Module 1: Scope and Risk

• Identify the scope of the opioid problem nationally.
• Reduce risks to patients, families, communities, providers, and the medical group from opioids.
• Be prepared to implement the Emergency Medicine Opioid workflow and model of care for opioid prescribing at Kaiser Permanente.

Module 2: Emergency Medicine Opioid Workflow

• Implement consistent assessment of risks and benefits, special considerations, and red flags for opioid treatment for non-cancer pain.
• Implement treatment decisions that align with recommendations for new pain complaints, recurrent pain complaints, and patients with red flags.
• Utilize KPHC and assessment tools.
• Effectively communicate treatment plans, risks, benefits, and therapy goals to patients.

Module 3: ER/LA Opioid Characteristics and Management

• Integrate general and product-specific information about extended-release long-acting opioid analgesics into prescribing decisions and treatment planning.
• Counsel patients on the safe use of opioids.

Bibliography 

• Centers for Disease Control and Prevention: National Vital Statistics System Mortality Statistics (www.cdc.gov/nchs/nvss/deaths.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fnchs%2Fdeaths.htm)
• The Commonwealth Fund: “It’s Really, Truly Everywhere”: How the Opioid Crisis Worsened with COVID-19 (https://www.commonwealthfund.org/publications/podcast/2021/jun/its-really-truly-everywhere-how-opioid-crisis-worsened-covid-19)
• drugpolicy.org: Drug Overdose (https://drugpolicy.org/issues/drug-overdose)
• Substance Abuse and Mental Health Services Administration: Treatment Episode Data Set (TEDS) 2005 – 2015; National Admissions to Substance Abuse Treatment Services (www.samhsa.gov/data/report/treatment-episode-data-set-teds-2005-2015-national)
• Collaborative for REMS Education (http://core-rems.org/)
• ER/LA Opioid REMS Selected Important Safety Information (https://opioidanalgesicrems.com/home.html)
• Group Health’s Initiative To Avert Opioid Misuse And Overdose Among Patients With Chronic Noncancer Pain - PMC (www.ncbi.nlm.nih.gov/pmc/articles/PMC3286629/)
• Department of Veterans Affairs (www.healthquality.va.gov/guidelines/Pain/cot/VADoDOTCPG022717.pdf)
• Manchikanti, L., & Singh, A. (2008). Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician, 11(2 Suppl), S63-S88.(www.painphysicianjournal.com/current/pdf?article=OTgz&journal=42)
• Medical Board of California Guidelines for Prescribing Controlled Substances for Pain (www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf)
• Medline Plus: “Opiate and opioid withdrawal” (https://medlineplus.gov/ency/article/000949.htm)
• Morales ME, Yong RJ. Racial and Ethnic Disparities in the Treatment of Chronic Pain. Pain Med. 2021 Feb 4;22(1):75-90. doi: 10.1093/pm/pnaa427. PMID: 33367911