Certificate Program: De-stress Pain Management: Rethinking Opioid and Non-Opioid Therapies
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The goal of this series is to provide osteopathic primary care clinicians, with evidence-based, multidisciplinary strategies to improve knowledge and competence of pain management with non-pharmacologic and non-opioid therapies and the methodology to safely integrate opioids into treatment regimens to mitigate risks of opioid use disorder while addressing current barriers to optimal management.
- Recall the 12 recommendations for clinicians who are prescribing opioids from the CDC Clinical Practice Guidelines for Prescribing Opioids for Pain, 2022.
- Explain strategies to facilitate safe integration of opioid analgesics into treatment plans with considerations for consistent patient education.
- Detail strategies to facilitate tapering of opioids following evidence-based practices.
- Characterize key clinical presentations of patients at risk for opioid disorder or who may be inappropriately using opioids.
- Review strategies for implementing OMT into treatment regimens.
There are 8 courses contained within this series, which will be released on a rolling basis from October 2023 through March 2024.
- I. The Etiopathogenesis and Basics of Pain
- II. Assessment and Measurement of Pain in Patients
- III. Treatment Planning
- IV. Non-Pharmacologic Approaches to Pain Management: OMT
- V. Other Non-Pharmacologic Approaches to Pain Management
- VI. Pharmacologic Approaches to Pain Management
- VII. Managing Patients on Opioids
- VIII. Opioid Use Disorder (OUD)
Disclosure Statements
ACOFP and ACOI are committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of an ineligible company. In accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education, ACOFP and ACOI require that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company (those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients). Individuals in a position to control the content may include, but are not limited to, planning committee members, authors, faculty, speakers, reviewers, and activity staff. ACOFP and ACOI review all disclosed relationships to determine which are relevant and then work with the applicable contributors to mitigate the relevant financial relationships. No relevant financial relationships were identified for any individual in control of content for this specific activity series.
CME Credit and Designation Statements
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Osteopathic Family Physicians (ACOFP) and American College of Osteopathic Internists (ACOI). ACOFP is accredited by the ACCME to provide continuing medical education for physicians. ACOFP designates this enduring activity series for a maximum of 6.5 AMA PRA Category 1 Credits™. Physicians should only claim the credit commensurate with the extent of their participation in the activity. ACOFP is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. ACOFP designates this enduring activity series for a maximum of 6.5 AOA Category 1-A credits and will report continuing medical education (CME) credits commensurate with the physician’s participation in this program.
Support Acknowledgement
The activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies.
Disclaimer
ACOFP and ACOI present this information for educational purposes only. The content is provided solely by individuals who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. ACOFP, ACOI, and the supporter assume no liability for the information herein.
DEA MATE Requirements
As an accredited organization named in section 1263 of CAA 2023, ACOFP and ACOI have developed this series that may satisfy all or portions of your DEA training requirements.
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Contains 4 Component(s), Includes Credits
This course covers the Etiopathogenesis and Basics of Pain as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. You will be learning the definitions of the different types of pain and the mechanisms of pain. Also included are the history and societal costs of pain, and ways to apply what you've learned, along with many resources to provide you with an opportunity to expand your knowledge even further. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
This module begins with a brief overview the history of pain to its current understanding. This will be followed by a review of the International Association for the Study of Pain (IASP) definition of pain and different types of pain (nociceptive, nociplastic and neuropathic pain). Finally, outline the relationships between acute, subacute and chronic pain.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from October 31, 2023 until October 31, 2026.
