Opioid and Non-Opioid Medications Management: Filling in the Gaps, Prescribing for the Whole Patient

Target Audience & Educational Design:
The pharmacologic management of chronic pain is an important aspect of clinical practice in the primary care setting. However, strategies aimed at optimizing the use of non-opioid analgesics while mitigating the potential risks associated with opioid use can be difficult to implement in daily clinical practice. The focus of this enduring course is to provide useful, practical information about the use of opioid and non-opioid analgesics to improve the effective pharmacologic management of adults with chronic pain in the primary care setting.This enduring activity consisting of video lectures accompanied by slides is designed for all practitioners seeking to improve their knowledge of pharmaceutical control of chronic pain.

Educational Objectives: After completing this enduring activity, the learner should be better able to…

1. Review complexities and gain insights into the recent epidemiological evidence related to substance abuse and misuse, opioid analgesic and heroin overdose deaths, and the growing problem of benzodiazepines use by recreational uses, drug abusers, and patients suffering with chronic pain
2. Review the opioid pharmacologic agents and understand potential benefits and short-comings of the evolving abuse deterrent formulations
3. Assess for and interpret aberrant drug-related behaviors, integrate risk assessment tools, and risk management strategies into clinical practice as a means to improving and identifying appropriate patients for ongoing opioid management and identifying those patients not benefiting and/or need to be weaned or detoxified
4. Apply greater knowledge of more comprehensive assessment of sleep disorders in chronic pain patients and pharmacologic options that may be used to help patients
5. Review NSAID pharmacology for oral and topical formulations, examine evidence for these agents related to analgesic efficacy as well as potential adverse events including renal, cardiac, gastrointestinal toxicities, and death.
6. Define the unique pharmacologic properties and toxicities of methadone while utilizing recommended evidence-based practices when prescribing methadone.
7. Define opioid induced constipation, screening tools that can be used to better assess this condition, and know when a prescriptive therapy for opioid induced constipation should be considered.

Fee Information:
Course fee for AAPM Members: $349.00 - NEW PRICING - NOW $99.00
Course fee for AAPM Non-Members: $449.00 - NEW PRICING - NOW $199.00

Accreditation:
The American Academy of Pain Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physician Credit Designation:
The American Academy of Pain Medicine designates this enduring material activity for a maximum of 6.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Opioid Management and Controversies
.75 credits - Opioid Management (intro) and Opioid Pharmacology (running time 38:23)
.25 credits - Medically Directed Opioid Tapering: When, Where & How (running time 21:59)
.5 credits - Opioid-Induced Hyperalgesia: Does it Really Exist? (running time 24:50) 
.5 credits - Methadone: What Physicians Need to Know (running time 28:37) 
1.0 credit - Integrating Recent Guidelines into Clinical Practice (running time 1:06:10) 

Non-Opioid Analgesics and Agents
.75 credits - Pharmacologic Neuropathic Pain Treatment: Anticonvulsants (running time 47:26)
.75 credits - Psychiatric Medication Primer for the Pain Clinician: Depression and Anxiety (running time 40:45) 
.5 credits - Topical Analgesics (running time 33:03)
.25 credits - Muscle Relaxers: Review of Agents and Evidence (running time 15:45)

Other Pain Conditions
.75 credits - Headache Medications (running time 40:11) 
.75 credits - Insomnia: Medication Approaches (running time 38:52) 

Term of Offering:
This activity was originally released on August 17, 2016 and is valid through August 17, 2019. Re-reviewed and updated August 17, 2019. Valid through August 17, 2021. 

Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The American Academy of Pain Medicine does not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Faculty/Planner Disclosure Policy Statement:
It is the policy of AAPM to plan and implement educational activities in accordance with ACCME’s Essential Areas and Elements to ensure balance, independence, objectivity, and scientific rigor. As an ACCME accredited provider, AAPM is eligible to receive commercial support from commercial interests but cannot receive guidance, either nuanced or direct, on the content of the activity or on who should deliver the content. All program faculty and planners are required to disclose all financial relationships they may have or have had within the last 12 months with commercial interests whose products or services are related to the subject matter of the presentation. Any real or apparent conflicts of interest will be resolved prior to the presentation. All confirmed faculty disclosure information will be made available to participants prior to the activity. Faculty will also be expected to disclose this information to the audience both verbally and in print (slide presentation) at the beginning of each presentation. Faculty members are also required to inform program participants if any unlabeled uses of products regulated by the U.S. Food and Drug Administration will be discussed.

Instructions for Course Participants:
This enduring material activity will consist of a didactic video presentation accompanied by PowerPoint slides.
- While listening to/viewing content, you may pause the presentation at any time to record notes, etc., and re-start where you left off.
- You are required to view the entire presentation in order to receive credit.
- After viewing the presentation(s), learners must proceed to the activity evaluation which must be completed prior to receipt of your certificate.
- After completing the activity evaluation(s), a statement of credit will be generated and printed on your own at your convenience.

For additional assistance: Please contact the American Academy of Pain Medicine, 8735 W. Higgins Road, Suite 300, Chicago, IL 60631, 847-375-4731. If you need further assistance with software requirements please contact support@blueskybroadcast.com.

