Course 13: Managing Pain in Patients At Risk for Substance Use Disorder
What You’ll Learn
- Use safe and appropriate pain management strategies in people with serious illness at risk for or with concurrent substance use disorder
- Recognize indications for specialist referral and available community resources to assist you in treating the at-risk patient
- Utilize the opioid risk tool (ORT) to assess the appropriate level of clinical surveillance for high-risk patients
What You’ll Earn
Only CAPC members who are logged in can earn the following free Continuing Education Credits:
- Case Management: 1.00 CE
- Medicine: 0.50 CME, 0.50 ABIM MOC (Medical Knowledge Only)
- Nursing: 1.00 CNE, 1.00 Pharmacotherapy
- Social Work: 1.00 CE (NYSED)
- Social Work: 1.00 CE (NASW)
- Social Work: 1.00 CE (NYSED)
Tools & Resources
Case examples used in the CAPC curriculum to illustrate pain management techniques.
Course citations. Center to Advance Palliative Care, 2015.
Validated instrument to assess pain intensity and impact on function over time.
List of red flags that indicate a need to assess patients for substance use disorder.
Documentation of patient and clinician goals and expectations for safe and effective opioid treatment.
Sample protocol for managing constipation. Organizations can create similar protocols in collaboration with referring clinicians and pharmacists. Lee Health, 2013.
Key terms related to pain and pain management. Center to Advance Palliative Care, 2015.
When to use - and when to avoid - 6 classes of analgesics including acetaminophen, NSAIDs, opioids, antiepileptics, antidepressants, and corticosteroids. Center to Advance Palliative Care, updated 2018.
Opioid treatment specialists by state, and resources for substance use disorder from the Substance Abuse and Mental Health Services Administration (SAMHSA).
Adapted from the Opioid Risk Tool questionnaire developed by Lynn R. Webster, MD to assess risk of opioid use disorder. This adapted version uses currently recommended terminology, for example ‘opioid use disorder’ and ‘substance use disorder’.
Diane E. Meier, MD, FACP, FAAHPM
Director Emerita and Strategic Medical Advisor, Center to Advance Palliative Care
Lynn Hallarman, MD
Palliative Care Educational Consultant
Associate Professor of Medicine
Stony Brook University
Andrew E. Esch, MD, MBA
Vice President, Education, Center to Advance Palliative Care
Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN. Consultant, Center to Advance Palliative Care.
Jaime Goldberg, MSW, LCSW, ACHP-SW. PhD student, University of Wisconsin-Madison School of Social Work.
Philip Higgins, PhD, LICSW. President, Lighthouse Counseling of Salem, Inc.
Lynn Hill Spragens, MBA. Partner, Spragens & Gualtieri-Reed.
Jay R. Horton, PhD, ACHPN, FNP-BC, MPH, CENP. Director of Nursing Safety, Quality, and Performance Improvement Mount Sinai Hospital. Assistant Professor Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai.
Khadidjatou Kane, MD. Oncology Hospitalist, Assistant Professor of Hospital Medicine, Northwestern University Feinberg School of Medicine.
Lolita Melhado, MSN, ARNP, FNP-BC. Family Nurse Practitioner/Palliative Care, Gulf Coast Medical Center - Lee Memorial Health System.
Bridget Montana, MSN, APRN, FPCN, MBA. Hope HealthCare Services, Chief Operating Officer.
Colleen Mulkerin, MSW, LCSW. Director Palliative Care Consult Service, Hartford Hospital.
Drew Rosielle, MD, FAAHPM. Palliative Care, Fairview Health Services, University of Minnesota Medical School.
David Weissman, MD. President, Palliative Care Education, LLC.
Sherika S. Newman, DO. Hospice & Palliative Medicine, Family Medicine Piedmont Healthcare.*
Karl Bezak, MD. Clinical Assistant Professor of Medicine, Palliative Care and Medical Ethics, University of Pittsburg (UPMC).*
Sivan Ben-Moshe, MD. Fellow, Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.
Sachin Kale, MD. Fellow, Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.
Katie Wang, MD. Fellow, Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.
*indicates ABIM Peer Reviewer