Case Study I: Starting opioids, discussing monitoring
Case Study II: Assessing aberrant opioid taking behavior, increasing monitoring
Case Study III: Addressing lack of opioid benefit and excessive risk, discontinuing opioids
Case Study IVa: Inherited Patient on High Dose Opioids, Part A
Case Study IVb: Inherited Patient on High Dose Opioids, Part B
Case Study V: Established Patient with Evidence of Illicit Drug Use
Case Study VI: PDMP Questionable Activity in an Established Patient
Case Study VII: PDMP Questionable Activity in a New Patient
Empower Yourselves [Download]
Educate Your Patients [Download]
Education Empowers Everyone [Download]
REMS Program Companies/FDA
Patient Counseling Document: http://www.er-la-opioidrems.com/IwgUI/rems/home.action
How to Dispose of Unused Medications [Download]
Medication Guides: http://www.er-la-opioidrems.com/IwgUI/rems/products.action
American Academy of Pain Medicine
Eight Opioid Safety Practices for Patients and Caregivers
http://www.painmed.org/files/eight-opioid-safety-practices-for-patients-and-caregivers.pdf
Find a Physician
http://persweb.connect2amc.com/aapm/FindaPhysician/tabid/177/Default.aspx
U.S. Pain Foundation
DEA Drug Take-Back Initiative
http://www.deadiversion.usdoj.gov/drug_disposal/takeback/
Substance Abuse Treatment Locator
Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/treatment/index.aspx
CASA Addiction Treatment Patient Guide
Task Force on Pain and Prescription Opioid Misuse
New Hampshire Medical Society
http://www.nhms.org/resources/opioid
FDA Blueprint ER/LA Opioids Summary Chart
[Download]
Patient Counseling Tips [Download]
Side Effects / Drug Interactions [Download]
Patient Counseling Document and Important Safety Information: http://www.er-la-opioidrems.com/IwgUI/rems/home.action
DailyMed: http://dailymed.nlm.nih.gov/dailymed/about.cfm
FDA Blueprint ER/LA Opioids Summary Chart [Download]
FDA Blueprint Update [Download]
Screener & Opioid Assessment for Patients with Pain
© Inflexxion, Inc. Available for download after registration at www.painEDU.org
A validation study can be found here: Akbik H et al. Validation and Clinical Application of the Screener and Opioid Assessment for Patients with Pain (SOAPP). J Pain Symptom Manage 2006;32:287e293.
Opioid Risk Tool
Posted with permission from Dr. Lynn Webster, please enter password "risktool"
Opioid Risk Tool [Download]
Explanatory Article [Download]
Webster, LR, Webster R. Predicting aberrant behaviors in Opioid-treated patients; preliminary validation of the opioid risk tool. Pain Med 2005 ; 6 (6): 432
Screening for Alcohol Misuse
http://www.hepatitis.va.gov/provider/tools/audit-c.asp
Reference: Bush K et al. The AUDIT Alcohol Consumption Questions (AUDIT-C): An Effective Brief Screening Test for Problem Drinking. Arch Intern Med. 1998;158:1789-1795.
Screening for Substance Abuse Disorders Using “Single” Questions
Validation 1: Smith P et al. Primary Care Validation of a Single-Question Alcohol Screening Test. J Gen Intern Med 24(7):783–8.
Validation 2: Smith P et al. A Single-Question Screening Test for Drug Use in Primary Care. Arch Intern Med. 2010;170(13):1155-1160.
Current Opioid Misuse Measure
© Inflexxion, Inc. Available for download after registration at www.painEDU.org
Validation: Butler SF et al. Development and validation of the Current Opioid Misuse Measure. Pain 130(2007):144–156.
PHQ 9 to Screen for Mental Illness
Link to UMass Medical: http://www.umassmed.edu/Content.aspx?id=96774
[ Download ]
PHQ 2
Provided by the Utah Department of Health [Download]
PEG Scale
Validation Study and Scale: Krebs EE et al. Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. J Gen Intern Med 24(6):733–8.
Brief Pain Inventory and Brief Pain Inventory Short Form
© MD Anderson Cancer Center
The Centrality of Pain Scale (Nicolaides)
Validation and information can be found here: Nicolaidis C, Chianello T, Gerrity M. Development and preliminary psychometric testing of the centrality of pain scale. Pain Med. 2011 Apr;12(4):612-7.
Pain Assessment and Documentation Tool
Validation and tool: Passik SD et al. A New Tool to Assess and Document Pain Outcomes in Chronic Pain Patients Receiving Opioid Therapy. Clin Ther 26(4):552-561.
