View the Opioid Prescribing modules offered by CDC: 

Options for reviewing the modules include:  

  1. View slides
  2. Listen to transcript,
  3. Read the transcript
  4. View the webcast (if compatible)

I recommend that you view the slides while listening to the transcript (A&B).  You will have to advance the slides per your estimate of when the slide should change based on the presenter’s content.

For the paper,

  1. Summarize of the main concepts for each of the modules reviewed.
  2. Identify a conclusion or plan for opioid prescribing as an APRN.
  3. The paper is to be 1000-1200 words, excluding title page and references. Use APA format.

Expectations

  • Length: The paper is to be 1000-1200 words, excluding title page and references.
  • Format: APA Style

CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and

patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain

treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose.

The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

Nonpharmacologic therapy and nonopioid pharmacologic therapy
are preferred for chronic pain. Clinicians should consider opioid
therapy only if expected benefits for both pain and function are
anticipated to outweigh risks to the patient. If opioids are used,
they should be combined with nonpharmacologic therapy and
nonopioid pharmacologic therapy, as appropriate.

Before starting opioid therapy for chronic pain, clinicians
should establish treatment goals with all patients, including
realistic goals for pain and function, and should consider how
opioid therapy will be discontinued if benefits do not outweigh
risks. Clinicians should continue opioid therapy only if there is
clinically meaningful improvement in pain and function that
outweighs risks to patient safety.

Before starting and periodically during opioid therapy, clinicians
should discuss with patients known risks and realistic benefits
of opioid therapy and patient and clinician responsibilities for
managing therapy.

DETERMINING WHEN TO INITIATE OR CONTINUE OPIOIDS FOR CHRONIC PAIN

1

2

3

CLINICAL REMINDERS

• Opioids are not first-line or routine
therapy for chronic pain

• Establish and measure goals for pain
and function

• Discuss benefits and risks and
availability of nonopioid therapies with
patient

IMPROVING PRACTICE THROUGH RECOMMENDATIONS

LEARN MORE | www.cdc.gov/drugoverdose/prescribing/guideline.html

GUIDELINE FOR PRESCRIBING
OPIOIDS FOR CHRONIC PAIN

When starting opioid therapy for chronic pain, clinicians should prescribe
immediate-release opioids instead of extended-release/long-acting (ER/LA)
opioids.

When opioids are started, clinicians should prescribe the lowest effective dosage.
Clinicians should use caution when prescribing opioids at any dosage, should
carefully reassess evidence of individual benefits and risks when considering
increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should
avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate
dosage to ≥90 MME/day.

Long-term opioid use often begins with treatment of acute pain. When opioids
are used for acute pain, clinicians should prescribe the lowest effective dose of
immediate-release opioids and should prescribe no greater quantity than needed
for the

ASSESSING BENEFITS AND
HARMS OF OPIOID THERAPY

THE EPIDEMIC

The United States is in the midst
of an epidemic of prescription
opioid overdose deaths, which
killed more than 14,000 people in
2014 alone.

Since 1999, sales of prescription
opioids—and related overdose
deaths—have quadrupled.

Since 1999, there
have been more than

165,000
deaths from overdose related to
prescription opioids.

GUIDANCE FOR OPIOID PRESCRIBING

The CDC Guideline for Prescribing Opioids for Chronic Pain1
provides up-to-date guidance on prescribing and weighing
the risks and benefits of opioids.

• Before starting and periodically during opioid therapy, discuss
the known risks and realistic benefits of opioids.

• Also discuss provider and patient responsibilities for
managing therapy.

• Within 1-4 weeks of starting opioid therapy, and at least every 3
months, evaluate benefits and harms with the patient.

ASSESS BENEFITS OF OPIOID THERAPY

Assess your patient’s pain and function regularly. A 30%
improvement in pain and function is considered clinically
meaningful. Discuss patient-centered goals and improvements
in function (such as returning to work and recreational
activities) and assess pain using validated instruments such
as the 3-item (PEG) Assessment Scale:

1. What number best describes your pain on average in the past
week? (from 0=no pain to 10=pain as bad as you can imagine)

2. What number best describes how, during the past week, pain
has interfered with your enjoyment of life? (from 0=does not
interfere to 10=completely interferes)

3. What number best describes how, during the past week, pain
has interfered with your general activity? (from 0=does not
interfere to 10=completely interferes)

If your patient does not have a 30% improvement in pain and function,
consider reducing dose or tapering and discontinuing opioids.
Continue opioids only as a careful decision by you and your patient
when improvements in both pain and function outweigh the harms.

1Recommendations do not apply to pain management in the context of active cancer treatment, palliative care, and end-of-life care.

L E A R N M O R E | www.cdc.gov/drugoverdose/prescribing/guideline.html

ASSESS HARMS OF OPIOID THERAPY
Long-term opioid therapy can cause harms ranging in severity from constipation and nausea to opioid use
disorder and overdose death. Certain factors can increase these risks, and it is important to assess and follow-
up regularly to reduce potential harms.

1 ASSESS. Evaluate for factors that could increase your patient’s risk for harm from opioid therapy such as:
• Personal or family history of substance use disorder

• Anxiety or depression

• Pregnancy

• Age 65 or older

• COPD or other underlying

Assessing Benefits and

Harms of Opioid Therapy

for Chronic Pain

Clinician Outreach and

Communication Activity

(COCA) Call

August 3, 2016

Office of Public Health Preparedness and Response

Division of Emergency Operations

Accreditation Statements
CME: The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Continuing Medical

Education (ACCME®) to provide continuing medical education for physicians. The Centers for Disease Control and Prevention

designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit

commensurate with the extent of their participation in the activity.

CNE: The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the

American Nurses Credentialing Center’s Commission on Accreditation. This activity provides 1.0 contact hour.

IACET CEU: The Centers for Disease Control and Prevention is authorized by IACET to offer 1.0 CEU’s for this program.

CECH: Sponsored by the Centers for Disease Control and Prevention, a designated provider of continuing education contact

hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is

designed for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to

receive up to 1.0 total Category I continuing education contact hours. Maximum advanced level continuing education contact

hours available are 0. CDC provider number 98614.

CPE: The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Pharmacy Education as

a provider of continuing pharmacy education. This program is a designated event for pharmacists to receive 0.1 CEUs in

pharmacy education. The Universal Activity Number is 0387-0000-16-150-L04-P and enduring 0387-0000-16-150-H04-P course

category. Course Category: This activity has been designated as knowledge-based. Once credit is claimed, an unofficial

statement of credit is immediately available on TCEOnline. Official credit will be uploaded within 60 days on the NABP/CPE

Monitor

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you have any comments/concerns regarding this program’s validity or relevancy to the veterinary profession.

CPH: The Centers for Disease Control and Prevention is