The main cause of drug overdose deaths are opioids, both prescribed and illegal, with the Centers for Disease Control and Prevention reporting 42,249 lethal overdoses in 2016 — 17,087 of which were related to prescription pain relievers and 15,469 related to heroin. According to the CDC, the rate of heroin overdose deaths quintupled from 2010 to 2016 and three out of four new heroin users started out misusing prescription painkillers. In 2015, according to the American Society of Addiction Medicine, 2 million Americans abused or were dependent on prescription opioids.

These heartbreaking statistics are only the beginning of the story. As the media have picked up the threads of individual narratives and the tragedies in towns across America, the public, government officials, and physicians in practice have learned the extent of the opioid addiction crisis — and vowed to do something about it.

The Massachusetts Medical Society’s Stance

Public health issues, including pain management, have always been on the radar of the Massachusetts Medical Society (MMS), the parent organization of NEJM Group.

In an effort to remove as many barriers as possible to prescriber education, the MMS has made a wide variety of CME activities on pain management and opioid prescribing available free.

Opioid Assessment and Treatment Tools and Resources for Physicians from the MMS

The MMS offers guidelines for the use of opioid therapy — and how to communicate with patients about their prescriptions. These guidelines came out in 2015 and have general applicability and are most relevant in primary care.

The MMS also has a webinar, called, “Incorporating the New Opioid Prescribing Guidelines Into Practice,” which discusses

  • trends in prescribing opioids
  • opioid misuse, and
  • principles for safe opioid prescribing.

Free CME on Opioids from the MMS

This CME offerings from the MMS is free to download (with registration) from their website:

Applying Best Practices to Prevent, Identify and Manage Prescription Misuse (1.00 CME Credit)

According to the United States Drug Enforcement Administration, more than 6 million Americans are misusing prescription drugs.  In 2015, Governor Baker announced that Massachusetts was in the midst of an opioid epidemic.  In 2019, there were 1,952 confirmed opioid-related overdose deaths.  The number of deaths continued to rise in 2020 with over 2,100 confirmed opioid-related overdose deaths which was a 5% increase over the previous year.

As a response to this wide-spread problem, the Board of Registration in Medicine in Massachusetts (MA BORIM) added an effective pain management educational requirement to obtain and renew medical licenses.  Prescribers should be aware of the federal and state laws and regulations that apply to prescribing controlled substances as prescription opioid misuse and/or use disorder has the potential to impact any patient.  There are many “warning signs” that may indicate prescription opioid misuse that physicians and other health care professionals should consider when managing a patient’s care.

CME on Pain Management, Addiction, and End-of-Life Care at

Go to the New England Journal of Medicine’s special collection of articles, interactive medical cases, and more to access CME on pain management, addiction, and end-of-life care.

Have you started to learn more about the opioid epidemic in the United States? Do you plan on taking advantage of the CME on this topic available to you? Share your experiences in the comments below.

Learn about our Free Pain Management CME

Interactive, Free Online CME on Pediatric Pain Management from Massachusetts General Hospital for Children

Several CME offerings from MGH for Children are free to use online (with free registration) from their website. They include:

Pediatric Pain Management

This interactive activity will enable clinicians to accurately assess pain in patients in various stages of development, identify warning signs, and select appropriate management strategies when treating headache and chronic abdominal pain.

pediatric pain management from MGH

Pediatric End of Life Care

This interactive activity explores the role of pediatric palliative care. Specific tools are provided to empower the clinician to initiate end of life care discussions with patients and their families, aid the family in advance care planning, and support the family after the death of their child. Concepts will be illustrated through interviews depicting families’ struggles with end of life care. Videos were provided by the Courageous Parents Network.

MOC Part II: Pediatric Respiratory Disorders

25 multiple choice questions with rationale and references. Assess your areas of strengths as well as keep current on new developments in the field of pediatric respiratory disorders.

Questions and Learning on Pain Management in NEJM Knowledge+

NEJM Knowledge+ Internal Medicine Board Review is carefully designed to map to the ABIM blueprint. That means the breakdown of subspecialties and topics covered in our question bank and practice exams mirrors those found on a typical ABIM exam. Likewise, our Family Medicine Board Review question bank maps to the ABFM blueprint. All the questions in NEJM Knowledge+ come with CME credit.

NEJM Knowledge+ includes about 25 questions on pain diagnosis and management and several questions on opioid addiction (for about 5 CME credits). Specific question topics include opioid addiction during pregnancy, treating pain related to cancer and cancer therapies, opioid-induced delirium, and treating upper back and neck pain after a motor vehicle accident. Each question includes a key learning point, detailed feedback, and links to relevant medical journal articles to deepen your understanding of the topic.

Have you started to learn more about the opioid epidemic in the United States? Do you plan on taking advantage of the CME on this topic available to you? Share your experiences in the comments below.