The American Pain Society (APS) may soon be out of business if its membership approves a resolution to file for bankruptcy.

The APS asked its membership to vote on a recommendation from its board of directors that it cease operations. The recommendation comes in the face of continuing litigation against opioid manufacturers, which has ensnared the APS.

"Despite our best efforts to negotiate and collaborate on getting dismissal of these lawsuits, APS has been unable to accomplish that and remains subject to current and potential future litigation," the APS board wrote in a May 20 letter to its members.

"This, combined with the declining membership and meeting attendance, has created the perfect storm," said the board, which consists of President William Maixner, DDS, PhD; President-Elect Gary A. Walco, PhD, ABPP; Treasurer Tonya Palermo, PhD; and Secretary Yenisel Cruz-Almeida, PhD.

The nonprofit Chicago-based organization, which also publishes The Journal of Pain, has billed itself as "a multidisciplinary community that brings together a diverse group of scientists, clinicians, and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering."

It began in 1978 as an organization dedicated to the study of pain and held its first scientific meeting in 1979. APS has published guidelines for clinicians and patients (adults and children) for treating and managing pain associated with sickle cell disease, arthritis, cancer, fibromyalgia, low back pain, and chronic noncancer pain. The group grew from 500 charter members to its current 1150, but membership had been higher.

The APS has acted as a grant-making body, as well, funneling funds from entities such as the Mayday Fund, Patient-Centered Outcomes Research Institute (PCOR)I, and pharmaceutical companies.

But it also is known as the organization that in the mid-1990s introduced and lobbied for the concept of pain as the "fifth vital sign," which many experts blame for the overutilization of opioids.

The APS has also accepted contributions from opioid manufacturers. A lawsuit filed against Purdue Pharma by the state of Tennessee revealed the drugmaker paid the APS $3.1 million from 1997 to 2012, The Tennessean reports.

A February 2018 report from Sen. Claire McCaskill (D-Mo.) found that from 2012 to 2017, the APS received $962,724 from Purdue, Janssen, Depomed, Insys, and Mylan, making it the fourth biggest recipient of opioid industry money over that timeframe.

The US Pain Foundation was the biggest recipient, at $2.9 million, followed by the Academy of Integrative Pain Management ($1.2 million) and the American Academy of Pain Medicine ($1.1 million). The Academy of Integrative Pain Management was shuttered on January 31, 2019.

An APS spokesman told Medscape Medical News that he had been advised by counsel not to comment on how the organization has been funded.

If the membership approves the bankruptcy filing, it would be under Chapter 7. If the filing is approved by the court, a trustee would be appointed to take possession of APS' assets and to then distribute them to the organization's creditors.

"Concluding APS' operations in this manner ends any future legal exposure to APS," said the board, in its letter.

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