Effective Strategies for Chronic Pain Management: A Risk Evaluation and Mitigation Strategy for ER/LA Opioid Analgesics

This program is developed through a providership between the University of North Texas Health Science Center and Antidote Education Company.

Commercial Support

This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies.  Please see for a listing of the member companies.  This activity is intended to be fully compliant with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration.

Release date: February 27, 2015

Valid through: February 27, 2016

Specialty: Primary Care

Estimated Time to Complete: 60 minutes per activity for a total of 4 hours.

Target Audience

This activity is intended to educate primary care and specialist providers who treat patients with chronic pain.

Program Overview

This series of 4 webinars provides an in-depth look at how to assess our patient's risk for misuse or abuse, how to manage the patients we are treating, and a review of the extended release and long-acting drugs in our arsenal. The final webinar will take a look at the practicalities of treating patients with ER/LA opioids and a review of the legal issues.

Between 1999 and 2010, the rate of death due to overdoses of prescription opioids in the US has quadrupled. Today, the number deaths due to drug overdose is greater than those from gunshot wounds and car crashes. According to the FDA, more than 33 million Americans misused extended-release and long-acting (ER/LA) opioids during 2007. This topic is relevant both to our communities and to our patient populations.

We as providers want to provide care for our patients with chronic pain, but we want to do so without causing them harm while keeping ourselves protected legally.

Although highly effective, these drugs are potentially addictive and can pose critical clinical dilemmas. On July 9, 2012, the U.S. Food and Drug Administration (FDA) announced a risk evaluation and mitigation strategy (REMS) for extended-release (ER) and long-acting (LA) opioid products. The goal of the REMS is to reduce serious adverse outcomes resulting from inappropriate prescribing, misuse, and abuse of ER/LA opioid analgesics while maintaining patient access to these pain medications. Adverse outcomes of concern include addiction, unintentional overdose and death.

Learning Objectives

  • Describe how to assess patients for treatment with ER/LA opioid analgesics.
  • Be familiar with how to initiate therapy, modify dose, and discontinue use of ER/LA opioid analgesics.
  • Be knowledgeable about how to manage ongoing therapy with ER/LA opioid analgesics.
  • Be familiar with general and product-specific drug information concerning ER/LA opioid analgesics.
  • Know how to counsel patients and caregivers about the safe use of ER/LA opioid analgesics, including proper storage and disposal.
  • Recognize and discuss the regulatory, statutory and legal issues that complicate prescribing opioid analgesics.

Webinar links


Charles E. Argoff, MD
Professor of Neurology at Albany Medical College
Director of the Comprehensive Pain Center
Albany Medical Center
Albany, NY

Jen Bolen, JD
(Former) Assistant US Attorney, US Department of Justice
Dallas, TX

Louis Kuritzky, MD
Clinical Assistant Professor Emeritus
Dept of Community Health & Family Medicine
University of Florida
Gainesville, FL

Janet Lieto, DO
Assistant Professor at UNTHSC/TCOM,
Chief Medical Director, Community Hospice of Texas
Ft. Worth, TX

Bill H. McCarberg, MD
Founder, Chronic Pain Management Program for Kaiser Permanente (retired) San Diego, CA
Primary care physician, Neighborhood Healthcare
Escondido, CA

Steven Stanos, DO
Medical Director, Occupational Medicine Services at Swedish Spine, Sports, and Musculoskeletal Medicine, Swedish Medical Group
Physician, Pain and Headache Clinic
Swedish Medical Center
Seattle, WA

Accreditation Statement

The University of North Texas Health Science Center at Fort Worth is accredited by the American Osteopathic Association to award continuing medical education to physicians.

The University of North Texas Health Science Center is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


The University of North Texas Health Science Center presents this activity for educational purposes only. Participants are expected to utilized their own expertise and judgement while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.


This educational program and its content are copyright 2014-2015 by Antidote Education Company and the University of North Texas Health Science Center.