Overview

While prescription opioids serve an invaluable role for the treatment of cancer pain and pain at the end of life, their overuse for acute and chronic non-cancer pain as well as the increasing availability of heroin and illicit fentanyl, have contributed to the highest rates of overdose and opioid addiction in U.S. history. Evidence-informed solutions are urgently needed to address these issues and to promote high-quality care for those with pain. This course and the report it is based on are a response to that need. They offer timely information and a path forward for all who are committed to addressing injuries and deaths associated with opioids in the United States.

Syllabus

Introduction and Data

This module reviews the data available about opioid use disorders in the United States. Information about general trends in opioid overdose, and some limitations of current data systems are discussed. This module draws from section 6 of the "The Opioid Epidemic" report (2017).

Prescription Drug Monitoring Programs (PDMPs)

This module provides an overview of Prescription Drug Monitoring Programs (PDMPs). Explanations of how PDMPs are used to reduce the supply of prescription opioids likely to be misused are discussed. A review of the research about PDMPs is also included. This module draws from section one of the "The Opioid Epidemic" report (2017).

Clinical Guidelines

This module reviews prescribing guidelines as an intervention for reducing high risk opioid prescribing. A conversation between the course instructors and representatives from CDC’s National Center for Injury Prevention and Control about CDC’s Guideline for Prescribing Opioids for Chronic Pain provides insight into the process of developing and disseminating one guideline. This module aligns with section two of of the "The Opioid Epidemic" report (2017).

Pharmacy Benefit Managers

This module provides an overview of the role of pharmacy benefit managers and pharmacies in the supply of prescription opioids. Opportunities to monitor high risk prescribing through PBMs and pharmacies are also discussed. This module draws from section three of the "The Opioid Epidemic" report (2017).

Engineering Strategies

This module introduces the idea that redesigning opioid medications and the pill vials they are prescribed in is one strategy to reduce unintentional opioid poisonings and diversion. The module features a discussion of a prototype design for a pill vial engineered to dispense a specified amount of medication at programmed intervals to authorized users. This module aligns with section four of the "The Opioid Epidemic" report (2017).

Engaging Patients and the General Public

This module reviews strategies for communicating with patients and the public about opioid use disorders. Safe storage and disposal strategies are also discussed. This module draws from section five of the "The Opioid Epidemic" report (2017).

Treating Opioid Use Disorders

This module discusses addiction as a disease and medication as treatment. Consideration of known risk factors for disease are also reviewed. This module aligns with section seven of the "The Opioid Epidemic" report (2017).

Naloxone

This module describes naloxone, a medication that effectively reverses an opioid overdose, and how access to naloxone has increased. The role of government agencies in disseminating naloxone prescriptions is also highlighted. This module draws from section eight of the "The Opioid Epidemic" report (2017).

Harm Reduction

This module provides an overview of harm reduction in the context of opioid use disorders. Examples of harm reduction strategies are provided, and the available evidence discussed. This module aligns with section nine of the "The Opioid Epidemic" report (2017).

Stigma

This module discusses the stigma surrounding drug use and treatment. Strategies for combatting stigma by providing alternatives to stigmatizing language are discussed. This module draws from section 10 of the "The Opioid Epidemic" report (2017).