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Safe Opioid Prescribing and Risk Evaluation and Mitigation Strategies (REMS) (CME)

Date: 
Monday, November 2, 2015
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Course topic: 

Internet Enduring Material Sponsored by:

Stanford University School of Medicine

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Presented by:

The Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine, in collaboration with the American Academy of Pain Medicine

Course Description

This course aims to improve knowledge, competence and performance in prescribing opioids in the treatment of chronic pain. Specifically, it will increase knowledge of the significant potential for abuse of opioid analgesics and knowledge of the emerging opioid formulations and combinations with the goal to decrease the risks of diversion and abuse. This course will focus on the assessment and recognition of psychological co-morbidities that increase the risk for opioid abuse and diversion, developing treatment plans and implementing interventions aimed at decreasing risk for unintentional misuse in addition to abuse of and addiction to opioid analgesics.

Intended Audience

This course is designed for a national and international audience of physicians, nurse practitioners and physician assistants in all clinical specialties.

Dates, Duration & Fee

  • Release Date: November 2, 2015
  • Expiration Date: August 31, 2017
  • Estimated Time to Complete: 4.5 hours
  • CME Credits Offered: 4.50
  • Registration fee: Free

Please review all of the information on this page before clicking the Courseware tab at the top of the page to begin the course.

To Obtain CME Credits

  • Review the information below and complete the entire activity.
  • Complete the CME Post-test, CME Evaluation Survey, and CME Activity Completion Statement at the end of the activity.
  • You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question to pass the post-test.
  • Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
  • Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

*Participation in any content marked optional is not certified for AMA PRA Category 1 Credit™.

Learning Objectives

At the conclusion of this activity, participants should be able to:

  • Determine the general characteristics, toxicities and drug interactions associated with opioids and incorporate this knowledge in practice.
  • Utilize various opioid risk assessment tools to reduce the risk of opioid misuse and to ensure patient safety.
  • Evaluate and interpret functional improvement, urine drug testing, and data from prescription drug monitoring systems.
  • Develop and implement strategies for termination of opioid therapy and perform the required steps for proper documentation and referral.
  • Integrate counseling of patients/caregivers on the safe use of opioids into practice.

Table of Contents

1. Introduction 
2. Risk Assessment and Substance Abuse Disorders
3. Initiation, Modification, and Discontinuation of Opioid Therapy
4. Managing Therapy with Opioids 
5. Course Wrap-up 
6. Optional Content: Opioid Prescribing Tools 
7. Resources and References
8. Help!

Disclosures

The following planner indicated having relevant relationship(s) with industry to disclose:

Lynn Webster, MD
Vice President, Scientific Affairs
PRA Health Sciences
Raleigh, NC
Planner

Dr. Webster has indicated that he is on the advisory boards of AcelRx Pharmaceuticals, AstraZeneca, Charleston Labs, Collegium Pharmaceuticals, Covidien Mallinckrodt, Egalet, Inspirion Pharmaceuticals, Insys Therapeutics, Jazz Pharmaceuticals, Kaleo, Mallinckrodt Pharmaceuticals, Medtronic, Nektar Therapeutics, Orexo Pharmaceuticals, Pfizer Inc., Proove Biosciences, Salix Pharmaceuticals, Signature Therapeutics, Teva Pharmaceuticals, and Trevena; serves as a consultant to Acura Pharmaceuticals, AstraZeneca, BioDelivery Sciences International (BDSI), Covidien Mallinckrodt, CVS Caremark, Grunenthal USA, Insys Therapeutics, Jazz Pharmaceuticals, Mallinckrodt, Medtronic, Nektar Therapeutics, Neura Therapeutik, Nevro Corp., Proove Biosciences, Salix Pharmaceuticals, Shionogi, and Zogenix; has received honoraria from AstraZeneca, Covidien Mallinckrodt, Jazz Pharmaceuticals, Medtronic, Nektar Therapeutics, and Salix Pharmaceuticals; has received travel expenses from Cara Therapeutics, Charleston Labs, Collegium Pharmaceuticals, Grunenthal USA, Insys Therapeutics, Kaleo, Mallinckrodt, Nevro Corp., Orexo Pharmaceuticals, Pfizer Inc., Proove Biosciences, QRx Pharma, TEVA, Trevena and Zogenix; and has been employed by CRI Lifetree and PRA Health Sciences.

The following planners, speakers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity:

Sean Mackey, MD, PhD
Redlich Professor and Professor of Neurology
Anesthesiology, Perioperative and Pain Medicine
Stanford University Medical Center
Course Director

Sam Lahidji, MD 
Adjunct Clinical Instructor 
Anesthesiology, Perioperative and Pain Medicine 
Stanford University School of Medicine
Chief, Pain Management
Kaiser Permanete, East Bay
Co-Course Director
Author/Presenter

Gabriel Schonwald, MD 
Adjunct Clinical Assistant Professor 
Anesthesiology, Perioperative and Pain Medicine 
Stanford University School of Medicine
Planner 
Author/Presenter

Jordan Newmark, MD
Clinical Assistant Professor
Anesthesiology, Perioperative and Pain Medicine 
Associate Fellowship Director, Pain Medicine
Stanford University School of Medicine
Planner 
Author/Presenter

Ming-Chih J Kao, MD, PhD
Clinical Assistant Professor
Anesthesiology, Perioperative and Pain Medicine
Orthopaedic Surgery
Stanford University School of Medicine
Planner

Technical Design and Development

Ian Mackey
Video Editing, Recording

Hardware/Software Requirements

  • Computer with Internet connection
  • Current version of Chrome, Firefox or Safari browser. You must have javascript enabled.

Accreditation and Designation of Credits

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 4.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support Acknowledgement

The Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane .stanford.edu/portals/cultural.html

CME Privacy Policy

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Contact Information

If you are having technical problems (video freezes or is unplayable, can't print your certificate, etc.) you can submit a Help Request to the OpenEdX Team. If you have questions related to CME credit, requirements (Pre-test, Post-test, Evaluation, Attestation) or course content, you can contact the CME Online support team at cmeonline@stanford.edu

Resources and References

Model Policy for the Use of Controlled Substances for the Treatment of Pain Federation of State Medical Boards of the United States, Inc.http://www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/pain_policy_july2013.pdf

VA/DoD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Painhttp://www.healthquality.va.gov/Chronic_Opioid_Therapy_COT.asp

American Pain Society/American Academy of Pain Medicine Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

For a complete list, go to Resources and References page in the Courseware tab above.

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