Dosing and Titrating Opioids

This is the fourth webinar in a COCA Call series about CDC Guideline for Prescribing Opioids for Chronic Pain. To view a list of other webinars in the series, visit the opioid call series overview webpage

Date:Wednesday, August 17, 2016

Presenter(s)

Overview

Evidence indicates that the risk for opioid-use disorder and overdose increases as dosage increases. CDC Guideline for Prescribing Opioids for Chronic Pain provides recommendations about the types of opioid formulations at initiation, starting dosages, morphine milligram equivalent dosage calculation methods, dose titrating considerations, and tapering methods. During this COCA Call, clinicians will learn about the association between opioid dosage and opioid therapy benefits and harms. In addition, presenters will use a case study of a patient with severe back pain on oxycodone to guide clinicians through safe opioid prescribing practices.

Objectives

• Describe the evidence for the association between opioid dosage and opioid therapy benefits and harms.
• Compare and contrast immediate release and extended-release/long-acting opioid formulations.
• Identify methods for calculating morphine milligram equivalent dosage.
• List the steps for titrating opioids to specific dosage thresholds.
• Identify best practices for opioid tapering and discontinuation.

Call Materials

• Slides: Read Now
• Transcript: Read Now
• Audio: Listen Now
• Webcast: Watch Now

Additional Resources

CDC Guideline for Prescribing Opioids for Chronic Pain and Related Materials

• SAMHSA Buprenorphine Training for Physicians
• MMWR: CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
• JAMA Special Communication: CDC Guideline for Prescribing Opioids for Chronic Pain
• Guideline Resources: Clinical Tools
  • Pocket Guide: Tapering Opioids for Chronic Pain
  • Guideline for Prescribing Opioids for Chronic Pain: Recommendations
  • Checklist for Prescribing Opioids for Chronic Pain
  • Nonopioid Treatments for Chronic Pain
  • Assessing Benefits and Harms of Opioid Therapy
  • Calculating Total Daily Dose of Opioids for Safer Dosage
  • Prescription Drug Monitoring Programs (PDMPs)

CDC Vital Signs

• CDC Vital Signs: Opioid Painkiller Prescribing – Where You Live Makes a Difference

CDC Injury Prevention and Control

• CDC Prescription Drug Overdose
• Prescription Drug Overdose: What Health Care Providers Need to Know about the Epidemic
• Prescription Drug Overdose Prevention for States

Other Agency Resources

• The White House - Office of National Drug Control Policy: Opioid Abuse in the United States[471KB]
• NIH Pain Consortium Centers of Excellence in Pain Education (CoEPEs)
• Providers' Clinical Support System for Medication Assisted Treatment
• Providers' Clinical Support System for Opioid Therapies
• CMS Improvements to Medicare Drug and Health Plans
• SAMHSA - Substance Abuse and Mental Health Services Administration
• National Institute on Drug Abuse
• PDMP Center of Excellence, Brandeis University

Call Format

• Audio conference call on 8/17/16: 2:00 - 3:00 PM EDT
• Web-on-demand training after 3:00 PM EDT on 8/17/16
• Materials: PowerPoint slide set

Accreditation Statements

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 0387-0000-16-151-L04-P and enduring 0387-0000-16-151-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.

AAVSB/RACE:This program was reviewed and approved by the AAVSB RACE program for 1.0 hours of continuing education in the jurisdictions which recognize AAVSB RACE approval. Please contact the AAVSB RACE Program at race@aavsb.org if 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 a pre-approved provider of Certified in Public Health (CPH) recertification credits and is authorized to offer 1 CPH recertification credit for this program.

CDC is an approved provider of CPH Recertification Credits by the National Board of Public Health Examiners. Effective October 1, 2013, the National Board of Public Health Examiners (NBPHE) accepts continuing education units (CEU) for CPH recertification credits from CDC. Please select CEU as your choice for continuing education when registering for a course on TCEOnline. Learners seeking CPH should use the guidelines provided by the NBPHE for calculating recertification credits. For assistance please contact NBPHE at http://www.NBPHE.org.

There is no cost for this program.

DISCLOSURE: In compliance with continuing education requirements, CDC, our planners, our presenters, and their spouses/partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Planners have reviewed content to ensure there is no bias.
CDC does not accept commercial support.