SCOPE of Pain: Safe & Competent Opioid Prescribing Education

By Dr. Daniel Alford, MD, MPH

What's SCOPE of Pain: Safe & Competent Opioid Prescribing Education about?

Helpful discussions of challenges commonly faced by health care clinicians when prescribing opioids. Hosted by Dr. Daniel P. Alford, MD, MPH, Director of the Safe and Competent Opioid Prescribing Education program (SCOPE of Pain) at Boston University's Chobanian & Avedisian School of Medicine.

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SCOPE of Pain: Safe & Competent Opioid Prescribing Education episodes:

03.03.2020
Ep #019: How Do I Treat Pain in a Patient With Opioid Addiction?
Your surgical colleague asks if your patient who is taking buprenorphine for his opioid use disorder should stop before hip replacement surgery and requests your guidance on how to manage postoperative pain in this patient. What will you recommend?
03.03.2020
Ep #018: I Don't Want Addicted Patients in Our Practice
How do you educate your medical director about the importance and benefits of offering medications, such as buprenorphine for the treatment of patients with opioid use disorder?
03.03.2020
Ep #017: Opioids are Not Effective for Treating Chronic Pain
Your medical director states all patients on chronic opioid therapy should be tapered, as there's no evidence opioids are effective for chronic pain. What is the actual efficacy of opioids for chronic pain?
03.03.2020
Ep #016: My Wife Overdosed on Her Fentanyl Patch!
How will you manage a patient's chronic pain and likely opioid use disorder after her opioid overdose?
03.03.2020
Ep #015: I Need Opioids for My Sprained Ankle
A patient with a twisted ankle requests a prescription for oxycodone. How will you respond to his request for opioids for his acute pain?
03.03.2020
Ep #014: Will Post-Surgery Opioids Make Me Addicted?
A patient is afraid receiving postoperative opioid analgesics will result in opioid addiction. How will you educate this patient about the risks and benefits of opioids for managing her postoperative pain?
03.03.2020
Ep #013: The CDC Guideline Requires All Patients to be Tapered
Your medical director states that over the next six months, all patients on opioids must be decreased below 90 morphine milligram equivalents as per the mandate of the CDC guideline. What does the CDC guideline say about a dosing threshold...
11.15.2018
Ep #012: The Anonymous Call – Your Patient Is Selling His Opioids
You get an anonymous phone call stating your patient, who you've been treating with chronic opioids for chronic pain for the past six months, is selling his opioids. How will you respond to this concerning, anonymous call regarding potential opioid...
10.19.2018
Ep #011: The Patient Overly-Focused on Opioid Therapy
A patient treated with long-term high-dose opioids for chronic pain insists on having her opioid dose increased to improve her pain management and refuses to consider adding other non-opioid medications or accepting referrals to other forms of pain treatment, including...
10.03.2018
Ep #010: The Unsanctioned Opioid Dose Escalation
Your patient, who you've been treating with chronic opioids for chronic painful diabetic neuropathy for the past 11 months calls the on-call service asking for an early refill. She states her pain has worsened, she took extra tablets and has...
08.24.2018
Ep #009: I Will Report Your for Patient Abandonment
When discussing tapering a patient's opioids due to lack of benefit and apparent harm, she continues to request a higher opioid dose. She states her pain is so severe she's unable to get out of bed most days. She angrily...
08.10.2018
Ep #008: The New Patient on High-Dose Opioids
A new patient has been treated with high-dose opioids, extended-release morphine, (100 mg twice per day) for chronic back pain after multiple failed surgeries. His previous primary care physician recently retired and gave him enough opioid until his visit with...
06.29.2018
Ep #007: Your Staff is Treating Me Like a Drug Addict
Your long-term patient who is stable on chronic low-dose opioids for chronic pain complains he feels the front desk and lab staff treat him like a heroin addict. How do you address this patient's concerns?
06.15.2018
Ep #006: Can You Give Me an Opioid Refill Until I Find a New Doctor?
When discussing tapering your patient's opioid due to lack of benefit, functional decline and apparent harm (she fell asleep while smoking), she angrily states, "I thought you trusted me. I thought we had a good relationship," and then asks, "Can...
06.01.2018
Ep #005: I'm Using Cannabis to Treat My Pain
Your patient, who has been stable on chronic low-dose opioids for chronic pain, discloses he started buying cannabis from his friend to treat his pain and help him sleep. What changes will you make in his treatment plan and how...
05.18.2018
Ep #004: The Unexpected Urine Test – Negative for the Prescribed Opioid
Your patient, who has been stable on chronic, low-dose opioids for chronic pain for the past three years with excellent pain and functional improvements, has an unexpected urine drug test, which is negative for the prescribed opioid. How will you...
05.07.2018
Ep #003: The Unexpected Urine Test – Positive for Cocaine
Your patient on chronic opioids for post-traumatic chronic knee pain for the past two years has achieved very good pain relief and excellent functional benefits, including working full time. At yesterday's visit, he denied illicit drug use, but his urine...
04.23.2018
Ep #002: You Treat Me Like a Drug Addict
When discussing the need for routine urine drug testing with your patient who is on chronic opioids for chronic back pain, she becomes visibly upset and asks, "Why are you treating me like a drug addict?" How will you respond?
04.04.2018
Ep #001: My Pain is a "20" on a 10-point Scale
When assessing a new patient's chronic pain from bilateral knee osteoarthritis, he states his pain is a 20 on a 0 to 10 pain scale. Why is this patient reporting pain above the 10-point scale? And how will you respond?
04.04.2018
Introduction: Welcome to "SCOPE of Pain"
Dr. Daniel Alford – Professor of Medicine and course director for Boston University Chobanian & Avedisian School of Medicine's SCOPE of Pain safer opioid prescribing program – shares more than 20 years' experience as a general internist along with...

What's SCOPE of Pain: Safe & Competent Opioid Prescribing Education about?

Download our free app to listen on your phone

SCOPE of Pain: Safe & Competent Opioid Prescribing Education episodes:

Ep #019: How Do I Treat Pain in a Patient With Opioid Addiction?

Ep #018: I Don't Want Addicted Patients in Our Practice

Ep #017: Opioids are Not Effective for Treating Chronic Pain

Ep #016: My Wife Overdosed on Her Fentanyl Patch!

Ep #015: I Need Opioids for My Sprained Ankle

Ep #014: Will Post-Surgery Opioids Make Me Addicted?

Ep #013: The CDC Guideline Requires All Patients to be Tapered

Ep #012: The Anonymous Call – Your Patient Is Selling His Opioids

Ep #011: The Patient Overly-Focused on Opioid Therapy

Ep #010: The Unsanctioned Opioid Dose Escalation

Ep #009: I Will Report Your for Patient Abandonment

Ep #008: The New Patient on High-Dose Opioids

Ep #007: Your Staff is Treating Me Like a Drug Addict

Ep #006: Can You Give Me an Opioid Refill Until I Find a New Doctor?

Ep #005: I'm Using Cannabis to Treat My Pain

Ep #004: The Unexpected Urine Test – Negative for the Prescribed Opioid

Ep #003: The Unexpected Urine Test – Positive for Cocaine

Ep #002: You Treat Me Like a Drug Addict

Ep #001: My Pain is a "20" on a 10-point Scale

Introduction: Welcome to "SCOPE of Pain"