Robert Agnello, DO, FACOFP (he/him/his)
Assistant Professor of Family Medicine
Campbell University School of Osteopathic Medicine
Dr. Robert N. Agnello is an assistant professor of family medicine and osteopathic manipulative medicine at Campbell University School of Osteopathic Medicine (CUSOM). He has been adjunct faculty since CUSOM’s inception in 2013, assisting the OMM department. Dr. Agnello is board-certified in family medicine since 2001 and holds a CAQ in pain medicine since 2017. His clinical interests lie in pain management through integrative osteopathic medicine, combining various strategies. His research focuses on complementary care modalities and their impact on pain, including osteopathic manipulation, auricular acupuncture, and functional medicine. Dr. Agnello is actively involved in professional organizations such as the American College of Osteopathic Family Physicians (ACOFP), American Osteopathic Association (AOA), and American Academy of Osteopathy (AAO).Dr. Robert N. Agnello, DO, FACOFP has no disclosures.
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Contains 4 Component(s), Includes Credits
This course covers the Assessment and Measurement of Pain in Patients as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Examine the tools needed to assess and measure pain. • Evaluate individuals experiencing chronic pain, particularly in at-risk populations. • Discover the operational process for taking patient history and conducting physical examinations. • Evaluate an individual's physical, cognitive, and emotional capabilities. • Promote the understanding of stigma surrounding chronic pain and opioid use. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
This module provides a review of the tools and operational processes available to measure and assess a patient’s pain physically, cognitively, and emotionally while also considering the stigma that patients may face when seeking care for their pain.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from November 30, 2023 until November 30, 2026.
Dr. Anthony Dekker, Do, FACOFP, FAAFP, FAOAAM, DFASAM
American College of Osteopathic Family Physicians
Anthony Dekker, DO, FACOFP, FAAFP, FAOAAM, DFASAM is currently the Chief Medical Officer of the Division of Developmental Disabilities for the State of Arizona. He is committed to the mission of advocating for our members in DDD. Previously he retired after 37 years of federal service, lastly being a member of the Primary Care Service Line at the Gallup Indian Medical Center in the Indian Health Service.
Born and raised in Western Michigan, he graduated from Hope College in Holland Michigan. He completed his osteopathic education at Michigan State University in 1978. He completed his internship and family medicine residency at the Chicago College of Osteopathic Medicine and an Adolescent and Young Adult Medicine fellowship at Rush-Presbyterian-St Luke’s Medical Center in Chicago. As a Public Health Service Scholar, he served Chicago’s South Side for fourteen years. He was Professor and Chair of Family Medicine at the Kansas City University School of Medicine and Clinical Associate Professor at the University of Kansas Medical Center and the University of Missouri-Kansas City (Children’s Mercy Hospital) during his four years in Kansas City. He served in the Indian Health Service from 1998 to 2010 in the Phoenix Indian Medical Center as the Associate Director, Ambulatory Care and Community Health and 2020 to 2022 at the Gallup Indian Medical Center. He also served in the Department of Defense and the Northern Arizona VA Healthcare System.
Dr. Dekker is board certified in Family Practice and Osteopathic Manipulative Treatment, Adolescent and Young Adult Medicine, Addiction Medicine and Pain Medicine. He is a Fellow in numerous professional societies. His areas of expertise include developmental disorders, addiction medicine, chronic pain syndromes, informatics, high risk youth, domestic violence and behavioral health. Past faculty appointments include clinical professorships at George Washington University (Washington DC), and currently at the Burrell College of Osteopathic Medicine and Andrew Taylor Still University (Mesa, AZ).
Dr. Anthony Dekker, Do, FACOFP, FAAFP, FAOAAM, DFASAM has no disclosures.
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Contains 4 Component(s), Includes Credits
This course covers Treatment Planning as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Classify various levels of challenges associated with pain management. • Summarize the updated CDC Clinical Practice Guidelines for Prescribing Opioids for Pain, along with the recommendations categories and evidence types. • Develop treatment goals, which will include a multidisciplinary care team, to maximize patient outcomes. • Outline ways to reduce the chronic use of opioids in pain management. • Analyze the different considerations that should be made when prescribing opioids to patients, including but not limited to, a patient's medical history. • Identify ongoing disparities and barriers to care access some patients encounter when seeking pain treatment. CME Credit Available: 1.00 AOA Category 1-A credits 1.00 AMA PRA Category 1 Credits™
In this module, hear an overview of the key components of an effective treatment plan, including the most recent CDC Clinical Practice Guidelines for Prescribing Opioids for Pain, and discuss how to develop treatment goals. Also included is an introduction to reducing chronic use of opioids, considerations for taking a patient-centric approach to pain management and the impact of social determinants of health on access to pain treatment.
