Healthcare professionals should know the best clinical practices in opioid prescribing, including the associated risks of opioids, approaches to the assessment of pain and function, and pain management modalities. Pharmacologic and nonpharmacologic approaches should be used on the basis of current knowledge in the evidence base or best clinical practices. Patients with moderate-to-severe chronic pain who have been assessed and treated, over a period of time, with nonopioid therapy or nonpharmacologic pain therapy without adequate pain relief, are considered to be candidates for a trial of opioid therapy. Initial treatment should always be considered individually determined and as a trial of therapy, not a definitive course of treatment
This course is designed for healthcare team members who prescribe, monitor, recommend, administer, or dispense appropriate evidence-based drug therapy.
The purpose of this course is to provide clinicians who prescribe or distribute opioids with an appreciation for the complexities of opioid prescribing and the dual risks of litigation due to inadequate pain control and drug diversion or misuse in order to provide the best possible patient care and to prevent a growing social problem.
Upon completion of this course, you should be able to:
- Identify ways to collaborate with the healthcare team to help promote patient safety.
- Discuss safe strategies for starting and stopping an opioid.
- Identify risky medication combinations involving opioids.
- Review the role of opioid overdose reversal agents.
- Summarize important patient counseling tips for patients who are taking opioids.
Sara Klockars, PharmD, BCPS, is an Associate Editor at Prescriber Insights and Pharmacist’s Letter. She earned her PharmD degree from Ohio Northern University. She then completed two years of clinical pharmacy residency at the Medical University of South Carolina. Prior to coming to Prescriber Insights and Pharmacist’s Letter in 2019, Sara was a Clinical Pharmacy Specialist at Kaiser Permanente Colorado working alongside prescribers and pharmacists in an integrated healthcare system. She spent 12 years as part of the Primary Care team and built a practice in Dermatology, where she practiced for 4 years prior to joining TRC. In addition to dermatology, Sara’s professional interests include pharmacist and prescriber education, promoting evidence-based, cost-effective care, and other specialty pharmacy areas (rheumatology, gastroenterology, etc.).
Jeffrey Bratberg, PharmD, FAPhA, studies the essential and emerging roles community pharmacists play regarding opioid overdose, harm reduction and opioid use disorder treatment. He advocates for pharmacists’ expanded roles in medication access, public health promotion, and policy change through research, practice, and teaching. He is an associate editor of the Journal of the American Pharmacists Association (JAPhA) and co-produces and hosts a weekly public health pharmacy podcast with his pharmacy students, called “The Regimen.”
Contributing faculty, Sara Klockars, PharmD, BCPS, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Contributing faculty, Jeffrey Bratberg, PharmD, FAPhA, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.
#24-684: Opioids: Strategies for Safe Use
Opioid analgesics are approved by the FDA for the treatment of moderate or severe pain. However, individual patients differ greatly in clinical response to different opioid analgesics, and patient populations show widely variable response to the same opioid and dose. These response variations make opioid prescribing challenging. Further, the important role of opioid analgesics is broadly accepted in acute pain, cancer pain, and palliative and end-of-life care, but it is controversial for the management of chronic noncancer pain. Opioids are not a panacea for pain, nor are they safe and effective for every patient. However, they can be a useful tool, and knowledge of medical advances can give clinicians greater confidence to safely and effectively prescribe these drugs.
Learners should engage with the webinar, below, and the provided resources to explore the topics covered in this course.
The following webinar, produced by NetCE, provides a discussion of the safe use of opioids.
Opioid prescribing and dispensing are essential aspects of patient care, but safe practices are essential. The following resources are provided in the event that you are interested in further exploring the topic, or even trying some of the approaches discussed in this webinar.
| CDC Clinical Practice Guideline for Prescribing Opioids for Pain |
| https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm |
| DEA Take Back Day |
| https://www.dea.gov/takebackday |
| U.S. Food and Drug Administration |
| https://www.fda.gov/drugs/information-drug-class/opioid-medications |
| Substance Abuse and Mental Health Services Administration |
| https://www.samhsa.gov/blog/category/opioids |
| American Academy of Pain Medicine |
| https://painmed.org |
Mention of commercial products does not indicate endorsement.