Chronic pain is recognized as a complicated medical condition requiring a substantial amount of knowledge and skill for appropriate evaluation, assessment, and management. Pain is sometimes treated in an emergency department with opioid-based medicine and often is not recognized as requiring pain-specific clinical expertise.
Provider education is most effective when provided by professional peers as opposed to concerned citizens. Members of the provider education sector group should include clinicians and work with other organizations offering continuing medical education (CME) to providers in the community to optimize their efforts. The local hospitals, statewide chronic pain organizations, local addiction treatment specialists, and local pain specialists are all examples of the kinds of resources that can support these efforts.
While much of the emphasis in these efforts is on those writing the actual prescriptions, it is important to also engage with nurses and pharmacists. Nurse practitioners should be receiving the same provider education as all other providers. The nurses being discussed here are those without prescriptive authority. Nurses have a vital role in caring for patients with chronic pain and/or addiction and should understand the signs of patients’ risk behavior and be able to care for them effectively. Pharmacists also have an incredibly important role in this effort. Pharmacists should understand the problem and what their role is in identifying diversion, forgery, and promoting patient safety.
Communities and professional organizations are continually developing new and creative ways to optimize education for providers and other clinicians. The following is a list of some of the activities that have been successfully implemented:
Promoting adoption of the CPI toolkits for primary care providers, emergency departments, and care managers.
One-on-one provider education or “academic detailing” on pain management.
Continuing medical education sessions on pain management, appropriate prescribing, and diversion control.
Pharmacist continuing education on diversion, forgery and the use of the PDMP.
Promoting provider and dispenser use of the PDMP.
Information concerning the Good Samaritan Law and prescribing naloxone.