Privacy Policy:
For information on the American Academy of Pain Medicine (AAPM) privacy policy, please visit: http://www.painmed.org/privacy-policy/

Course Planners:
W. Michael Hooten, MD
Professor of Anesthesiology
Mayo Clinic College of Medicine
Rochester, MN
No relevant financial relationships

Steven P. Stanos Jr., DO
Medical Director, Pain Services Swedish Health Services
Seattle, WA
Analgesic Solutions (Consultant); Astra Zeneca (Consultant); Collegium (Consultant); MyMatrixx (Consultant); Pfizer (Consultant); Purdue (Consultant)

Jennifer Westlund, MSW
Director of Education 
American Academy of Pain Medicine
No relevant financial relationships

Mary O'Keefe
Education Manager
American Academy of Pain Medicine
No relevant financial relationships

Enduring Material Reviewers
Bernard Canlas, MD
VA Puget Sound Health Care System
Tacoma, WA
No relevant financial relationships

Michael Harned, MD
University of Kentucky
Lexington, KY
Medtronic (Speaker & Fellow Education); St. Jude (Speaker & Fellow Education)

Michael Leong, MD
Stanford Pain Management Center
Redwood City, CA
Boston Scientific (Advisory Board Member); Jazz Pharmaceuticals (Consultant); Sorrento Therapeutics (Consultant)

Meda Raghavendra, MD
Loyola Medicine
Chicago, IL
No relevant financial relationships

Armando Villarreal, MD, MBA
Rochester Neurosurgery Partners
Rochester, NY
No relevant financial relationships

Course Faculty:
Charles E. Argoff, MD
Albany Medical College
Albany, NY
Allergan (Speaker); AstraZeneca (Speaker, Consultant); Collegium (Consultant); Daiichi Sankyo (Consultant); Depomed (Consultant, Speaker); Dong Therapeutics (Principal Investigator); Endo (Principal Investigator); Forest (Principal Investigator); Janssen (Speaker); Lilly (Principal Investigator); Pfizer (Consultant); Purdue (Consultant); Teva (Consultant); Xenoport (Speaker)

Zahid H. Bajwa, MD
Boston PainCare Center
Waltham, MA
Allergan (Consultant); Boston Scientific (DMSB); Depomed (Consultant/Speaker Bureau); GLG (Consultant); Guidepoint (Consultant); Kaleo (Consultant); Medacarp (Consultant); McKinsey (Consultant); TEVA (Speaker Bureau); Uptodate.com (Expert Reviewer)

Michael R. Clark, MD, MPH, MBA
Johns Hopkins Univrsity
Baltimore, MD
No relevant financial relationships

Edward C. Covington, MD
Cleveland Clinic Foundation
Cleveland, OH
No relevant financial relationships

Richard C. Dart, MD, PhD
Rocky Mountain Poison and Drug Center
Denver, CO
Denver Health which operates the RADARS System

Halena Gazelka, MD
Mayo Clinic
Rochester, MN
No relevant financial relationships

Jeffrey A. Gudin, MD
Englewood Hospital Pain Center
Englewood, NJ
Astrazeneca (Speaker Bureau); Daiichi Sankyo (Consultant); Depomed (Consultant); Endo (Speaker Bureau); Iroko (Speaker Bureau); Insys (Consultant); Kaleo (Speaker Bureau); Purdue (Speaker Bureau); Quest Diagnostics (Consultant); Salix (Speaker Bureau); Teva (Consultant)

W. Michael Hooten, MD 
Mayo Clinic
Rochester, MN
No relevant financial relationships

Marvin D. Seppala, MD
Hazelden Betty Ford Foundation
Center City, MN
No relevant financial relationships

Steven P. Stanos, Jr., DO 
Swedish Health Services
Seattle, WA
Analgesic Solutions (Consultant); Astra Zeneca (Consultant); Collegium (Consultant); MyMatrixx (Consultant); Pfizer (Consultant); Purdue (Consultant)

David J. Tauben, MD
University of Washington
Seattle, WA
CORE-REMS ER/LA Opioid Analgesics REMS Training Program
(through PainCareLive.com; Faculty); NIH Pain Consortium
(Principal Investigator)

James C. Watson, MD
Mayo Clinic
Rochester, MN
No relevant financial relationships

Lynn R. Webster, MD, FACPM, FASAM
PRA Health Sciences
Salt Lake City, UT
Cara Therapeutics (Consultant); Charleston Labs (Advisory); Collegium (Advisory); CVS Caremark (Consultant); Egalet (Advisory Board Member); Grunenthal USA (Consultant); Inspirion (Advisory); Insys Therapeutics (Advisory Board Member); Kaleo (Advisory Board Member); Mallinckrodt (Consultant); Nevro Corportation (Consultant); Orexo Pharmaceuticals (Advisory Board Member); Pfizer (Advisory); TEVA (Consultant); Proove Biosciences (Advisory Board Member); Signature Therapeutics (Advisory Board Member); Travena (Advisory Board Member); Zogenix (Consultant)

Funding:
Funding for this enduring activity was provided by the American Academy of Pain Medicine. Commercial support was not provided for this enduring activity.