Overview

SAFE Opioid Prescribing | Strategies. Assessment. Fundamentals. Education 

Complete all SAFE Opioid Prescribing modules to receive your training completion certificate! These SAFE Opioid Prescribing modules are designed to help you understand that evaluation is essential for safe and effective pain management when using ER/LA opioids. The modules will also provide best practices for how to start therapy with ER/LA opioids, how to stop, and what to do in between.

There are a variety of pharmacologic and non-pharmacologic approaches to managing chronic pain. Opioids, particularly the extended-release (ER) and long-acting (LA) preparations, are among the most commonly used medications. While they are effective pain relievers, there are also a number of significant risks that must be taken into consideration when prescribing ER and LA opioids. Clinicians often face challenges in defining the most appropriate analgesic regimen for their individual patients. 

In 2012, U.S. Food and Drug Administration (FDA) determined that a Risk Evaluation and Mitigation Strategy (REMS) is necessary. This strategy was developed by the FDA in collaboration with a variety of stakeholder groups, including pain researchers and experts, medical associations, clinicians, educators, and industry funders and includes customized educational programs to ensure that the benefits of ER/LA opioid analgesics continue to outweigh the risks of adverse outcomes (addiction, unintentional overdose, and death) that often result from inappropriate prescribing, abuse, and misuse.  


Learning Objectives

  • Identify risk factors for opioid-related aberrant behavior
  • Differentiate between tolerance, physical dependence, and addiction
  • Convert patients from immediate-release to ER/LA opioids as well as from one ER/LA opioid to another
  • Identify predisposing risk factors for significant respiratory depression 


Faculty Disclosures

Charles E. Argoff, MD, FABPM

Speakers Bureau for Allergan, Inc., AstraZeneca Pharmaceuticals LP, Depomed, Inc., Iroko Pharmaceuticals, LLC, Millennium Laboratories, LLC, Teva Pharmaceuticals Industries Ltd., and XenoPort, Inc.; Advisory Board for AstraZeneca Pharmaceuticals LP, Collegium Pharmaceutical, Inc., Depomed, Inc., Endo Pharmaceuticals Inc., Pfizer Inc., Purdue Pharma L.P., Shionogi & Co. Ltd., Teva Pharmaceuticals Industries Ltd., and XenoPort, Inc.; Research Support from Eli Lilly and Company, Endo Pharmaceuticals Inc., and Forest Laboratories, Inc. 

Katherine E. Galluzzi, DO, CMD, FACOFP

Has No financial relationships to disclose. 

Michael J. Brennan, MD

Advisory Board member for Depomed, Inc., Insys Therapeutics Inc., Iroko Pharmaceuticals, LLC, Mallinckrodt Pharmaceuticals, Nektar Therapeutics, Purdue Pharma L.P., Teva Pharmaceuticals Industries Ltd., and Zogenix, Inc. Consultant for Purdue Pharma L.P., Teva Pharmaceuticals Industries Ltd., and Zogenix, Inc. Speakers Bureau member for Depomed, Inc., Iroko Pharmaceuticals, LLC, Johnson & Johnson, Purdue Pharma L.P., Teva Pharmaceuticals Industries Ltd., and Zogenix, Inc.

Jeffrey Gudin, MD

Speakers Bureau honorarium from Endo Pharmaceuticals, Covidien, Nektar, Pfizer, and Purdue. Consultant honorarium from Alere and Shionogi. 

Bill McCarberg, MD, FABPM

Advisory Board member for AstraZeneca Pharmaceuticals LP, Collegium Pharmaceutical, Inc., Depomed, Inc., Inspirion Pharmaceuticals, LLC, Iroko Pharmaceuticals, LLC, Janssen Pharmaceuticals, Inc., Kaléo, Inc., Mallinckrodt Pharmaceuticals, Millennium Laboratories, LLC, Pfizer Inc., Salix Pharmaceuticals, Inc., Takeda Pharmaceuticals U.S.A., Inc., and Zogenix, Inc. Owns stock in BioSpecifics Technologies Corp., Galena Biopharma, Inc., Johnson & Johnson, Nektar Therapeutics, and Protein Design Labs, Inc. 

