OMED 2015

Learn best practices for safe prescribing of ER/LA opioid analgesics

“Physicians must balance the use, availability, and the necessity for pain management against the risk of serious adverse outcomes,” says Katherine Galluzzi, DO.


Concerned about a spike in deaths from opioid overdoses, in 2012 the Food and Drug Administration mandated that a REMS, or Risk Evaluation Mitigation Strategy, be created for extended-release and long-acting (ER/LA) opioid analgesics.

The Collaboration for REMS Education (CO*RE), a team of 10 partners and three organizations, created CME modules for physicians based on the FDA’s blueprint for ER/LA opioid REMS.

Katherine Galluzzi, DO, a member of the CO*RE content development team, and Annette Carron, DO, presented the CO*RE REMS curriculum at OMED on Monday.

“Physicians must balance the use, availability, and the necessity for pain management against the risk of serious adverse outcomes,” Dr. Galluzzi said.

Dr. Carron agreed, emphasizing that the curriculum is not a lecture on treatment of pain, but rather a program designed to enhance the safe use of long-acting opioid analgesics.

The curriculum is available for free on the CO*RE website and covers the following:

  • How to assess patients for treatment with ER/LA opioid analgesics, evaluate risks vs. benefits and screen for possible aberrant behaviors such as misuse, abuse, diversion and addiction.
  • Best practices for starting and stopping opioid treatment.
  • How to modify doses and safe opioid rotation or conversion techniques, including the use of equianalgesic dosing tables.
  • Managing ongoing therapy with ER/LA opioid analgesics.
  • How to correctly screen for adverse effects and aberrant behaviors.
  • Counseling patients and caregivers on the safe use of these drugs, including how to store and dispose of them.
  • Review of general and product-specific drug information on ER/LA opioid analgesics.

At OMED, Dr. Galluzzi emphasized the importance of understanding how to use these drugs safely.

“The reality is, pain is a universal symptom. At some point we are all going to need potent analgesia for the symptoms that we are experiencing,” she said, noting that the CO*RE REMS website provides tools to help physicians select patients who have appropriate indications for and who may benefit from opioid use.

The website also provides guidance for physicians on how to use the drugs with caution, monitor them in an ongoing fashion and ensure safe use and appropriate storage and disposal of ER/LA opioids.

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