Opioid Prescribing CME

Most states now require some CME specifically covering controlled substances prescribing. Our Hospital Medicine Update program includes 2 hours of content on this subject, including:

  • Discussing both the FSMB and CDC guidelines on prescribing opioids, in length, including:
    • Chronic pain management
    • Patient evaluation and risk stratification
    • Treatment plans and goals
    • Informed consent and treatment agreements for chronic opioid therapy
  • Prescribing naloxone for opioid reversal
  • Strategies to recognize diversion
    • Drug testing
    • Documentation of patient encounters, prescribing habits and therapy results
    • Deciding when consultation and referral is warranted/appropriate
    • When and how to discontinue opioid therapy 
  • Using the PDMP to improve prescribing habits
  • Reviewing various laws concerning PDMP registration and usage
  • Reviewing and understanding morphine equivalents and morphine equivalent daily dosing (MEDD)
  • Understanding risks of using opioids to treat acute pain leading to chronic opioid use and opioid use disorder
  • Understanding risks of combining opioids and benzodiazepines
  • Recognizing and treating addiction and substance/opioid use disorder
  • Reviewing CDC tools available to assist in responsible opioid prescribing
  • Understanding risks of combining opioids and benzodiazepines
  • Understanding risks of addiction from opioids and other schedule II drugs
  • Use of non-opioid medications and treatments to manage chronic pain
  • Use of implantable devices to manage chronic pain
  • Overview of palliative care, hospice, and end-of-life pain and symptom management
  • Reviewing the FDA Blueprint regarding use of extended release and long acting opioids

Information from most states is listed below. A handful of states certify CME that meets their requirements, but most don’t. We have researched the requirements, and believe that our content satisfies the requirements for most states. If you have questions regarding your state’s requirements, please contact your state medical board.

 

Alabama:

  • 2 hours or equivalent credits every 2 calendar years for ACSC holders
  • Any program covering the areas of (any or all):
    • Controlled substance prescribing practices
    • Recognizing signs of the abuse or misuse of controlled substances, or
    • Controlled substance prescribing for chronic pain management

https://www.albme.org/cscme.html

Alaska:

  • 2 hours every 2 years for new applicants and existing licensees with DEA registration
  • Topics must specifically include all 3 of the following:
    • Pain management
    • Opioid use
    • Addiction

https://www.commerce.alaska.gov/web/portals/5/pub/MedicalStatutes.pdf  (page 12)

Arizona:

  • 3 hours every 2 years for DEA registration holders
  • Topics should cover (any or all):
    • Opioid prescribing
    • Substance use disorder, or
    • Addiction

https://apps.azsos.gov/public_services/Title_04/4-16.pdf   (page 4)

Arkansas:

  • 1 hour every 1 year
  • Topics should specifically cover
    • The prescribing of opioids and benzodiazepines

http://www.armedicalboard.org/Professionals/pdf/mpa.pdf   (Page 92)

California:

  • 12 hours one time (Pathologists and radiologists are exempted from this requirement)
  • Topics of 1) pain management and 2) the treatment of terminally ill and dying patients, divided per licensee’s preference or scope of practice to total 12 hours
    • 1 hour must include the risks of addiction associated with the use of Schedule II drugs

http://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=BPC&division=2.&title=&part=&chapter=5.&article=10.   (Art 10.2190.5)

 

 

Connecticut:

  • 1 hour initial, then every 6 years in Risk Management topics
  • Risk management: (Includes, but not limited to…)
    • prescribing controlled substances and pain management

https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Physician/Continuing-Medical-Education

Deleware:

  • 2 hours every 2 years
  • Topics covering the areas of
    • controlled substance prescribing practices
    • treatment of chronic pain, or
    • other topics related to the prescribing of controlled substances

https://regulations.delaware.gov/AdminCode/title24/Uniform%20Controlled%20Substances%20Act%20Regulations.shtml   (Sect 3.1.3)

District of Columbia:

