Patient care in any practice setting has become increasingly complicated due to several factors, including but not limited to: Substance use disorders (SUDs), diversion of medications, and management of injuries and illnesses with symptoms of moderate to severe pain. Marketing strategies by the pharmaceutical industry, self-medication of partially treated or undiagnosed illness, an increasing number of older patients, and accepted societal norms surrounding prescription pain management further impede optimal patient care. Recognizing, understanding, and addressing patient behaviors, as well as the rationales behind these behaviors, is critical to successfully manage patients and protect practitioners and their practices. This course will review three major areas complicating patient care: Drug diversion, SUD, and pain management considerations in patients with SUD.
The goal of this course is to equip nurses, social workers, counselors, and physicians in both acute and post-acute care with how to prevent, identify, and manage substance abuse among residents and/or patients.
DSM™ and DSM-5™ are registered trademarks of the American Psychiatric Association. The American Psychiatric Association is not affiliated with nor endorses this course.
Patient care in any practice setting has become increasingly complicated due to several factors, including but not limited to: Substance use disorders (SUDs), diversion of medications, and management of injuries and illnesses with symptoms of moderate to severe pain. Marketing strategies by the pharmaceutical industry, self-medication of partially treated or undiagnosed illness, an increasing number of older patients, and accepted societal norms surrounding prescription pain management further impede optimal patient care. Recognizing, understanding, and addressing patient behaviors, as well as the rationales behind these behaviors, is critical to successfully manage patients and protect practitioners and their practices. This course will review three major areas complicating patient care: Drug diversion, SUD, and pain management considerations in patients with SUD. The goal of this course is to equip nurses, social workers, counselors, and physicians in both acute and post-acute care with how to prevent, identify, and manage substance abuse among residents and/or patients. DSM™ and DSM-5™ are registered trademarks of the American Psychiatric Association. The American Psychiatric Association is not affiliated with nor endorses this course.
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling (CEBroker Provider #50-290)
Ohio Counselor, Social Worker and Marriage and Family Therapist Board (CEBroker Provider # 50-290)
Florida Board of Nursing (CEBroker Provider #50-290)
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
As a Jointly Accredited Organization, Relias LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Relias LLC maintains responsibility for this course. Social workers completing this course receive 3.75 Clinical continuing education credits.
Relias, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0009.
Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of licensed master social work and licensed clinical social work in New York. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice for an LMSW and LCSW. A licensee who practices beyond the authorized scope of practice could be charged with unprofessional conduct under the Education Law and Regents Rules.
As a provider of online, asynchronous education, some courses offered by Relias Learning are considered “self-study” under section 74.10(c)(2)(ii)(b)(4) of the Commissioner’s Regulations. The regulations limit self-study activities taken from a provider approved by the Education Department to no more than 12 hours in the 36-month registration period or one-third of the hours in a registration period other than 36 months.
Social workers will receive 3.75 continuing education hours for participating in this course. This activity is approved for 3.75 contact hours.
Georgia Board of Nursing (CEBroker Provider #50-290)
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
South Carolina Board of Nursing (CEBroker Provider #50-290)
Florida Board of Medicine (CEBroker Provider #50-290)
Physicians will receive 3.75 AMA PRA category 1 Credits™.
Florida Physician Assistants (CEBroker Provider #50-290)
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
New Mexico Board of Nursing (CEBroker Provider #50-290)
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
State Medical Board of Ohio (CEBroker Provider #: 50-290)
Louisiana State Board of Medical Examiners (CEBroker Provider #: 50-290)
Mississippi State Board of Medical Licensure (CEBroker Provider #: 50-290)
South Carolina Board of Social Work Examiners (CEBroker Provider 50-290)
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 3.75 contact hours for participating in this course.
Mississippi Board of Nursing (CEBroker Provider #50-290)
North Dakota Board of Nursing (CEBroker Provider #50-290)
West Virginia Board of Social Work (CEBroker Provider #50-290)
South Carolina Board of Examiners for Licensure of Professional Counselors and Therapists (CEBroker Provider #50-290)
Physicians will receive 3.75 AMA PRA category 1 Credits™.
