Clinical Challenges in Opioid Prescribing: Balancing Safety and Efficacy

Take a SAMHSA-supported, live, continuing medical education (CME) course on balancing safety and efficacy in prescribing opioid analgesics for chronic pain.

Purpose of the Course

Each year, millions of patients are treated with prescription opioid drugs for a variety of serious medical conditions. This free SAMHSA-sponsored course will help medical professionals address the balance between providing optimal pain relief and preventing inappropriate use of opioid analgesics, including avoiding adverse outcomes for their patients, for the community, and for themselves. Primary care physicians constitute the principal audience for the course, although physician extenders such as independent nurse practitioners and physician assistants are also welcome.

This activity has been approved for AMA PRA Category 1 Credit(s)TM.

Educational Objectives

On completing this course, participants will be able to:

  • Describe the nature of chronic pain and options for its treatment.
  • Select patients who are appropriate candidates for opioid management of chronic pain.
  • Define risk factors for potential misuse, abuse, and diversion of prescribed opioid medications.
  • Recognize the importance of consistent screening for risk prior to prescribing.
  • Outline a time-efficient method of conducting risk screening.
  • Follow an evidence-based protocol for starting patients on opioid analgesic therapy, including safely initiating and titrating opioids.
  • Monitor patients’ response to opioids and address problems such as inadequate response to treatment.
  • Recognize problematic or aberrant drug-taking behaviors and be able to distinguish unintentional misuse, pseudoaddiction, or chemical coping from deliberate misuse, abuse, and diversion.
  • Outline a time-efficient approach to dealing appropriately with aberrant drug-taking behaviors, including referral to specialized addiction treatment programs when indicated.

Continuing Medical Education Credits

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 Postgraduate Institute for Medicine and SAMHSA. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education (CME) for physicians.

The Postgraduate Institute for Medicine designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Postgraduate Institute for Medicine logo


For more information, contact:

Anthony Campbell, MD
Medical Officer, Division of Pharmacologic Therapies
Substance Abuse and Mental Health Services Administration
Tel: 240-276-2702

Contact SAMHSA


Technical and financial support for the course is granted JBS International, Inc., under contract HHSS28320070003I/HHSS28342007T with the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. LCDR Brandon Johnson, MBA, and LCDR Sidney Hairston, both of the Division of Pharmacologic Therapies of the Center for Substance Abuse Treatment, serve as Government Project Officers. Robert Lubran, MS, MPA, the director of the Division of Pharmacologic Therapies, and Melinda Campopiano, MD, medical officer for the Center for Substance Abuse Treatment, provided valuable guidance, as did other experts within government agencies and private-sector organizations. Jane Maxwell, PhD, research professor at the Addiction Research Institute at the School of Social Work, University of Texas at Austin, has updated the data for the curriculum.

Faculty for this year’s live course include:

  • Louis Baxter, Sr., MD, FASAM: Executive Medical Director, Professional Assistance Program of New Jersey, and Director, American Board of Addiction Medicine, and Immediate Past President, American Society of Addiction Medicine, Chevy Chase, Maryland
  • Anton C. Bizzell, MD: President and CEO, The Bizzell Group, LLC
  • James W. Finch, MD: Medical Director, Changes by Choice, Durham, North Carolina, and Director of Physician Education, North Carolina Governor’s Institute on Alcohol and Drug Abuse
  • John Hopper, MD, FAAP, FACP, FASAM: Residency Program Director and Vice Chair for Education, Department of Internal Medicine, St. Joseph Mercy Hospital, and Clinical Associate Professor of Internal Medicine, Pediatrics, Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
  • Theodore V. (Ted) Parran, Jr., MD, FACP: Carter and Isabel Wang Professor of Medical Education, and Chair, Medical Education, and Addiction Medicine Fellowship Co-Director, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Stephen Wyatt, DO: Medical Director of Addiction Medicine, Behavioral Health Service Line, Carolinas HealthCare System, Charlotte, NC
  • Jacqueline Peterson Tulsky, MD: Emeritus Professor of Medicine, HIV/AIDS Division at San Francisco General Hospital, University of California, San Francisco
  • Bill McFeature, PhD: JBS International, Primary Care and Behavioral Health Integration-SBIRT Consultant, and Radford University Adjunct Faculty Member


The views expressed in this course and related materials do not necessarily reflect the official policies of the U.S. Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Last Updated: 01/18/2018