__________________ Effective Management of Acute and Chronic Pain with Opioid Analgesics, 2nd Edition
The core messages are directed to prescribers, pharmacists, and nurses, but are also relevant for other HCPs who participate in the management of pain. The course work is not intended to be exhaustive nor a substitute for a more comprehensive pain management course. Accrediting bodies and CE providers will ensure that the CE activities developed comply with the standards for CE of the Accreditation Council for Continuing Medical Education [1] [2]. or another CE accrediting body, depending on the target audience’s medical specialty or health care profession. FDA is making the FDA Blueprint, approved as part of the Opioid Analgesic REMS, available on the REMS@FDA Website (www.fda.gov/REMS), where it will remain posted for use by CE providers as they develop the CE materials and activities. A list of the REMS-compliant CE activities supported by unrestricted educational grants from the opioid analgesic companies to accredited CE providers will be posted at www.opioidanalgesicREMS.com as that information becomes available. Reasons Why HCP Education Is So Important Adverse outcomes of addiction, unintentional overdose, and death resulting from inappropriate prescribing, abuse, and misuse of opioids have emerged as major public health problems. It is critical that HCPs are knowledgeable about the risks associated with opioid analgesics as they pertain to their patients as well as from a public health perspective. The data continue to show problems associated with prescription opioid analgesics. • In 2015, over 52,404 Americans died from drug poisonings, and of these, 24% or approximately 12,570 deaths involved opioid analgesics [3]. • Based on the 2016 National Survey on Drug Use and Health (NSDUH), an estimated 11.5 million Americans aged 12 or older misused a prescription pain reliever in the past year ― with hydrocodone, oxycodone, and codeine products being the most commonly reported [4]. • The most common source of pain relievers in the 2016 NSDUH was “a friend or relative” (53%). “A physician’s prescription” was the second most common source, reported by approximately 35% of respondents [5]. The nation is facing competing public health problems: the need to adequately treat a large number of Americans with acute and chronic pain and an epidemic of prescription opioid abuse. Described in the 2011 report by the National Academies of Science, Engineering, and Medicine (NASEM), Relieving PAIN in America, A Blueprint for Transforming Prevention, Care, Education, and Research [6]. 100 million Americans suffer from common chronic pain conditions; fewer than half of Americans undergoing surgery report adequate pain relief;
and 60% of Americans visiting the emergency department with acute painful conditions receive analgesics. The increasing availability of prescription opioids since the 1990’s has been accompanied by an epidemic of opioid addiction. The Substance Abuse and Mental Health Services Administration’s National Survey of Drug Use and Health has shown that most people who use prescription analgesics “nonmedically” obtain them from friends or family, who it is believed obtained the drugs from a doctor’s prescription [7]. Some of the immediate consequences of untreated or undertreated pain include reduced quality of life, impaired physical function, and high economic costs. Chronic pain is associated with physical disability, fear, anger, depression, anxiety, and reduced ability to carry out the roles of family member, friend, and employee. It is critically important that HCPs have all the information they need to properly treat their patients and safely manage their pain. It is also critical for HCPs to understand when opioid analgesics are the appropriate treatment and how to implement best practices to ensure their patients’ safety. A 2017 report by NASEM, Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use , describes the challenges of providing adequate pain management and calls for the establishment of “comprehensive pain education materials and curricula” for HCP [8]. Having broad knowledge about how to manage patients with pain can create the opportunity for HCPs to consider all options for pain management, including nonpharmacologic and non-opioid pharmacologic options, and to reserve opioids for when non-opioid options are inadequate and when the benefits of the opioids are expected to outweigh the risks. This information can also aid HCPs in identifying and intervening when encountering obstacles that may reduce access to nonpharmacological and non-opioid medication options. Fully informed HCPs can help contribute to national efforts to address opioid addiction and reduce opioid misuse and abuse. Purpose of the Opioid Analgesic REMS HCP Educational Effort Following completion of educational activities under the Opioid Analgesic REMS, HCPs should be knowledgeable about the following. • The fundamental concepts of pain management, including definitions and mechanisms of pain • How to assess patients in pain, identifying risk factors for abuse and addiction • The range of therapeutic options for managing pain, including nonpharmacologic approaches and pharmacologic (non-opioid and opioid analgesics) therapies • How to integrate opioid analgesics into a pain treatment plan individualized to the needs of the patient
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MDUT1125
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