South Carolina Board of Medical Examiners (CEBroker Provider #50-290)
Tennessee Board of Medical Examiners (CEBroker Provider #50-290)>
Physicians will receive 3.75 AMA PRA category 1 Credits™
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Florida Board of Pharmacy (CEBroker Provider #50-290)
This activity is approved for 3.75 contact hours.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Drug Classifications and Diversion
Defining Drug Diversion
Classifications
State-Level Classifications
Further Categorization
Legal Ramifications
Review
Summary
Section 3: Rationales and Behaviors
Rationales for Diversion
Income-Driven Diversion
Substance Use and Self-Medication
Common Diversion Methods to Obtain Prescription Medications
Common Drug Diversion Behaviors in Clinical Practice
Individual Patient Behaviors
Prescriber and Support Staff Behaviors
Meet JT
A Pill Mill
An Oxycodone Addiction
The Small-Town Pharmacist
Sharing Medications
Review
Summary
Section 4: Detection and Prevention
Patient Histories and Physical Assessment
Prescription Drug Monitoring Programs (PDMPs)
Patient-Prescriber Agreements or “Narcotics Contracts”
Drug Screens
Prevention of Diversion and Abuse Checklist
Pharmacist Refusal to Fill Prescriptions
Patient Counseling and Drug Regimen Review
Diagnosis Verification
Reporting Diversion
Review
Summary
Section 5: Substance Use Disorders
Scope of the Problem
Definitions
Review
Summary
Section 6: The Reward Pathway of the Brain
Anatomy and Physiology
Factors Contributing to Addiction
Review
Summary
Section 7: Signs, Symptoms, and Substances Used
Signs and Symptoms
Illicit, Prescription, and OTC Substances
Review
Summary
Section 8: Screening and Treatment of SUD
Screening
Nonpharmacological Treatment of SUD
Detoxification
Pharmacological Treatment of SUD
Naloxone Treatment of Opioid Overdose
Review
Summary
Section 9: Defining and Managing Pain
Pain
Neuropathic Pain
Nociceptive Pain
Acute vs. Chronic Pain
Pain Management
Trends in Pain Management
Prescribing Rates and Drug Overdose
Review
Summary
Section 10: Assessment and Establishing Goals of Treatment
Assessment
Pain Scores
Activities of Daily Living
Psychiatric Assessment
Expectations of Pain Management
Review
Summary
Section 11: Treatment of Pain
Nonpharmacological Treatment
Pharmacological Management of Nociceptive Pain
Chronic Neuropathic Pain
Adjuvant Drug Therapy
Opioid-Related Pain Management Recommendations
Review
Summary
Section 12: Pain Management in Patients with SUD
Treatment of Pain
Acute Pain Treatment in SUD
Chronic Pain Management in SUD
Review
Summary
Section 13: Conclusion
Course Summary
Course Contributors
Resources
References
Doug earned his Doctor of Pharmacy (PharmD) from the Raabe College of Pharmacy at Ohio Northern University in 2011. He completed a PGY-1 residency in Pharmacy Practice at MetroHealth Medical Center in Cleveland, Ohio, and completed a specialty residency in Drug Information and Medical Information at Duke University Hospital and GlaxoSmithKline. He is a board-certified pharmacotherapy specialist, and has worked as a clinical pharmacist within the Center for Medication Policy of the Duke University Health System since 2013. His primary responsibilities include chairing the Pharmaceutical Utilization Management Program and Medication Alert Optimization Committee for the health system. He also serves as an APPE preceptor, PGY-1 residency coordinator, and is a member of the Duke University Health System Institutional Review Board. Disclosure: Doug Raiff, PharmD, BCPS has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.Instructor: Johnny J. Bethea, II, RPh
Johnny received a B.S. Pharmacy degree from the College of Pharmacy at the Medical University of South Carolina. He has earned certificates in Medication Therapy Management, Injectable Medications, and Asthma Therapy Management. At Relias, Johnny serves as a Partner in Behavioral Health Solutions, where duties include serving on Clinical Analytics and Applications Team, developing algorithms to improve clinical outcomes, engineering clinical consultant, SME, writer, and editor. In addition, he has served on the Executive Board of Directors for CMHCs and other medical organizations, pharmacy manager, APPE Preceptor, and college of pharmacy dean’s advisory council. Disclosure: Johnny J. Bethea, II, RPh discloses the following potential conflict of interests/commercial interests: Relevant Financial Relationship with Relias LLC as a Salaried Employee All of the relationships listed for this individual have been mitigated.Relevant Non-Financial Relationship with No Entities Exists as a Contributor All of the relationships listed for this individual have been mitigated.
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