CME Credit Available:
1.00 AOA Category 1-A credits
1.00 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from November 30, 2023, until November 30, 2026.
Dr. Jeff Cashman DO, MS, FACOFP
American College of Osteopathic Family Physicians
Dr. Jeff Cashman DO, MS, FACOFP earned his Bachelor of Science degree in Industrial Engineering from Clemson University (2001), a master’s degree in Epidemiology from the Medical University of South Carolina (2006) and his Doctor of Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine-Georgia Campus (2010). He completed his family medicine residency at AnMed Health Family medicine residency in Anderson, SC in 2013.
Dr. Cashman currently serves as the Associate Dean for Pre-Clinical Medical Education at the Edward Via College of Osteopathic Medicine – Carolinas Campus; previously serving as the Associate Dean of OMS-IV and Graduate Medical Education and Discipline Chair of Family Medicine. As well, he serves as a preceptor at the Spartanburg Regional Family Medicine Residency and is the team physician for Spartanburg High School. Prior to starting at VCOM-Carolinas, Dr. Cashman practiced inpatient and outpatient medicine at Mary Black Hospital in Spartanburg, SC.
Dr. Cashman serves as the Speaker of the House of Delegates for the South Carolina Medical Association and was the first Osteopathic President of the Spartanburg County Medical Society. He is involved with the South Carolina Osteopathic Medical Society and previously chaired the SCMA Bioethics Committee and SC Ethics Pandemic Task Force. He is the Leadership Director for VCOM-Carolinas’ HRSA funded Primary Care Champions Fellowship and was named to the SC Rural Physician Board.
Jeff Cashman DO, MS, FACOFP has no disclosures.
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Contains 4 Component(s), Includes Credits
This course covers the Non-Pharmacologic Approaches to Pain Management: OMT as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Outline the history of osteopathic medicine. • Summarize the tenets of osteopathic medicine and guiding principles, and osteopathic manipulative treatment (OMT). • Identify the most common OMT techniques used today, along with those that help patients with OUD withdrawal symptoms. • Analyze various evidence-based studies and their results with specific regard to managing pain through OMT techniques. • Develop a provider checklist for assessing patient boundaries and comfort when taking a patient's trauma history before administering OMT practices. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
This module provides some background on osteopathic principles and osteopathic manipulative treatments (OMT), how OMT can help patients suffering from OUD, and what various evidence-based studies have found in the efficacy of OMT treatments for pain management, along with many resources to provide you with an opportunity to expand your knowledge even further.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from January 15, 2024, until January 15, 2027.
Dr. Melinda Ford, FACOFP
American College of Osteopathic Family Physicians
Dr. Melinda Ford, FACOFP dist. is an assistant professor at the Ohio University Heritage College of Osteopathic Medicine and also works for OhioHealth Physician Group Heritage College as a family medicine and addiction physician. Dr. Ford is board certified in family practice and osteopathic manipulative medicine with a certificate of qualification in addiction medicine. She has made numerous presentations and contributions in the area of addiction treatment, and currently serves as Chair of the board for the Ohio Professional's Health Program- Ohio's confidential monitoring program for impaired health professionals.
Dr. Melinda Ford, FACOFP has no disclosures.
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Contains 5 Component(s), Includes Credits
This course covers the Other Non-Pharmacologic Approaches to Pain Management as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Review the historical background of non-pharmacologic approaches. • Interpret knowledge of the various types of physical therapy. • Comprehend pain psychology with consideration of psychological interventions. • Understand the field of implantable devices and surgical procedures with a focus on their applications. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
In this module you will be learning about other non-pharmacologic approaches to pain management that include physical therapy, pain psychology, and implantable devices/surgical procedures, along with many resources to provide you with an opportunity to expand your knowledge even further.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from January 15, 2024, until January 15, 2027.
