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CE Pain Management Opioid Prescribing

The course teaches nurses comprehensive pain assessment, multimodal analgesia strategies, opioid pharmacology, risk evaluation, and naloxone overdose response, enabling safe, evidence‑based opioid prescribing across acute, chronic, and peri‑operative care.

Who Should Take This

Registered nurses, nurse practitioners, and clinical nurse specialists who regularly assess and manage patients receiving opioid or non‑opioid analgesics in acute, chronic, or peri‑operative settings are ideal. They have foundational knowledge of pain management and seek to deepen expertise in safe opioid prescribing, risk mitigation, and emergency overdose protocols.

What's Included in AccelaStudy® AI

Adaptive Knowledge Graph
Practice Questions
Lesson Modules
Console Simulator Labs
Exam Tips & Strategy
20 Activity Formats

Course Outline

65 learning goals
1 Pain Assessment
3 topics

Pain assessment scales and tools

  • Identify validated pain assessment scales including the Numeric Rating Scale, Visual Analog Scale, Wong-Baker FACES, and FLACC for nonverbal patients.
  • Explain the appropriate selection of pain assessment tools based on patient age, cognitive status, cultural background, and clinical setting.
  • Describe the components of a comprehensive pain assessment including location, onset, duration, character, aggravating and alleviating factors, and functional impact.

Acute versus chronic pain differentiation

  • Differentiate between acute nociceptive pain, chronic pain, neuropathic pain, and mixed pain syndromes based on pathophysiology and clinical presentation.
  • Analyze patient presentations to classify pain type and determine the most appropriate initial assessment and treatment pathway.

Special population pain assessment

  • Describe pain assessment challenges in neonates, cognitively impaired adults, and sedated or intubated patients using behavioral observation tools.
  • Analyze cultural and psychosocial factors that influence pain expression, reporting, and treatment preferences across diverse patient populations.
  • Synthesize an individualized pain assessment plan for a complex patient incorporating validated tools, cultural considerations, and interdisciplinary input.
2 Multimodal Analgesia
3 topics

Non-opioid pharmacological interventions

  • Identify non-opioid analgesics including acetaminophen, NSAIDs, gabapentinoids, muscle relaxants, and topical agents used in multimodal pain regimens.
  • Explain the mechanism of action, contraindications, and adverse effects of NSAIDs including GI bleeding risk, renal toxicity, and cardiovascular concerns.
  • Describe the role of adjuvant medications including antidepressants, anticonvulsants, and corticosteroids in managing neuropathic and inflammatory pain.

Non-pharmacological pain interventions

  • Identify evidence-based non-pharmacological pain management strategies including physical therapy, cognitive behavioral therapy, acupuncture, and TENS.
  • Explain the integration of complementary therapies such as guided imagery, massage, heat and cold therapy, and mindfulness into multimodal pain care plans.

Multimodal strategy design

  • Analyze patient-specific factors including comorbidities, allergies, prior treatment responses, and surgical procedure to design an optimal multimodal analgesia plan.
  • Evaluate the effectiveness of multimodal analgesia protocols by comparing pain scores, opioid consumption, functional outcomes, and adverse event rates.
  • Synthesize a unit-level multimodal analgesia protocol incorporating pharmacological and non-pharmacological interventions tailored to a specific clinical population.
3 Opioid Pharmacology
3 topics

Opioid classification and mechanisms

  • Identify opioid receptor types including mu, kappa, and delta and describe their primary pharmacological effects on pain perception and CNS function.
  • Explain the pharmacokinetic differences among common opioids including morphine, hydromorphone, oxycodone, fentanyl, and methadone.
  • Describe opioid formulations including immediate-release, extended-release, transdermal, and parenteral routes and their appropriate clinical indications.

Equianalgesic dosing and conversions

  • Recognize equianalgesic dose tables and the concept of morphine milligram equivalents for comparing potency across different opioid formulations.
  • Calculate equianalgesic doses when converting between opioid agents including appropriate dose reduction factors to account for incomplete cross-tolerance.
  • Analyze complex opioid rotation scenarios involving renal impairment, hepatic dysfunction, or transition from parenteral to oral routes.

