Prescription Opioids: Risk Management and Strategies for Safe Use

Course Overview
This course will extensively cover the various approaches recommended or mandated for use by clinicians who prescribe opioids, in order to reduce risk and improve outcomes. The goal of this course is provide clinicians with an understanding of the essential components of appropriate opioid prescribing. This objective will be achieved through discussion of behavioral responses in patients receiving opioids for pain; the antecedents, catalysts, manifestations, and consequences of the dramatic and widespread increase in clinical and illicit use of prescription opioids; the assessment and management of pain patient risk of developing problems with their prescribed opioid analgesic; governmental, law enforcement, and industry strategies and tactics to reduce prescription opioid abuse; and treatment approaches for patients with comorbid chronic pain and substance use disorders. Among primary care providers, considerable evidence has found widespread misunderstanding of opioid and other substance abuse and addiction and confusion in distinguishing physiological tolerance and dependence and uncontrolled pain behaviors from symptoms of opioid use disorder.

Learning Outcomes 
Upon the completion of this course, the learner should be able to:

• Define terms associated with opioid therapy and aberrant drug use.
• Analyze behavioral responses to prescribed opioids and signs of emerging opioid misuse.
• Outline the impact of clinical and professional society attitudes toward opioid prescribing.
• Review the role of OxyContin in the rise of prescribed opioids for chronic noncancer pain.
• Evaluate the basic epidemiology of prescription opioid use, misuse, and dependence in the United States.
• Identify factors that influence opioid prescribing decisions.
• Describe the morbidity and mortality associated with the use of prescription opioids.
• Discuss characteristics of appropriate and inappropriate opioid prescribing and contributory factors to both.
• Compare opioid abuse risk assessment tools and the utility of risk stratification.
• Outline the appropriate periodic review and monitoring of patients prescribed opioid analgesics, including the role of urine drug testing.
• Describe necessary components of patient/caregiver education for prescribed opioid analgesics, including guidance on the safe use and disposal of medications.
• Compare available opioid abuse-deterrent formulations.
• Evaluate government and industry efforts to address problems arising from prescription opioid analgesic misuse.
• Review the unintended negative consequences of efforts to reduce prescribed opioid analgesic misuse, diversion, and overdose.
• Discuss treatment considerations for patients with active or remitted substance use disorder who require prescribed opioid analgesics for chronic pain.

About the Author/Presenter 
Mark Rose, BS, MA, LP, is a licensed psychologist in the State of Minnesota with a private consulting practice and a medical research analyst with a biomedical communications firm. Earlier healthcare technology assessment work led to medical device and pharmaceutical sector experience in new product development involving cancer ablative devices and pain therapeutics. Along with substantial experience in addiction research, Mr. Rose has contributed to the authorship of numerous papers on CNS, oncology, and other medical disorders. He is the lead author of papers published in peer-reviewed addiction, psychiatry, and pain medicine journals and has written books on prescription opioids and alcoholism published by the Hazelden Foundation. He also serves as an Expert Advisor and Expert Witness to law firms that represent disability claimants or criminal defendants on cases related to chronic pain, psychiatric/substance use disorders, and acute pharmacologic/toxicologic effects. Mr. Rose is on the Board of Directors of the Minneapolis-based International Institute of Anti-Aging Medicine and is a member of several professional organizations.

Audience/Accreditations and Approvals 
TRC Healthcare/ NetCE 
In support of improving patient care, this activity has been planned and implemented by TRC Healthcare/ NetCE. TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 
This course is designed for the following healthcare professions (select your profession for details): 
Nursing, Pharmacy, Physician

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