Opioid analgesics are an important part of our therapeutic armamentarium, but can also have serious consequences. As the pendulum swings from liberal opioid prescribing to a more measured approach, clinicians must ensure it does not swing too far. All opioids are not the same and they vary in their potential for respiratory depression, the major cause of overdose death. Three atypical opioids—buprenorphine, tapentadol, and tramadol—are currently available. Unlike conventional opioids that primarily rely on mu-opioid receptor agonism for analgesia and adverse effects, atypical opioids have additional mechanisms of action that increase the separation between desired therapeutic and unwanted effects. In particular, several groups have identified buprenorphine as a preferred opioid for chronic pain because it has a ceiling to respiratory depression. However, buprenorphine’s complex pharmacology and development history, which includes treatment of opioid use disorder, have led to longstanding misconceptions that buprenorphine is a weaker older drug with limited utility. The faculty will address misconceptions about the pharmacology, analgesic efficacy, and safety of buprenorphine, and provide recommendations on the appropriate use of buprenorphine for chronic pain, including conversion strategies for switching from conventional opioids to buprenorphine.
Lynn R. Webster, MD
Vice President of Scientific Affairs,
PRA Health Sciences
Salt Lake City, Utah
Richard L. Rauck, MD
President, Carolinas Pain Institute
Medical Director, Center for Clinical Research
Pain Fellowship Director,
Wake Forest University School of Medicine
Winston-Salem, North Carolina
After completing this activity, participants should be better able to:
- Describe the pharmacologic and safety differences between conventional and atypical opioids.
- Identify appropriate patients who would benefit from buprenorphine as a first-line opioid analgesic.
- Describe a strategy to transition opioid therapy from full mu-opioid analgesics to buprenorphine when appropriate.
Register now! There is no registration fee to attend this CME activity.
Supported by an educational grant from BioDelivery Sciences International, Inc.
Accreditation and Credit Designation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Center for Independent Healthcare Education (Center) and PharmaCom Group. Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Center designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AAPA accepts AMA PRA Category 1 Credit™ for the PRA from organizations accredited by ACCME.
Nurse Practitioners will receive certificate of AMA PRA Category 1 Credit™ as this is an ACCME accredited program and its accreditation is recognized by Nurse Practitioner boards.