First Do No Harm: Safe and Effective Management of Pain

Episode 1: Initial Assessment and Treatment Approaches
Episode 2: Initiating and Discontinuing Opioid Analgesic treatment and Other Pain Strategies
Episode 3: Ongoing Treatment for Pain Management
Episode 4: Implementing Effective Counseling and Management Strategies

Released On
October 31, 2019

Expires On
October 31, 2020

Media Type
Internet

Completion Time
150 minutes

Specialty
Neurology

Topic(s)
Pain Management

Scroll to the Bottom of this Information to Begin this Course

This activity is provided by Antidote Education Company, ArcheMedX, INCDEDO and ACOOG.

 

Supported by an educational grant from the Opioid Analgesic REMS Program Companies. Please see https://ce.opioidanalgesicrems.com/RpcCEUI/rems/pdf/resources/List_of_RPC_Companies.pdf for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the US Food and Drug Administration.

Credit Available

  • Physicians — maximum of 2.5 AMA PRA Category 1 Credits

All other health care professionals completing this course will be issued a statement of participation.

Target Audience

Health care providers involved with direct patient care, including those registered with the DEA, eligible to prescribe all opioid analgesics, as well as non-prescribers involved in the care of patients receiving opioid analgesic therapy, non-pharmacologic therapies, and non-opioid medication therapies.

Statement of Purpose

Follow 4 patients suffering with pain as you learn and apply the fundamentals of acute and chronic pain management. The four cases provide a framework for demonstrating safe prescribing of opioid analgesics.

The curriculum is intended to provide strategies to address and overcome the barriers and gaps in the knowledge and competence of health care providers in an engaging and personalized manner to promote the appropriate use and care of patients with pain, while reducing serious adverse outcomes resulting from inappropriate prescribing, misuse, and abuse of opioid analgesics, while maintaining patient access to effective pain management.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Evaluate the fundamental concepts of pain management including definitions and mechanisms of pain
  • Perform an effective assessment of patients with pain to determine the most appropriate treatment options.
  • Identify patients at risk of abuse and addiction
  • Create an effective individualized pain treatment plan including nonpharmacologic approaches and pharmacologic (non-opioid and opioid) therapies as appropriate
  • Determine which patients are appropriate for opioid pain analgesia
  • Initiate opioid analgesic therapy in a safe manner
  • Modify opioid analgesic therapy to achieve adequate pain relief while using the least amount of medication for the shortest amount of time
  • Manage ongoing therapy for patients using opioid analgesic therapy
  • Employ best-practices for counseling patients and caregivers about the safety and risks related to opioid analgesic therapies
  • Discuss the basic elements of addiction medicine, particularly opioid use disorder.
  • Identify patients with opioid use disorder
  • Safely discontinue opioid analgesic therapy when appropriate

Faculty

James Atchison, DO

Chair
Department of Physical Medicine and Rehabilitation & Department of Neurologic Surgery Mayo Clinic
Jacksonville FL

Bio
James Atchison, D.O. is a physician in the Department of Physical Medicine and Rehabilitation at Mayo Clinic hospital in Jacksonville, Florida, where he holds a joint appointment with the Department of Neurologic Surgery. Dr. Atchison specializes in the evaluation and treatment of non-operative spine care and rehabilitation, spinal manipulation, and comprehensive chronic pain management. He received his Doctor of Osteopathic Medicine degree from Ohio University College of Osteopathic Medicine in Athens, Ohio, followed by an internship in internal medicine at Cuyahoga Falls General Hospital in Cuyahoga Falls, Ohio. He then completed his Physical Medicine and Rehabilitation residency at Ohio State University in Columbus, Ohio. Dr. Atchison is a nationally recognized teacher and researcher, and in 2010 was presented with the American Academy of Physical Medicine and Rehabilitation Distinguished Clinician Award. Dr. Atchison has spent his career providing excellent patient care in academic medical institutions, including the University of Kentucky, University of Florida, Northwestern University, and Mayo Clinic.

Brian Erickson, MD

Medical Director
Healtheast Pain Center
St. Paul MN

Bio
Brian Erickson MD is a Board Certified Psychiatrist, with added qualification in Psychosomatic Medicine. He is certified by the American Academy of Pain Medicine. He is Medical Director of the HealthEast Pain Center, a multidisciplinary pain center. He is affiliated with the University of MN Pain Fellowship. He previously worked with the University of Vermont Pain Center and Pain Fellowship. He was medical director of a Chronic Pain Program in Duluth, MN. He has been a long-term Suboxone provider.

