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	Website of the Month Partners Against Pain     Partners Against Pain (a Purdue Web Site), a project of Purdue Pharma, LP, is an alliance of patients, caregivers, and healthcare providers working together to alleviate unnecessary suffering by their efforts to advance standards of pain care through education and advocacy. The web site has useful tools available to promote September as Pain Awareness Month as well as pain relief advocacy throughout the year.

Latest News

Kathryn Keller Receives State Pain Initiative Champion Award

The Alliance of State Pain Initiatives annually issues State Pain Initiative Champion Awards to recognize individuals who have made outstanding contributions to the growth, development, and accomplishments of a State Pain Initiative.  Kathryn H. Keller, Pharm.D., CPE, Secretary for the NCPI, received a "2009 State Pain Initiative Champion Award" at a luncheon of the Alliance of State Pain Initiatives Annual Conference on October 25, 2009, in San Francisco.  Further information about Kathy's contributions to the NCPI and to pain management can be viewed here.  Congratulations, Kathy!   State Pain Initiative Champion Award recipient Dr. Kathryn H. Keller is pictured with Dr. June Dahl, Director of the Alliance of State Pain Initiatives (ASPI), and with fellow awardee, Dr. Timothy Dauwalder, DO, Board member of the Southern California Cancer Pain Initiative (SCCPI) and Hospice Medical Director for the Visiting Nurse Association and Hospice of Southern California, in Claremont.               Board Secretary for the Northern California Pain Initiative, Kathryn H. Keller, PharmD, CPE, displays her "2009 State Pain Initiative Champion Award" at a luncheon of the Alliance of State Pain Initiatives Annual Conference on October 25, 2009, in San Francisco.

Editorial Recognizes Pain Awareness Month

September is Pain Awareness Month.  An editorial prepared by the American Cancer Society and ACS-CAN appears in this month's issue of CA: A Journal for Cancer Clinicians.  This editorial highlights details of the pain education and empowerment project conducted by the Society's National Cancer Information Center.  Kudos to Rebecca Kirch, Director of Policy with ACS-CAN, and everyone at the NCIC who were involved in this project.  A summary of the project's findings, prepared by the American Cancer Society's Cancer Action Network, can be viewed here.  The full text of the editorial can be viewed here.

Challenges and Obstacles for People with Pain

In recognition of September - Pain Awareness Month, available here is a presentation by Penney Cowan, Executive Director, American Chronic Pain Association, and member of Northern California Pain Initiative (NCPI), who spoke about the "Challenges and Obstacles for Individuals With Pain" at "Improving Pain Management in California," December 5, 2008, a pain forum sponsored by the NCPI- American Cancer Society, California Division, Inc., made possible through a grant from American Cancer Society Cancer Action Network and Purdue Pharma L.P.

CME Activity on Responsible Opioid Prescribing

The Continuing Medical Education (CME) accredited version of the book Responsible Opioid Prescribing is now available.  This activity is jointly sponsored by the University of Wisconsin School of Medicine and Public Health, the Alliance of State Pain Initiatives, and the Federation of State Medical Boards. A joint press release by the sponsoring organizations can be viewed here.  More information about the activity, including where to purchase the book and how to register for the online CME post-test, can be viewed at http://www.aspi.wisc.edu/rop.html.  If you have additional questions, please contact Ronna Popkin at rapopkin@wisc.edu.

Update on FDA Withdrawal of Short-Acting Opiates From the US Market

On 31 March 2009, the FDA announced the mandatory withdrawal form the US market of short-acting “narcotics” manufactured by nine companies, as none of the products have been approved for use (demonstrating safety and efficacy). This includes all morphine 20mg/ml products and several other short-acting forms of morphine, as well as oxycodone and hydrocodone (but not oxycodone 20mg/ml). Thanks to input from palliative care and pain management providers and organizations, the FDA has reversed itself for now on withdrawing morphine 20mg/ml from the market. A conference call on this issue, held with the FDA on 9 April 2009, is available for replay, until 15 April 2009, 11:59 PM EDT, at 1-866-419-2678.  You will be asked to leave your name and telephone number. Other products (morphine, oxycodone and hydromorphone IR tablets) are not affected by this reversal.  You may already find shortages for these products; manufacturing is mandated to cease on 9 May 2009.  For more information on the shortages of these drugs, refer to this bulletin from the American Society of Health System Pharmacists (ASHP). Health care professionals are encouraged to report each and every shortage of these medications encountered to the email address drugshortages@fda.hhs.gov. All correspondence should include your professional information, name of the drug, your location, name of wholesaler, (ASK the pharmacist which wholesaler they use  -- Cardinal, McKesson or AmeriSource-Bergen are the big three) as well as your affiliation with NCPI or other association involved with promoting pain management. Health care professionals need to concretely demonstrate how patient care is being negatively impacted by this FDA action.  See the FDA web site for more information at http://www.fda.gov/cder/drug/unapproved_drugs/morphine_extension.htm Comments to legislators may best be directed to those on committees with FDA oversight, especially if you live or work in their districts. The committees have web sites listing all committee members: House: Energy and Commerce Chair, Rep. Henry Waxman (D-CA) http://energycommerce.house.gov/   Senate: Health, Education, Labor and Pensions Chair, Sen. Edward Kennedy (D-MA) http://help.senate.gov/ The Hospice and Palliative Care Coalition expressed their concern in a letter sent to the FDA. The coalition consists of The American Academy of Hospice and Palliative Care (AAHPM), The National Hospice and Palliative Care Organization (NHPCO), The Hospice and Palliative Nurses Association (HPNA) and The Center to Advance Palliative Care (CAPC).

