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CME Corner

This activity has expired. CME/CE credit is no longer available and the following content may not be available or may not be up-to-date. For a list of current activities that offer CME/CE credit, click here.

Program Detail

Release Date: June-25-09
Credit Expiration Date: June-25-10

Faculty

Chairperson*
Bill H. McCarberg, MD
Adjunct Assistant Clinical Professor
Department of Medicine
University of California
Staff Physician
Department of Family Medicine
Kaiser Permanente
San Diego, California

Faculty*
Charles E. Argoff, MD
Professor of Neurology
Albany Medical College
Director, Comprehensive Pain Program
Albany Medical Center
Albany, New York

Daniel A. Brzusek, DO
Clinical Assistant Professor
Department of Rehabilitation Medicine
University of Washington
Seattle, Washington


Martin Grabois, MD
Professor and Chairman
Department of Physical Medicine and Rehabilitation
Professor, Department of Anesthesiology
Baylor College of Medicine
Director, Pain Program
Department of Physical Medicine and Rehabilitation
Baylor Clinic
Houston, Texas

Steven P. Stanos, DO
Assistant Professor
Department of Physical Medicine and Rehabilitation
Assistant Program Director
Multidisciplinary Pain Fellowship
Northwestern University Medical School
Feinberg School of Medicine
Medical Director, Center for Pain Management
Rehabilitation Institute of Chicago
Chicago, Illinois

Editor*
Denise M. Erkkila, RPh
DIME
Chicago Illinois

Credit Hours

1.5

Medium

Link - Online

Program Description

Chronic pain is common in patients undergoing rehabilitation, and optimal management requires a comprehensive and structured treatment plan. Opioid analgesics are highly effective for treating nonmalignant pain, but controversy exists regarding opioid use as part of the overall rehabilitation plan. The increase in opioid use has been accompanied by a significant increase in abuse. Increased diversion and abuse of prescription opioids result in substantial morbidity and mortality, including thousands of related accidental poisoning deaths. Identification of at-risk patients and better oversight of prescribers have not effectively reduced the risk of opioid diversion and abuse. In fact, increased federal oversight has created a barrier to the effective management of chronic pain using opioid analgesics. The introduction of effective extended-release opioid formulations has failed to decrease the risk of diversion and abuse because the extended-release properties can be easily disabled by abusers. Further advances in pharmaceutical technology may be of value, with formulations designed to be resistant to tampering or accidental misuse. No single approach will eliminate diversion and abuse of prescription opioids. Comprehensive programs that assess the risk of opioid abuse and the risks and benefits of specific treatments, obtain clear patient agreement for treatment goals, employ oversight for prescribers and patients, and use effective treatments with a low abuse potential hold possibilities for effective pain control while minimizing the risk of diversion and abuse of these drugs.

Program Developer/Facilitator

DIME

Target Audience

This activity is targeted to physicians and other healthcare professionals with an interest in patients who require treatment with opioid analgesics to manage chronic pain.

Learning Objectives

Upon completion of this educational activity, the participant should be able to:

  1. Describe appropriate uses for opioid analgesics in the setting of rehabilitation medicine.
  2. Review the risks and benefits of opioids vs other medications (eg NSAIDs) for chronic pain management in patients undergoing rehabilitation.
  3. Recognize the public health consequences of prescription opioid diversion and abuse and their impact on the use of these agents for the treatment of patients with chronic pain.
  4. Identify emerging opioid formulations and combinations that have the potential to decrease the risks of diversion and abuse.
  5. Assess multifaceted interventions aimed at improving adherence to and decreasing the risk of abuse of opioid analgesics.

Disclosures

DIME requires that all persons who were in a position to control or influence the content of this CME activity disclose all relevant financial relationships with any commercial interest. This information is used to: (1) determine whether a conflict exists, (2) resolve the conflict by initiating a content validation process, and (3) advise learners of this information.


Bill H. McCarberg, MD
Sources of Funding for Research: None
Consulting Agreements: None
Speakers’ Bureau/Honorarium Agreements: Alpharma Inc.; Cephalon, Inc.; Endo Pharmaceuticals; King Pharmaceuticals, Inc.; Eli Lilly and Company; Merck & Co., Inc.; Pfizer Inc; PriCara, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or Experimental Drug Use: None

Charles E. Argoff, MD
Sources of Funding for Research: Endo
Pharmaceuticals
Consulting Agreements: Endo Pharmaceuticals;
King Pharmaceuticals, Inc.; PriCara, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Speakers’ Bureau/Honorarium Agreements: Endo
Pharmaceuticals; King Pharmaceuticals, Inc.
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or
Experimental Drug Use: None

Daniel A. Brzusek, DO
Sources of Funding for Research: None
Consulting Agreements: None
Speakers’ Bureau/Honorarium Agreements: None
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or
Experimental Drug Use: None

Martin Grabois, MD
Sources of Funding for Research: None
Consulting Agreements: None
Speakers’ Bureau/Honorarium Agreements: None
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or
Experimental Drug Use: None

Steven P. Stanos, DO
Sources of Funding for Research: Abbott Laboratories
Consulting Agreements/Advisory Board Memberships :Abbott Laboratories; Alpharma Inc.; Cephalon, Inc.; Endo Pharmaceuticals
Speakers’ Bureau/Honorarium Agreements: Endo
Pharmaceuticals; Ortho-McNeil-Janssen
Pharmaceuticals, Inc; Pfizer Inc
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or Experimental Drug Use: Morphine sulfate extended-release with sequestered naltrexone hydrochloride, oxycodone hydrochloride controlled-release, immediate-release oxycodone hydrochloride subtherapeutic niacin

Denise M. Erkkila, RPh
Sources of Funding for Research: None
Consulting Agreements: None
Speakers’ Bureau/Honorarium Agreements: None
Financial Interests/Stock Ownership: None
Discussion of Off-Label, Investigational, or
Experimental Drug Use: None

*This CME/CE activity includes discussions regarding the use of medications that may be outside their currently approved labeling. Physicians should consult the current prescribing information for these products. DIME requires the speaker to disclose that the product is not labeled for the use under discussion. Compliance is documentation that demonstrates the provider has a practice in place to make this requirement known to the faculty. This CME activity was planned and produced in accordance with the ACCME Essential Areas and Policies.

Credit Statements

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

DIME designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Instructions for receiving credit:
This activity includes a posttest, which must be completed to receive continuing education credit. A minimum score of 70% is required on the test to receive credit. Continuing education certificates will be mailed within 4–6 weeks. There is no fee for participating in the program or for the generation of the certificate.

To complete the posttest and request credit, visit http://www.dimeded.org/updates/PMR17916.html.

Commercial Support Statements

This activity is funded through an educational grant from King Pharmaceuticals, Inc.

Certificate Fee

$0.00

By clicking START PROGRAM I acknowledge that I have read the CME/CE information above.

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