Annette T. Carron, DO, MACOI (she/her/hers)
Director Geriatrics and Palliative Care
Henry Ford Macomb Hospital
Past-President ACOI
Associate Professor, MSU-COM
Medical Director Heart to Heart Hospice -
Contains 4 Component(s), Includes Credits
This course covers the Pharmacologic Approaches to Pain Management as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Define the mechanism of action and mode of action for both opioids and non-opioid medications. • Outline the advantages versus the disadvantages to prescribing NSAIDs for pain management in patients. • Analyze when to prescribe the non-opioids, acetaminophen, gabapentinoids, antidepressants, and muscle relaxers. • Identify the various types of opioids and their effects on the brain and body, along with the CDC's prescribing recommendations. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
This module provides information about the mechanism of action for both non-opioids and opioids, side effects, and the CDC and the FDA recommendations for prescribing, and much more, along with many resources to provide you with an opportunity to expand your knowledge even further.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from February 15, 2024, until February 15, 2027.
Jeff Cashman DO, MS, FACOFP
American College of Osteopathic Family Physicians
Jeff Cashman DO, MS, FACOFP Earned his Bachelor of Science degree in Industrial Engineering from Clemson University (2001), a master’s degree in Epidemiology from the Medical University of South Carolina (2006) and his Doctor of Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine-Georgia Campus (2010). He completed his family medicine residency at AnMed Health Family medicine residency in Anderson, SC in 2013.
Dr. Cashman currently serves as the Associate Dean for Pre-Clinical Medical Education at the Edward Via College of Osteopathic Medicine – Carolinas Campus; previously serving as the Associate Dean of OMS-IV and Graduate Medical Education and Discipline Chair of Family Medicine. As well, he serves as a preceptor at the Spartanburg Regional Family Medicine Residency and is the team physician for Spartanburg High School. Prior to starting at VCOM-Carolinas, Dr. Cashman practiced inpatient and outpatient medicine at Mary Black Hospital in Spartanburg, SC.
Dr. Cashman serves as the Speaker of the House of Delegates for the South Carolina Medical Association and was the first Osteopathic President of the Spartanburg County Medical Society. He is involved with the South Carolina Osteopathic Medical Society and previously chaired the SCMA Bioethics Committee and SC Ethics Pandemic Task Force. He is the Leadership Director for VCOM-Carolinas’ HRSA funded Primary Care Champions Fellowship and was named to the SC Rural Physician Board.
Dr. Jeff Cashman DO, MS, FACOFP, has no disclosures.
Rachael Sanchez, DO
American College of Osteopathic Family Physicians
Rachael Sanchez, DO, is a board-certified Doctor of Osteopathic Medicine with the American College of Osteopathic Family Physicians. In 2008, she earned her Doctor of Osteopathy from the Lake Erie College of Osteopathic Medicine in Bradenton, Florida and completed her transitional internship at the Naval Medical Center in Portsmouth, Virginia the following year.
Dr. Sanchez served as a general medical officer in the United States Navy and then completed her residency training in family practice at St. Petersburg General Hospital in St. Petersburg, Florida and her fellowship training was in addiction medicine at the University of Florida. She is a member of the American Osteopathic Association, American College of Family Practitioners, American Society of Addiction Medicine, Florida Osteopathic Medical Association and American College of Physicians. In 2023, Dr. Sanchez spoke on pain and substance use disorders (SUD) at the Florida Society of Addiction Medicine.
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Contains 4 Component(s), Includes Credits
This course covers Managing Patients on Opioids as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Recognize and address adverse events associated with opioid use. • Effectively communicate information about opioids to patients. • Determine when a consultation with a pain specialist is necessary. • Understand the importance of and know how to safely dispose of unused opioids. CME Credit Available: .75 AOA Category 1-A credits .75 AMA PRA Category 1 Credits™
This module provides information about the adverse events and drug interactions related to opioids, educating patients, assessing inappropriate opioid use, determining when to involve a pain specialist, and promoting safe disposal of unused opioids.
