After reviewing this page, be sure to go back to the Activity page, using the long, yellow-orange clickable button above, and look for a similar button for the next instructions.Reminder: Spending more than 15 minutes on any page will result in being logged out. To keep from being automatically logged out, avoid bookmarking module pages. Instead, please be sure to always access the activity through the activity homepage, to ensure being able to progress through the modules correctly.
Goal: To enhance clinical skills of health professional trainees in treating pain safely and effectively while reducing the risk of addiction/abuse/misuse of opioids and other prescribed controlled substances and also in recognizing and addressing addiction/substance abuse/misuse in patients being treated for pain.Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain, developed by professional organizations of pain specialists based on an extensive review of the literature, include recommendations for a practice plan designed to reduce risk of addiction and other substance abuse (Chou et al, 2009). According to national surveys, physicians do not follow key elements of that plan (CASA, 2005; Adams, et al. 2001). The need for education/skills training in order to be able to follow the guidelines with respect to planning chronic opioid therapy is evident from national physician surveys (CASA, 2005; CASA, 2000; Morley-Forster, et al. 2003). Based on the overall results of their physician survey on the problem of drug diversion, CASA concluded that physicians should receive more continuing medical education related to prescribing and administering controlled substances and identifying, diagnosing, and treating substance abuse and addiction (CASA, 2005). References Adams NJ, Plane MB, Fleming MF, et al., Opioids and the treatment of chronic pain in a primary care sample. J Pain Symptom Manage 2001; 22 pp. 791–796. CASA: The National Center on Addiction and Substance Abuse at Columbia University (CASA). Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S. July 2005. Available at: http://www.casacolumbia.org/addiction-research/reports/under-the-counter-diversion-abuse-controlled-perscription-drugs. Accessed July 11, 2008. CASA: The National Center on Addiction and Substance Abuse at Columbia University. National Survey of Primary Care Physicians and Patients on Substance Abuse. April, 2000. Chou R, Fanciullo G, Fine P, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009a; 10(2): 113-130. Morley-Forster PK, Clark AJ, Speechley M, Moulin DE. Attitudes toward opioid use for chronic pain: a Canadian physician survey. Pain Res Manage. 2003;8: 189–94
Educational Objectives:After completing this activity participants will be able to:
Review basic pain history, assessment, and diagnosis
Describe the main pharmacological and non-pharmacological categories of pain treatments used as first-line treatment for different categories of pain and common pain conditions
Collaborate with colleagues in a multi-dimensional/multidisciplinary approach to pain management with a medical “home”
Recognize when opioid therapy is indicated based on pain severity, functioning, and risk of addiction or abuse, and potential harm from side effects
Develop an opioid medication treatment plan that minimizes risk of addiction, misuse, overdose, and side effects
Modules in this Training Activity
Pain Clinical Module 1: Integrated Approach to Pain Using First-Line Treatments
Pain Clinical Module 2: Risks and Benefits of Opioid Pain Treatment: Effective Prescribing and Monitoring
Pain Clinical Module 3: Advanced Opioid Pain Treatment Concepts for Medical Residents
Audience and Accreditation
Health care professional clinical level students, interns, and residents
Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records.
Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.
Technical Requirement: To participate in this activity, you will need a computer, an Internet connection, and a Web browser. This activity requires Chrome, Firefox, and IE7 or higher.