“I’ll be going out of town next week,” says Mrs. Johnson, “so I’m hoping you can refill my prescription today.” Mrs. Johnson is a long-term patient whom you trust, but this is her second request for an early refill of oxycodone. How should you evaluate her request in light of the 16,000 unintended deaths each year from prescription opioid analgesics?
Every touch point with a patient is an opportunity to consider risks of opioid therapy and to realign management towards best health outcomes. This one-hour webinar offers an ethical framework for evaluation that will also help you to engage patients in conversations that build partnership. You’ll hear examples of dialogue that squarely addresses high-risk situations and options for tapering or alternative treatment.
Please note that some of the resources included with this course may have been revised since the original publication in 2015 or may no longer be available.
At the conclusion of this webinar, participants will be able to:
- Identify patients managed with pain medications who may require a transition in their management.
- Communicate the basis for their assessment to the patient, and document the discussion.
- Outline and implement a management plan for ongoing patient care.
Michael Schiesser, MD, Internal Medicine, Bellevue, is a widely accomplished and respected physician leader. He is a national expert in issues of pain care, addiction medicine, and evolving standards of care in clinical delivery involving controlled substances. His patient advocacy resulted in changes in Washington State law, state licensing commission rules, and a Pulitzer Prize-winning collaboration with the Seattle Times.
Dr. Schiesser has authored and delivered pain and addiction-related education to thousands of physicians across the United States. His areas of expertise include laboratory industry, regulatory policy, health administration, and legislative affairs.
Marcy Hipskind, MD. Family Practice, Bellingham
Gordon Irving, MD, Anesthesiology, Medical Director, Pain and Headache Center, Swedish Medical Center
Celia Smith, CCMEP, Director, Continuing Medical Education, Physicians Insurance
Catherine Walberg, JD, General Council/Senior Vice President, Physicians Insurance
Original release: March 2015
Last Reviewed and Updated: March 2017
Expiration: March 2018
2017 Review Group
Michael Schiesser, MD, Internal Medicine, Bellevue
Marsha Hughes, VP, Risk Management, Physicians Insurance
Celia Smith, CHCP, Dir, Continuing Medical Education, Physicians Insurance
This CME activity was planned and produced in accordance with the ACCME Essentials.
Category 1 credit is applicable throughout the United States.
Estimated time to complete this activity: 1 hour
Physicians in Washington who complete this course will fulfill the risk management education requirement mandated by the Washington Health Services Act of 1993.
Physicians Insurance/Experix is accredited by the Washington State Medical Association CME Accreditation Committee to provide continuing medical education for physicians.
Physicians Insurance/Experix designates this enduring material for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the criteria for up to 1 hour of Category I CME to satisfy the relicensure requirements of the Washington State Medical Quality Assurance Commission.
Neither the presenter nor the planners for this activity have any relevant financial relationships to disclose.
The following medications for withdrawal are mentioned in this
CME activity but are not labeled for the use under discussion:
• Clonidine 0.1 mg for sweats
• Hydroxyzine 25 mg for sleep or anxiety qid
• Pramipexole 0.125 mg for restless leg symptoms
Resolution of Conflicts of Interest
Physicians Insurance/Experix has implemented a process to resolve conflicts of interest for each continuing medical education activity, to help ensure content objectivity, independence, fair balance, and content that is aligned with the interest of the public. Conflicts, if any, are resolved through a peer-review process.