About the Mandate
The 2019 Texas Legislature passed three bills that requires physicians to complete at least two hours of CME in opioid prescribing.
Texas Medical Board Guidance
Click here to view the website.
Pain Management and the Prescription of Opioids
At least 2 of the 24 formal (CME) hours must involve the study of the following topics:
- best practices, alternative treatment options, and multi-modal approaches to pain management that may include physical therapy, psychotherapy, and other treatments;
- safe and effective pain management related to the prescription of opioids and other controlled substances, including education regarding:
– standards of care;
– identification of drug-seeking behavior in patients; and
– effectively communicating with patients regarding the prescription of an opioid or other controlled substances; and prescribing and monitoring of controlled substances.
These formal hours maybe credited towards
- the requirements for medical ethics or professional responsibility for any physician, or
- the 10 hours of pain management continuing education required for those physicians practicing in pain clinics (see info below under “Additional Requirements”).
This requirement applies to the renewal of a license on or after September 1, 2020.
The Texas Orthopaedic Association is accredited by the Texas Medical Association to provide continuing medical education for physicians.
CME Designation Statement
The Texas Orthopaedic Association designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Ethics Designation Statement
This course has been designated by the Texas Orthopaedic Association for 2.0 credits of education in medical ethics and/or professional responsibility.
Pain Management and Prescription of Opioids Statement
This course has been designated by the Texas Orthopaedic Association for 2.0 credits of education in pain management and prescription of opioids.
- Determine when to utilize the Prescription Monitoring Program.
- Identify the various side effects of opioid use.
- Identify non-opioid treatments for acute and chronic pain.
- Summarize the literature surrounding outcomes of patients on opioids prior to surgical treatments.
- What are opioids?
- How do opioids work?
- What problems can opioids cause?
- How do opioids impact the cost of care provided by physicians?
- What are best practices and legal requirements for writing opioids?
- What is the state’s Prescription Monitoring Program and how does it work?
- How does a physician identify patients who should not receive opioids or who need a higher level of care?
- What should physicians do if they get in over their head with writing for opioids for their patients?
Adam Bruggeman, MD
Submitted on: 07/02/2020
Medtronic: Paid consultant
NovaBone: Paid consultant
SI-BONE: Paid consultant
Stryker: Paid consultant
Texas Medical Association: Board or committee member
Texas Orthopaedic Association: Board or committee member
TOA mandates all instructors, planners, and other individuals in a position to control or influence the content of an educational activity to disclose all relevant financial relationships or affiliations during the past 12 months with any commercial interest. All identified conflicts of interest must be resolved and the education content vetted by the TOA for fair balance, scientific objectivity and appropriateness.
Ken J Kaminski, MD, FAAOS
AAOS: Board or committee member
Fusion5: Paid consultant
Texas Orthopedic Association: Board or committee member
Vinod Kumar Panchbhavi, MD, FAAOS, FACS
AAOS: Board or committee member
American Orthopaedic Foot and Ankle Society: Board or committee member
Foot and Ankle InternationalTechniques in Foot & Ankle SurgeryOrthopedia.com: Editorial or governing board
Stryker: Paid presenter or speaker
Wolters Kluwer Health – Lippincott Williams & Wilkins: Publishing royalties, financial or material support
Luis H Urrea II, MD, FAAOS
El Paso County Medical Society Executive Board: Board or committee member
Texas Medical Association Council on Socioeconomics: Board or committee member
Texas Orthopaedic Association Leadership Council: Board or committee member
Texas Orthopaedic Association PAC Board of Directors: Board or committee member
TEXPAC Board of Directors: Board or committee member
Sources for Continued Study
- Centers for Disease Control. “Pocket Guide: Tapering Opioids for Chronic Pain.” Retrieved from Centers for Disease Control website: https://www.cdc.gov/drugoverdose/pdf/clinical_pocket_guide_tapering-a.pdf
- Davenport, S et al, “Costs and Comorbidities of Opioid Use Disorder: The Impact of Opioid Use Disorder for Patients with Chronic Medical Conditions.” Milliman White Paper, 2019.
- S. Department of Health and Human Services (2019, May). “Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations.” Retrieved from U.S. Department of Health and Human Services website: https://www.hhs.gov/ash/advisory-committees/pain/reports/index.html
- S. Food and Drug Administration (2016, August). “FDA Warns About Serious Risks and Death When Combining Opioid Pain or Cough Medicines with Benzodiazepines; Requires Its Strongest Warning.” Retrieved from U.S. Food and Drug Administration website: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-serious-risks-and-death-when-combining-opioid-pain-or
- Washington State Agency Medical Directors’ Group. “Interagency Guideline on Prescribing Opioids for Pain.” 2015: http://www.agencymeddirectors.wa.gov/Files/2015AMDGOpioidGuideline.pdf
- American Academy of Orthopaedic Surgeons’ Pain Relief Toolkit: https://www5.aaos.org/PainReliefToolkit/?ssopc=1
Watch the Videos
CME credit is available to dues-paying members of the Texas Orthopaedic Association and Texas Ophthalmological Association. (Your dues must be current.)
Click here to fill out the course evaluation form. Once you have filled out the form, you will then complete a CME Reporting Form so that the Texas Orthopaedic Association can e-mail a CME certificate to you.
Questions? Contact Ed Berg at firstname.lastname@example.org.