The appropriate and safe management of pain, and concerns about opioid overuse, abuse and overdose, have been making headlines for the past 20 years. Historically, opioids have been used for chronic non-cancer pain despite a lack of high-quality evidence for efficacy. Pain management societies and organizations (eg, THE Joint Commission on Accreditation of Healthcare Organizations [JCAHO]) embraced pain as a “vital sign” in the mid-1990s and encouraged more aggressive use of opioids for chronic pain. The amount of prescription opioids sold in the US increased nearly 4-fold from 1999 to 2014, despite no increase in reported pain.
According to IMS Health, a firm that tracks national prescription statistics, the number of opioid prescriptions dispensed peaked in 2012. For the first time in 20 years, the IMS data indicated a 12% overall decline in US opioid dispensing since the peak. Tightening of federal regulations for opioid prescriptions (eg, moving hydrocodone to schedule II status) likely contributed to the decline. Experts note, however, that the level of prescribing is still very high – with a growing overdose epidemic including fatal overdoses, which reached 28,000 in 2014.
Regulators and the public are looking to clinicians to "do the right thing" regarding pain management, but the "right thing" has been a moving target. What actions are in the patient’s or public’s best interest, and in the best interest of the clinician and their professional practice? There are opposing pressures from 1) patients and pain management experts who advocate providing opioids for individuals with pain, and 2) families, caregivers, and regulatory officials, who want to prevent prescription drug diversion, abuse and overdose. Finding the right balance to provide safe and effective pain management is a “moral imperative,” professional responsibility, and duty of healthcare professionals.
- This accredited program is targeted to pharmacy technicians.
This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.
CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours. CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists:
This continuing education activity meets the requirements of:
The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
This is a pharmacotherapeutics/pharmacology CE activity.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Requirements for CE Credit
- Discuss opioid use in the US today and the potential barriers to obtaining legitimate opioid medications. List the risk factors that contribute to opioid overdose and death.
- List the elements of safe opioid use. Describe an indicator of potential prescription opioid misuse or abuse.
- List required items that must be on an opioid (Schedule II) prescription. Explain how a prescription drug monitoring program (PDMP) can be used to help determine the validity of opioid prescriptions and improve opioid safety.
Chris Stock, PharmD, BCPP
Disclosure : Dr. Chris Stock report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.
Disclosure : Dr. Gasbarro reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.