YAFI Online Programming // Disease State Management and Drug Therapy

Rational Opioid Use

Continuous Learning after the CDC Guideline

Educational Objectives

After participating in this activity pharmacists will be able to:

  • Discuss the continuing need to follow pain management guidelines judiciously to mitigate epidemic opioid overdose
  • Outline the CDC’s recommendations from the 2016 Guideline for Prescribing Opioids for Chronic Pain and lessons learned since their release
  • Discuss talking points and approaches to work with prescribers and ensure patient safety when opioids are prescribed
  • List patient counseling points regarding the safe use of opioids
  • Identify factors that put patients at highest risk of overdose who may need rescue medication

After participating in this activity pharmacy technicians will be able to:

  • Describe the principles behind careful pain management
  • List common mechanisms used to safeguard opioid use
  • Recognize when to refer patients to the pharmacist for issues related to pain management or risk of overdose

Session Offered

Release Date: March 15, 2019

Expiration Date: March 15, 2022

Course Fee


Session Codes

19YC04-ABC36 Pharmacist

19YC04-CBA24 Pharmacy Technician

Accreditation Hours

2.0 hours of CE


Daily (chronic) pain is common among adults living in the United States. It is often treated with opioids despite the lack of evidence for long-term benefit. Given the opioid overdose epidemic in the US, the Centers for Disease Control and Prevention has created an evidence- and expert-opinion-based guideline for prescribing opioids for chronic pain. The overall guideline has been developed to help identify the risks and benefits of opioid therapy and improve long-term safety. Included are 12 recommendations on determining when to use opioids for chronic pain; optimal prescribing (selection, dosage, duration, followup, discontinuation); and assessing risks and addressing harms of opioid therapy. The pharmacy team, both pharmacists and pharmacy technicians, have an important role in counseling patients about safe use of opioids. The team can also work with prescribers to ensure their optimal and safe use in patients with chronic pain. Identification of factors putting patients at high risk for opioid overdose and methods to minimize those risks are provided.

Accreditation Statements

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and pharmacy technicians are eligible to participate in this application-based activity and will receive up to 0.2 CEU (2 contact hours) for completing the activity, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor on- line system and your participation will be recorded with CPE Monitor within 72 hours of submission


Grant funding: Daiichi Sankyo, Inc.

Cost: Free

Initial Release Date: March 15, 2019
Expiration Date: March 15, 2022

To obtain CPE credit, visit the UConn Online CE Center

Use your NABP E-profile ID and the session code 19YC04-ABC36 for pharmacists or 19YC04-CBA24 for pharmacy technicians to access the online quiz and evaluation.

First- time users must pre-register in the Online CE Center. Test results will be displayed immediately and your participation will be recorded with CPE Mon- itor within 72 hours of completing the requirements.

For questions concerning the online CPE activities, email joanne.nault@uconn.edu


Lisa M. Holle, PharmD, BCOP, FHOPA, is an Associate Clinical Professor, Department of Pharmacy Practice, University Of Connecticut School of Pharmacy, Storrs, CT and Associate Professor, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT.

Faculty Disclosure

Dr. Holle has no actual or potential conflicts of interest associated with this article.

Disclosure of Discussions of Off-label and Investigational Drug Use

This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.



Approximately 20% of adults (50 million) in the United States suffer from daily (chronic) pain, and another 8% (20 million) have reported severe pain (i.e., pain that frequently limits life or work activities).1 This pain is often severe enough to cause worsening health, increased use of healthcare resources, and disability. Results of randomized clinical trials of opioids for treatment of pain have shown their effectiveness when used in the short term (12 weeks or fewer).2 However, the benefit of long-term use (more than three months) is limited.3 Despite this data, prescribers often use opioids to treat chronic pain, with one in five adults with noncancer-related pain prescribed opioids.4 In fact, the rate of prescribing opioids for pain nearly quadrupled from 1999 to 2014.5 At the same time, prescription opioid deaths from both illicit opioids and misuse of prescription opioids tripled, resulting in the opioid overdose epidemic.6

In the midst of this opioid overdose epidemic, the Centers for Disease Control and Prevention (CDC) created a guideline for prescribing opioids for chronic pain in adult patients with chronic pain treated in an outpatient setting (Table 1).7 Other pain-related guidelines are available and should be used for patients with cancer or palliative chronic pain and patients with acute pain treated by specialists like emergency clinicians or surgeons.8-11 Since this guideline’s publication, the opioid prescribing rate, including high dosage opioid prescriptions, is decreasing, yet drug overdose deaths reached an all-time high in the latest report analyzing data through 2016. Thus, understanding appropriate opioid use and prescribing continues to be a hot topic and one in which pharmacy teams should be well versed. This article provides the pharmacy team with a guideline overview, updates related to opioids, and tools they need to apply it to their practice.



Full List of References

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3. Chou R, Deyo R, Devine B, et al. The effectiveness and risks of long-term opioid treatment of chronic pain. Evidence Report/Technology Assessment No. 218. Agency for Healthcare Research and Quality. https://effectivehealthcare.ahrq.gov/topics/chronic-pain-opioidtreatment/research. Accessed March 2, 2019

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