Opioid CME

The BoardVitals Opioid CME Review offers clinicians 10 AMA PRA Category 1 Credits^TM and over 250 Opioid board review questions for free. The questions cover key topics including prescribing opioids and other controlled substances, pain management and palliative care, and substance use disorders. This question bank will assist clinicians meet their State CME requirements.

The BoardVitals Addiction Medicine CME Review also features:

• Free CME Credits
• Quick and Convenient CME
• Computer, phone, and tablet access
• Constantly updated up-to-date questions
• Questions that are targeted specifically to the exam
• Online CME tracker
• 100% Pass Guarantee
• Statistical comparison to other Addiction Medicine test-takers (Nationally)

After completing this activity, you should be able to:

• Identify the most commonly abused substances
• Recognize the most common indicators and symptoms of substance abuse and pain medicine dependency
• Describe the underlying pathophysiology of disease and basic science knowledge
• Formulate treatment for chronic pain management and substance abuse

Target Audience: Clinicians who deal with opioid prescribing and patients dealing with substance abuse and pain management

After completing Extended-Release and Long-Acting Opioids: Assessing Risks, Safe Prescribing, you will be able to:
• Appropriately assess patients for the treatment of pain with ER/LA opioid analgesics, including analyzing risks versus potential benefits
• Assess patient’s risk of abuse, including substance use and psychiatric history
• Identify state and federal regulations on opioid prescribing
• Incorporate strategies to effectively initiate therapy, modify dosing or discontinue use of ER/LA opioid analgesics in patients with pain
• Manage ongoing therapy with ER/LA opioid analgesics
• Incorporate effective counseling for patients and caregivers about the safe use of ER/LA opioid analgesics
• Discuss general and product-specific drug information related to ER/LA opioid analgesics

Target Audience: Prescribers of ER/LA opioids

After completing Safe and Effective Opioid Prescribing for Chronic Pain, you will be able to:
• Discuss the breadth and quality of evidence for the use of opioids for chronic pain, including current gaps in knowledge.
• Describe appropriate assessment, monitoring and documentation strategies to meet best practice standards and medico-legal requirements to support opioid prescribing.
• Apply appropriate communications strategies when initiating, managing, and, if necessary, terminating opioids for patients with chronic pain.
• Describe, screen for, and manage potential co-morbidities in chronic pain patients.
• Apply a practical framework for decision-making on the initiation, maintenance, and discontinuation of opioid analgesics for the treatment of chronic pain.
This program meets the criteria of the Massachusetts Board of Registration in Medicine for 4 hours of risk management study and 4 hours of opioid education.

Target Audience:
Physicians, nurse practitioners, physician assistants, dentists, and pharmacists

After completing Scope of Pain: Safe & Competent Opioid Prescribing Education, you will be able to:
• Discuss prevalence of chronic pain in the US
• Discuss prevalence of the use and misuse of opioid analgesics
• Describe the pharmacology, efficacy and safety of opioid analgesics
• Describe the components of a thorough opioid misuse risk assessment for a potential candidate for chronic opioid therapy
• Describe universal precautions and their role in chronic opioid therapy
• Describe monitoring and documentation strategies for chronic opioid therapy
• Describe initiating opioid therapy
• Apply counseling and communication strategies to ensure appropriate and safe use of opioid medications
• Assess differential diagnosis for aberrant medication taking behavior – Pain relief vs drug seeking

Target Audience: Physicians focusing on Pain Management

Opioid use disorder (OUD) affects millions of individuals globally and is best defined by the Diagnostic and Statistic Manual of Mental Disorders, Fifth Edition (DSM-5) as a condition due to tolerance, manifestation of physical dependence, and loss of control leading to health hazards.The scale of the problem is staggering, and while the causes are manifold, it is fueled in part by widespread availability: the Centers for Disease Control and Prevention estimates that the distribution of prescription opioid analgesics rose over fivefold between 1997 and 2007.

By the end of the session the participant will be able to:

• Describe the epidemiology of OUD and dependence, and outline current and the significance of inappropriate selection and treatment of opioid therapy
• Identify long-acting treatment modalities for OUD and dependence, and apply them to patient cases using evidence-based medicine
• Identify challenges associated with the selection and implementation of drug regimens to the treatment of OUD and dependence, including risk factors for opioid overdose
• Develop strategies for recognizing and improving therapeutic adherence in patients treated for OUD and opioid dependence

Target Audience:

Healthcare professionals specializing in: addiction specialists, pain management specialists, primary care physicians, and psychiatrists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in pain management or substance abuse; and any other health professionals who encounter OUD in the clinical setting.

Every 7 minutes in our country, a person dies from a drug overdose, while a child is also born approximately every 30 minutes dependent on opioids. How do we as healthcare professionals offer non-stigmatic patient care and contribute to the progress of society in the right direction? Substance use disorder (addiction) is likened to an iceberg or a weed, in that the issues underneath the surface are typically even more complicated than what is viewed from the surface. Addiction spans hundreds of substances of abuse highlighted by stimulants (cocaine and methamphetamine), cannabis (plant, synthetics, and extracts), and opioids (heroin, fentanyl, and carfentanyl). As one can recall with the substance of ethyl alcohol (i.e. beer, wine, and hard liquor), a substance may never actually chemically change, yet can move across legal classifications of substances, leaving all healthcare professionals in need of knowledge on all substances of abuse. Opioid use disorder (opioid addiction) is combated with the medication-assisted treatments (MAT) of naltrexone, methadone, and buprenorphine, while opioid overdose respiratory depression is reversed with naloxone. Over the course of this activity, we will aim for “higher” education on all of these dynamic aspects. Unlike opioids, this activity is sure to open your eyes and possibly even elevate your blood pressure and/or heart rate!!!

According to the 2015 National Survey on Drug Use and Health, approximately 3.8 million people (1.4% of those ages 12 or older) reported misusing prescription pain relievers, while another 329,000 people reported using heroin. Within the same year, 52,404 lethal overdoses took place, making drug overdose the leading cause of accidental death within the United States. Stancliff et al estimated that as of 2012, approximately 80% of people dependent on heroin or prescription opioids were not engaged in any treatment and many in treatment do not use the most effective medication-assisted treatments available to them.

Despite recent increased awareness of opioid use disorder (OUD) and efforts to improve access to care, several barriers to treatment still exist, including financial, geographic, regulatory, and social. In 2012, only 2.2% of physicians in the United States obtained waivers to prescribe buprenorphine for the treatment of OUD. Of those who received waivers, 41.6% were psychiatrists. This may be perceived as a potential barrier to OUD treatment as patients are often resistant to referrals to psychiatric and/or addiction clinics given the stigmas commonly surrounding addiction and mental health. Furthermore, physicians with waivers were found to practice primarily in urban settings, leaving a large portion of the rural population without access to buprenorphine treatment.

With all this in mind, education is needed in regards to current and emerging treatment options for OUD available to multiple patient populations. Also, with the deaths due to drug overdoses still elevated, education on how to recognize and reverse an opioid overdose is needed.

This presentation will address the above needs by discussing the science behind opioid use disorder as well as reflect upon current statistics associated with its impact on the United States. During the discussion, opioid overdose risks will be discussed and participants will be able to practice recognizing key symptoms of an overdose situation. Steps of using naloxone will be discussed and connected to how to appropriately seek out treatment for maintenance of opioid use disorder. Finally, new buprenorphine products and the potential role of naltrexone will be applied to this stigmatized population.