Navigating Opioid REMS, Part 2: Tailoring Treatment for Safe, Effective Pain Management (Webinar)

Pain Management
1.25 AMA PRA Category 1 Credit(s)
Launch Date:
May 09, 2013
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

physicians and other healthcare professionals who treat patients with chronic pain

Relevant Terms:

Abuse-deterrent Opioids, Anxiety, Chemical Coping, Chronic Low Back Pain, Chronic Pain, Drug Dependence, Opioids, Opioid Therapy, Pain Medicine, Patient Education, Risk Reduction, Risk Stratification

Charles E. Argoff, MD 

Charles E. Argoff, MD
Professor of Neurology
Albany Medical College
Director, Comprehensive Pain Program
Albany Medical Center
Albany, New York

Dr. Argoff is professor of neurology at Albany Medical College and director of the Comprehensive Pain Center at Albany Medical Center, both in New York.
A member of the International Association for the Study of Pain, the American Academy of Pain Medicine, and the American Academy of Neurology, among other professional organizations, Dr. Argoff also serves on the editorial board of the Clinical Journal of Pain and as a reviewer for the Journal of Pain, Brain, Journal of the American Medical Association, Archives of Physical Medicine and Rehabilitation, Journal of Musculoskeletal Pain, Journal of Pain and Symptom Management, and the Clinical Journal of Pain. He is co-editor of the Neuropathic Pain Section of Pain Medicine.
In addition to writing on many types of pain, including myofascial, spinal, radicular, and neuropathic pain, Dr. Argoff has authored articles on such treatments as topical analgesics, interventional pain management, botulinum toxins, and oral analgesics, and has contributed many book chapters. He has served as a guest editor for and contributor to the Clinical Journal of Pain and Current Pain and Headache Reports, among other peer-reviewed journals. Dr. Argoff also played an active role in the development of consensus guidelines on the assessment, diagnosis, and treatment of diabetic peripheral neuropathic pain published in Mayo Clinic Proceedings and has contributed to other published guidelines in neuropathic pain treatment. He an editor of the textbook Raj's Practical Management of Pain, fourth edition, and he recently published the third edition of Pain Management Secrets.
Dr. Argoff received his medical degree from Northwestern University's Feinberg School of Medicine in Chicago, Illinois. He completed an internship in the Department of Medicine and a residency in the Department of Neurology at the State University of New York in Stony Brook and a fellowship in developmental and metabolic neurology at the National Institutes of Health/National Institute of Neurological Disorders and Stroke.

Bill H. McCarberg, MD

Bill H. McCarberg, MD
Chronic Pain Management Program
Kaiser Permanente
Adjunct Assistant Clinical Professor
University of California, San Diego School of Medicine
San Diego, California

Bill H. McCarberg, MD, is founder of the Chronic Pain Management Program for Kaiser Permanente in San Diego, CA and an adjunct assistant clinical professor at the University of California, San Diego, School of Medicine.
With extensive expertise in pain medicine and pain management, Dr. McCarberg has research interests that include chronic pain, low back pain, and osteoarthritis. He has given more than 250 presentations on pain management and is the author or co-author of 80 articles, book chapters, and books.
Current president of the Western Pain Society and a member of the board of directors of the American Academy of Pain Medicine and the National Pain Foundation, Dr. McCarberg also is a member of the American Academy of Family Physicians, the American Academy of Pain Medicine, the American Pain Society, and the International Association for the Study of Pain. He has received several honors, including the Shilling Compassionate Care Award and the American Pain Society's Elizabeth Narcessian Award for leadership in pain education. In 2008, he was the Ambassador of the Year for the National Pain Foundation.
Consistently noted as a top-rated clinician, Dr. McCarberg has been ranked in the top 10% of member appraisals for physician services at Kaiser Permanente since 1998.
Dr. McCarberg received his medical degree from Northwestern University Feinberg School of Medicine in Chicago and completed an internship and a residency in family practice at Highland Hospital in Rochester, NY. He is board-certified by the American College of Pain Medicine and the American Board of Family Practice and is certified in geriatrics.

Marc R. Gerber, MD, PA

Marc R. Gerber, MD, PA Private Practice
MRG Rehabilitation & Pain Medicine
Orlando, Florida

Dr. Gerber practices at MRG Rehabilitation and Pain Medicine in Orlando, Florida and is clinical assistant professor at the University of Central Florida College of Medicine. He specializes in the nonsurgical treatment of musculoskeletal injuries, neck and low back conditions, pain management, electrodiagnostic medicine, and sports medicine.
Practicing medicine in Central Florida since 1996 and an expert in pain medicine for the Florida Department of Health, Dr. Gerber lectures locally and nationally on topics relating to pain management. He is board certified and a fellow of the American Academy of Physical Medicine and Rehabilitation. He also is subspecialty board certified in pain medicine—among the first physicians in the nation to be dually board certified in this specialty. Dr. Gerber belongs to numerous specialty organizations and serves as a physician volunteer at sporting events including the annual Walt Disney World Marathon.
Dr. Gerber earned his bachelor's in biology from State University of New York at Binghamton and his medical degree from Downstate Medical Center in Brooklyn, New York. He completed 2 years of residency in general surgery prior to completing his residency in physical medicine and rehabilitation at the State University of New York Health Science Center at Syracuse.

