Managing Acute & Chronic Pain with Opioid Analgesics in Patients on Medication Assisted Treatment (MAT) - Revised

Presenter: Daniel P. Alford, MD, MPH, FACP, FASAM

Fee:  No Cost

Module Description

This module addresses the challenges of treating acute and chronic pain in patients with opioid use disorders maintained on MAT, including methadone, buprenorphine and naltrexone. 

Patients with a history of opioid use disorders often have increased pain sensitivity.  Opioid agonists taken once per day to treat opioid addiction (methadone, buprenorphine) do not provide analgesia beyond 8 hours and may interfere with co-administered opioid analgesics.

The appropriate treatment of acute pain in patients on methadone and buprenorphine includes continuing the patient’s baseline opioid requirements to avoid increased pain sensitivity associated with opioid withdrawal. These patients are also at risk of cross-tolerance to opioid analgesics and therefore adequate pain control will often necessitate higher opioid doses at shorter dosing intervals. Various treatment options will be discussed for both outpatient and inpatient acute pain management.

For patients on MAT and suffering from chronic pain, nonopioid analgesics and nonpharmacological approaches should be tried. Strategies for managing chronic pain requiring opioids will be presented.

Educational Objectives: 

At the conclusion of this activity, learners should be able to:

  • Describe the epidemiology of pain among individuals with opioid use disorder and factors that influence the overlap
  • Contrast the key role of patient and provider perspectives on pain management
  • Discuss general principles of and different specific approaches for acute and chronic pain management in patients with opioid use disorder treated with methadone, buprenorphine, or naltrexone

Accreditation Statement: The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement: The American Society of Addiction Medicine (ASAM) designates this enduring material for a maximum of one (1) AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accreditation Release Date: January 14, 2019

Accreditation Expiration Date: July 31, 2019

Method of participation in the activity: To be awarded a maximum of 1 AMA PRA Category 1 Credits™ you must:

  1. Review 1 training module (1 hour) provided in this activity. 
  2. Earn a minimum cumulative score of 70% on the examination. 
  3. Complete a final evaluation and follow instructions at the end of the course regarding how to retrieve your Certificate of Completion as well as a CME Credit Certificate*.

*Credit will not be awarded unless all components of the program are completed. Partial credit will not be awarded.

Key:

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Online Module Pre Test
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Online Module Post Test
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5 Questions  |  Unlimited attempts  |  4/5 points to pass Please answer the following questions to the best of your ability. NOTE: In order to receive your CME Certificate/Certificate of Completion, you must earn a score of 4 out of 5 on this post-test. Upon passing the post-test, you will be directed to complete an evaluation. *If you would like to view the correct answers, explanations and references to the post-test, please refer back to the "Show Answers" tab which will appear in this component after you successfully pass.*
Evaluation
Please answer the following evaluation questions to the best of your ability. NOTE: Upon completion, you will receive a verification code on the last page of the survey. Return to this page and enter the verification code in its designated component below to claim your CME Credit Certificate/Certificate of Completion.
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