American Pain Society releases new Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Non-cancer Pain

The American Pain Society (APS) and the American Academy of Pain Medicine (AAPM) have jointly published a new comprehensive clinical practice guideline to assist clinicians in prescribing opioid pain medications for patients with chronic non-cancer pain.  The guideline appears in the February 2009 issue of The Journal of Pain, the APS peer-reviewed publication.  The abstract for the journal article can be viewed here.  This web page containing the abstract includes a link to the complete article.  A press release from the American Pain Society announcing the publication of the guideline can be viewed at http://www.ampainsoc.org/press/2009/downloads/20090210.pdf.

CME Webcast on Treating Painful Vertebral Compression Fractures

The Cleveland Clinic has made available for viewing at any time an archived webcast of a satellite symposium from the Pallative Medicine 2007 International Symposium.   To view the webcast, go to http://www.clevelandclinicmeded.com/fractures

New Pain Management Toolkit on Pain and Dementia

The Resource Center of the Alliance of State Pain Initiatives (ASPI) has released a new educational tool for detecting pain in patients with dementia.  “Detecting Discomfort in Dementia: Focus on Behaviors - What Nursing Assistants Need to Know About Pain” was developed under the direction of Karen Stevenson, MS, RN, Manager of Professional Education and Institutional Change Programs for ASPI and June Dahl, PhD., Senior Advisor for ASPI.  The 13-minute educational video and the accompanying booklet, “Tools for Inservice Education” provide the necessary information to help nursing assistants understand the role they play in practicing good care for cognitively impaired residents in pain. This videotape, as well as others in the ASPI video series on effective pain management practices, can be ordered online from The Resource Center of the Alliance of State Pain Initiatives, at http://www.trc.wisc.edu.

Racial, Cultural, Ethnic Factors Affect End-of-Life Care

The California HealthCare Foundation has published a new report describing how Californians' end-of-life care differs by race, culture and ethnicity.  The report identifies gaps in providing culturally sensitive services and offers recommendations for change. The full report, plus supplemental materials on methodology, are available for free download from the California HealthCare Foundation website, at http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=131674.

2008 Progress Report Card Now Available from the Pain and Policy Studies Group

The Pain and Policy Studies Group has made available on its website the 2008 update to its two reports -- a Progress Report Card and an Evaluation Guide.  The Report Card provides a letter grade for each State based on the quality of its policies (laws, regulations, guidelines) that influence pain management.  The Evaluation Guide provides a profile of each state's policies and how the policies enhance or impede pain management. Both documents can be viewed or downloaded from the Pain and Policy Studies Group website at http://www.painpolicy.wisc.edu/Achieving_Balance/index.html

July 2009 Issue of ASPI Pain Relief Forum Newsletter Online

The July 2009 edition of the Pain Relief Forum E-Newsletter of the Alliance of State Pain Initiatives is now online and can be viewed at http://aspi.wisc.edu/newsletter/

Pain Terminology Online

A sample list of frequently used pain terminology is now available online.  A link to the list can be found here on the "Related Topics" links page.  To go directly to the online list, click here.

Assessment Tools for Adult and Pediatric Patients

The following links provide assessment tools to facilitate the management of pain: Partners Against Pain http://www.partnersagainstpain.com/index-mp.aspx?sid=3  David Geffen School of Medicine at UCLA Department of Anesthesiology  http://www.anes.ucla.edu/pain/assessment_tools.html  City of Hope Beckman Research Institute http://prc.coh.org/pain_assessment.asp   Cancer Pain Release (for elderly patients) http://whocancerpain.bcg.wisc.edu/old_site/eng/13_2/resources.html  Endo Pharmaceuticals http://www.endo.com/Pain_management_tools.aspx

Interactive Communication on American Pain Foundation website

PainAid http://www.painfoundation.org/PainAid/page.asp?file=page_home.htm  is the interactive section of the American Pain Foundation's website.  Find Conference Rooms (regularly scheduled chats on a range of issues); Discussion Boards (threaded message boards on a broad range of topics); and Ask the Expert feature (pose questions to licensed healthcare professionals)

Sales and Marketing of Palladone Suspended

Sales and marketing of Palladone (hydromorphone hydrochloride, extended release capsules) has been suspended by Purdue Pharma.  Further information is available at http://www.fda.gov/medwatch/SAFETY/2005/safety05.htm#Palladone

Duragesic Package Insert Black Box Warning Changes Announced

Duragesic (fentanyl transdermal system) package insert black box warning changes have been announced regarding product safety. Further information is available at http://www.fda.gov/medwatch/SAFETY/2005/safety05.htm#Duragesic

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