Minimizing the Misuse of Prescription Opioids in Patients With Chronic Non-Malignant Pain

Abstract This educational module has been designed as an introduction for health professions students, residents, and practicing providers to a standardized approach to the management of patients with chronic non-malignant pain which integrates techniques for the prevention and detection of misuse of prescription opioids. The product is a case-study module designed for use by a faculty facilitator with a small group of learners. In this module, participants care longitudinally for a single patient with a common chronic pain complaint of low back pain. The case study is structured in five sections, beginning with background information and followed by three office visits and a separate review of lab results which take place over the course of 9 months. Each visit begins with a medication list and a description of the patient's current condition, and ends with questions for discussion. The questions are tied to the specific learning objectives for each visit. Participants work from two sets of printed pages. The first packet includes and introduction, the case study and references. The second packet contains 28 pages of supporting materials which include clinical tools completed to model what this patient's chart might look like. Participants are instructed to keep the two resources side by side as they work through this module. We recommend a minimum of 3 hours to complete the entire module. This module has been implemented with students, residents, and practice physicians in primary care fields and has been well received. It has been used in the pain management course held every year for the third-year medical students at the University of Massachusetts Medical School. It was also used with the second-year family medicine residents and at faculty retreats. The module was developed as part of NIDA's Center of Excellence in Physician Information and has been peer reviewed both internally at the institution, and externally by a volunteer review group.