Adverse effects and monitoring

  • Identify common opioid adverse effects including respiratory depression, sedation, constipation, nausea, pruritus, and urinary retention.
  • Explain opioid-induced respiratory depression monitoring including sedation scales, capnography, pulse oximetry, and high-risk patient identification.
4 Opioid Risk Evaluation
3 topics

Risk assessment tools and screening

  • Identify validated opioid risk assessment tools including the Opioid Risk Tool, SOAPP-R, and DIRE Score and describe their clinical application.
  • Describe risk factors for opioid misuse including personal and family history of substance use disorder, psychiatric comorbidities, and prior overdose.
  • Explain the FDA Risk Evaluation and Mitigation Strategy for extended-release and long-acting opioid formulations including prescriber and patient requirements.

Informed consent and treatment agreements

  • Describe the components of informed consent for opioid therapy including risks, benefits, alternatives, treatment goals, and exit strategies.
  • Explain opioid treatment agreement elements including urine drug testing, pill counts, single-prescriber and single-pharmacy requirements, and refill policies.

Risk stratification and monitoring

  • Analyze patient risk stratification results to determine the appropriate level of monitoring, follow-up frequency, and treatment modifications.
  • Synthesize a comprehensive opioid risk management plan for a high-risk patient incorporating screening, monitoring, naloxone co-prescription, and referral pathways.
5 Naloxone and Overdose Response
2 topics

Naloxone pharmacology and administration

  • Describe the mechanism of action of naloxone as a competitive opioid antagonist and its onset, duration, and routes of administration.
  • Identify the indications for naloxone co-prescription including patients on high MME doses, concurrent benzodiazepine use, and history of overdose.
  • Explain naloxone formulations including intranasal, intramuscular, and auto-injector devices and instruct patients and caregivers on proper use.

Overdose response protocols

  • Analyze clinical scenarios of suspected opioid overdose to determine appropriate naloxone dosing, repeat dosing intervals, and post-reversal monitoring requirements.
  • Synthesize a facility-level naloxone distribution and overdose response education program for patients, families, and community stakeholders.
6 PDMP and Regulatory Requirements
3 topics

Prescription Drug Monitoring Programs

  • Identify the purpose and function of state Prescription Drug Monitoring Programs and the mandatory query requirements for controlled substance prescribing.
  • Explain how to interpret PDMP reports including identifying patterns of doctor shopping, early refills, overlapping prescriptions, and high-risk combinations.
  • Describe the DEA scheduling system for controlled substances including Schedule II through V classifications and prescribing restrictions for each.

State and federal opioid regulations

  • Identify key federal regulations governing opioid prescribing including the Controlled Substances Act, SUPPORT Act, and prescribing limit mandates.
  • Explain state-specific continuing education requirements for opioid prescribing including mandatory training hours and content areas for license renewal.
  • Analyze prescribing scenarios to determine compliance with CDC opioid prescribing guidelines including MME thresholds, duration limits, and co-prescribing recommendations.

Documentation and compliance

  • Synthesize a compliant opioid prescribing documentation template incorporating pain assessment, treatment plan, risk evaluation, PDMP query, and informed consent.
7 Opioid Use Disorder
3 topics

OUD recognition and screening

  • Identify the DSM-5 diagnostic criteria for opioid use disorder including the 11 criteria and severity classifications of mild, moderate, and severe.
  • Describe aberrant drug-related behaviors that may indicate opioid misuse including lost prescriptions, dose escalation without authorization, and multiple provider visits.
  • Explain urine drug testing interpretation including immunoassay screening, confirmatory testing, expected metabolites, and common causes of false results.

Medication-assisted treatment

  • Describe medication-assisted treatment options for OUD including buprenorphine, methadone, and naltrexone with their mechanisms, indications, and regulatory frameworks.
  • Analyze clinical scenarios to identify patients appropriate for MAT referral and determine barriers to treatment access including stigma and regulatory hurdles.

