On Friday, August 23, 2013, I attended the beginning of the 20th Annual Napa Pain Conference. It was great to see old faces and make new acquaintances. This conference has grown over the years, and the speakers this year were outstanding and information presented was very relevant to the treatment of chronic pain patients.

I attended a lecture by Dr. Scott Fishman entitled, “The Legal Landscape of Opioid Prescribing” where he presented many facts relating to the worldwide use of opioids. Great attention was paid to the legitimate and illegitimate uses of opioids. He discussed the hazards of prescribing opioids safely … and many in attendance could relate to this and the federal and state governments are involved to reduce the misuse of opioids. As an example, methadone is widely used for the treatment of pain. Dr. Fishman stated that one third of all overdose deaths were attributed to methadone. He also stated that 2% of all prescriptions in the United States are for opioids.

In a US Senate committee judiciary meeting in 2008, a statement was given by Dr. Nora Volkow stating that, “prescriptions for opiates, specifically hydrocodone and oxycodone products, had escalated from around 40 million in 1991 to nearly 180 million in 2007, with the US being their biggest consumer.” Dr. Fishman asserted that there is little evidence to support high doses of opioids being effective. According to DEA facts on prescription drug abuse, nearly 7,000,000 Americans are abusing prescription drugs, and prescription pain relievers are the new drug users’ drug of choice.

Dr. Fishman also discussed opioid overdosing, poisoning deaths in the US, and teen abuse of prescription medications. This is not a very pleasant presentation; however, this information will help prescribers to become more diligent in the monitoring of patients and to avoid opiate abuse.

Again I enjoyed this year’s conference immensely, and I felt very fortunate to attend. I will continue to attend future events to enhance my knowledge because conferences like these will only allow us to gain knowledge and understanding and to expand the level of care to our patients. I hope you all can attend next year.

Another conference for you to consider is Mechanism of Action: Electrical Stimulation of the Nervous System, March 28-30, 2014, in Orlando, Florida. Drs. Eric Grigsby and Elliott Krames will put on this conference.

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