Original Publication
Open Access

Minimizing the Misuse of Prescription Opioids in Patients With Chronic Non-Malignant Pain

Published: August 16, 2012 | 10.15766/mep_2374-8265.9205

Included in this publication:

  • Pain Module Instructor's Guide.pdf
  • Pain Module Supporting Documents.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This educational module has been designed as an introduction for health professions students, residents, and practicing providers to a standardized approach to the management of patients with chronic non-malignant pain which integrates techniques for the prevention and detection of misuse of prescription opioids. The product is a case-study module designed for use by a faculty facilitator with a small group of learners. In this module, participants care longitudinally for a single patient with a common chronic pain complaint of low back pain. The case study is structured in five sections, beginning with background information and followed by three office visits and a separate review of lab results which take place over the course of 9 months. Each visit begins with a medication list and a description of the patient’s current condition, and ends with questions for discussion. The questions are tied to the specific learning objectives for each visit. Participants work from two sets of printed pages. The first packet includes and introduction, the case study and references. The second packet contains 28 pages of supporting materials which include clinical tools completed to model what this patient’s chart might look like. Participants are instructed to keep the two resources side by side as they work through this module. We recommend a minimum of 3 hours to complete the entire module. This module has been implemented with students, residents, and practice physicians in primary care fields and has been well received. It has been used in the pain management course held every year for the third-year medical students at the University of Massachusetts Medical School. It was also used with the second-year family medicine residents and at faculty retreats. The module was developed as part of NIDA's Center of Excellence in Physician Information and has been peer reviewed both internally at the institution, and externally by a volunteer review group.

Educational Objectives

By the end of this module, the learner will be able to:

  1. Discuss the components of the accepted standard of care for chronic nonmalignant pain.
  2. Describe the use of a number of clinical tools to support the management of chronic nonmalignant pain in primary care settings.
  3. Describe strategies for optimizing safety in the provision of opioid analgesics for chronic pain.
  4. Describe the approach to preventing and detecting the misuse of opioid pain medications in patients being treated for chronic pain.
  5. Describe the differences between physical dependence on and addiction to opioid pain medications and how to recognize addiction in chronic pain patients.

Author Information

  • Jeffrey Baxter, MD: University of Massachusetts Medical School

None to report. 

This material was developed with some support from the NIDA Centers of Excellence in Physician Information Program.

Prior Presentations
Minimizing risk in the prescription of opioids for chronic pain. Faculty development workshop at: Association for Medical Education and Research in Substance Abuse (AMERSA); November 2009.

Minimizing risk in the prescription of opioids for chronic pain. Presented at: Society of Teachers of Family Medicine Predoctoral Education Conference; January 2010; Jacksonville, FL.

Minimizing risk in the prescription of opioids for chronic pain. Presented at: American Society of Addiction Medicine Annual Medical-Scientific Conference; April 16, 2010; San Francisco, CA.


Baxter J. Minimizing the misuse of prescription opioids in patients with chronic non-malignant pain. MedEdPORTAL. 2012;8:9205. https://doi.org/10.15766/mep_2374-8265.9205