Urine Drug Testing
Urine Drug Testing in Clinical Practice – 5th Edition Now Available On Line
Especially useful for those treating patients with chronic opioids for management of pain, this 20-page monograph (with 115 references) provides a complete review of urine drug testing methods and discusses interpretation of results. Sections on Whom to Test, Why to Test, and When to Test lay the foundation for the sections on methods and interpretation. Alternative technologies – blood, saliva, sweat, and hair – are reviewed in light of their benefits and limitations.
The authors include PCSS-M mentor, Howard Heit, MD, Douglas Gourlay, MD and Yale Caplan, PhD. The monograph is sponsored by the California Academy of Family Physicians (CAFP) in cooperation with PharamCom Group, Inc. and is supported by an educational grant from Purdue Pharma.
The updated edition is available from the CAFP website http://www.pharmacomgroup.com/udt/udt5.pdf as an accredited CME activity. Physicians can receive 2 hours of Category 1 credit (acceptable for 2 Prescribed credits by AAFP) for reading the monograph and completing the self-assessments questions located on the website.
Drug Retention Times
U.S. Department of Energy: ORISE [Download]
SAHMSA Overdose Prevention Toolkit
http://store.samhsa.gov/product/SMA13-4742
Boston Medical Center Agreement Form [Download]
Low Literacy Medication Management Contract
© Inflexxion, Inc. Available at www.painEDU.org
Opioid Informed Consent and Agreements
New Hampshire Medical Society
http://www.nhms.org/resources/opioid
REMS Program Companies/FDA
Patient Counseling Tips [Download]
Side Effects / Drug Interactions [Download]
Patient Counseling Document and Important Safety Information: http://www.er-la-opioidrems.com/IwgUI/rems/home.action
DailyMed: http://dailymed.nlm.nih.gov/dailymed/about.cfm
FDA Blueprint ER/LA Opioids Summary Chart [Download]
A Brief Overview of REMS: http://www.fda.gov/downloads/AboutFDA/Transparency/Basics/UCM328784.pdf
Responsible Opioid Prescribing: A Clinician's Guide
Federation of State Medical Boards
Providers' Clinical Support System
Available through the American Academy for Addiction Psychiatrists: http://www.pcss-o.org/
For Medication Assisted Treatment: http://pcssmat.org/
Substance Abuse Treatment Locator
Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/treatment/index.aspx
DEA Office of Diversion Control
Practitioner's Manual [Download]
Pain and Policy Studies Group
Offered by the University of Wisconsin Schools of Medicine & Public Health
http://www.painpolicy.wisc.edu/
Alcohol, Other Drugs, and Health: Current Evidence Journal Club
http://www.bu.edu/aodhealth/club.html
Addiction Technology Transfer Center Network
http://www.nattc.org/home/
Information on Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Through Substance Abuse and Mental Health Administration (SAMHSA): http://beta.samhsa.gov/sbirt
Through Massachusetts SBIRT: http://www.masbirt.org/
SAMHSA's TIP Series:
http://store.samhsa.gov/list/series?name=TIP-Series-Treatment-Improvement-Protocols-TIPS-
National Institute on Drug Abuse Resources:
http://www.drugabuse.gov/nidamed-medical-health-professionals
Federation of State Medical Boards [Download]
PDMP Center for Excellence Brandeis University: http://www.pdmpexcellence.org/
Alliance of States with Prescription Monitoring Programs: http://www.pmpalliance.org/
CDC Guideline for Prescribing Opioids for Chronic Pain
http://www.cdc.gov/drugoverdose/prescribing/guideline.html
http://www.cdc.gov/drugoverdose/pdf/pdo_checklist-a.pdf
Model Policy for the Use of Controlled Substances for the Treatment of Pain
Federation of State Medical Boards of the United States, Inc.
http://www.fsmb.org/pdf/pain_policy_july2013.pdf
VA/DoD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain
http://www.healthquality.va.gov/Chronic_Opioid_Therapy_COT.asp
American Pain Society/American Academy of Pain Medicine Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext
Interagency Guideline on Opioid Dosing for Chronic Non-cancer Pain: an Educational Aid to Improve Care and Safety with Opioid Therapy 2010 Update
http://www.agencymeddirectors.wa.gov/opioiddosing.asp#GD
WHO Opioid Overdose Guidelines
http://www.who.int/substance_abuse/publications/management_opioid_overdose/en/
A comprehensive list of all sources cited in presentations including article titles [Download]
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