Minimizing the Misuse of Prescription Opioids in Patients With Chronic Nonmalignant Pain

Developer: University of Massachusetts Medical School (Massachusetts Consortium)

Curriculum resource type: Case-based learning (CBL)

Method used: Case-based, small-group module led by faculty facilitator

Intended audience: Third- and fourth-year medical students; first- and second-year residents in adult primary care fields

Implementation time: 2 hours

Additional components: Student module; patient chart; Part 2: Faculty Guide

Educational objectives:

• Discuss the accepted standard of care for chronic nonmalignant pain.
• Describe clinical tools used to manage chronic nonmalignant pain in primary care settings.
• Describe strategies for optimizing safety in the provision of opioid analgesics for chronic pain.
• Describe how to prevent and detect the misuse of opioid pain medications in patients being treated for chronic pain.
• Describe the differences between physical dependence on and addiction to opioid pain medications and how to recognize addiction in chronic pain patients.

Evaluation tools: 20-question quiz

Curriculum resource description: This educational module provides an introduction to a standardized approach to the management of patients with chronic nonmalignant pain that integrates techniques for the prevention and detection of misuse of prescription opioids. Increasing provider knowledge and skills early in the educational process will improve patient safety and the quality of pain treatment while decreasing the misuse and diversion of prescription opioids.

This product is a case study module designed for use by a faculty facilitator with a small group of medical students or residents early in their training. In this module, participants care longitudinally for a single patient with a common chronic pain complaint-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) that take place over the course of 9 months. Participants work from two documents. The first document contains the case study and the second contains supporting materials, including reference materials and clinical tools completed to model what this patient's clinical chart might look like. Participants use the two resources side by side as they work through the module.

Key words: Drug abuse; drug addiction; substance-related disorders; opioids; chronic pain; problem-based learning