" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

May 29, 2013


  1. ASIPP 2013 Board of Directors Election Results
  2. Just One Week Left to Register for ASIPP 15th Annual Meeting
  3. ASIPP to Partner with Henry Schein GPO
  4. AAN: Don't Stop Warfarin for Dental Visits
  5. More Kids Exposed to Legal Pot
  6. Pain Pill Shortage Drives Fla. Drug Addicts to Heroin
  7. House GOPs Still Oppose Compounding Bill
  8. Drug Eases Constipation from Opioids
  9. No. of Ky Babies Born Addicted to Drugs Increases

boardASIPP 2013 Board of Directors Election Results


 The election for ASIPP's Board of Directors closed on May 17, 2013. We are pleased to announce the members of the 2013-2014 ASIPP Board of Directors:

  • Chairman of the Board and Chief Executive Officer - Laxmaiah Manchikanti, MD
  • President - Hans C. Hansen, MD
  • Immediate Past President - Frank Falco, MD
  • President-Elect - Ramsin Benyamin, MD
  • First Executive Vice President - David L. Caraway, MD, PhD
  • Second Executive Vice President - Aaron Calodney, MD
  • Vice President-Strategic Planning - Francis Riegler, MD
  • Secretary - Peter Staats, MD
  • Treasurer - David Bryce, MD
  • Directors-at-Large - Salahadin Abdi, MD, PhD; Mark V. Boswell, MD, PhD; Harold Cordner, MD; Tim Deer, MD; Sudhir Diwan, MD; Haroon Hameed, MD; Joshua A Hirsch, MD; Alan Kaye, MD, PhD; Allan T. Parr, MD, Gabor B. Racz, MD; David M. Schultz, MD; John Swicegood, MD; and Andrea M. Trescot, MD (Resident Member - Mariam Hameed, MD)
  • Director Emeritus - Standiford Helm, II, MD and David Kloth, MD
  • Lifetime Directors - Cyrus E. Bakhit, MD, Laxmaiah Manchikanti, MD, Vijay Singh, MD

Please help us welcome the new board members. We especially encourage you to attend the business meeting and dinner at the Annual Meeting on the evening of June 9 for the installation and introduction of the new board.


We would like to thank all of those who participated in the elections. ASIPP's reputation of excellence is due to the interest and involvement of its members - we applaud those who are willing to serve in any capacity.

AnnualJust One Week Left to Register for ASIPP 15th Annual Meeting!


What are you waiting for? The  meeting starts NEXT FRIDAY!


If you have not yet registered for the ASIPP 15th Annual Meeting, there is still time to do so. Not only is this the "can't miss" meeting of the year, will be the last year we will hold the Annual Meeting in Washington, DC. Join us on June 8-11 for this historic meeting.


The ASI PP 15th Annual Meeting titled "IPM: Strategies to Prevent Falling Over the Cliff," is geared to help both you and your staff prepare for all the changes coming with the Affordable Care Act (ObamaCare). The strategies and information you will receive at this meeting will be unparalleled to any other meeting.


Take advantage of this opportunity and "arm yourself for the future!"


Click HERE to register

Click HERE to view Brochure


GPOASIPP to Partner with Henry Schein GPO


After almost 2 years of struggles with single-dose vials cost issues, 3 solutions were recommended: reduce the price, use compounded drugs, or allow physicians to divide them into smaller vials in practices. While we disagree with the second option, we have been pursuing the first and third options. The third option we continue to on, however the first option has become a reality. Finally, we have achieved what we believe is the best solution for this issue and one that will provide significant reductions in price by joining a GPO.


ASIPP is pleased to announce that we have formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today. While the cost of contrast media has skyrocketed due to the single dose vial issue, because we have partnered with Henry Schein, this could enable you to purchase Omnipaque 240mg/50 ml for slightly above $4.50.


It will be easy for ASIPP and SIPMS members in good standing. to enroll and begin to realize the savings this partnership can bring you. We will keep you updated on how to take advantage of this great savings opportunity. We will have more information on this in the upcoming weeks. Henry Schein will be on hand at the ASIPP Annual Meeting on June 8-11 to answer all your questions!

warfarinAAN: Don't Stop Warfarin for Dental Visits


Patients taking aspirin or warfarin (Coumadin) for prevention after a stroke don't need to stop the drug for dental procedures and probably can stay on it for most other minor medical procedures, the American Academy of Neurology recommended.

Prostate or hernia procedures, electromyography, and saphenous vein ablation might be candidates for continued warfarin or aspirin, according to the guidelines published in the May 28 issue of Neurology.


Heparin bridging to reduce stroke risk for patients who do go off chronic warfarin therapy before their surgery doesn't clearly help and might harm, Melissa J. Armstrong, MD, of the University of Maryland in Baltimore, and colleagues on the writing committee cautioned.


MedPage Today




ASIPP has performed a survey on this issue (Manchikanti L, et al. Assessment of practice patterns of perioperative management of antiplatelet and anticoagulant therapy in interventional pain management. Pain Physician 2012; 15:E955-E968.). Based on this survey many of the physicians continue to discontinue various antithrombotics. A comprehensive review performed on antithrombotic therapy (Manchikanti L, et al. Assessment of bleeding risk of interventional techniques: A best evidence synthesis of practice patterns and perioperative management of anticoagulant and antithrombotic therapy. Pain Physician 2013; 16:SE261-SE318.) and ASIPP guidelines also have commented on these issues. The guidelines state the following on anticoagulation:


There is good evidence for the risk of thromboembolic phenomenon in patients who discontinue antithrombotic therapy, spontaneous epidural hematomas occur with or without traumatic injury in patients with or without anticoagulant therapy associated with stressors such as chiropractic manipulation, diving, and anatomic abnormalities such as ankylosing spondylitis, and the lack of necessity of discontinuation of nonsteroidal anti-inflammatory drugs (NSAIDs), including low dose aspirin prior to performing interventional techniques.


