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Risk for Opioid Overdose: Identifying At-Risk Patients in Your Practice Hidden in Plain Sight

Premiere Date: Tuesday, November 10, 2020

This activity offers CE credit for:

  1. Physicians (CME)
  2. Pharmacists (ACPE)
  3. ABIM (MOC)
  4. Other


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Wednesday, November 10, 2021
Note: Credit Is No Longer Available

Faculty


Mark S. Gold, MDMark S. Gold, MD 
ASAM's Annual Lifetime Achievement John P. McGovern Award & Prize Winner
Adjunct Professor of Psychiatry
Washington University School of Medicine
St. Louis, MO
17th University of Florida Distinguished Alumni Professor
Gainesville, FL

Steven P. Stanos, DOSteven P. Stanos, DO 
Executive Medical Director, Rehabilitation and Performance Medicine
Swedish Pain Services
Swedish Health System
Seattle, WA

Statement of Need

What is the profile of someone at risk for overdose? For many, the perception of overdose risk is tied to someone who is an injection drug user, someone with an opioid use disorder that takes more than they can handle, or someone who unknowingly encounters a drug laced with dangerous levels of fentanyl. Few would dispute that these individuals should have ready access to the opioid reversal agent naloxone. While these are accurate profiles of individuals at risk, is the profile too narrow and biased with misconceptions?

The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain recommends co-prescribing naloxone for patients at risk for overdose, including patients with a history of overdose or substance use, patients taking benzodiazepines, and patients taking ≥ 50 MMEs of opioids daily. Yet, in a March 24, 2020 CME Outfitters Risk Evaluation and Mitigations Strategies (REMS) webcast, among 477 internists, primary care providers, nurse practitioners, and PAs, 73% co-prescribed naloxone in patients receiving high dose opioids (≥ 50 MME/day) less than 50% of the time. Thirty seven percent never co-prescribed naloxone in this patient population.

The objective of this webcast is to raise awareness about the risk of overdose among patients with chronic pain in everyday practice and actionable changes to practice that are needed to mitigate that risk.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Recognize the distinct patient profiles of individuals at risk of opioid overdose
  • Initiate discussions about overdose risk with chronic pain patients prescribed high dose opioids (= 50 MME)
  • Co-prescribe and counsel chronic pain patients on high dose opioids (= 50 MME) who are at risk for overdose about appropriate use of naloxone

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Recognize the distinct patient profiles of individuals at risk of opioid overdose
  • Explain how to initiate discussions about overdose risk with chronic pain patients prescribed high dose opioids (= 50 MME)
  • Identify chronic pain patients on high dose opioids (= 50 MME) who are at risk for overdose that may benefit from a co-prescription for naloxone

Financial Support

Supported by an educational grant from Emergent BioSolutions

Target Audience

Physicians, PAs, nurse practitioners, and pharmacists

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note to Nurse Practitioners: Nurse Practitioners can apply for AMA PRA Category 1 Credit™ through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. .75 contact hours (0.075 CEUs). Universal Activity Number: Enduring: 0376-0000-20-131-H08-P

Type: knowledge-based

ABIM/MOC Credit:
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to .75 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Format: Enduring material

Royal College MOC Credit:
Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME's "CME in Support of MOC" program in Section 3 of the Royal College's MOC Program.

Note to PAs: PAs may claim a maximum of 1 Category 0.75 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

MIPS Improvement Activity: This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Post-tests, credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit https://www.cmeoutfitters.com/privacy-and-confidentiality-policy/

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Gold reports that he serves as a consultant for ADAPT Pharma and Magstim Company Ltd.

Dr. Stanos reports that he serves as a consultant for Eli Lilly and Company; Pfizer Inc.; and Sanofi.

Tony Graham, MD (peer reviewer) has no disclosures to report.

Mae Ochoa, RPh (peer reviewer) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Evan Luberger (planning committee) has no disclosures to report

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

MMV-107-111020-66

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