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Prescription Drug Misuse and Addiction: Compassionate Care for a Complex Problem


Prescription Drug Misuse and Addiction: Compassionate Care for a Complex Problem Banner

  • Overview
  • Faculty
  • Support
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Date & Location
Friday, October 23, 2015, 12:00 AM - Saturday, December 31, 2022, 12:00 AM, Online Course

Overview
Internet Enduring Material Sponsored by the Stanford University School of Medicine. Presented by the Psychiatry and Behavioral Sciences Department at Stanford University School of Medicine.

This CME activity provides a practical approach to the management of prescription drug misuse and addiction, including how to use the clinical interview and CURES (California’s Prescription Drug Monitoring Program) to identify if a problem exists, and how to intervene once the problem has been identified. Animated didactic videos, interactive slides, and video case scenarios will be used to put these principles into practice with a treatment algorithm. The most compassionate approach to tapering patients down and off the medication they are misusing will also be discussed.

Intended Audience
This course is designed for physicians and all health care providers who interact with patients around the issue of prescription medication, e.g. nurses, pharmacists, physician assistants.

Registration
  Release Date: October 23, 2015
  Latest Review Date:  July 14, 2021
  Expiration Date: December 31, 2022
  Estimated Time to Complete: 2.0 Hours
  Registration Fee: FREE

Credits
AMA PRA Category 1 Credits™ (2.00 hours), Non-Physician Participation Credit (2.00 hours)

Objectives

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


  1. Describe the current state of the prescription drug misuse problem.
  2. Describe the role of the provider in the prescription drug misuse problem.
  3. Recognize drug-seeking patterns and strategies used by patients who are misusing prescription medications.
  4. Diagnose a prescription drug use problem when it is present.
  5. Reduce or avoid using enabling and defensive behaviors which exacerbate the problem in the patient.
  6. Describe the implications for treatment and outcomes when prescription drug misuse is recognized as a chronic medical illness.
  7. Interpret findings on CURES, California’s prescription drug monitoring program, to identify a prescription drug problem.

Accreditation
In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Credit Designation American Medical Association (AMA) Stanford Medicine designates this Enduring Material for a maximum of 2.00 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional Information

Bibliography

Administration SA and MHS. Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013.

Centers for Disease Control and Prevention (institution). No Title. http://www.cdc.gov/vaccines/about/terms/glossary.htm#e. Accessed July 30, 2015.

Chen LH, Hedegaard H, Warner M. QuickStats: Rates of deaths from drug poisoning and drug poisoning involving opioid analgesics—United States, 1999–2013. MMWR Morb Mortal Wkly Rep. 2015;64(01):32.

Crews F, He J, Hodge C. Adolescent cortical development: a critical period of vulnerability for addiction. Pharmacol Biochem Behav. 2007;86(2):189-199.

Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 2013.

Drugfree.org. 2012 Partnership Attitude Tracking Study. 2013. http://www.drugfree.org/wp-content/uploads/2013/04/PATS-2012-FULL-REPORT2.pdf. Accessed December 16, 2013.

George O, Le Moal M, Koob GF. Allostasis and addiction: role of the dopamine and corticotropin-releasing factor systems. Physiol Behav. 2012;106(1):58-64.

Humphreys K. Circles of Recovery: Self-Help Organizations for Addictions. Vol (Edwards G, ed.). Cambridge: Cambridge University Press; 2004.

Kauer JA, Malenka RC. Synaptic plasticity and addiction. Nat Rev Neurosci. 2007;8(11):844-858.

Lembke A. From self-medication to intoxication: time for a paradigm shift. Addiction. 2013;108(4):670-671.

Lembke A. Why doctors prescribe opioids to known opioid abusers. N Engl J Med. 2013;368(5):485.

Manchikanti L. National drug control policy and prescription drug abuse: facts and fallacies. Pain Physician. 2007;10(3):399-424.

Manchikanti L, Singh A. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008;11:S63-S88.

McDonald DC, Carlson K, Izrael D. Geographic variation in opioid prescribing in the U.S. J Pain. 2012;13(10):988-996.

Nestler EJ. Is there a common molecular pathway for addiction? Nat Neurosci. 2005;8(11):1445-1449.

Paulozzi LJ. Prescription drug overdoses: a review. J Safety Res. 2012;43(4):283-289.

Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital Signs: Overdoses of Prescription Opioid Pain Relievers --- {United States}, 1999–2008. MMWR Morb Mortal Wkly Rep. 2011;60(43):1487-1492.

Ries RK, Fiellin DA, Miller SC, Saitz R. Principles of Addiction Medicine, 4th Ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Williams; 2009.

Robison LM, Sclar DA, Skaer TL, Galin RS. National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990-1995. Clin Pediatr (Phila). 1999;38(4):209-217.

Schultz W. Potential vulnerabilities of neuronal reward, risk, and decision mechanisms to addictive drugs. Neuron. 2011;69(4):603-617.

Selemon LD. A role for synaptic plasticity in the adolescent development of executive function. Transl Psychiatry. 2013;3:e238.

Steketee JD, Kalivas PW. Drug wanting: behavioral sensitization and relapse to drug-seeking behavior. Pharmacol Rev. 2011;63(2):348-365.

Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD; 2013.

Sullivan MD, Howe CQ. Opioid therapy for chronic pain in the United States: promises and perils. Pain. 2013;154 Suppl:S94-S100.

Warner M, Chen LH, Makuc DM, Anderson RN MA. Drug poisoning deaths in the United States, 1980–2008. NCHS data brief, no 81 Hyattsville, MD US Dep Heal Hum Serv CDC. 2011.

Weisner CM, Campbell CI, Ray GT, et al. Trends in prescribed opioid therapy for non-cancer pain for individuals with prior substance use disorders. Pain. 2009;145(3):287-293.

Wise RA, Koob GF. The development and maintenance of drug addiction. Neuropsychopharmacology. 2014;39(2):254-262.

For a complete list, please view the References/Bibliography page in the Course.



Disclosures:
Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity.

Anna Lembke, MD
Assistant Professor of Psychiatry and Behavioral Sciences
Director, Stanford Addiction Medicine Program
Stanford University School of Medicine
Course Director
Speaker

This activity received no commercial support.

Prescription Drug Misuse and Addiction on edX
INSTRUCTIONS: Click "Launch Website" to begin this course on edX.org.  At the end of the course with successful completion, an evaluation and claim credit url link will be provided to you to access the Stanford Center for Continuing Medical Education MY CE Portal with more detailed instructions.  
Launch Video

 

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