Chronic Pain, Opioids, and Suicide

This learning module will examine the trends and demographics for suicide in the US, the role that prescription and illicit opioids and Opioid Use Disorder (OUD) have played in those trends, the risk factors for suicidality in the context of chronic pain and in OUD, and the impact of opioid de-prescribing on suicidality and on population health. A broad overview of compassionate opioid tapering will be covered, as well as the concept of Complex Persistent Opioid Dependence (CPOD).


Learning Objectives:

At the end of this module, participants will better understand:

  1. The links between opioid use, chronic pain, suicide, and the subsequent impact on patient care.
  2. Prevention strategies for unintentional opioid overdose and suicide.
  3. The principles of ethical and compassionate opioid tapering aimed at reducing unintentional overdose and suicide.

Module Structure:

This module is self-paced and available to any user who registers with the Maine Medical Association, Center for Quality Improvement Learning Lab. The estimated time to complete is approximately 60 minutes. The module consists of multiple sub-sections or units and will contain various elements, including hyperlinks to readings and web resources, video lessons, and pre-and post-assessments needed to obtain a CME Certificate or a CME Certificate of Participation.

The Maine Medical Education Trust designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity qualifies for 1 credit of the 3 CME credit requirement for opioid medication education found in P.L. 2015, Chapter 488, Maine’s legislation to address the opioid drug crisis.

This activity qualifies for 1 hour of the 8 hours of training on opioid or other substance use disorders and the appropriate treatment of pain required by the MATE Act.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and Maine Medical Association, Center for Quality Improvement. The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

None of the planners or presenters for this activity have relevant financial relationships to disclose.

Duration & Fee:  FREE for Maine Clinicians

Estimated Time to Complete: 60 minutes

(note: the module is divided into short digestible units [10-20 mins] that can be completed in small increments)

Hardware/Software Requirements:

  • Computer with Internet connection
  • Current version of Chrome, Firefox or Safari browser. You must have JavaScript enabled.
  • The quiz tool within the online modules are not fully compatible with smartphones or tablets. To avoid issues, such as answers not being recorded, we recommend using a computer to complete the pre- and post-tests.

Assessment and Grading:

This learning module begins with a pre-test that will test your knowledge and allow you to gauge your baseline understanding of the topics to be covered. Your pre-test score will not count toward your overall grade. At the end of the module, there is a post-test that will determine your final grade. A comparison of your pre-test score and post-test score will help to assess how much knowledge you’ve gained. You will have three attempts to complete the post-test. Your score must be 75% or better in order to receive the 1 AMA PRA Category 1 Credit™. Please complete the evaluation survey at the conclusion of the learning module.

To Obtain a CME Certificate or a CME Certificate of Participation:

  • Complete the entire learning module.
  • Complete the pre-test, post-test, and Survey Monkey evaluation at the end of the module.
  • Earn a score of 75% or higher on the post-test in order to receive a certificate.

Upon completion of the evaluation in Survey Monkey, including the required demographic information, a CME Certificate will be emailed to M.D.s and D.O.s and a CME Certificate of Participation will be emailed to all other learners. These certificates will be emailed within 10 business days of completing the evaluation.

Table of Contents:  The units will consist of the following:

  1. Introduction
  2. Pre-Assessment
  3. Unit 1 Data trends on suicidality in the US
  4. Unit 2 Risk factors for suicidality
  5. Unit 3 Overdose and suicidality
  6. Unit 4 Interventions to reduce the risk of suicidality
  7. Unit 5 Tapering considerations
  8. Post-Assessment

Disclosures: The planners and presenters for this module have no relevant financial relationships to disclose.

Noah Nesin, MD, FAAFP
Innovation Advisor
Penobscot Community Health Center

Amy Carter, BSHA-M
Maine Medical Association, Center for Quality Improvement

Janet Johnson
Administrative Assistant
Maine Medical Association, Center for Quality Improvement

Funding: This module is made possible by the generous support and funding from our partners at the Maine Board of Licensure in Medicine.

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