Dosing and Titrating Opioids
This is the fourth webinar in a COCA Call series about CDC Guideline for Prescribing Opioids for Chronic Pain. To view a list of other webinars in the series, visit the opioid call series overview webpage
Date:Wednesday, August 17, 2016
Deborah Dowell, MD, MPH
Senior Medical Advisor
Division of Unintentional Injury Prevention
National Center for Injury Control and Prevention
Centers for Disease Control and Prevention
Jane Ballantyne, MD, FRCA
Professor, Anesthesiology and Pain Medicine
Director, UW Pain Fellowship
University of Washington
Mark Sullivan, MD, PhD
Professor, Psychiatry and Behavioral Sciences
Anesthesiology and Pain Medicine
Bioethics and Humanities
University of Washington
Evidence indicates that the risk for opioid-use disorder and overdose increases as dosage increases. CDC Guideline for Prescribing Opioids for Chronic Pain provides recommendations about the types of opioid formulations at initiation, starting dosages, morphine milligram equivalent dosage calculation methods, dose titrating considerations, and tapering methods. During this COCA Call, clinicians will learn about the association between opioid dosage and opioid therapy benefits and harms. In addition, presenters will use a case study of a patient with severe back pain on oxycodone to guide clinicians through safe opioid prescribing practices.
- Describe the evidence for the association between opioid dosage and opioid therapy benefits and harms.
- Compare and contrast immediate release and extended-release/long-acting opioid formulations.
- Identify methods for calculating morphine milligram equivalent dosage.
- List the steps for titrating opioids to specific dosage thresholds.
- Identify best practices for opioid tapering and discontinuation.
CDC Guideline for Prescribing Opioids for Chronic Pain and Related Materials
- SAMHSA Buprenorphine Training for Physicians
- MMWR: CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
- JAMA Special Communication: CDC Guideline for Prescribing Opioids for Chronic Pain
- Guideline Resources: Clinical Tools
- Pocket Guide: Tapering Opioids for Chronic Pain
- Guideline for Prescribing Opioids for Chronic Pain: Recommendations
- Checklist for Prescribing Opioids for Chronic Pain
- Nonopioid Treatments for Chronic Pain
- Assessing Benefits and Harms of Opioid Therapy
- Calculating Total Daily Dose of Opioids for Safer Dosage
- Prescription Drug Monitoring Programs (PDMPs)
CDC Vital Signs
CDC Injury Prevention and Control
- CDC Prescription Drug Overdose
- Prescription Drug Overdose: What Health Care Providers Need to Know about the Epidemic
- Prescription Drug Overdose Prevention for States
Other Agency Resources
- The White House – Office of National Drug Control Policy: Opioid Abuse in the United States[471KB]
- NIH Pain Consortium Centers of Excellence in Pain Education (CoEPEs)
- Providers’ Clinical Support System for Medication Assisted Treatment
- Providers’ Clinical Support System for Opioid Therapies
- CMS Improvements to Medicare Drug and Health Plans
- SAMHSA – Substance Abuse and Mental Health Services Administration
- National Institute on Drug Abuse
- PDMP Center of Excellence, Brandeis University
- Audio conference call on 8/17/16: 2:00 – 3:00 PM EDT
- Web-on-demand training after 3:00 PM EDT on 8/17/16
- Materials: PowerPoint slide set
“WC2286” for attendees who participate in the live call (must be completed by September 16, 2016)
“WD2286” for attendees who participate in the online presentation (must be completed by September 16, 2018)
- Physician Assistants
- Health Educators
- Other Clinicians
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- Support/Funding:Centers for Disease Control and Prevention, Emergency Risk Communications Branch
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- Page last reviewed: August 3, 2016
- Page last updated: January 31, 2018
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