CME Credit Available:
.75 AOA Category 1-A credits
.75 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from February 15, 2024, until February 15, 2027.
Dr. Rachael Sanchez, DO
American College of Osteopathic Family Physicians
Rachael Sanchez, DO, is a board-certified Doctor of Osteopathic Medicine with the American College of Osteopathic Family Physicians. In 2008, she earned her Doctor of Osteopathy from the Lake Erie College of Osteopathic Medicine in Bradenton, Florida and completed her transitional internship at the Naval Medical Center in Portsmouth, Virginia the following year.
Dr. Sanchez served as a general medical officer in the United States Navy and then completed her residency training in family practice at St. Petersburg General Hospital in St. Petersburg, Florida and her fellowship training was in addiction medicine at the University of Florida. She is a member of the American Osteopathic Association, American College of Family Practitioners, American Society of Addiction Medicine, Florida Osteopathic Medical Association and American College of Physicians. In 2023, Dr. Sanchez spoke on pain and substance use disorders (SUD) at the Florida Society of Addiction Medicine.
Dr. Racheal Sanchez, DO, has no disclosures.
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Contains 5 Component(s), Includes Credits
This course covers Opioid Use Disorder (OUD) as a part of the collaborative series, "De-Stress Pain Management: Rethinking Opioid and Non-Opioid Therapies," by the American College of Family Physicians and the American College of Osteopathic Internists. This series is aligned with the FDA's Opioid Analgesic REMS Education Blueprint, that will allow you to complete the education at your own pace. Learning Objectives: • Identify addiction, withdrawal symptoms and risk factors in patients who suffer from opioid use disorder. • Outline the neurobiological factors associated with OUD. • Apply various screening tools, medication-assisted treatment (MAT) regimens, alternate approaches and assessments for the identification and treatment of patients with opioid use disorder. • Construct a plan for referring patients with OUD to addiction medicine. • Develop ways to reduce stigmatizing situations and language surrounding OUD in healthcare. CME Credit Available: 1.00 AOA Category 1-A credits 1.00 AMA PRA Category 1 Credits™
This module provides information on addiction, withdrawal symptoms, and risk factors in patients who suffer from OUD, various MAT regimens for treating patients with OUD, and when to refer patients to addiction medicine and much more, along with many resources to provide you with an opportunity to expand your knowledge even further.
CME Credit Available:
1.00 AOA Category 1-A credits
1.00 AMA PRA Category 1 Credits™
Review and Release Date:
This activity is valid from March 15, 2024, until March 15, 2027.
Dr Kristin Martin, DO MS, FAAFP
American College of Osteopathic Family Physicians
Dr Kristin Martin, DO MS, FAAFP is an emergency room and family practice physician based in Arkansas. She has worked as an Emergency Room medical director, Regional Medical Director, Hospitalist Director and is board certified by the American College of Osteopathic Family Medicine and a fellow of the American Academy of Family Physicians. She is adjunct faculty for University of Arkansas Medical Sciences, Arkansas College of Osteopathic Medicine and Debusk College of Osteopathic Medicine - Lincoln Memorial University. She is the CEO of Arkansas Emergency Physician Associates, ER company and River Valley Medical Wellness outpatient clinic and currently is credentialed at ten different ER facilities in Arkansas ranging from high acuity medical centers to critical access hospitals. Dr Martin earned her master's in biomedical science and Doctor of Osteopathy degree from Oklahoma State University - Center for Health Sciences in 2007. She has previously served on the American College of Osteopathic Family Physicians, Board of Governors as a Resident. She belongs to numerous organizations and has presented and published in areas from emergency medicine, family practice, opioid research, geriatrics and surgery.
Dr Kristin Martin, DO MS, FAAFP, has no disclosures.
