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Chronic Pain Management CME

Chronic Pain Management CME

Length of time to complete activity: 2 hour 45 minutes

Technical Requirements:
To participant in this online educational activity, you must have a computer with Internet access and speakers.

Physician Practice Gap:
The Iowa Board of Medicine found that during 2009-2010, the Board charged five physicians and issued confidential reprimands to another six for inappropriate pain medication practices, such as prescribing controlled substances to drug-seeking patients. At the start of 2011, the Board had 25 open cases involving similar allegations.

On August 17, 2011, the Iowa Board of Medicine amended the Iowa Administrative Code 653 Chapter 11, requiring physicians to complete continuing medical education on chronic pain medication management. This administrative rule was changed in an effort to assist physicians in reducing patients' abuse and misuse of pain medications.

Based on this information, it has been concluded that physicians are in need of training regarding the prescribing, monitoring and if needed, the discontinuing of treatment, for patients with chronic pain.

Learning Objectives:

  • Explain the epidemiology of chronic pain and the misuse of opioids.
  • Discuss when opioids are indicated for chronic pain treatment.
  • Explore tools for assessing risk and monitoring benefit and harm of opioids.
  • Examine the initiation and ongoing management of patients with chronic pain treated with opioid-based therapies.
  • Identify diversion and drug seeking tactics and behaviors.
  • Discuss best practice methods for working with patients suspected of diversion and drug seeking behaviors.
  • Describe the discontinuing of opioid for pain due to lack of benefits or increased risk.
  • Explain the referring or initiating treatment for opioid addition process.
  • Explore how to incorporate evidence-based, best-practices into your practice.
  • Create a team and system to support you and your patients.
  • Review case study of a patient with chronic pain.
  • Discuss how to register and use the state Prescription Management Program (PMP).

Intended Audience:
Physicians who regularly provide primary health care to patients, all emergency physicians, family medicine, general practice physicians, internists, neurologists, pain medicine specialists, psychiatrists, pediatricians, and any other physicians who regularly provides primary health care to patients.


  • Christopher W. Shanahan, MD, MPH, Assistant Professor of Medicine, Boston University School of Medicine, Boston MA; Associate Medical Director for the Massachusetts Screening Brief Intervention and Referral to Treatment Program.
  • Daniel P. Alford, MD, MPH, Associate Professor of Medicine, Boston University School of Medicine, Boston, MA; Medical Director of the Boston Medical Center Office-based Opioid Treatment Program.
  • Therese Witkowski, Co-Coordinator for the Iowa Prescription Monitoring Program (PMP).

Disclosure of Relevant Financial Relations:
All parties involved in the planning and presentation of this CME activity are required to disclose any relevant financial relations with commercial interests, as defined by the Accreditation Council for Continuing Medical Education (ACCME). The faculty and planners of this activity have no relevant financial relationships to report.

CME Accreditation:
This activity has been planned and implemented in accordance with ACCME® Essential Areas and Elements and Iowa Medical Society (IMS) policies through the joint sponsorship of Mercy Iowa City and the Iowa Medical Society. Mercy Iowa City is accredited by the IMS to provide continuing medical education for physicians.

Mercy Iowa City designates this education activity for a maximum of 2.75 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Iowa Medical Society

Minimum Performance Level:
Participants in this activity must achieve a score of 75 percent or better on the post-test to receive CME credit for this activity. IMS staff will review participant post-test scores and determine if the minimum performance level has been met. When confirmation of achievement of the minimum performance level has been received, a certificate will be e-mailed to the participant. In the event that the minimum performance level has not been achieved, the participant will be notified by IMS and allowed to repeat the activity.

Process for Completion:

Upon completion of the registration form the following will take place:

  1. Participants will be directed to online pre-test that must be completed and submitted prior to participating in the activity.
  2. Once the pre-test has been completed, participants will be directed to the first section of the activity. Participants must view each segment of the activity to complete the activity.
  3. Once the final segment has been viewed, participants must click on the link to direct them to the online post-test.
  4. Upon completion of the online post-test and evaluation, participants will be deemed as completing the activity.
  5. The CME certificate will be sent via e-mail to each participant.

If you should have questions prior to, during or following your participation in this activity, please contact Kara Bylund at kbylund@iowamedical.org or (515) 223-1401, ext. 207. E-mail and phone messages will be responded to Monday through Friday, 8:00 am to 4:00 p.m.

Privacy and Confidentiality:
The Iowa Medical Society respects your privacy and is committed to protecting it at all times. Personal information obtained through the registration and program materials is used for documentation of participation and validation of completion of the activity, and will not be sold or distributed to others.

Material Reproduction:
The Iowa Medical Society is the owner of the material presented in this CME activity. Copying of materials, or distribution of these materials by other persons/organizations, than IMS and those authorized by IMS is prohibited.

Review and Termination of Activity:
This activity is scheduled to be reviewed on or before December 31, 2015. The CME accreditation for this course will terminate on December 31, 2015.

Released: August 2011

Reviewed: June 2014

Online registration not available.

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