Serving our Patients: Balancing Pain Management with the Safe Use of Opioid Analgesics

ACPE Number: 0204-0000-20-408-H08-P
Release Date: March 31, 2020
Expiration Date: March 31, 2021
Activity Type: Application-based
CE Credits: 3.0 hours
Activity Fee: Free of charge

Accreditation for Pharmacists

The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  

Target Audience

This activity was planned to meet the educational needs of pharmacists in all practice settings.

Format and Instructions

The activity consists of three 1-hour modules, each divided into two parts to allow flexibility in completing the education. The modules must be completed consecutively.

  • For each module, answer the pre-assessment questions, view both parts, and complete the post-assessment (score of at least 70% is required).
  • Following module 3, complete the evaluation and claim continuing education credit within 60 days of completing the activity. No partial credit is available.
  • Verify credits were successfully transferred to CPE Monitor before the ACPE 60-day deadline by checking your NABP eProfile account.
  • Optional: Download an ASHP Certificate of Completion of this REMS-compliant activity. 

Activity Overview

Pain, both acute and chronic, is often undertreated, especially today when patients, caregivers, and healthcare professionals alike are understandably hesitant to use opioid analgesics in the midst of the opioid crisis in the United States. This activity provides pharmacists with knowledge and strategies for taking an active role in pain management, working with the interprofessional team to ensure that patients receive safe and appropriate pain therapy individualized for their needs.

This opioid analgesic REMS-compliant CE activity consists of three modules that focus on the fundamentals of pain, nonpharmacologic and pharmacologic (opioid and nonopioid) treatment options, and strategies for safe and appropriate management of acute and chronic pain. Approaches for identifying and managing patients with opioid use disorder are also addressed. Expert faculty use clinical case scenarios to apply the concepts and tools to practice. 

Learning Objectives

At the conclusion of this application-based educational activity, participants should be able to

  1. Explain the fundamentals of pain management, including definitions, etiology, and mechanisms of pain.
  2. Use patient history and available tools to assess a patient’s pain and potential risk for adverse effects from opioid therapy, including opioid use disorder (OUD).
  3. Develop individualized pain management plans for patients with pain, including therapy goals, pharmacologic and nonpharmacologic options, and interprofessional collaboration.
  4. Apply interprofessional strategies to ensure safe and appropriate analgesic therapy for patients with acute and chronic pain.
  5. Counsel patients and caregivers on the safe use of opioid therapy, including proper storage and disposal.
  6. Identify patients who may benefit from referral to a pain specialist.
  7. Illustrate an approach for identifying and managing patients with OUD.
  8. Counsel patients and caregivers on the use of naloxone in the event of an opioid overdose.


Fundamentals of Pain Management: A Primer for Pharmacists

  • Part 1: Assessment and Strategies for Managing Pain (approximately 30 minutes)
  • Part 2: Managing Acute Pain (approximately 30 minutes)

This module focuses on the fundamentals of pain pathophysiology, pain and risk assessments, and therapeutic options for managing pain. The most up-to-date evidence for treating acute pain is also reviewed.


  Lee A. Kral, Pharm.D., CPE
  Clinical Assistant Professor
  The University of Iowa Carver College of Medicine
  Clinical Pharmacy Specialist, Pain Management
  University of Iowa Hospitals & Clinics
  Iowa City, Iowa

Lee A. Kral is Clinical Assistant Professor at The University of Iowa Carver College of Medicine and a faculty member of the Pain Medicine Fellowship. She received Bachelor of Science and Doctor of Pharmacy degrees from The University of Iowa College of Pharmacy, completed residency at The University of Iowa Hospitals & Clinics (UIHC), and is a certified pain educator.

Dr. Kral runs a chronic pain medication management clinic within the Pain Management Clinic at UIHC working with chronic pain patients. She also works with the Acute Pain Service, engaged in pre-operative pain assessments for the surgical teams and perioperative interdisciplinary pain management.

Optimizing Pain Management: An Individualized Approach to Care

  • Part 1: Overview of Nonopioid Analgesics (approximately 30 minutes)
  • Part 2: Overview of Opioid Analgesics (approximately 30 minutes)

Nonopioid and opioid analgesics commonly used for pain management are compared in this module, along with key medication-related factors that can assist with formulating an individualized care plan. Also included is a discussion of best practices related to the safe use of opioids.


  Michele L. Matthews, Pharm.D., BCACP, CPE, FASHP
  Vice-Chair and Professor of Pharmacy Practice
  MCPHS University
  Advanced Practice Pharmacist
  Brigham and Women’s Hospital
  Boston, Massachusetts

Michele Matthews is Vice Chair and Professor in the Department of Pharmacy Practice at MCPHS University in Boston and serves as co-chair of the University’s Opioid Task Force. She is an advanced practice pharmacist specializing in pain management and addiction medicine at Brigham and Women’s Hospital. She participates in team-based care of patients with chronic non-cancer pain at Brigham and Women’s Pain Management Center, and she implemented a pharmacist-run chronic pain management clinic embedded within the hospital’s largest primary care center where she has prescriptive authority under collaborative drug therapy management. She has also developed an innovative collaborative care model for the management of opioid use disorder within the primary care setting and serves as the care manager for this program.