There is fair evidence that excessive bleeding, including epidural hematoma formation may occur with interventional techniques when antithrombotic therapy is continued, the risk of thromboembolic phenomenon is higher than the risk of epidural hematomas with discontinuation of antiplatelet therapy prior to interventional techniques, to continue phosphodiesterase inhibitors (dipyridamole [Persantine], cilostazol [Pletal], and Aggrenox [aspirin and dipyridamole]), and that anatomic conditions such as spondylosis, ankylosing spondylitis and spinal stenosis, and procedures involving the cervical spine; multiple attempts; and large bore needles increase the risk of epidural hematoma; and rapid assessment and surgical or nonsurgical intervention to manage patients with epidural hematoma can avoid permanent neurological complications.


There is limited evidence to discontinue antiplatelet therapy with platelet aggregation inhibitors to avoid bleeding and epidural hematomas and/or to continue antiplatelet therapy clopidogrel (Plavix), ticlopidine (Ticlid), or prasugrel (Effient) during interventional techniques to avoid cerebrovascular and cardiovascular thromboembolic fatalities. There is limited evidence in reference to newer antithrombotic agents dabigatran (Pradaxa®) and rivaroxaban (Xarelto®) to discontinue to avoid bleeding and epidural hematomas during interventional techniques and to continue to avoid cerebrovascular and cardiovascular thromboembolic events.



kidsMore Kids Exposed to Legal Pot


The decriminalization of medical marijuana in Colorado led to a marked increase in accidental ingestions of the substance among young children, a retrospective, single-center study showed.


During 5 years preceding October 2009, when the Justice Department determined that medical marijuana users would no longer be prosecuted, there were no cases of marijuana ingestion among children younger than 12 in a Colorado children's hospital (0%, 95% CI 0 to 0.6), according to George Sam Wang, MD, of the Rocky Mountain Poison and Drug Center in Denver, and colleagues.


But between 2009 and 2011, 14 of 588 accidental ingestions were marijuana-related (2.4%, 95% CI 1.4 to 4, P<0.001), the researchers reported online in JAMA Pediatrics.


In 2001, the state of Colorado opened a registry of medical marijuana users, and the total number of individuals enrolled now stands at 89,000.


The number of enrollees rose sharply following the policy shift by the federal government, with 60,000 registry identification cards being issued in 2009 alone compared with only 2,000 in the preceding 8 years.


MedPage Today

painPain Pill Shortage Drives Fla. Drug Addicts to Heroin

Experts mount campaign to slow increasing trend


MIAMI - Kevin Foley stood before a judge in Broward County's drug court - fellow abusers sitting behind in him in the pews - talking about the fitful life of a recovering addict, the random drug tests, the counseling and what he hoped was his next, clean chapter.


Foley, 21, has been hooked on heroin for nearly two years. Before that, he was popping oxycodone and other prescription pills snapped up as Florida became a bustling marketplace of illegal pill mills. He turned to heroin after his drug of choice became too expensive. "I was chasing the next high," says Foley, who landed in drug court after a heroin possession arrest in December. "I wanted to try it all."


Heroin is inching back into Florida, the unintended consequence of the state's epic war on prescription pills. Now, with Florida officials successfully slowing the supplies, shutting down the pill mills that masqueraded as pain centers and arresting thousands of addicts and even doctors, heroin has become a popular substitute.


Florida Today

compoundHouse GOPs Still Oppose Compounding Bill


WASHINGTON -- The FDA's push to gain more authority over large-scale compounding pharmacies like those at the center of last fall's fungal meningitis outbreak continues to gain opposition from House Republicans.


On Thursday, the day after a Senate committee cleared a bill giving the FDA greater power to regulate certain compounders, Republicans in the GOP-controlled House chamber reiterated during an Energy and Commerce Health Subcommittee hearing on the issue that such authority isn't needed.


The lawmakers maintained that the agency had all the authority it needed to prevent the outbreak -- which has killed 55 people and sickened more than 750 -- through greater monitoring of compounders that act like manufacturers.


MedPage Today

easesDrug Eases Constipation from Opioids


ORLANDO -- A peripherally acting opioid receptor antagonist alleviated opioid-induced constipation in two pivotal phase III trials, a researcher reported here.


During 12 weeks of treatment in a study known as KODIAC-04, 44.4% of patients receiving 25 mg daily of naloxegol responded to treatment, compared with 29.3% of patients given placebo (P=0.001), according to William D. Chey, MD, of the University of Michigan in Ann Arbor, and colleagues.


And in a similar study referred to as KODIAC-05, 39.7% of patients on that dose of naloxegol were responders compared with 29.3% of patients on placebo (P=0.021), he reported at the annual Digestive Disease Week.


MedPage Today

babiesNo. of Ky Babies Born Addicted to Drugs Increases


FRANKFORT, Ky. (AP) - Health officials, health care workers and drug control professionals are talking about the problems surrounding Kentucky babies who are born addicted to drugs.


The Courier-Journal (http://cjky.it/17ZQlz1) reports that hospitalizations for addicted newborns rose from 29 in 2000 to 730 in 2011, a 2,400 percent increase.


At a meeting last week in Frankfort, about 75 experts on the subject said there are encouraging signs despite the numbers.


Those signs include a reduction in the amount of controlled substances dispensed and the promise of getting more pregnant women into substance abuse treatment under federal health reform.







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American Society of Interventional Pain Physicians ®
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Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org