Pain Management

Upcoming Pain Management Events

• MAT Waiver Training
  
  • Date: Friday, August 20, 2021
    
  • Time: 8 a.m. - 12:30 p.m. PST
    
  • Location: Virtual
    
  • Tuition: No Cost
    
  
  For more information, please view the training brochure. Click here to register.
  
  For details about waiver training requirements and exemptions, please see these FAQs from the Substance Abuse and Mental Health Services Administration (SAMHSA). 
  
  
  
  
• The 34rd Annual Chronic Pain Management Conference: A One-Day Virtual Interactive Learning Experience
  
  Friday, September 17, 2021
  
  Presented by the Foundation for Medical Excellence, in coopoeration with the College of Physicians and Surgeons of British Columbia
  
  This course is desigend to assist clinicians in successfully managing patients with complex pain, anxiety, and substance use, issues that impact multiple dimensions of the patient's life, and will provide the participants the knowledge and skills to address some of the key issues that practitioners face in the practices.
  
  Registration information is available at TFME.org.

Pain Management Updates

ATTENTION: CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain

Authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain are advising against misapplication of the guideline that can risk patient health and safety, raising awareness of the following issues:

• Misapplication of recommendations to populations outside of the Guideline's scope. The Guideline is intended for primary care clinicians treating chronic pain for patients 18 and older. Examples of misapplication include applying the Guideline to patients in active cancer treatment, patients experiencing acute sickle cell crises, or patients experiencing post-surgical pain.
• Misapplication of the Guideline's dosage recommendation that results in hard limits or “cutting off" opioids. The Guideline states, “When opioids are started, clinicians should prescribe the lowest effective dosage. Clinicians should… avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day." The recommendation statement does not suggest discontinuation of opioids already prescribed at higher dosages.
• The Guideline does not support abrupt tapering or sudden discontinuation of opioids. These practices can result in severe opioid withdrawal symptoms including pain and psychological distress, and some patients might seek other sources of opioids. In addition, policies that mandate hard limits conflict with the Guideline's emphasis on individualized assessment of the benefits and risks of opioids given the specific circumstances and unique needs of each patient.
• Misapplication of the Guideline's dosage recommendation to patients receiving or starting medication-assisted treatment for opioid use disorder. The Guideline's recommendation about dosage applies to use of opioids in the management of chronic pain, not to the use of medication-assisted treatment for opioid use disorder. The Guideline strongly recommends offering medication-assisted treatment for patients with opioid use disorder.

More information about the CDC Guideline for Prescribing Opioids for Chronic Pain and how appropriately apply it to patient care, visit the CDC's website.

Oregon Medical Board Information

SAMHSA began certifying PAs and NPs on February 21, 2017.  As of August 28, 2018, there were 687 certified PAs nationwide and 2,471 certified NPs.  SAMHSA says, "More buprenorphine prescribers are needed to combat the opioid crisis and treat substance use disorders, particularly in rural areas."