Dr. Matthews earned her Doctor of Pharmacy degree at MCPHS University and completed an ASHP-accredited PGY1 pharmacy practice residency at Robert Wood Johnson University Hospital in New Brunswick, New Jersey. She has published several articles and book chapters on topics related to pain management and substance use disorders. She has also been involved with numerous research projects focusing on interprofessional education and training for pain management and the pharmacist’s role in improving medication management in patients on high-risk medications. She is co-investigator for an NIH Center of Excellence in Pain Education grant that was awarded to improve pain management education in medical, nursing, pharmacy, and dental schools.

Dr. Matthews is involved with several professional organizations, serving as a current member of the Opioid Task Force and former chair of the Section Advisory Group on Pain and Palliative Care for the American Society of Health-System Pharmacists. She is also past chair of the Pain and Palliative Care Practice and Research Network for the American College of Clinical Pharmacy. She is a founding member and trustee of the Society of Pain and Palliative Care Pharmacists and serves as chair of its membership committee.

Meeting the Challenges of Chronic Pain Management and Opioid Use Disorder

  • Part 1: Initiating Opioid Therapy for Chronic Pain (approximately 30 minutes)
  • Part 2: Managing Long-Term Opioid Therapy and Opioid Use Disorder (approximately 30 minutes)

This module provides a comparison of treatment considerations for acute and chronic pain, emphasizing key strategies for managing chronic pain successfully. The complexity of long-term opioid therapy and the emerging role of pharmacists in the treatment of opioid use disorder are discussed.


  Timothy J. Atkinson, Pharm.D., BCPS, CPE
  Activity Chair
  Clinical Pharmacy Specialist, Pain Management
  Director, PGY2 Pain Management and Palliative Care Residency
  VA Tennessee Valley Healthcare System
  Murfreesboro, Tennessee 

Timothy J. Atkinson is Clinical Pharmacy Specialist in Pain Management at the VA Tennessee Valley Healthcare System (TVHS) in Murfreesboro, Tennessee, where he specializes in complex and high risk pain medication management through direct patient care and electronic consult services within the regional referral pain clinic. He also is Director of the ASHP-accredited PGY2 Pain Management and Palliative Care Residency program at TVHS and represents pain management on the national VA Residency Advisory Board.

Dr. Atkinson earned a Doctor of Pharmacy degree at Lake Erie College of Osteopathic Medicine School of Pharmacy in Erie, Pennsylvania. His residency training was at the Department of Veterans Affairs—PGY1 pharmacy residency at VA Western New York Healthcare system in Buffalo and PGY2 residency in pain management and palliative care pharmacy at Albany Stratton Veterans Affairs Medical Center in Albany, New York. He is a certified pain educator and board certified pharmacotherapy specialist.

Dr. Atkinson is a strong advocate for expansion of clinical pharmacy led pain medication management. His research interests include opioid equivalencies, serum level monitoring, pain management in specialty disease states, and the elderly. In 2019, he won the VA Clinical Pharmacy Practice Office’s Mental Health/Pain Strong Practice competition, and he was TVHS PGY1 preceptor of the year in 2018.

Expert Insight

Expert Insight is a series of short, referenced articles that aim to improve patient outcomes and practice by engaging learners to follow through with intended practice changes. Written by individual faculty, the articles offer interactive features that facilitate sharing of practice strategies among peers.

Taking the Pain out of Implementing Changes in Practice
Timothy J. Atkinson, Pharm.D., BCPS, CPE
Read now

Long-Term Risks of Opioids – The Science, the Stories, and the Oath
Lee A. Kral, Pharm.D., CPE
Read now

Working Together Is Success: The Construct and Value of Pain Teams
Michele L. Matthews, Pharm.D., BCACP, CPE, FASHP
Read now

Expert Reviewer

  Chris Herndon, Pharm.D., BCACP, FASHP
  Southern Illinois University Edwardsville
  Edwardsville, Illinois

Chris Herndon is Professor with the Southern Illinois University Edwardsville (SIUE) School of Pharmacy.  Currently, Dr. Herndon sees patients with chronic pain and opioid use disorder patients within a family medicine residency clinic. His scholarship interest focuses primarily on pain and palliative care education, and he is Principal Investigator for the National Institutes of Health Center of Excellence in Pain Education at SIUE.

Dr. Herndon earned Bachelor of Science in Pharmacy and Doctor of Pharmacy degrees at St. Louis College of Pharmacy in St. Louis, Missouri, and then completed a geriatric pharmacotherapy specialty residency at the University of New Mexico Health Sciences Center in Albuquerque.

Dr. Herndon served as President of the Society of Pain and Palliative Care Pharmacists in 2019. He has received many awards on the state and national levels, including the 2006 Pain Champion Award from the Alliance of State Pain Initiatives, 2012 Academic Pain Educator of the Year Award from the American Society of Pain Educators, and 2016 Pharmacist of the Year from the Illinois Pharmacist’s Association. In addition, he was awarded the Distinguished Service Award from the American Pain Society in 2018.


In accordance with ACPE Standards for Commercial Support, ASHP policy requires that all faculty, planners, reviewers, staff, and others in a position to control the content of this presentation disclose their financial relationships.  In this activity, only the individual below has disclosed a relevant financial relationship. No other persons associated with this activity have disclosed any relevant financial relationships.

Timothy J. Atkinson, Pharm.D., BCPS, CPE

  • axialHealthcare, Inc. - consultant
  • Purdue Pharma LP - advisory committee

System Technical Requirements

Learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating web sites. View the minimum technical and system requirements for learning activities. 

  Provided by ASHP and supported by an independent educational grant from the Opioid Analgesic REMS Program Companies. Please see for a listing of REMS Program Companies.     This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the US Food and Drug   Administration (FDA).