  • 5 hours (10% of CE requirements) every 2 years on Public Health Priorities (list of 10 topics)
  • Public health Priorities list includes:
    • Responsible opioid prescribing and effective pain management

https://dchealth.dc.gov/sites/default/files/dc/sites/doh/service_content/attachments/10%25%20CE%20-%20Public%20Notice%20-%2066%20DCR%2014518-14519.pdf

Florida:

  • 2 hours every 2 years
  • Instruction must include information on all:
    • the current standards for prescribing controlled substances, particularly opiates
    • alternatives to these standards
    • nonpharmacological therapies
    • prescribing emergency opioid antagonists
    • the risks of opioid addiction following all stages of treatment in the management of acute pain

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0456/0456.html    (Chapter 456.0301)

Georgia:

  • 3 hours one time
  • Topic should cover instruction on:
    • controlled substance prescribing guidelines
    • recognizing signs of the abuse or misuse of controlled substances
    • controlled substance prescribing for chronic pain management

http://rules.sos.ga.gov/GAC/360-2  (Rule 360-15-.01)

Illinois:

  • 3 hours every 3 years
  • Course should cover:
    • safe opioid prescribing practices

https://www.idfpr.com/FAQ/DPR/Safe%20Opioid%20RX%20CE%20FAQ.pdf

Indiana:

  • 2 hours every 2 years
  • Topic should cover instruction on:
    • Opioid prescribing and opioid abuse

https://www.in.gov/pla/medical.htm

Iowa:

  • 2 hours every 5 years
  • Course should focus on:
    • The CDC guideline for proper opioid prescribing

https://medicalboard.iowa.gov/chronic-pain-and-end-life-training

Kentucky:

  • 5 hours every 3 years from a state approved program for prescribers of controlled substances
  • Approval for our program is pending with this state
  • Topics relating to:
    • the use of KASPER
    • pain management
    • addiction disorders
    • or a combination of two or more of those subjects

https://kbml.ky.gov/cme/Pages/default.aspx

Louisiana:

  • 3 hours one time from a state approved course
  • Approval for our program is pending with this state
  • Topics include:
    • Drug diversion training
    • Best practices regarding prescribing of controlled substances
    • Appropriate treatment for addiction
    • Any other matters pertaining to the prescribing of CDS that are deemed appropriate by the licensing board

http://www.lsbme.la.gov/content/board-approved-cme-courses-cds-requirements

Maine:

  • 3 hours every 2 years
  • Content should include:
    • prescribing of opioid medication
    • CDC guidelines for opioid prescribing

https://www.maine.gov/md/sites/maine.gov.md/files/inline-files/Chapter%2021%2005.27.20.pdf

Maryland:

  • 2 hours every 2 years
  • Content should be related to:
    • The prescribing or dispensing of CDS

http://mgaleg.maryland.gov/2018RS/fnotes/bil_0002/hb1452.pdf

Massachusetts:

  • 3 hours every 2 years if the physician prescribes controlled substances
  • Content related to:
    • Opioid Education and Pain Management

https://www.mass.gov/service-details/continuing-medical-education-pilot-program

Michigan:

  • 3 hours every 3 years
  • Content should cover:
    • Pain and symptom management

https://www.michigan.gov/documents/lara/LARA_Medicine_CE_Brochure_5-11_376428_7.pdf

Minnesota:

  • 2 hours every 2 years
  • Topics must cover:
    • best practices in prescribing opioids and controlled substances
    • Non-pharamacological and implantable device alternatives for treatment of pain and ongoing pain management

https://www.revisor.mn.gov/statutes/cite/214.12

Mississippi:

  • 5 hours every 2 years for those with active DEA certification
  • Topics related to:
    • The prescribing of medications, with an emphasis on controlled substances

https://www.msbml.ms.gov/sites/default/files/Rules_Laws_Policies/2-2020AdministrativeCode.pdf

Nebraska:

  • 3 hours every 2 years for those who prescribe controlled substances
  • Topics may include:
    • education regarding prescribing and administering opiates
    • the risks and indicators regarding development of addiction to opiates
    • emergency opiate situations
  • One-half hour of the three hours of continuing education shall cover the prescription drug monitoring program

https://nebraskalegislature.gov/FloorDocs/105/PDF/Slip/LB731.pdf

Nevada:

  • 2 hours every 2 years for all physicians
  • Topics of:
    • Ethics or Pain Management
  • 2 hours every 2 years for physicians who prescribe controlled substances
  • Topics of:
    • Misuse and abuse of controlled substances
    • Prescribing of opioids, or
    • Addiction

http://medboard.nv.gov/uploadedFiles/mednvgov/content/Licensees/CME_Requirements_MDs_PAs.pdf

New Hampshire:

  • 3 hours every 2 years
  • Content should be in the areas of:
    • pain management
    • addiction disorder
    • or a combination

https://www.oplc.nh.gov/medicine/opioid-prescribing.htm

New Jersey:

  • 1 hour every 2 years
  • topics concerning prescription opioid drugs, including
    • responsible prescribing practices
    • alternatives to opioids for managing and treating pain
    • the risks and signs of opioid abuse, addiction, and diversion

https://www.njconsumeraffairs.gov/regulations/Chapter-35-State-Board-of-Medical-Examiners.pdf

New Mexico:

  • 5 hours every 3 years
  • Programs shall include:
    • an understanding of the pharmacology and risks of controlled substances
    • a basic awareness of the problems of abuse, addiction and diversion
    • awareness of state and federal regulations for the prescription of controlled substances
    • management of the treatment of pain

https://www.nmmb.state.nm.us/docs/rules/16.10.14%20NMAC%20as%20of%203.24.20.pdf

New York:

  • 3 hours every 3 years
  • Course work or training must include all of the following eight (8) topics:
    • New York State and federal requirements for prescribing controlled substances
    • Pain management
    • Appropriate prescribing
    • Managing acute pain
    • Palliative medicine
    • Prevention, screening and signs of addiction
    • Responses to abuse and addiction
    • End of life care

https://www.health.ny.gov/professionals/narcotic/mandatory_prescriber_education/docs/guidance.pdf

North Carolina:

  • 3 hours every 3 years
  • Content shall include all of the following:
    • instruction on controlled substance prescribing practices
    • recognizing signs of the abuse or misuse of controlled substances
    • controlled substance prescribing for chronic pain management

https://www.ncmedboard.org/images/uploads/article_images/21_ncac_32r_.0101_-approved.pdf

Oklahoma:

  • 1 hour every 3 years
  • Complete topics in:
    • Pain Management

http://www.okmedicalboard.org/download/908/sb848.pdf

Oregon:

https://www.oregon.gov/omb/Topics-of-Interest/Pages/Continuing-Education.aspx

Pennsylvania:

  • 4 hours for initial license
    • 2 hours in pain management or the identification of addiction
    • 2 hours in the practices of prescribing or dispensing of opioids
  • 2 hours every 2 years for renewals
  • Topics could include:
    • pain management
    • the identification of addiction, or
    • the practices of prescribing or dispensing of opioids

https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Documents/Special%20Notices/MedSN%20-%20Notice%20Regarding%20Opioid%20Education.pdf

Rhode Island:

  • 4 hours every 2 years from multiple topics (5) of health concern
  • Topics to choose from include:
    • Opioid pain management / chronic pain management

https://health.ri.gov/licenses/detail.php?id=200#section1

South Carolina:

  • 2 hours every 2 years
  • Content should include:
    • safe prescribing and monitoring of controlled substances

https://www.llr.sc.gov/med/PDF/Medical_CE_Reqs.pdf

Tennessee:

  • 2 hours every 2 years
  • Content must include:
    • instruction in the Department’s treatment guidelines on opioids, benzodiazepines, barbiturates, and carisoprodol
    • may include topics such as medicine addiction, risk management tools, and other topics approved

https://publications.tnsosfiles.com/rules/0880/0880-02.20191023.pdf  (page 57)

Texas:

  • 2 hours every 2 years
  • Course must involve the study of the following topics:
    • best practices, alternative treatment options, and multi-modal approaches to pain management that may include physical therapy, psychotherapy, and other treatments
    • safe and effective pain management related to the prescription of opioids and other controlled substances, including education regarding:
      • standards of care
      • identification of drug-seeking behavior in patients
      • effectively communicating with patients regarding the prescription of an opioid or other controlled substances
    • prescribing and monitoring of controlled substances

http://www.tmb.state.tx.us/page/resources-cme-for-md-dos

Utah:

  • 5 hours every 2 years for controlled substance prescribers
  • An SBIRT-training class must be completed once
  • Topics of educational content covering the following:
    • the scope of the controlled substance abuse problem in Utah and the nation
    • all elements of the FDA Blueprint for Prescriber Education under the FDA's Extended Release and Long-Acting Opioid Analgesics Risk Evaluation and Mitigation Strategy, as published July 9, 2012
    • the national and Utah-specific resources available to prescribers to assist in appropriate controlled substance and opioid prescribing
    • patient record documentation for controlled substance and opioid prescribing; and
    • office policies, procedures, and implementation

https://le.utah.gov/xcode/Title58/Chapter37/C58-37-S6.5_2018050820180508.pdf

Vermont:

  • 2 hours every 2 years
  • Topics must be covered:
    • abuse and diversion, safe use, and appropriate storage and disposal of controlled substances
    • the appropriate use of the Vermont Prescription Monitoring System
    • risk assessment for abuse or addiction
    • pharmacological and nonpharmacological alternatives to opioids for managing pain
    • medication tapering and cessation of the use of controlled substances; and
    • relevant State and federal laws and regulations concerning the prescription of opioid controlled substances

https://www.healthvermont.gov/sites/default/files/documents/pdf/CME%20Excerpt%20of%20Rules%20for%20License%20Renewal.pdf

Virginia:

  • 2 hours every 2 years
  • Content should relate to:
    • pain management
    • the responsible prescribing of controlled substances
    • and the diagnosis and management of addiction

https://www.dhp.virginia.gov/medicine/docs/CME2019.pdf

Washington:

  • 1 hour one time
  • Content regarding:
    • best practices in the prescribing of opioids

https://app.leg.wa.gov/wac/default.aspx?cite=246-919-875&pdf=true

West Virginia:

  • 3 hours every 2 years
  • Topic should include:
    • drug diversion training
    • best practice prescribing of controlled substances

https://wvbom.wv.gov/Cont_Med_Education.asp

Wisconsin:

  • 2 hours every 2 years from a state approved program
  • Approval for our program is pending with this state
  • Content related to:
    • opioid prescribing

https://docs.legis.wisconsin.gov/code/admin_code/med/13.pdf

Wyoming:

  • 1 hour every 2 years for physicians with controlled substance registration
  • Topics should include:
    • responsible prescribing of controlled substances or the treatment of substance abuse disorders

https://da26d420-a-84cef9ff-s-sites.googlegroups.com/a/wyo.gov/wyomedboard/files-1/Dr%20letter%20FINAL%20regarding%20controlled%20substance%20prescribing%20CME%20%28KDB%29.pdf?attachauth=ANoY7coaBlUmNFqqUrm30K-57zPaCmSTQc47By0mh2VQ54TwbEN8p4QuElNCnWMVWF2Xeolde3Lbf8FYsjxQ73BfMot79zPhrv0j5lWqRzReo_hBC0hVdzxMaMe0-nNd11w69S0T16FmIh9AwS5H18KO9bqaka5yy9pH89Ndk-9PTlNwdUMISHQCvjkLYDkyo9m9XCW51ZyPwhsUpQKzGkZDbfTyYeAqhvWipIsh4RnlLjeRg2qa39L2j3dDbfdHVwYD2QNi5PAmnINGDIFU1PFvzQukvH8qC24pXAgOk1VyLVyTAl9O4lk%3D&attredirects=0