Harm reduction and recovery support

  • Explain harm reduction strategies including needle exchange programs, safe injection sites, fentanyl test strips, and community naloxone distribution.
  • Synthesize a comprehensive opioid stewardship program for a healthcare facility incorporating prescribing guidelines, risk assessment, PDMP integration, and MAT referral pathways.
8 Perioperative Pain Management
2 topics

Preoperative and postoperative pain planning

  • Describe preoperative pain assessment and optimization strategies including identification of opioid-tolerant patients and preemptive analgesia approaches.
  • Explain Enhanced Recovery After Surgery protocols and their multimodal pain management components including regional anesthesia and early mobilization.
  • Analyze postoperative pain management scenarios to determine appropriate opioid tapering schedules and transition from parenteral to oral analgesia.

Regional anesthesia and nerve blocks

  • Identify common regional anesthesia techniques including epidural analgesia, peripheral nerve blocks, and local anesthetic infiltration used in perioperative pain management.
  • Describe nursing assessment and monitoring responsibilities for patients receiving regional anesthesia including dermatome checks, motor function, and catheter site care.
9 Chronic Pain Syndromes
2 topics

Common chronic pain conditions

  • Identify common chronic pain syndromes including fibromyalgia, complex regional pain syndrome, chronic low back pain, and central sensitization conditions.
  • Explain the biopsychosocial model of chronic pain including the interplay of biological, psychological, and social factors in pain persistence and disability.
  • Describe functional goal-setting for chronic pain patients emphasizing activity improvement, quality of life, and realistic expectations rather than complete pain elimination.

Interdisciplinary chronic pain management

  • Analyze the components of an interdisciplinary chronic pain program including physical rehabilitation, psychological support, medication management, and self-management education.
  • Synthesize a long-term chronic pain management plan integrating pharmacological and non-pharmacological strategies with measurable functional outcome goals.
10 Patient and Caregiver Education
2 topics

Pain education and health literacy

  • Identify patient education topics for safe opioid use including storage, disposal, sharing prohibition, signs of overdose, and naloxone availability.
  • Explain health literacy considerations when designing pain management education materials including readability, teach-back methods, and multilingual resources.
  • Describe safe opioid disposal methods including FDA-recommended disposal options, drug take-back programs, and home deactivation systems.

Family and caregiver involvement

  • Analyze barriers to effective patient pain education including cultural beliefs, fear of addiction, stoicism, and cognitive impairment and develop targeted solutions.
  • Synthesize a comprehensive patient and caregiver pain education program covering safe medication use, non-pharmacological strategies, and overdose response.

Scope

Included Topics

  • Pain assessment scales and validated tools including Numeric Rating Scale, Visual Analog Scale, Wong-Baker FACES, FLACC, and behavioral observation tools for nonverbal patients.
  • Multimodal analgesia strategies incorporating non-opioid pharmacological agents, adjuvant medications, and evidence-based non-pharmacological interventions.
  • Opioid pharmacology including receptor types, pharmacokinetics, equianalgesic dosing, dose conversions, and adverse effect management.
  • Opioid risk evaluation tools including ORT, SOAPP-R, DIRE Score, FDA REMS requirements, informed consent, and treatment agreements.
  • Naloxone pharmacology, formulations, co-prescription indications, and overdose response protocols for patients, caregivers, and community settings.
  • Prescription Drug Monitoring Programs including mandatory query requirements, report interpretation, and integration into clinical workflow.
  • State and federal regulatory requirements for opioid prescribing including CDC guidelines, DEA scheduling, MME thresholds, and continuing education mandates.
  • Opioid use disorder recognition, DSM-5 criteria, medication-assisted treatment options, urine drug testing interpretation, and harm reduction strategies.
  • Perioperative pain management including ERAS protocols, regional anesthesia nursing responsibilities, and opioid tapering strategies.
  • Chronic pain syndromes, biopsychosocial model, interdisciplinary treatment programs, and functional goal-setting approaches.

Not Covered

  • Advanced anesthesiology techniques, surgical procedures, or interventional pain procedures beyond nursing scope of practice.
  • Detailed organic chemistry or molecular pharmacology of opioid receptor signaling beyond clinical practitioner understanding.
  • State-specific legal codes or case law unless used as illustrative examples of regulatory principles.
  • Addiction psychiatry or substance abuse counseling techniques beyond screening, referral, and basic therapeutic communication.
  • Veterinary pain management or non-human pharmacological applications.

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