denotes an abstract that is clinically relevant.
denotes that this is a recommended PHD Trainee Session.
denotes that this is a ticketed session.Hematology Disease Topics & Pathways:
sickle cell disease, Diseases, Hemoglobinopathies, Clinically relevant
Description:
In the US chronic pain remains the most common and costly medical condition, yet strategies to effectively treat chronic pain are fraught with frustration and dissatisfaction for both the patient and provider. Chronic pain affects over 50% of adults living with sickle cell disease (SCD) and imparts a tremendous burden on the individual and society. The etiology of chronic pain in SCD is complex and represents a convergence of several pathophysiological mechanisms that are still being explored. Evidence remains poor for the use of opioids in managing chronic pain in all populations. Despite the significant risks associated with this practice, optimal evidence-based effective alternatives are lacking, and chronic opioid therapy remains the mainstay for treating chronic sickle cell pain. This session will review the epidemiology and pathophysiology of the various chronic pain syndromes seen in SCD and the impact of chronic pain and its current treatment on the sickle cell brain. The session will additionally provide a practical approach to managing chronic pain in SCD.
Dr. Amanda Brandow will cover the epidemiology, underlying biology and therapeutic interventions for diagnosis and treatment of chronic neuropathic pain in SCD. This talk will describe the alterations of functional connectivity in the brain among individuals with SCD suffering from chronic pain, highlighting the role of central sensitization in the etiology of SCD chronic pain.
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Dr. Ifeyinwa Osunkwo will discuss the known complications of chronic long-term opioid use with a specific focus on opioid induced hyperalgesia that is commonly seen among individuals receiving chronic opioid therapy. She will discuss the long-term consequences of chronic opioid use on the brain, cognition and mood and share potential mitigation strategies proven successful in the general chronic pain literature that could be considered in SCD. This talk will also compare the effects of chronic opioids seen in the general population to potential presentations (physical, cognitive, behavioral) seen in SCD.
Dr. Lawrence Long will build on the previous two presentations by providing a step-wise approach to the practicing provider on how to establish a comprehensive chronic pain management strategy for individuals living with SCD in their practice including information on how to use opioids judiciously, assessing opioid risk, and other non-opioid options for chronic pain management. He will also address how to standardize one’s clinical practice to ensure patient and provider safety and adherence to best practices. This session will include a discussion of the recent chronic pain guidelines (ASH, CDC, and NHLBI) with a focus on practical aspects of managing chronic pain in SCD but will also include how to develop acute pain management care plans.
Dr. Amanda Brandow will cover the epidemiology, underlying biology and therapeutic interventions for diagnosis and treatment of chronic neuropathic pain in SCD. This talk will describe the alterations of functional connectivity in the brain among individuals with SCD suffering from chronic pain, highlighting the role of central sensitization in the etiology of SCD chronic pain.
.
Dr. Ifeyinwa Osunkwo will discuss the known complications of chronic long-term opioid use with a specific focus on opioid induced hyperalgesia that is commonly seen among individuals receiving chronic opioid therapy. She will discuss the long-term consequences of chronic opioid use on the brain, cognition and mood and share potential mitigation strategies proven successful in the general chronic pain literature that could be considered in SCD. This talk will also compare the effects of chronic opioids seen in the general population to potential presentations (physical, cognitive, behavioral) seen in SCD.
Dr. Lawrence Long will build on the previous two presentations by providing a step-wise approach to the practicing provider on how to establish a comprehensive chronic pain management strategy for individuals living with SCD in their practice including information on how to use opioids judiciously, assessing opioid risk, and other non-opioid options for chronic pain management. He will also address how to standardize one’s clinical practice to ensure patient and provider safety and adherence to best practices. This session will include a discussion of the recent chronic pain guidelines (ASH, CDC, and NHLBI) with a focus on practical aspects of managing chronic pain in SCD but will also include how to develop acute pain management care plans.