CLE Online

Introduction

Pain Relief Pharmacology: The Facts of Life

• painkillers mostly affect the brain, not the injury
• real experimental data show analgesics much less effective than we believe
• this includes drugs for depression, NSAIDS, and "muscle relaxants"
• we were misled systematically to unwarranted enthusiasm
• in clinical experience, some drugs, including opioids, help some people

Dr. Thomas L. Perry — Department of Anesthesiology, University of BC, Vancouver

2017 Canadian Guideline On Opioids For Chronic Pain

• reason for guideline
• process
• major findings
• implications for medical practice in Canada

Jason Busse, DC, PhD — Associate Professor, Faculty of Medicine, McMaster University, Hamilton

Networking Break

Cannabis Marijuana

• medical uses
• how it works
• current status and issues
• advantages and risks

Dr. Launette Rieb — Department of Family Practice, University of BC, Vancouver

Addiction Issues In Personal Injury Litigation

• addressing addiction issues with the appropriate expert
• compelling an IME with an addiction medicine specialist
• importance of addressing addiction isues from the plaintiff's perspective

Marc Kazimirski — KazLaw Injury Lawyers, Vancouver
Alison L. Murray, QC — Murray Jamieson, Vancouver
Dr. Paul W. Sobey — Clinical Professor, Faculty of Medicine, University of BC, Vancouver

Networking Lunch

Drug Screening and Testing

• what it is as a clinical tool
• where is it done?
  • MMT clinic/CPSBC/CNCP/occupational
  • part of IME/hospital/workplace
• is patient report accurate?
• high quality medical monitoring: what it looks like
• advantages and limitations: FP and FN
• type of biological samples: how long lab keeps it
• type of biological testing
  • immunoassay and LCMS
• types of labs and qualifications: what to expect from each
• current legislation
• evidence
• cases

Dr. Paul W. Sobey — Clinical Professor, Faculty of Medicine, University of BC, Vancouver

IMEs: Medical Ethics and Legal Practicalities

• how the IME physician is not in a standard physician-patient relationship
• the IME physician and the duty to Do No Harm
• how reliable are IMEs?
  
• access to the IME and Medical Records generally in the context of litigation

Robert C. Brun, QC — Harris & Brun, Vancouver
Jason Busse, DC, PhD — Associate Professor, Faculty of Medicine, McMaster University, Hamilton

Networking Break

Medical Legal Panel

• double doctoring, diversion, and drug abuse
• the GP in the trenches
• college complaints and investigations
• cannabis marijuana—proof as a special damage

Jennifer J.L. Brun — Harris & Brun, Vancouver
Dr. Garry Feinstadt — Physician and Surgeon, Vancouver
James A. Hanson — Hanson and Company, North Vancouver
Dr. Thomas L. Perry — Department of Anesthesiology, University of BC, Vancouver

Concluding Remarks