Each issue in this 10-part series focuses on key topics surrounding the use of opioid therapy. A feature article written by an expert in the field of pain management is accompanied by commentary from a primary care physician addressing the topic from a day-to-day practice perspective. Each issue follows a step in the National Initiative on Pain Control^® (NIPC^®) treatment algorithm, which highlights key steps in managing and treating patients who are receiving opioid therapy.

Perry G. Fine, MD
American Pain Foundation Board of Directors
NIPC Chairman

Treatment principles courtesy of the NIPC faculty
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Discontinuing Opioid Therapy: Developing and Implementing an “Exit Strategy"

Authored by
Charles E. Argoff, MD, Professor of Neurology, Albany College of Medicine, Director, Comprehensive Pain Program, Albany Medical Center, New York, New York

Commentary by Louis Kuritzky, MD Clinical Assistant Professor, Family Medicine Residency Program, Department of Community Health & Family Medicine, University of Florida College of Medicine, Gainesville, Florida

Opioid Rotation

Authored by
Perry G. Fine, MD
Professor of Anesthesiology, Pain Research Center, University of Utah School of Medicine, Salt Lake City, Utah

Commentary by Paul P. Doghramji, MD, FAAP Medical Director of Health Services, Ursinus College, and Family Physician, Collegeville Family Practice, Collegeville, Pennsylvania

Appropriate Documentation of Opioid Therapy: The Emergence of the 4 A’s and Trust and Verify as the Paradigm

Authored by
Steven D. Passik, PhD
Associate Attending Psychologist, Department of Psychiatry and Behaviorial Sciences, Memorial Sloan-Kettering Cancer Center; Associate Professor of Psychiatry, Cornell University Medical College, New York, New York

Commentary by Susan E. W. Cochella, MD, MPH Associate Professor, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah

Urine Drug Testing: An Underused Tool

Authored by
Michael M. Bottros, MD
Fellow, Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

Paul J. Christo, MD, MBA
Assistant Professor, Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins University School of Medicine,Baltimore, Maryland

Commentary by Marc E. Babitz, MD Division Director, Division of Family Health and Preparedness, Utah Department of Health, Salt Lake City, Utah Dr. Babitz has reported no conflict of interest relevant to this commentary

Opioid Therapy in Patients With a History of Substance Use Disorders

Authored by
Seddon R. Savage, MS, MD
Director, Dartmouth Center for Addiction, Recovery and Education, Associate Professor of Anesthesiology,Dartmouth Medical School, Hanover, New Hampshire

Commentary by Michael P. Rosenthal, MD Chair, Department of Family and Community Medicine, Christiana Care Health System, Wilmington, Delaware; Professor of Family Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania

Addressing Patient Concerns Associated With Chronic Pain Treatment and Opioid Use

Authored by
John F. Peppin, DO, FACP
Director, Clinical Research Program, The Pain Treatment Center of the Bluegrass; Associate Medical Director, Hospice of the Bluegrass, Lexington, Kentucky

Commentary by Louis Kuritzky, MD Clinical Assistant Professor, Family Medicine Residency Program, Department of Community Health & Family Medicine, University of Florida College of Medicine, Gainesville, Florida

Integration of Nonpharmacologic and Multidisciplinary Therapies Into the Opioid Treatment Plan

Authored by
Paul Arnstein, RN, PhD, FNP-C
Clinical Nurse Specialist for Pain Relief, Massachusetts General Hospital; Associate Professor, MGH Institute of Health Professions,Boston, Massachusetts

Commentary by Susan Cochella, MD, MPH Associate Professor, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah

Risk Stratification and Evaluation of High-Risk Behaviors for Chronic Opioid Therapy

Authored by
David A. Fishbain, MD, FAPA
Professor of Psychiatry, Adjunct Professor of Neurological Surgery and Anesthesiology, University of Miami, Miller School of Medicine, Miami, Florida

Commentary by Marc E. Babitz, MD Division Director, Division of Family Health and Preparedness, Utah Department of Health Salt Lake City, Utah

Informed Consent and Management Plans to Optimize Opioid Therapy for Chronic Pain

Authored by
Lynn R. Webster, MD, FACPM, FASM
Medical Director and Cofounder, Lifetree Clinical Research^® and Pain Clinic, Salt Lake City, Utah

Commentary by Michael P. Rosenthal, MD Chair, Department of Family and Community Medicine, Christiana Care Health System, Wilmington, Delaware; Professor of Family Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania

Vol 1, Issue 1

Patient Selection and Initiation of Opioid Therapy as a Component of Pain Treatment

Authored by
Roger Chou, MD
Department of Medicine, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon

Commentary by Paul P. Doghramji, MD, FAAP Medical Director of Health Services, Ursinus College, and Family Physician, Collegeville Family Practice, Collegeville, Pennsylvania

This independent medical education activity is sponsored by the American Pain Foundation (APF) and supported through an educational grant from Endo Pharmaceuticals.

This activity is provided for educational purposes only. The information presented in this activity represents the views and opinions of the NIPC Task Force and individual authors/presenters and does not constitute the opinion or endorsement of, or promotion by, the American Pain Foundation, or the program grantor(s). Reasonable efforts have been made to present educational subject matter in a balanced, unbiased fashion and in compliance with regulatory requirements. Healthcare professionals and other individuals should review and consider other publications and materials relevant to the subject matter rather than relying solely on the information contained in this activity, particularly as it may relate to patient diagnostic or treatment decisions.