How to Taper Patients Off of Chronic Opioid Therapy

Thursday, August 2, 2018, 12:00 AM - Monday, August 2, 2021, 12:00 AM PST

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

This CME activity will enable doctors to recognize when risks of chronic opioid therapy outweigh benefits, and how to safely and compassionately taper patients off of chronic opioid therapy (including the use of buprenorphine to make this transition). A real life patient case scenario will be used to illustrate these principles in practice, including what to say to patients to communicate risks and provide support through the difficult period of withdrawal. When to refer for addiction treatment will also be discussed.

Intended Audience

This course is designed to meet the educational needs of physicians and nurses in primary care, family practice, internal medicine, neurology, oncology, psychiatry, addiction medicine, and interested Allied Health Professionals.

• Release Date: August 2, 2018
• Expiration Date: August 2, 2021
• Estimated Time to Complete: 1.25 hours
• CME Credits Offered: 1.25
• Registration Fee: FREE

AMA PRA Category 1 Credits™ (1.25 hours), Non-Physician Participation Credit (1.25 hours)

1. Recognize when risks of chronic opioid therapy outweigh benefits and effectively communicate this information to patients.
2. Employ language to prepare patients in advance for the opioid taper, and to provide emotional support in the midst of withdrawal.
3. Integrate the key features of a successful outpatient taper off of chronic opioid therapy: go slowly, take breaks, never go backwards.
4. Distinguish the signs and symptoms of opioid use disorder (addiction), and intervene with compassion when, in the process of a taper, an opioid use disorder comes to light.
5. Counsel patients on non-opioid alternatives to chronic pain.

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Please check with your state’s credentialing board for their requirements.

 

Cultural and Linguistic Competency

The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: http://lane.stanford.edu/portals/cultural.html

Bibliography

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.

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

Disclosures 

The following planner, speakers and author has indicated that she has no relationships with industry to disclose relative to the content of this activity:

• Anna Lembke, MD
  Associate Professor of Psychiatry and Behavioral Sciences
  Program Director for the Stanford University Addiction Medicine Fellowship
  Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic
  Stanford University School of Medicine
  Course Director
  Speaker/Author
• Laura
  Speaker
  The patient in the course, using the pseudonym Laura, has indicated that she has no relationships with industry to disclose relative to the content of this activity.

Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.