Improve Professional Training on Opioids and Alternative Pain Management Approaches
Introductory Paragraph
The importance of engaging prescribers in efforts to prevent prescription drug misuse is critical to provide credibility, reach target audiences, and provide their perspective.
Key Information
The importance of engaging prescribers in efforts to prevent prescription drug misuse is critical to provide credibility, reach target audiences, and provide their perspective.
Current Status
- 72% of doctors in one study indicated their knowledge of opioid dependence was low.[1]
- Many doctors in one study rated their training "unsatisfactory."[2]
- Only 5 states require all physicians to receive opioid-related CME.[3]
- Physicians who studied at lower-ranked medical schools prescribe nearly three times as many opioids per year as those who attended top-tier institutions [4]
- On average, the researchers found, physicians who attended Harvard wrote fewer than 100 opioid prescriptions per year, while physicians trained at the lowest-ranked schools wrote about 300 per year.[5]
Medical Education
Best Practices
- CDC Prescribing Guidelines
- Non-pharmacologic therapies
- Non-opioid pharmacologic therapies
- “Start low and go slow”
- Regularly monitor patients
Screening Before Prescribing
DIRE Scoring System
- A validated measure used to predict patient suitability for long-term opioid analgesic treatment for non-cancer pain.[11]12
- DIRE Rubric via University of Colorado, Denver
Alternative Pain Management Approaches
Training Curriculum & Programs
Project ECHO
This ECHO provides training in opioid addiction treatment at no cost, delivered right to your clinic, with a variety of bi-weekly schedules to choose from. They serve federally-qualified health centers, with a special focus on those that received the Substance Abuse Service Expansion awards using simple videoconferencing technology, healthcare teams connect to a community of learners. This free program ends in August of 2018.
Applying CDC's Guidelines for Prescribing Opioids
See Tools & Resources for more
Training Courses Coming Soon:
- Communicating With Patients: Providers will learn communication strategies they can use when treating chronic pain, including motivational interviewing.
- Deciding Whether to Prescribe: In this section of the training, providers learn mechanisms for deciding if opioids should be prescribed, and next steps for treatment – whether opioid or non-opioid treatments are selected.
- Dosing and Titration of Opioids: How Much, How Long, and How and When to Stop? When providers choose to prescribe opioids, they need to know how to properly dose and titrate opioids to reduce risk of opioid use disorder and overdose. This module explains methods of dosing and titration.
- Reducing the Risks of Opioids: Providers will learn best risk mitigation strategies and when to employ them after prescribing an opioid.
- Assessing and Addressing Opioid Use Disorder: This module describes methods available to a provider for assessing and addressing an opioid use disorder when it is suspected.
- Implementing the CDC Guideline: This module provides strategies and tools for implementing the CDC Guideline for Prescribing Opioids for Chronic Pain in a provider’s own practice, while outlining steps to overcome common barriers to implementation.
COCA Call Webinar Series
Providers' Clinical Support System For Opioid Therapies
[12]is a national training and mentoring project developed in response to the prescription opioid overdose epidemic. The consortium of major stakeholders and constituency groups with interests in safe and effective use of opioid medications offers extensive experience in the treatment of substance use disorders and specifically, opioid use disorder treatment, as well as the interface of pain and opioid use disorder. PCSS-O makes available at no cost CME programs on the safe and effective use of opioids for treatment of chronic pain and safe and effective treatment of opioid use disorder.
Core Curriculum
PCSS-O clinical experts have created a comprehensive course on opioid prescribing for primary care providers in the essential evidence-based clinical practices in treating chronic pain—with or without medications.
This course will provide clinicians with a solid base when treating chronic pain. The curriculum was created in an effort to consolidate the vast amount of information available to clinicians into a course that provides clinicians with the information, resources, and knowledge they need to treat their patients who suffer from chronic pain, including non-pharmacological treatments. The result is the most comprehensive and up to date curriculum developed thus far for the treatment of chronic pain.
Clinical Online Modules
PCSS-O offers a large library of online modules that allow you to take trainings when you want and at your own pace. The modules enhance prescribers’ and other health professionals’ knowledge, skills, and attitudes regarding safe and effective use of medication assisted treatment of opioid use disorder. Most modules include CME credit. Details about obtaining credit are provided with each module description and are noted on the page.
These online modules are designed to increase your:
- understanding of the current state of opioid use disorder
- understanding of treatment issues for special populations
- ability to assess and treat patients
CO*RE/ASAM Opioid Prescribing
The CO*RE/ASAM Opioid Prescribing: Safe Practice, Changing Lives course addresses this public health crisis. This comprehensive course was developed by renowned experts from Collaborative for REMS Education (CO*RE) and incorporates all six units outlined in FDA blueprint for safe opioid prescribing. The updated course also provides necessary context for safe opioid prescribing by discussing biopsychosocial aspects of pain, the newest clinical guidelines on the treatment of chronic pain, and state policies about prescribing opioids.[13]
SAFE Opioid Course
Board Approved CME Regarding Opioid Prescribing
Best Prescribing Practices - Dentists
Best Prescribing Practices in Dentistry Course - Cost is only $25. This 1-hour online, self-paced course will provide information to understand the significance of the opioid epidemic, understand the role of dentists, learn best practices and strategies for preventing prescription drug diversion and abuse, and identify tools and resources.
Relevant Research
Impactful Federal, State, and Local Policies
Available Tools & Resources
Pain Management Best Practices- Interagency Task Force[14]A report by the Pain Management Best Practices Inter-Agency Task Force (Task Force) to guide the public at large, federal agencies, and private stakeholders.
Promising Practices
Sources
- ↑ [1]Davis, C. S., & Carr, D. (2016). Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements. Drug and Alcohol Dependence, 163, 100–107. https://doi.org/10.1016/j.drugalcdep.2016.04.002
- ↑ [2]Davis, C. S., & Carr, D. (2016). Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements. Drug and Alcohol Dependence, 163, 100–107. https://doi.org/10.1016/j.drugalcdep.2016.04.002
- ↑ [3]Davis, C. S., & Carr, D. (2016). Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements. Drug and Alcohol Dependence, 163, 100–107. https://doi.org/10.1016/j.drugalcdep.2016.04.002
- ↑ [4]Doctors who attend lower-tier medical schools prescribe far more opioids. (2017, August 7). Retrieved November 24, 2019, from STAT website: https://www.statnews.com/2017/08/07/doctors-opioid-prescriptions/
- ↑ [5]Doctors who attend lower-tier medical schools prescribe far more opioids. (2017, August 7). Retrieved November 24, 2019, from STAT website: https://www.statnews.com/2017/08/07/doctors-opioid-prescriptions/
- ↑ [6]Forum, A. P. (n.d.). Https://www.addictionpolicy.org/404. Retrieved November 24, 2019, from https://www.addictionpolicy.org/404
- ↑ [7]Can't find source
- ↑ [8]HealthITSecurity. (2016, November 2). Addressing Opioid Abuse with Analytics, Population Health Strategies. Retrieved November 24, 2019, from HealthITAnalytics website: https://healthitanalytics.com/features/addressing-opioid-abuse-with-analytics-population-health-strategies
- ↑ [9]Can't find source
- ↑ [10]page not found
- ↑ [11]Page not found
- ↑ http://pcss-o.org/ PCSS-O
- ↑ [12]HealthI Security. (2016, November 2). Addressing Opioid Abuse with Analytics, Population Health Strategies. Retrieved November 24, 2019, from HealthITAnalytics website: https://healthitanalytics.com/features/addressing-opioid-abuse-with-analytics-population-health-strategies
- ↑ https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf