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Opioid Analgesics: Risk Evaluation and Mitigation Strategy (REMS)

This activity is jointly provided by the Potomac Center for Medical Education and Rockpointe in collaboration with the National Council for Behavioral Health. This activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies.

Please see https://ce.opioidanalgesicrems.com/RpcCEUI/rems/pdf/resources/List_of_RPC_Companies.pdf for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the US Food and Drug Administration.


June 28, 2019


June 28, 2020


Charles E. Argoff, MD
Professor of Neurology
Albany Medical College
Director, Comprehensive Pain Center
Director, Pain Management Fellowship
Albany Medical Center
Albany, NY

Timothy J. Atkinson, PharmD, BCPS, CPE
Clinical Pharmacy Specialist, Pain Management
Director, PGY2 Pain Management and Palliative Care Residency
Owner, Vanguard Pain Management Consulting LLC
Nashville, TN

Christopher Gharibo, MD
Associate Professor of Anesthesiology and Orthopedics
Medical Director of Pain Medicine
NYU Langone Health
New York, NY

Aaron Williams, MA
Senior Director of Training and TA for Substance Use
National Council for Behavioral Health
Washington, DC


Faculty Speaker/Steering Committee

The faculty/steering committee reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Charles E. Argoff, MDAdvisory Board: BioDelivery Sciences, Collegium, Flowonix, Kaleo, Lilly, Novartis, Pfizer, Regeneron, Scilex, Shionoghi, Teva, US WorldMeds, Vertex; Grant/Research Support: Allergan, Grünenthal, Jazz; Royalty: Elsevier; Speaker's Bureau: Allergan, Amgen, Assertio Therapeutics, Daiichi Sankyo, Lilly, Novartis, TerSera Therapeutics, Teva; Stock/Shareholder: Assertio, Pfizer

Timothy J. Atkinson, PharmD, BCPS, CPE: Advisory Board: Daiichi Sankyo, Purdue Pharma; Consultant: Axial Healthcare

Christopher Gharibo, MD: Advisory Board/Speaker's Bureau: AstraZeneca, Daiichi Sankyo, Kaleo, Noven, Pernix Therapeutics

Aaron Williams, MA: Nothing to disclose

Non-faculty Content Contributors

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Chad Williamson, MS, MBA, CMPP; Kathy Merlo; Blair St. Amand; Martin Myers, MD; Ashley Marostica RN, MSN, CCM; Brian Jack, MD; USF Health CPD staff: Nothing to disclose.


acpeThe Potomac Center for Medical Education is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.



The Potomac Center for Medical Education designates this educational activity for a maximum of 2.25 hours (0.225 CEUs) of continuing education credit (UAN number 0418-9999-19-002-H05-P).

This is a knowledge-based activity.

UAN: 0418-9999-19-002-H05-P
Credits: 2.25 hours (0.225 ceu)

Type of Activity: Knowledge
Media: Internet

Fee Information: There is no fee for this educational activity.
Estimated time to complete activity: 135 minutes


This activity is intended for the multidisciplinary healthcare team, (PCPs, nurses, behavioral health providers, psychiatrists, and pharmacists) who need to obtain a balance between optimal pain reduction and minimization of adverse events (e.g. abuse, addiction, side effects, and risk of workplace accidents).


During the period June 28, 2019 through June 28, 2020, participants must 1) read the learning objectives and faculty disclosures; 2) review the full content of the educational activity; and 3) complete the posttest and the evaluation form. To answer the questions, click on your selected choice for each answer then proceed to the next question. Once completed, click on Submit Posttest at the bottom of the page. Your posttest will automatically be graded. If you successfully complete the posttest (score of 66% or higher), your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records. If you receive a score lower than 83%, you will receive a message notifying you that you did not pass the posttest. You will have 5 opportunities to pass the posttest. To receive Credit, you must provide your date of birth (mm/dd) and NABP number. All Credit information will be uploaded into CPE monitor within 30 days.


Pain continues to be a significant public-health problem in the US, causing significant reductions in patients' quality of life. Despite the pain-relieving properties of opioid medications, patients with acute and chronic pain are often undertreated due to a variety of physician- and patient-related concerns and barriers, including the potential for misuse and abuse.

The Food and Drug Administration (FDA) developed the Risk Evaluation and Mitigation Strategy (REMS) to ensure the benefits outweigh the risks with opioid treatments. The FDA Blueprint was recently updated to include more information on pain management, including components of an effective treatment plan, nonpharmacologic and pharmacologic treatments for pain (nonopioid and opioid analgesics), and a primer on addiction medicine. The updated blueprint applies not only to prescribers, but to all healthcare providers involved in the management of patients with acute and chronic pain.

Click here for the National Council for Behavioral Health resources.


This program is designed to address the following NAM competencies: provide patient-centered care and employ evidence-based practice.

At the conclusion of this activity, participants should be able to:

  • Identify risk factors and vulnerabilities associated with addiction to opioid analgesics and provide patient/caregiver counselling when necessary
  • Discuss the components of an effective treatment plan, including patient interactions, treatment goals, and collaboration within the healthcare team
  • Analyze the specific benefits and risks to initiating non-medication therapies before utilizing long-term medications
  • Recognize patients who are candidates for treatment with nonopioid pharmacologic analgesics
  • Explain the decision to initiate long-term opioid analgesics, including ER/LA opioids, with consideration to providing in-home naloxone
  • Determine when referral to a pain specialist is appropriate for a patient with chronic pain


Please ensure the computer system you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac &/Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Peripherals: Computer speakers or headphones
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft PowerPoint, Flash Player & HTML5

Disclosure/Conflict of Interest Statement:

Potomac Center for Medical Education (PCME) adheres to the policies and guidelines set forth to providers by the Accreditation Council for Pharmacy Education (ACPE), the Accreditation Council for Continuing Medical Education (ACCME), and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.

All persons in a position to control the content of a continuing medical education program provided by PCME are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts of interest are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.

The content of this activity was vetted by an external reviewer to assure objectivity and that the activity is free of commercial bias.

FDA Disclosure:

The contents of some CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

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