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
Several CME offerings from the MMS are free to download (with free registration) from their website. They include:
Promulgated by the Massachusetts Medical Society (MMS) in 2015, these guidelines are now incorporated into the Massachusetts Board of Registration in Medicine’s comprehensive advisory to physicians on prescribing issues and practices. The purpose of this educational activity is to help prescribers integrate these new guidelines into practice. The course is recommended for all prescribers who are seeking guidance in best practices in opioid prescribing, both in acute and chronic pain situations. Topics include recognizing, prescribing, and treating patients at risk for opioid addiction, utilizing the MA Prescription Monitoring Program, identifying effective screening tools and patient communication strategies, and becoming familiar with pain consultations and resources for alternative pain treatment therapies.
MassPAT (Massachusetts Prescription Awareness Tool) is the Prescription Monitoring Program’s (PMP) online system launched by the MA Department of Public Health on August 22, 2016. The Massachusetts Medical Society and the MA Department of Public Health have developed this course, based on an archived webinar, to address various legal and regulatory requirements and to help prescribers implement use of this tool into daily clinical workflow. This online course also addresses how prescribers can use MassPAT to inform best prescribing habits.
Legal Advisor: Identifying Drug Dependence (1.00 CME Credit). This CME activity helps make physicians aware of the laws and regulations that apply to controlled substances in both the state and federal level. It discusses the importance of informed consent and agreement for treatment, uses case studies to offer strategies for identifying patients who may be at risk for addiction, and offers preventative measures to avoid addiction in patients.
CME on Pain Management, Addiction, and End-of-Life Care at NEJM.org
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.
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:
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.
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.
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.