Bill McCarberg, MD

Adjunct Assistant Clinical Professor
University of California San Diego
San Diego, CA

Bio
Dr. McCarberg is the founder of the Chronic Pain Management Program for Kaiser Permanente (retired) in San Diego, California. He is currently working with Neighborhood Healthcare in Escondido California (Federally Qualified Health Center) and Elizabeth Hospice. He is past president of the American Academy of Pain Medicine and president of the Western Pain Society. His is also Adjunct Assistant Clinical Professor at the University of California at San Diego School Medicine. Dr. McCarberg is a member of the American Academy of Family Physicians, the American Academy of Pain Medicine, the American Pain Society, and the International Association for the Study of Pain. He has served the field as Board of Directors of the American Pain Society and recently on the Professional Education and Training Sub-committee of the NIH’s Interagency Pain Research Coordinating Committee, that has proposed the US Department of Health and Human Service’s National Pain Strategy. He has given more than 250 presentations on pain management issues and is the author or co-author of 115 articles, book chapters and books. He is board certified by the American Board of Pain Medicine, the American Board of Family Practice and additionally certified in Geriatrics and Hospice and Palliative Care. Dr. McCarberg received his MD degree from Northwestern University Medical School in Chicago, Illinois. He completed a medical internship and a residency in family practice at Highland Hospital in Rochester, New York.

Tim Munzing, MD

Director
Kaiser Permanente Orange County Family Medicine Residency Program
Anaheim, CA

Bio
Dr. Munzing has been a family physician, clinician, leader and educator with Kaiser Permanente in Orange County, California for the past 33 years, including for over 30 years as the founding Family Medicine residency program director. Dr. Munzing serves on the national ACGME Family Medicine Review Committee, responsible for the accreditation of over 600 Family Medicine residency programs. He was the recipient of the 2017 National Family Medicine Outstanding Program Director of the Year Award and the 2017 California Academy of Family Physicians Hero of Family Medicine Award.
Dr. Munzing is a leading national expert on appropriate (legal vs illegal) Opioid Prescribing. He has served as a medical expert reviewer for the DEA, FBI, DOJ and Medical Board of California for over 15 years, having reviewed over 200 cases in over fifteen states.
Dr. Munzing has lectured on the subject to thousands of physicians and healthcare leaders, law enforcement, and prosecutors across the United States. He published a peer-reviewed article entitled “Guide to Appropriate Opioid Prescribing for Noncancer Pain" in May 2017 in the Permanente Journal, which is now being used nationally by physicians, law enforcement and prosecutors.

Steven Stanos, DO

Medical Director
Pain Medicine and Services
Swedish Health System
Seattle, WA

Bio
Steven P. Stanos, DO currently serves as Medical Director of Swedish Health System Pain Medicine and Services in Seattle, Washington and leads Swedish's comprehensive pain center, Swedish Pain Services. The center provides interventional pain management, medical management, addiction treatment, and comprehensive interdisciplinary pain services. Prior to joining Swedish, he served as medical director of the Center for Pain Management at the Rehabilitation Institute of Chicago (RIC) from 2002-2014. At RIC he was an Assistant Professor at Northwestern University Medical School Feinberg School of Medicine and co-chair of the multidisciplinary pain fellowship.
He is board certified in physical medicine and rehabilitation and pain medicine by the American Board of Pain Medicine and by the American Board of Anesthesia.
Dr. Stanos is a Past President of the American Academy of Pain Medicine. Dr Stanos served as a panel member on the Service Delivery and Reimbursement work group for the National Pain Strategy and as invited consultant for the CDC Opioid Guideline for Prescribing Opioids for Chronic Pain. He currently serves on the American Medical Association (AMA) Opioid Task Force.
Dr. Stanos’ work includes ongoing educational initiatives for primary care, pain medicine, and physical medicine specialists around the United States and abroad. Dr. Stanos has published numerous scientific articles and book chapters related to pain management. Steven has been involved in the development and publication of treatment guidelines related to rehabilitation approaches for chronic pain and low back pain conditions and serves on the editorial board for the journal Pain Medicine.
A Mayday Foundation Advocacy fellow in 2013, his advocacy continues to focus on increasing awareness and access for interdisciplinary biopsychosocially-based pain care for patients suffering with chronic pain. He has appeared on CNN, National Public Radio, Fox News, regional print and television news on topics related to pain medicine and rehabilitation.

