 tender points in various parts of the body. However,
there have been several studies disputing the validity of the tender
point diagnostic concept in clinical practice. For example, does
having fewer than 11 tender points preclude a fibromyalgia diagnosis?
Although early studies suggested that fibromyalgia patients had
tenderness in discrete areas, it is well established today they
have increased pain sensitivity throughout the body. The goal of
this study was to compare randomly presented evoked pressure pain
assessment with more standard methods in tracking changes in clinical
pain.
Sixty-five
participants in a clinical trial of the efficacy of acupuncture
were evaluated for this study. Although both the evoked and standard
pain measures improved during the study, only one of the evoked
measures, multiple random staircase stimuli (MRS), improved with
acupuncture treatment. With MRS, pressure stimuli are administered
from a remote device from which patients are shielded. Participants,
therefore, are not able to anticipate the intensity of the stimuli.
The
authors concluded that pressure pain testing that applies stimuli
in a random order is associated with improvements in clinical pain,
but this association is not stronger than other experimental techniques.
A
Scientific Research Symposium on Women's Health Issues
The
National Fibromyalgia Research Association will be presenting a
Scientific Research Symposium on September 9–10 in Salem,
OR. Leading doctors in the fields of fibromyalgia, arthritis, rheumatology,
pain, and women's health will be in attendance to discuss their
latest findings regarding fibromyalgia and the central nervous system.
Fibromyalgia affects 10 million Americans, 90% of them women between
20–55 years of age. It also affects 2% of the 55 or older
population. Contact 800/574 3468 or www.nfra.net for further information.
American
Pharmacists Association Foundation Announces Incentive Grants for
Serving Patients with Pain Management
The
American Pharmacists Association (APhA) Foundation will award $1,000
grants for projects that support a pain management practice model
in ambulatory care practice settings, which improve patient care
and treatment. Projects may include patient education, screening,
wellness, and/or support services in an effort to address the spectrum
of patient and provider needs when focusing on pain management.
These incentive grants provide seed money to help pharmacists initiate
a 12-month innovative practice project or to support an already
existing project within one's practice, which focuses on serving
patients with pain management. For more information, click
here.
American
Cancer Society Request for Applications: Pilot and Exploratory Projects
in Palliative Care
This
request for applications is limited to applications that focus on
palliative care research projects for seriously ill cancer patients
and their families in three specific areas:
- Exploring
the relationship of pain and other distressing symptoms on quality
and quantity of life, independence, function, and disability and
developing interventions directed at their treatment in patients
with advanced and chronic illnesses.
-
Studying methods of improving communication between adults living
with serious illness, their families, and their healthcare providers.
- Evaluating
models and systems of care for patients living with advanced illness
and their families.
For
more information, click here.
New
NIH Funding Opportunity: New Models of Pain Relevant to the Trigeminal
System (R21)
This
funding opportunity seeks to stimulate research on chronic orofacial
pain disorders, which will provide insights into the pathophysiological
mechanisms underlying these conditions and the biological mechanisms
underlying analgesic treatments of these disorders. Two major goals
of this funding opportunity are to stimulate research on patients
with chronic painful disorders, and to stimulate the development
and use of novel animal models of chronic orofacial pain conditions.
As an adjunct to these two goals, this initiative also encourages
the development of novel measures of pain in patients and animals
that are noninvasive and objective, and that permit a behavioral
or functional assessment of pain. The primary outcome of this initiative
will be increased knowledge of the biological mechanisms underlying
chronic pain disorders, nociception, and analgesic therapies. For
more information, click
here.
New
NIH Funding Opportunity: Collaborative Research on Tinnitus (R01)
The
purpose of this request for applications (RFA) is to support collaborative
research teams that investigate tinnitus. In the past, tinnitus
research was undertaken by a small number of individuals working
largely independently of each other. In some cases, researchers
formed small teams, but most worked from within their own discipline,
using insights from other disciplines on an ad hoc basis. In the
context of modern clinical science, this approach no longer allows
the depth of knowledge within the various disciplines, which have
a perspective on tinnitus, to be used effectively. If there is to
be significant progress toward understanding the neural correlates
of tinnitus, designing effective treatments, and developing preventive
measures, interdisciplinary approaches should be adopted. Such teamwork
has proven effective in many areas of clinical importance. For more
information, click here.
Annual
Meeting CD Available
 The
2006 conference may be over but you still have the unique opportunity
to learn from the expert presenters. This CD of the proceedings
of the 25th Annual Meeting of the American Pain Society consists
of 40 presentations from the meeting. Topics include the epidemiology
of prescription opioid abuse; spinal second messenger pathways under
different pain conditions; sex, pain, and the primary afferent;
evaluation of fibromyalgia pain from bench to bedside, and what
it means to have a right to pain relief.
All
sessions are in MP3 audio file format on one CD. Play the files
on your computer or portable MP3 player. Visit www.aven.com/conf.cfm/cid/924
to order your copy.
Using
the APS Membership Directory
 One
of your most valuable membership benefits is the annual APS
Membership Directory. Its purpose is to encourage networking
among members. This valuable tool is perfect for locating other
healthcare professionals and specialists who are committed to advancing
pain-related research, education, treatment, and professional practice.
The
alphabetical section of the membership directory lists the preferred
mailing addresses, e-mail addresses, and phone numbers, when available,
of more than 3,200 APS members. Other lists in the directory can
be used to quickly locate individuals by professional discipline
or medical specialty and city and state.
The
directory also includes important APS information, such as officer,
board, committee, and staff lists. It contains details about special
interest groups (SIGs) and regional sections. In addition, you'll
find contact information and profiles for more than 20 corporate
members. Every APS member receives the printed directory. For your
convenience, the directory is also available online.
List
Your Fellowship Opportunities by August 11
 In
an effort to inform qualified candidates about training opportunities
in pain research, APS is soliciting information related to post-graduate
and post-doctoral training programs focusing on pain research. We
are interested in formal training programs with multiple faculty
and opportunities for research.
These
opportunities will then be posted on the APS Web site in a searchable
directory as a resource for those seeking fellowship opportunities
in pain research.
Click
here to link to a questionnaire that collects information about
your institution's fellowship opportunities that fit the above criteria.
Please complete this questionnaire as completely as possible for
each fellowship program by August 11.
 Pain
Awareness Month Is Coming
APS
E-News will feature special coverage during September in honor of
Pain Awareness Month.
APS
Call for 2007 Paper and Poster Abstracts
 The
Call for 2007 Paper and Poster Abstracts will be available online
beginning September 1, 2006. The submission deadline is October
27, 2006.
APS
Receives Design Awards
APS
is proud to announce that we received the Best of Category 2006
Printing Industry of Illinois-Indiana Association (PII) Pinnacle
Achievement in Print Excellence (AIPX) Award for our Annual Scientific
Meeting (San Antonio) save-the-date collateral printed piece. This
competition recognizes outstanding craftsmanship in the creation,
design, and production  of
printed materials. In addition, our save-the-date piece also received
the national Awards for Publication Excellence (APEX) 2006 Award
in the Marketing and Public Relations Brochures, Manuals and Reports/Category.
Is
It Time to Renew Your APS Membership?
Renew
online today at www.ampainsoc.org/members/login.
You
will need to log into the Member's Only site to renew your membership.
Click here
to login.
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