Opioid Therapies

The American Academy of Neurology is participating as one of 13 organizations in the Providers' Clinical Support System for Opioid Therapies (PCSS-O), a three-year grant funded by Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment. It is a collaborative project led by American Academy of Addiction Psychiatry along with 12 other national health and professional organizations. As a partner organization, the AAN is providing free webinars on the safe and effective prescribing of opioid medications in the treatment of pain and opioid use disorders, with a specific focus on concerns in neurologic practice.

Please contact Hannah Planalp with questions. Visit or email for more information about this project.

For more information on the opioid epidemic, visit the AMA website.

Free Webinars

The AAN hosted a series of webinars addressing opioid use in neurology.

Recording: Prescribing Opioids for Pain at the Time of Changing Pain Management Guidelines

Opioids have become an important topic in medical, public health, and political debate. Opioids are a very versatile class of analgesics; however, they have many side effects, including abuse and addiction, and under those circumstances they lead to overdose deaths. Prescription opioids for pain relief have come under scrutiny as the identified source of abused opioids. To minimize and prevent misuse of opioids, a number of professional societies have developed guidelines placing opioids as the second or third line of therapy, or only after all treatments fail. For practicing neurologists, same as for all clinicians, most important starting point is the most specific pain diagnosis. This should lead to a number of treatment options that do not rely on opioids, as with radicular low back pain and diabetic painful neuropathy, where professional societies have provided recommendations.

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Upon completion, participants should be able to:

  • Review pain assessment of neuropathic pain disorders, such as low back pain and diabetic painful neuropathy
  • Discuss treatment options, minimizing reliance on opioids, while recognizing that a few patients will require treatment with opioids
  • Discuss pharmacological properties of opioids as analgesics
Recording: Can Chronic Opioid Therapy Be Used Safely and Effectively for the Treatment of Chronic Pain?

This webinar will provide an overview of opioid therapy for the treatment of chronic pain. The 2016 guideline regarding chronic opioid therapy for the treatment of chronic non-cancer pain emphasized the lack of evidence for such treatment on a long term basis. This session will focus on key issues surrounding the use of chronic opioid therapy for chronic non-cancer pain, emphasizing realistic steps that can be taken to ensure safe use. It will also review the development of the CDC guideline.

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Upon completion, participants should be able to:

  • Describe realistic treatment outcomes when treating a person with chronic pain
  • Recognize the data that supports the use of chronic opioid therapy for the treatment of chronic pain
  • Implement measures in their practice that may minimize adverse outcomes associated with chronic opioid therapy for chronic pain
Recording: Providing Stepped Care Management for Pain in Your Practice and Community

Stepped care management, or chronic disease management, has been a rapidly-evolving health systems approach to common chronic diseases, such as diabetes. This approach to the care of pain in the office and the community is rapidly advancing in the VA and other health systems. This method provides a more comprehensive treatment model on a community-wide or health system basis, with improved integration of effective health services through the delivery of best practice care.  The overall goal is to prevent the transition of acute to chronic pain and long-term disability. This in turn would save productive lives and prevent transition to Federal and state disability systems. 

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Upon completion, participants should be able to:   

  • Understand the principals of primary, secondary and tertiary prevention regarding the care of patients presenting with acute episodes of pain
  • Understand how to layer best practice care delivery from what can effectively be done in the office for more simple pain problems and what can be done using additional community health care resources when pain becomes more complex
  • Describe the importance of preventing the transition from acute to chronic pain and long term disability
  • Describe the importance and key causes of transition from acute to chronic pain
  • Understand the relationship of development of chronic pain to development of long-term disability
  • Describe how health care coordination and collaboration can improve outcomes for pain patients
Recording: Reversing the Opioid Epidemic and Improving Outcomes for Your Pain Patients

Neurologists are frequent caregivers for patients with acute and chronic pain. This webinar will review the current state of evidence, guidelines and policies regarding use of opioids and alternatives for the treatment of these conditions. In addition, information regarding identification and treatment of dependence and addiction, indications and methods for opioid tapering, peri-operative opioid use, and definition of clinically meaningful improvement in pain and function will be discussed.

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Upon completion, participants should be able to:   

  • Describe the key causes of the opioid epidemic of morbidity and mortality over the past two decades
  • Understand the best available evidence on effectiveness and harms of opioids for acute and chronic pain
  • Describe the importance and key causes of transition from acute to chronic pain
  • Understand the relationship of development of chronic pain to development of long-term disability
  • Understand how to prevent inappropriate long-term opioid use and its associated dependence and opioid use disorder (addiction)
  • Describe the most effective alternatives to opioids in the treatment of chronic pain
  • Describe the role of stepped care management for the treatment of pain
Recording: Opioid Use in Acute and Chronic Care Headache Medicine

Headache medicine is a unique field in neurology which involves the treatment of head pain due to primary causes such as migraine, cluster and tension headaches or secondary causes such as injury, concussion, oncologic or vascular processes, pain syndromes, upper cervical issues and more. There are unique challenges a clinician faces with a patient who is unresponsive to traditional therapies or one who presents for care already on medications that may hinder headache treatment such as opioids. Opioid use and abuse in the United States has become a healthcare crisis. Education for clinicians on the evidence-based literature regarding opioid prescribing and side effect profiles is essential for safe use of these medicines. There is little or no evidence pointing to the efficacy of long-term use of opioids to treat chronic headache. Considering alternatives to opioid treatment such as injection therapies, adjunctive nontraditional procedures and medicines, and even surgical interventions can improve quality of care.

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Upon completion, participants should be able to:   

  • Review the evidence-based literature of the treatment of various headache syndromes with opioids in both an outpatient and emergency/urgent care setting
  • Identify the danger of opioid administration as it relates to the age of the patient, side effects of the drugs, potential interactions with other headache medicines, and the long-term risk of developing addiction
  • Identify alternative treatments for the chronic headache patient, when trying to avoid prescribing opioids
  • Discuss how the use of opioids to treat other concurrent pain syndromes in a headache patient may hinder care
Recording: Chronic Pain: A Multidisciplinary Approach

Chronic pain syndrome affects nearly 30 percent of the population and causes disability for nearly 8 percent. This can include headache, back, neck, extremity, and abdominal pain. Multidisciplinary approaches can address multiple factors that contribute to pain. This treatment requires multiple specialists (including medical and mental health professionals and physical/occupational therapists) to provide care in a coordinated process. Understanding when to utilize this approach as well as how to locate or create such programs is critical to improve the outcomes for our chronic pain patients.

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Upon completion, participants should be able to:   

  • Define chronic pain syndrome
  • Assess when chronic opioids may contribute to chronic pain versus benefit
  • Review the prevalence, chronicity, and impact of chronic pain syndrome
  • Define biopsychosocial model of pain treatment versus medicopharmacologic approach
  • Describe the role of the neurologist in a biopsychosocial model of pain treatment
  • Recognize the benefits of chronic pain rehabilitation

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