Managing Chronic Pain - A Pain Management & Opioid CE Program
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This review is intended to improve the provider’s ability to
safely treat chronic pain. The general concepts of pain management
are summarized, with a focus on drug therapy options.
Greater emphasis is placed on opioids due to the current opioid
epidemic in the US, and the responsibility of healthcare providers
to help prevent abuse and misuse.
Chronic pain management is a global health priority. Millions
of adults (11%-19% of the US population) suffer daily
from chronic, noncancer pain. A conservative estimate of the
economic burden of pain in the US, including both healthcare
costs and lost work productivity, is $560 - $635 billion annually.
Most patients use a combination of non-drug approaches and
medication to help alleviate pain. Although all drug treatments
have risks that must be carefully weighed against the potential
benefits, opioids carry the significant risks of addiction and
respiratory depression. The increasing rate of opioid overdose
deaths, which was 5 times higher in 2016 compared with 1999,
has overwhelmed this country – and created pressure for providers
to improve their knowledge of pain management...
Publication Date: 10/23/2018
Expiration Date: 10/23/2021
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based
This program was developed by The Rx Consultant and published by Continuing Education Network, Inc.
The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and
is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased,
balanced information to health care practitioners.
Programs developed by The Rx Consultant are written by health care providers with expertise in the topic
area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure
that every program presents information that is current, accurate, relevant to "real world" health care
providers, and written in an easy reading, "plain English" style.
Jeffrey Fudin, BSPharm, PharmD, DAIPM, FCCP, FASHP, FFSMB
is Chief Executive Officer and Chief Medical Officer for Remitigate,
LLC in Delmar NY. He serves as an Adjunct Associate Professor
at Western New England University College of Pharmacy in
Springfield MA, and also at the Albany College of Pharmacy &
Health Sciences in Albany NY. He is a Clinical Pharmacy Specialist
and Pain/Palliative Care Pharmacy Residency Director at the
Stratton VA Medical Center in Albany NY.
Jeffrey Bettinger, PharmD
is currently completing his PGY-2 Pain
and Palliative Care Pharmacy Residency at the Stratton VA Medical
Center in Albany NY.
Dr. Fudin has participated on the advisory board for Firstox, GlaxoSmithKline, AcelRx Pharmaceuticals, Daiichi Sankyo,
Scilex Pharmaceuticals, and Quest Diagnostics. He has also served on the speakers bureau for Acutis Diagnostics and Astra Zenca. Dr.
Bettinger reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in
this issue. This continuing education monograph is the sole work of the authors; stated opinions or assertions do not reflect the opinions of
employers or employee affiliates listed. The article was not prepared as part of the authors’ duties as federal employees.
This accredited program is targeted to
advanced practice/registered nurse
Goals & Objectives
At the conclusion of this program, participants will be able to:
- Describe the differences among chronic pain classifications. Describe the general treatment approach for noncancer pain.
- Describe how COX selectivity relates to the potential toxicity of different NSAIDs and list major precautions for all NSAIDs.
- Name 4 antidepressants and 3 anticonvulsants that may be effective for certain types of chronic pain; list precautions and
potential side effects for each.
- Explain how different chemical structures of opioids contribute to their clinical effects. Advise other providers and patients
regarding opioid side effects, drug-drug interactions, pharmacogenomic variability, and opioid rotation.
The Rx Consultant is a publication of Continuing Education Network, Inc.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a
provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.
ACPE Universal Activity Number: 0428-0000-18-022-H01-P
Exam & Credit Statement Procedures
Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and
Editorial and Review Board
Chief Editor and CE Administrator
Terry M. Baker, PharmD
Tracy Farnen, PharmD
James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA
Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA
Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA
Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System
Adjunct Clinical Professor
College of Pharmacy
Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Visiting Associate Professor and Lecturer
Samuel Merritt University
Pamela Mausner, MD
Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Senior Editorial Advisor
Gerard Hatheway, PharmD, PhD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD
Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners
Meuleman, RN, C, MS
About the Rx Consultant
The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to
educate patients about drugs and manage drug therapy. The reader is responsible for confirming
the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.
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