Content Planning:

Michael Fleming, MD, FAAFP

Clinical Associate Professor of Family Medicine
LSA Health Science Center
Shreveport, LA

Clinical Assistant Professor of Family and Community Medicine
Tulane University School of Medicine
New Orleans, LA

Chief Medical Officer
Antidote Education Company.

Bio
Dr. Fleming is chief medical officer for Antidote Education Company. He is a Clinical Associate Professor of Family Medicine at LSU Health Science Center in Shreveport, and Clinical Assistant Professor of Family and Community Medicine at Tulane University School of Medicine. Dr. Fleming has more than 29 years of medical field experience and is past President of the American Academy of Family Physicians and the Louisiana Academy of Family Physicians; and was founding President of the Louisiana Health Care Quality Forum.

Accreditation Statements

AMA: Antidote Education Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Antidote designates this enduring activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP: This Enduring Material activity, First Do No Harm: Safe and Effective Management of Pain, has been reviewed and is acceptable for up to 2.50 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins 10/31/2019. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AOA: The University of North Texas Health Science Center is accredited by the American Osteopathic Association to award continuing medical education to physicians.

The University of North Texas Health Science Center has requested that the AOA Council on Continuing Medical Education approve this program for 2.5 hours of AOA Category 1A credit. Approval is currently pending.

Maintenance of Certification (MOC)
Internal Medicine (ABIM): Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.5 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Anesthesiology (ABA): This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in Anesthesiology™ (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.

AANP:: This education activity is pending approval by the American Association of Nurse Practitioners of up to 2.5 contact hours of accredited education.

Disclosures of Conflicts of Interest

Antidote is committed to creating, developing, and operating high-quality, relevant, and practical continuing medical education activities that are in compliance with the ACCME's policies on commercial support and disclosure. Specifically, we are dedicated to ensuring that our events are planned and implemented free of the control of commercial interests and to identifying and resolving conflicts of interest of all persons in a position to control the content of an educational activity before the educational activity is delivered to our attendees. In addition, it is our standard practice to disclose all relevant financial relationships of our speakers in writing to our attendees before the beginning of an educational activity.

Individuals in a position to control the content of this CME activity reported the following relevant financial relationships with commercial interests.

James Atchison, DO

  • Consultant: Pfizer

Bill McCarberg, MD

  • Stock Holder: Johnson & Johnson, Collegium
  • Consultant: Pfizer, Scilex, Averitas
  • Honoraria: Scilex, Averitas, Adapt/Emergent Biosolutions

Steven Stanos, DO

  • Consultant: Pfizer, Scilex
  • Honoraria: Scilex
  • Research/Grant Support: Grunenthal

The following individuals have indicated no conflict of interest disclosures to report:

Brian Erickson, MD
Brad Irving, DO (Content Reviewer)
Lou Kuritzky, MD (Content Reviewer)
Timothy Munzing, MD
Matthew Fleming (Vice President, Antidote Education Company)
Michael O. Fleming, MD FAAFP (Chief Medical Officer, Course Director)
Laura Trimingham, MD (Editor)

Method of Participation

  1. Read the learning objectives and faculty disclosures.
  2. Click on the link below to participate in the online activity. Answer any polling questions presented.
  3. Complete the post-test and evaluation presented at the end of the activity.

A statement of credit will be issued automatically upon receipt of a completed activity evaluation form and a completed post-test with a score of 70% or better. You will have 3 opportunities to successfully complete the post-test.

Course Viewing Requirements

Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above

Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.

Off-Label or Investigational Product Discussion

This activity includes off-label discussion of medications that may be used to manage pain. Off-label use is noted when it arises.

Disclaimer

The material presented in this course is being made available by Antidote Education Company and ArcheMedX for educational purposes only. This material is not intended to represent the best or only methods or procedures appropriate for the medical situations discussed, but rather is intended to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations. Opinions expressed in this activity are those of the faculty and not of Antidote.

Every effort has been made to assure the accuracy of the data presented at this course. Physicians may care to check specific details such as drug doses and contraindications in standard sources prior to clinical application.

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