Reconceptualizing the Safety and Efficacy of Long-Term Opioid Therapy and Its Deprescribing Based on the Behavioral Impacts of Dependence and Tolerance

Needs Statement

Physiatrists, fellows, residents, medical students, advanced practice providers, and healthcare professionals in related disciplines need to receive regular updates on research advances in physical medicine and rehabilitation. Because the field incorporates a wide range of inpatient and outpatient practices, regular updates on evidenced-based guidelines, technical innovations, and cost-effective care are also essential. The series aims to expand the knowledge of learners, disseminate best practices in rehabilitative care and pain management, enhance the quality of rehabilitative care, and improve patient outcomes while using resources efficiently.

Educational Objectives

At the conclusion of the session, the participants should be able to:

• Differentiate between the relief and motivational effects of opioids and their analgesic effects with regard to their use in pain management.
• Discuss the basic concepts of complex persistent opioid dependence with long-term opioid therapy and describe how it can lead to the paradoxical opioid-induced chronic pain syndrome.
• Assess why opioid tapering often increases pain and opioid risks instead of decreasing them.
• Interpret the lived experiences of people on long-term opioid therapy and opioid taper.
• Apply a structured risk-benefit analysis to assess the effectiveness of long-term opioid therapy.
• Formulate treatment strategies for ineffective long-term opioid therapy and failed opioid taper.

Target Audience

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Policy

Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.

In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.

In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.

BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.

All of the relevant financial relationships listed for these individuals have been mitigated.