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Recovery from Epidemic Pain, Work/Family Stress, Sleep and Health Problems among First Responders


Three reversible epidemics drive the majority of costs in Workers' Compensation: Chronic Pain, Brain Injury, and PTSD. Chronic pain alone drives approximately 80% of the overall costs in the system. Nationwide, over 100 million Americans suffer chronic pain at a cost of over $625 billion annually, yet according to the landmark study at the Institute of Medicine, only 5 of the Nation's 133 medical schools provided any curriculum on the treatment of chronic pain. Despite the fact that all three epidemics and their associated disability and costs can be systematically reversed, evidence-based treatment is not routinely available - until now.

The use of chronic, high dose opiates for long term pain control was the standard of care less than 10 years ago. Because patients rapidly develop a tolerance to addictive medications, the dose had to be increased over and over to maintain any control over pain. Eventually, the pain control is negligible, but the side effects are serious and life-threatening. Moreover, individuals on chronic opiates experience more pain and disability, while patients actually have less pain and disability after chronic opiates have been stopped.

Law Enforcement personnel experience chronic pain due to traffic accidents, use of force, or repetitive motion injuries. In addition, long work hours coupled with on the job stressors prolong the recovery and result in suffering and poor job performance. Over the counter and other methods may have been attempted with little relief or success. This can lead to depression and other mental health related issues further complicating return to work.

In this course you will learn:

  • Causes and prevalence of Chronic Pain and Disability within law enforcement.
  • Chronic pain prevention and management including associated mental health concerns.
  • Chronic pain treatment and long-term effects on performance and productivity


  • Dr. Shelby Moreira, Psy.D., Forensic & Neurocognitive Specialist, Institutes of Health

    Dr. Moreira, is a bilingual team member of the Brain Injury Intensive Outpatient and Chronic Pain Rehabilitation Programs where she brings her expertise in diagnostic, neuro, forensic assessment and treatment to patients with varying degrees of traumatic brain injuries and neurocognitive disorders. Dr. Moreira's research has focused on the important differences in neurocognitive capacities of specific patient populations. Prior to joining Institutes of Health, Dr. Moreira worked as a trauma therapist at Rady Children's Hospital, and in the California State Prison System where she primarily focused on forensic, diagnostic, cognitive, neuro assessment and treatment.

  • Dr. Tomer Anbar, Ph.D., CGP, CTC CEO, Clinical Group, Institutes of Health

    Dr. Anbar is Founding Director and CEO | Clinical Group of Institutes of Health. In 2002 he launched the Mind/Body Health Initiative to address the chronic pain epidemic in the work comp space, and 2008 founded the Interdisciplinary Chronic Pain & Functional Restoration Program at Scripps Health in San Diego. As Chief Clinical Advisor of the California Employers’ Fraud Task Force, he advised the California Department of Industrial relations, insurance carriers, claims administrators, and employers on how to systematically improve clinical outcomes and more effectively address chronic pain, delayed recovery and related conditions. As former Chairman of the Pain Rehabilitation SIG of the American Pain Society and former Treasurer of the Musculoskeletal Pain SIG of the International Association for the Study of Pain comprised of 125 countries. Since then, Dr. Anbar has focused on promoting advances in the field of interdisciplinary biopsychosocial evidence-based care to address chronic pain, PTSD and brain injuries. His group’s chronic pain and functional restoration programs were adopted as models by the Navy in San Diego, and Intel-GE’s telehealth platform. Dr. Anbar is former head of the Unit of Clinical and Research Psychobiology at the National Institute of Neurology and Neurosurgery, a research component of the World Health Organization in Mexico City.

  • Dr. Clark Smith, M.D., DFAPA Medical Director, Institutes of Health

    Dr. Clark Smith, is Medical Director of Institutes of Health. Dr. Smith was founding Medical Director of San Diego's largest Chemical Dependency Recovery Hospital, Sharp McDonald Center/Vista Pacifica, from 1989 to 2012. He is board certified in Pain Management, Addictions and Forensic Psychiatry. Dr. Smith completed an Internal Medicine internship and worked as an emergency medicine physician while completing specialty training in Psychiatry. He was Chief Resident at the University of California San Diego (UCSD) Medical Center, Chief of Staff at Mesa Vista Hospital, and then UC San Diego. Dr. Smith is former president of the San Diego Psychiatric Society, the San Diego Psych-Law Society, and was an Adjunct Professor in Forensic Studies at Alliant University in San Diego.

November 17, 2021
Wed 11:30 AM PST

Duration 1H 30M

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