Steven Stanos, DO

Dr. Stanos receives advisory board/consultant honorarium from Endo Pharmaceuticals, Pfizer, MyMatrixx, and GlaxoSmith Kline. 

Disclosures

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose.

CME Information

CME

AMA PRA Category 1 Credits

Accreditation Statement

pmiCME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Designation Statement

pmiCME designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME

AANP

Accreditation Statement

pmiCME is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners. AANP Provider number 040308. This activity was planned in accordance with AANP Accreditation Standards and Policies.


Designation Statement

This program has been approved for 1.28 contact hour of continuing education, which includes 0.77 hour of pharmacology.

Instructions for Obtaining Credit

Once you have completed the activity, please click the "next" button to advance to the post-activity assessment. To complete this activity and claim credit, you must answer 3 out of the 4 questions correctly. If you are not successful after your first attempt, you will be given an opportunity to reflect upon the answer rationales and have the opportunity to review the educational content before proceeding. Once you have selected your answers, click the "submit" button to complete the evaluation questions and proceed to the claim credit screen.

Commercial Supporter

This educational activity is supported by an independent educational grant from the Extended-Release/Long-Acting Opioid Analgesic REMS Program Companies. Please see     http://ce.er-la-opioidrems.com/IwgCEUI/rems/pdf/List_of_RPC_Companies.pdf  for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Extended-Release/Long-Acting Opioid Analgesics REMS education requirements issued by the US Food & Drug Administration. 


Education Partner

Miller Medical Communications


Fine Print

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Internet Explorer (version 9.0 and above) is the minimum supported browser for Pri-Med Online eCME activities. Your Internet settings should be set to accept cookies and JavaScript. If cookies and/or JavaScript are disabled, the site may not function properly. A high-speed Internet connection (DSL, cable modem, or LAN-based) is not required; however, it is recommended for faster download times.

The opinions, ideas, and recommendations expressed in this educational activity are those of the faculty only and are not necessarily endorsed by, nor do they necessarily reflect, those of their affiliated institutions, pmiCME, pmiCME Advisory Boards and Consultants, DBC Pri-Med, LLC.

Clinical judgment must guide each clinician in weighing the possible risks, benefits, or contraindications of any diagnostics, interventions or treatments discussed. Clinicians should review manufacturers’ product information and consider these with the recommendations of other authorities when applying the assessment and/or clinical management strategies discussed in this activity to the care of their patients.

pmiCME educational activities are developed and conducted in accordance with the ACCME's Essential Areas and Policies. It is the mission of pmiCME to develop and present educational activities that are timely, fair-balanced, scientifically rigorous, and that serve to improve patient outcomes. To that end, we welcome your comments about how to better serve your needs.

pmiCME Accredited Provider
Pri-Med programs are owned and operated by DBC Pri-Med, LLC, a division of Diversified Communications, Inc. pmiCME, the accredited division of Pri-Med, is accredited with commendation by the ACCME and approved as a provider of continuing education by the AANP. pmiCME is the accredited provider for this activity.

Disclosures and Conflict of Interest
pmiCME requires all individuals in a position to influence educational content for pmiCME-certified CME activities to disclose relevant personal financial relationships with commercial interests prior to contributing to its educational activities. pmiCME assesses disclosed relationships and follows a defined process to resolve real or implied conflicts to ensure, to the best of its ability, that all educational content is free of commercial bias. Financial disclosures are listed in the activity syllabus and will also be printed on the slides and announced at the start of each presentation.

Discussion of Off-Label Uses and Investigational Products
During the course of their presentations, the faculty may mention uses of products that have not been approved in the United States for the indication(s) being discussed. All presenters are instructed to notify participants when they are discussing unapproved uses or investigational agents. In addition, specific slides will include notation of the off-label use or investigational agent being discussed. Views presented related to unapproved uses of products are solely those of the presenter(s) and are not endorsed by pmiCME or DBC Pri-Med, LLC.

Questions? If you have questions about this activity, please email support@pri-med.com or call (877) 477-4633.

SAFE Opioid Prescribing: ER/LA Opioids – Perspectives on Patient Assessment and Therapy Management

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