Roy Furman, MD, PhD 

Roy Furman, MD, PhD
Medical Director
Chief Information Officer
Intelligent Medical Decisions, Inc.
Philadelphia, Pennsylvania

Dr. Furman is medical director and chief information offi cer for Intelligent Medical Decisions, Inc. In this
role, he contributes extensive experience in medical practice, clinical and basic science research, and
software development.

A board certified neurologist, Dr. Furman has been a faculty member at the University of Pennsylvania in Philadelphia and is the founder and director of research and development for a successful software company focused on service to the healthcare, clinical research, and manufacturing industries.

Dr. Furman graduated with a BS from the Massachusetts Institute of Technology and received his
medical degree and PhD in molecular biology from the University of Pennsylvania.
1. Demonstrate an understanding of the principles of opioid rotation, including incomplete cross-tolerance.
2. Recognize and respond appropriately to aberrant drug-taking behaviors representing physical dependence, chemical coping, substance dependence, pseudoaddiction, and addiction.
3. Counsel patients and caregivers about the safe use and disposal of opioid analgesics, including general and product-specific information concerning extended-release/long-acting (ER/LA) products.

Statement of Need
Pain is prevalent and costly, yet remains undertreated and poorly treated, leading to greater disability than cancer, diabetes, and heart disease combined and representing an annual economic burden of up to $635 billion in the United States alone. Clinicians cite a lack of formal education in pain management, time constraints, an inconsistent lexicon, and changing legal environment as barriers to appropriate treatment. Opioid therapies, long used as effective analgesics, are associated with serious adverse outcomes, including addiction and unintentional overdose. Misuse and abuse of these agents, resulting in injury and death, are major public health problems. In 2009, nearly 343,000 visits to emergency departments involved nonmedical use of opioid analgesics. In 2008, nearly 14,800 Americans died from drug poisonings involving opioid analgesics. Physicians have identified opioid analgesia as one of the most complicated and worrisome responsibilities in pain management, as an inadequate understanding of issues such as risk assessment, tolerance, interpatient variability, and related phenomena may have the unintended effect of impeding patient access to pain relief. In addition, there is an urgent need for primary care physicians who are competent in pain management; currently, there is only one pain specialist for every 21,000 patients. With the recent release of an FDA Risk Evaluation and Mitigation Strategy in the area of opioid analgesia, it is imperative that physicians obtain education in the safe prescribing of these therapies.
Educate health care providers on REMS in the management of chronic pain using evidence-based, risk-directed strategies for optimizing pain management, in order to enhance patient care and improve outcomes.

Estimated Time for Completion
1.25 hours
Course Format
Enduring webinar
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Global Education Group and Applied Clinical Education. Global Education Group is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
Global Education Group designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Method of Participation
To receive CME credit, participants should read the preamble; complete the pre-test, view the webinar, and complete the post-test and activity evaluation. CME certificates will be made available immediately upon successful completion.
There are no fees for participating in or receiving credit for this activity.
Disclosure of Conflicts of Interest
Global Education Group requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflicts of interest they may have as related to the content of this activity. All identified conflicts of interest are vetted thoroughly by Global Education Group for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this activity.
Charles E. Argoff, MD
  • Consultant/Independent Contractor: Covidien, Depomed, Nuvo Research, Pfizer, Shionigi Pharm
  • Grant/Research Support: Endo Pharmaceuticals, Forest Laboratories, Lilly
  • Honoraria: Endo Pharmaceuticals
  • Speakers' Bureaus: Depomed, Endo Pharmaceuticals, Horizon, Lilly
  • Stock Shareholder: Pfizer
  • Other/Royalty: Elsevier (books: Pain Management Secrets, Raj's Practical Management of Pain)
Marc R. Gerber, MD
  • Speakers' Bureaus: Cephalon, Covidien, Endo, PriCara, Purdue
Bill H. McCarberg, MD, FABM
  • Consultant/Independent Contractor: Endo, Insys Therapeutics, NeurogesX, Pfizer, Pricara, Purdue, QRx Pharma, Salix, Sucampo, Teva
Roy Furman, MD, PhD
  • Nothing to disclose
The planners and managers reported the following fi nancial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this activity.

Ashley Marostica, RN, MSN
  • Nothing to disclose
Amanda Glazar, PhD
  • Nothing to disclose
Kathleen Wildasin, MA
  • Nothing to disclose
Jennifer Kulpa
  • Nothing to disclose
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group and Applied Clinical Education do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or courses of diagnosis or treatment discussed should not be used by clinicians without evaluation of patient conditions, contraindications, applicable manufacturer's product information, and the recommendations of other authorities.
Accreditor Contact Information
For information about the accreditation of this program, please contact Global Education Group at (303) 395-1782 or
This activity is jointly sponsored by Global Education Group and Applied Clinical Education.

This activity is supported by an educational grant from Mallinckrodt Pharmaceuticals.